The Human Fertilisation and Embryology Authority (HFEA), the UK's body for setting national reproductive policies, has overhauled its compensation model for third-party gamete providers. The new guidelines establish a flat rate of £35 ($56 USD) per clinic visit for sperm donors and £750 ($1,206 USD) per extraction cycle for women providing their eggs. Providers residing within the UK may be reimbursed on top of the flat rate for "excessive expenses" including travel. With the new scheme, HFEA hopes to address the UK's shortage of eggs and sperm for IVF - a problem that has driven many residents to travel abroad for assisted reproductive services.
Previously, gamete providers could be compensated only for out-of-pocket expenses plus loss of earnings (capped at £61.28 per day) with a maximum of £250 total. Under the old guidelines, these incentives were only available to those incurring expenses within the UK. The new system will offer the flat rate to providers travelling from overseas, although they will not be eligible for compensation for travel or other expenses.
Much of the press coverage (1, 2, 3) surrounding the announcement seems to pick up on the troubling possibility that tripling the cash incentive for egg providers could effectively "bribe" women to give up their eggs just for the money. Yet nearly all of the fertility experts, HFEA reps, and industry figures quoted speak to this concern narrowly in terms of how much money the service is worth due to how it "disrupts" the lives of providers in the short term. The Telegraph notes:
An egg donor has to be examined… [undergoes] a series of hormone injections and then have eggs collected while either sedated or under general anaesthetic. She will also need time off work to recover and may experience side-effects such as tiredness, abdominal pain, bloating, mood swings and headaches.
But serious concerns about the largely-unknown long-term health risks of egg extraction have hardly figured into the conversation. Although rare, serious and sometimes deadly short-term complications such as ovarian hyperstimulation syndrome have resulted from egg extraction procedures. Follow-up for egg providers is widely inconsistent due to lack of oversight and for the fact that growing market interests have painted egg harvesting as more of a commercial transaction than a serious medical procedure.
Director of Human Genetics Alert David King ardently objects to the decision noting that it "puts young women's health at risk," especially the financially vulnerable as economic downturns have in the past caused "massive spikes" in egg provider applications.
"Anyone who thinks £750 is not a financial incentive knows nothing about life on income support or with your students fees tripled…In reality, this is about the interests of the IVF industry in stopping the flow of IVF business to Spain."
Not only will the new payment system deter locals from traveling to Spain to cash in on its hefty offer for women's eggs (ironically, after which the UK's new egg prices are modeled), but it also invites people from surrounding countries to come to the UK and take advantage. The coercive potential of a £750 reward for selling one's eggs may be much higher for desperate individuals coming from economically- stricken countries like Greece or Iceland.
HFEA has shown some initiative in tracking the effects of increasing the financial incentives for gamete providers. They plan to implement a "real-time system" that will track the activity of individual gamete providers at all registered clinics. Women's health advocates, including groups such as Our Bodies Ourselves and Alliance for Humane Biotechnology, have lobbied for the implementation of similar registries in the U.S. to facilitate medical follow-up as well as long-term health studies on the effects of egg extraction. It remains unclear what, if anything, the HFEA will require in terms of long-term follow-up. The fact that the new system may lead many foreigners to travel to the UK to sell their eggs makes the prospect for comprehensive health follow-up rather dubious.
The HFEA's new compensation scheme will likely spur a significant increase in the number of people who wish to sell their gametes in the UK. This makes it even more crucial that the health of "donors" (especially women who provide eggs) does not take a back seat to the demands of a booming fertility industry. Given the precarious future of the HFEA as a functional oversight body because of pending cuts and parliamentary reorganization of public agencies, this major issue should occupy the agendas of public interest and public health advocates, officials, and policy-makers alike.
Previously on Biopolitical Times:
Posted in Biotech & Pharma, Doug Pet's Blog Posts, Egg Retrieval, Other Countries, Reproductive Justice, Health & Rights, The United Kingdom
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