Ethical dilemmas concerning IVF egg donation

There is no doubt that egg donation made parenthood possible for couples that otherwise could not have children. Bringing child’s smiles and laughter into the quiet houses of people who dreamed of an offspring but lacked the physical possibilities because of infertility. All this makes it somewhat of a miracle made possible by good altruistic people and the goods of human made technology. But is it all that flawless? Is the road to getting a woman pregnant using donated eggs free of ethical and moral dilemmas?

We all know nothing is that simple and everybody deciding to be a donor or a recipient should know about most concerning problems which we will walk you through below.

Altruism or business?
First of all let’s focus on the supposed total altruism of the whole procedure. Almost all of the egg donation ads offer the chance to change people’s life by fulfilling their dreams about a child… and they also offer money. The amount usually ranges from 4000$ to 10 000$ but you can find ads offering even 100 000$. You’re probably thinking why go with the 4000$ if there are offers giving 60 000$ or 80 000$. Well those offers are very characteristic and you might not meet the specific expectations like race or your university degree and your GPA (Grade Point Average) That doesn’t sound ok does it? In fact this does not look good at all and not at all altruistic. Do people who buy themselves a child for 100 000$ even deserve and do they even should have a child? They offer this kind amount of money for making sure the donor is a supermodel with high IQ and a degree, they want a certain skin colour, hair and eye colour. It isn’t the same thing as just wanting a child. When people decide to have a kid they decide to have a kid, not a previously designed superhuman.


An example of egg donor ad

Parents that don’t use egg donation also have some expectations of course, like maybe the dad would want a boy who plays sports well or the mother would like a girl with science skills and so on but this isn’t the same thing as paying money to rise the chance of these expectations to be fulfilled.

The point is the child isn’t even born yet and they already have requirements and expectations and they literally expect to have exactly what they want by spending money, this isn’t love.
Who would want to be a kid who was bought for 100 000$ and start thinking “If they just paid 4000$ like the rest of them…would I be worse or something? Less deserving of their love?”

This may sounds a bit harsh but those are just the things that come to mind when you really start thinking about those difficult subjects thoroughly.

Buying 100 000$ worth eggs from a donor does not mean that the child won’t be loved and cared for of course but it surely shows that maybe mixing money with medical donations is not the greatest idea in the world. There should be restrictions or even egg donations with no fee like in Canada where all donations must be voluntary and free of monetary compensation. We should at least restrict the fee to a more reasonable unnegotiable, symbolic sum.
Then there is also the “autonomy” dilemma. Is a young woman in collage which pays tuition able to make an autonomous decision when she is offered let’s say the minimum 4000$ even? Let’s also take under consideration the fact that she may not be fully aware about the future health problems because those have not been really studied yet. She will probably take the money and the risk.
When this huge amounts of money is at stake altruism and helping is just the background and the business is in the foreground. It can be easily seen that someone, some groups would take advantage of such situations.

Donor health
Secondly we should take a moment to think about the donor’s health. Many services claim that there is almost no monitoring on the wellbeing of donors after the procedures. Clinics are not required to monitor the health weeks, months and years after the procedure so we really don’t know what impact the egg extraction has on the donors in the long run. This mainly concerns the ovulation enhancing drugs and how they impact the donor. There are clinical reports showing that the frequency of ovarian cancer linked with the ovarian stimulation increases. There are also documented cases of hyperstimulation syndrome, lacerations, ovarian trauma, infection, infertility, and lacerations. The American Society for Reproductive Medicine believes that further research and studies are needed in this field.
Some studies show also that women who decide to donate eggs for financial reasons are more likely to suffer emotionally and regret their decision than women with altruistic motivations. So there are also some psychological concerns.
Donors should be fully aware of the possible problems. Medicine should of course help people in need but we have to know the risks first and we should not help one individual by putting another one’s health at risk.

What about the recipient?
The ethical dilemmas do not only concern the matters of the donor. The recipient not only has to bear in mind the ethical problems with the donors but also has to make some decisions on the moral and ethical level on her own. The most common dilemma is should you or should you not tell your child about its origins. Almost all specialist agree that telling is the best way, not only because the kid could found out about it for himself and that is the worst scenario (your trust levels will drop…a lot!) but also because it is believed to be the right and ethical thing to do. There are some exceptions however when not telling will benefit the child (do not mistake with your own benefit)

Mothers are also concerned with the genetic issues associated with the appearance of the child. They wonder if the kid will look like them and will people notice and ask dumb, unsubtle questions like “your boy doesn’t really look like you does he? you’re sure he’s yours?” Those can often be jokes but they can certainly make you feel uncomfortable. Anyway the child may not look like you, have different eye colour and a different nose but kids pick up everything else from the parents like types of laugh or smiles and mannerisms so don’t worry.
Those are issues which recipients do not pick up straight from the start and begin to think about it when they have already started the treatment. So maybe we should about making the psychological evaluations for recipients obligatory so nobody will be a victim of a spontaneous decision, not only for the good of the recipient but for the good of the children.

Never too late?
When you look up IVF and egg donations on the internet you will easily find advertisements saying that even women 50 years old or over can still be mothers, menopause? No worries – you pay you gain. It is of course hard to say but maybe women who cannot have babies naturally because of the advanced age shouldn’t have babies. It again sounds harsh but the truth is an older body is not well fitted to carry and give birth to a baby without having some negative impact on the mother’s health. The ethical issues in this case however go beyond health problems.

One thing that was often disregarded was the simple fact that if a 50 year old woman gave birth to a child, the same woman would be 60 years old when the kid is at the age of 10. Will she be fit enough to take care of the kid? It’s hard to say in this case. However there are cases that are downright scary!

Like the case that can be found on the website of an infertility treatment centre in India. Where a 69 old woman gave birth by egg donation. This woman will be 80 years old when her kid turns 10. Miracle or not this is crossing the line. The probability than was that they sentenced a kid to a life without a mother. It is not that we necessarily think the mother is the guilty one here. The mother’s great desire to have a child probably overwhelmed her mind and she was not thinking clearly and the clinic’s responsibility was to make a more insightful psychological evaluation and reason with her and explain she will cause the child pain if she decides for treatment.
That is why the psychological evaluations should be obligatory especially for a lot older women.

Let’s not turn egg donation into eggsploitation
Just as it was said in the beginning of this article, there is no doubt that egg donating can and does a lot of good. However there are people who will just see the financial opportunity and spoil something that was designed to help others and turn it into a source of huge income. We should definitively go into the “fee free” and voluntary egg donation direction so there is no doubt we are helping infertile couples not some opportunist who just wants to make money off of it. And last but not least we need more awareness about the health and future life of the donors and the children born from the egg donations.

So until the egg donation is really a donation not a paid for service we should all just be cautious and act according to our own conscience.