The Real Cost of Egg Donation?

Here’s a recent articlefrom the Timesonline (of London) about the risks of egg donation and the morality, in light of those risks,  of paying egg donors.   I’ve touched on this topic in other contexts several times recently so it seemed worth commenting on this article.  

The article first raises a crucial factual question:   How dangerous is it to be an egg donor?   Clearly in the view of a number of those interviewed, the answer is “pretty dangerous.”   That’s actually a surprise to me, but not because I’ve actually seen statistical studies to the contrary.  I’ve just never seen this contention seriously advanced before.   Perhaps that is unsurprising, given the market conditions here in the US.  (I’ll return to this point in a moment.)  Anyway, if anyone has links to other sources on the risk involved, I’d be interested to see them.    

A bit of background on UK law is useful in understanding the article.   Paying egg donors more than a nominal sum is unlawful in the UK. 

The Logical Extension?: Buying a Child

Over the last year or so there have been occasional stories about the globalization of surrogacy, some of which I’ve commented on here.  Two related stories from the UK have made me want to revisit this thread.   

This story (with it’s rather spectacular headline, but then, this is UK journalism) is really just another instance of the global surrogacy–a minor variation on an established theme.    Here, a UK couple (Nicky and Bobby Bains) purchased a donor egg which was fertilized with the husband’s sperm.   The resulting pre-embryo was then implanted in another woman’s womb.   This last women–the surrogate–eventually gave birth to the child.  

This is essentially routine gestational surrogacy, of the commercial sort, with a global twist.  

Global Surrogacy and Gay Fathers in Israel

I’ve written before about global surrogacy, sometimes from a critical perspective.  It’s only fair to note this development, which perhaps weights on the other side of the balance. 

The number of Israeli gay male couples becoming parents is on the rise.   These couples are denied access to surroacy in Israel.  But if they can travel outside the country, they can access these services.  Hence the increase in gay couples using surrogacy to create their families.  (Note that the featured couple did not travel to India, which is often the location people thing about if you consider global surrogacy.  They came to the US.)  

A couple of other interesting things are raised in the article.  

Global Surrogacy and Legal Parentage

Just a quick note here about a recent article from the UK press that raises a rather troubling prospect:  People using global surrogacy (the article mentions specifically people working through India)  may not end up as legal parents of their children.

This is really in the category of “variations on a theme” for me–it probably goes in the portable parenthood file.

I’ve also written about surrogacy in India before.   India is a destination for people from many parts of the world who want to use surrogacy.  Some come from parts of the world where commercial surrogacy is illegal.   Others come from places where surrogacy is unaffordable.

You could comply with Indian law and return home to where you came from with a child, but your legal relationship with that child in your home country may not be entirely clear.   This is the problem referred to in the article.   It seems to me to be quite plausible that you’d do nothing further when you came home.  But will your home country recognize you as a parent of a child?  Suppose you have no genetic connection to the child in question, but your home country weighs the DNA link heavily as a criteria for parenthood?   It does make me wonder.

Global Surrogacy Update

Here’s a recent article from the BBC. It’s been quite a while since I’ve discussed the globalization of surrogacy in any detail.   It sounds as though some sort of regulatory legislation may be proceeding in India, which is one of the main foreign destinations for intended parents.

Three things particularly strike me in the article.   First, the reference to someone as a professional surrogate mother.   There’s really no reason why only the brokers in the middle should be considered professional, but it does seem a bit at odds with the ideal of altruistic surrogacy.

Second, the reference to restrictions the intended parents place upon the surrogate–here the foods she eats and the methods of transportation she utilizes.   Actually, perhaps as much as anything what’s striking here is the phrase used in the story–”dictate terms.”    It’s all about control.   For that period of time during which she is pregnant, the surrogate may be subject to the terms dictated by the intended parents.   It’s really not that surprising, given how carefully pregnancy is managed these days.

Finally, the description of the relationship between surrogate and IP towards the end of the article as “mutually beneficial.”   The following quote is  “[s]he is getting the money she wants and we are getting a baby.”   I guess that makes it seem pretty stark to me.  And again, I am left to ponder the difference between the transaction described here and the actual purchase of a child.

Perhaps I just need to get over that hurdle and say that under certain circumstances, baby-selling could be okay.  But surely if I were to go down that path, I’d insist on rigorous regulation of the practice, which seems at odds with the current largely unregulated state of surrogacy.

Surrogacy Gone Bad

I digress from my discussion in progress to comment on this item from today’s news.   This is indeed surrogacy gone bad but not, I suspect, in the manner that most people think about.

It appears that SurroGenesis, a for-profit web-promoted, globally marketed surrogacy agency, has taken the money and run.   (I’m astonished to find that the website it still up and running.  I imagine it won’t be for long.)  SurroGenesis is one of a number (does anyone have any idea how many?) of for-profit surrogacy agencies that essentially act as a brokers and facilitators.  They locate surrogates and intended parents, as well as egg donors.   They connect them up with each other and, at least ostensibly, deal with a host of details.   Perhaps most important for the moment, they hold the money that is to be paid the surrogate.

Except, of course, in this case they didn’t hold the money.  They took it.   Perhaps as much as two million dollars all told.   For some couples this means they’ve paid SurroGenesis and lost their money.   That’s bad, of course, but there are a small number of people who find themselves in a much worse position.  In at least two instances recounted in the paper, there are women who are pregnant as surrogates, expecting to be paid and to deliver the children (in both senses of the words) to the intended parents in the not-too-distant future.  But now the money that made these transactions work is gone.  The intended parents have paid it, but the surrogates have not (and likely never will) receive it.  

Surrogacy Round-Up

A couple of different items relating to surrogacy have come across my desk (figuratively, anyway) in the past week or two.   Rather than do a series of short posts, I thought I’d try putting them together and then offering some comments.

But before that, a general observation:   It’s striking how much surrogacy is in the news these days.   I know that, given the commercial media and the Internet, news coverage begets more news coverage–once the NYT magazine runs a story on surrogacy, a thousand blogs (mine among them) comment on it and then more news outlets pick it up, some developing their own angles, creating their own news.    Still, even if I do a discount for that, surrogacy seems to be much in the news–more than a year ago or two years ago or five years ago.

Now it is not that the technology has suddenly changed.   The technology of surrogacy (which is basically IVF) has been around for a while now.   I’m sure the techniques and their reliability have improved, but I don’t think it is changing technology that has propelled the issue to higher visibility.    

The Global Fertility Market

Here’s a story from the Guardian (UK) that details a slightly different aspect of the global fertility market.  This is not an instance of outsources surrogacy, which I’ve discussed a bit before.   In this instance a German woman living in the UK purchased sperm from a Danish donor (via and New York seller, it appears) and had it shipped to India.  There it was used along with eggs from an Indian woman to create embryos that were then implanted in the German woman.  Both donors are and will remain anonymous.

The story details why she ended up going to these lengths.   It is not just about doing it cheaper.   It seems there is “acute” shortage of women donors (egg donors, that would be) in the UK.   That means long waits.   Also, she had five embryos implanted, which would not be permitted in the UK.

Apart from the fact that it is yet another glimpse of the brave new world in which we live, does this story have the potential to teach us anything?   What does it matter that this involves global travel as opposed to working strictly locally?   Is the concern about exploitation different when it is inexpensive egg donors India provides rather than low-paid surrogates?  It seems that difference might matter, as egg donation is more like sperm donation (which does not seem exploitative to me) than it is like surrogacy.   Still and all, there is something that makes me uneasy about stories like this.

News in Brief: Commercialization of Surrogacy Critique

Mostly just in case you missed it: Last week Ellen Goodman (Boston Globe columnist) commented on the recent flurry of stories about surrogacy. She’s done a nice job of putting a number of points together, wrapping up with a critique of commercial surrogacy. (Of course, I like it–we seem to agree on a number of points.)

It’s interesting, too, because it is further evidence of the re-emergence of surrogacy in the general public conscience. After a lot of attention at the time of Baby M and Johnson v. Calvert, surrogacy has been pretty much off the US for a decade or more. (Not so true for the rest of the world.)

Globalization, which reaches reproductive technology just as it reaches everything else, throws the varying approaches to surrogacy and the cultural practices surrounding them into high contrast. People set out from one country/culture to another in order to accomplish that which is forbidden at home. The US states where commercial surrogacy is centered represent pretty much an extreme end of the scale. It’s a good time to look at all the points in between.

Surrogacy on the Cover of Newsweek

In yet another sign that there’s a resurgence of interest in this topic, surrogacy is the cover story in this week’s Newsweek magazine. Interestingly, the focus is on the women who are surrogates. I think this consistent with recent press coverage, but quite different from when the main news was the wonders of technology or ART more generally. It deepens my conviction that it is a good cultural moment to be thinking about these things.

There’s quite a bit to say about this article, but I wanted to offer a brief take on how it is set up. The authors describe surrogacy as “an act of love but also a financial transaction.” This suggests is an interesting way to categorize surrogacy transactions. At one end of the spectrum you might place the ones in India I’ve previously discussed. They fall pretty firmly into the “financial transaction” realm. (Remember that in some the parties never meet. And no one portrayed the Indian women as engaging in acts of love.)