The Business of ART in a Down Market

I’ve been collecting all this little bits and pieces about the impact of the economic downturn on aspects of childbearing generally and ART in particular.  There’s nothing surprising here, really, but still I thought I’d cluster them together.

Let’s start on the supply side.   I noted before that the supply of sperm and eggs is up.   In an essentially unrestrained market like the US, this makes perfect sense.   People need money.  Some people who were not willing to sell sperm or eggs a year ago are now willing to do so.  It’s not that the price they recieve has risen, it’s that they need the money more.  (Indeed, it seems to me that if the supply of donors is increasing, the price paid to donors ought to go down.)

Perhaps it is worth noting that even as the US is experiencing an expanding supply of gametes, the UK is in the midst of a sperm shortage.   (That’s the backdrop for the post a couple of days ago.)

Now consider the other side of the equation.  We all know that having children is, at least in the short and medium run, expensive.   Maybe they support you in your old age, but for a long time, kids are a drain on household resources.

Given reduced resources, more people are thinking longer and harder about having kids and/or postponing having kids.   So, for example, the number of vasectomies is on the rise.   Additionally, the number of abortions is on the rise.   It may simply be unaffordable to have another child or to incur the financial losses of carrying a pregnancy to term.

It stands to reason that if fewer people are having children, the demand for ART should drop.   And the effect is multiplied because ART is itself expensive.  So that even were the general demand for children to remain constant, fewer people would be able to afford to purchase the services.   (ART is rarely covered by insurance–that’s a great topic for another time.)  If the general demand for children is actually falling even as the expense of ART becomes more prohibitive for more people, then the demand for ART certainly ought to fall, too.

Here’s at least one story that suggests that this is all happening.   One fertility specialist reports business is down 20%.  (I assume the birth rate is not down by that much, so this might illustrate the combined effect of a reduced demand for children and an inability to pay for expensive fertility services.)  And in response, the fertility specialist in this news story is discounting his services.

I am not an economist, but it seems to me that it isn’t hard to see that something needs to change here.   The supply of gametes is increasing as the demand is decreasing.   Surely the next thing that will happen is the amount paid to the donors will decline.

The bits and pieces I have found raise more questions for me than answers.   For example, it stands to reason that just as the number of women willing to be egg donors is rising, so the number of women willing to be surrogates shoudl be rising.  Is it?   Does this mean the compensation offered to a surrogate is or will be falling?   And what are the implications of that for the global outsourcing of surrogacy I’ve discussed before.

There also may well be a gendered impact here worth exploring.   The contributions of women (eggs and pregnancy) have been far more highly compensated than the contributions of men (sperm).    That might mean that the money women get from participating in ART is more crucial to their survival than is the money men get.   (It’s not like you could be supporting your family with sperm donations.)   This could, I think, lead to a more dramatic fall in prices as women compete more vigorously for the shrinking amount of money available.

I’ll keep watching for subsequent stories.

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4 responses to “The Business of ART in a Down Market

  1. I have seen an increase in the numbers of men and women who desire to participate in third party reproduction. At this point, however, there is no incentive for them to lower their reimbursements.

    The reason? The Clinics are limited to a finite number of transfers per year. So they just choose/offer the more qualified persons.

    • So there is increased competition for the limited number of donor slots? That’s interesting to think about. At the same time, I would think that clinics would be looking to cut their costs in order to charge less and compete for the smaller number of people seeking to purchase services. Hence, they’d have an reason to offer donors less. But it sounds like you have actual experience, versus me just speculating.

  2. You have to keep in mind however, that clinic donors are paid less than those supplied by Agencies or those who arrange their own matches.

    A clinic donor may be paid $2-3000. An agency donor can be paid $3500 to $10,000 depending on many factors. The independent donor can be anywhere as she is not compelled to adhere to ASRM compensation guidelines.

    The trade off for Intended Parents is that the clinic pool typically has less than a dozen donors at any one time which translates to reduced choice and long waiting lines. The Agency may have hundreds of potential donors which translates to short waits and a better chance of finding a physical match to your family.

    The independent girl can be similar to a clinic or agency candidate. On the other hand she may satisfy an archetypal itch, i.e. 6’3″ model, blond hair, ice blue eyes, Yale educated, MBA.

    And, yes, I have seen short, squat, dark hair, brown eyes, working class persons seek those donors out.

  3. I’m adding my own PS here. There’s a story circulating today about rising use of ART throughout the world. http://www.reuters.com/article/healthNews/idUSTRE5536KG20090604 But note that the stats quoted are 2002. No doubt use was rising, but equally clearly, the global economic downturn is not reflected in these numbers.

    One thing to note–the high rates of ICSI. More on that another time.

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