Why Pay More for Eggs?

I think I should begin with an apology to regular readers/commenters.   Somehow this past week (first week of classes) I lost control of the comments.   I’ve tried to play catch-up this AM but I let too much pile up and it is hard to follow the threads.  So I’ve done my best.   I think I’m now in a place where I can respond to comments relatively promptly and that should make it better from here on out.   But I really do appreciate the time and effort people put into the comments they add here and so I wanted to let you know that I’m aware I dropped the ball.  

All that said, this post is in part prompted by a comment/question from Kisarita on an earlier post–the one about raising the price paid to egg providers in the UK.     This is part of an effort to increase the number of women willing to provide eggs, and she asked why the HFEA wanted to do that.  

To back up a bit, stories have reported shortages of gamete donors in the UK for some time.      (I think mostly I’ve written about this as a sperm shortage, but I could have made the point more generally.)   So on the most simplistic (and unsatisfying) level, raising the payments is an attempt to alleviate the shortage of eggs.  (There’s also a proposal to allow the use of sperm from each provider to create a  larger number of children, which is a different approach to dealing with the sperm shortage.   Perhaps that’s worthy of separate discussion.) 

Really, though, I think what Kisarita is asking is why is the government responding to the shortage by seeking to increase the supply?    I think the answer is that if you don’t increase the supply you increase reproductive tourism.  In other words, people will travel to obtain what they cannot get in the UK.  

Of course, not everyone will travel.  It costs money and takes time (although I wonder if you can get eggs shipped to the UK, which would negate the time point.)    Added costs will surely deter some people.  But this hardly seems a sound policy basis for allotting a scarce resource.  (Okay–so we use the “who can afford it” method all the time.  But still, I don’t think I’d pick to say that anyone who can afford an egg gets one and those who cannot don’t.) 

You see the same thing happening with surrogacy–that’s the reason there is out-sourced surrogacy, which I’ve written about in the past.   There’s a new story from last week’s Slate that discusses this.   Where people cannot afford or do not have access to surrogacy in their own countries, they travel to others–India and the US being major destinations.

Whether you travel for gametes or travel for surrogates, the problem, I think, is that the destination country is almost assuredly one with weaker safeguards.     That’s why the items or services are available to you there when they are not available at home.  

To be more concrete, I’m going to discuss surrogacy first.   Surrogacy in India is less regulated than it is in the UK or even the US.     To my mind, the lack of regulation in India is quite problematic.  I worry a great deal about what’s happening to the surrogates there.    If I ban surrogacy here (or saddle it with too many restrictions) I’ll end up pushing more people there.   So while I might have made a nice statement about morality and law and surrogacy and all that, I may also have contributed to the exploitation of women  in India. 

Now I’m not opposed to the purchase/sale of eggs generally.  But I recognize that providing eggs is not without risk and pain.    I think some measure of government regulation is probably appropriate.  Beyond that, I think it important that the price offered to women is somewhat commensurate with the risk and pain.  

If there aren’t enough eggs available in the UK, some people will travel to where they can get them and those may be places where the women providing the eggs are far worse off than in the UK.   This being the case, the concerns that might lead me to be wary of markets for eggs generally might also lead me to want to ensure that most people stay in my controlled market in the UK.  Hence, I’d like to have more eggs available in the UK.  Hence, I’d like to raise payments. 

I can see that on some level this seems counter-intuitive and it is deeply pragmatic.   A purer approach wouldn’t raise the price.   But there are always trade-offs between pragmatism and principle–this may be a place to make them.   In any event, this is what I think is going on here.

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4 responses to “Why Pay More for Eggs?

  1. Hmm Julie you might be concerned about the end result being exploitation of women in India but I don’t have faith in government agencies being so altruistic.

    To me it seems that the agency is simply catering to the consumer. Which I do not think it is the place of an overseeing agency to do. They should not be explicitly tailoring their oversite to produce an outcome favorable to one portion of the equation. To do this they emphasize the commodification of the sellers, not to mention the product.

    • I tend to think about two different sorts of agencies. There are commercial agencies (typically private) that are essentially out to make money. They do indeed cater to the consumer. And I think they are not to be trusted to act with the well-being of women (or anyone else) in mind.

      Then there are government agencies, like the HFEA. (We don’t really have such an agency in the US.) The charge of the HFEA is more complicated–it’s not simply to cater to the consumrer, but to try to devise policy that serves the public interest. I think it is quite possible for such an agency to design meaningful regulations that try to balance various interests. Thus, you might try to make eggs available in order to allow otherwise infertile couples to have children, but you might try to do so in ways that do not unduly exploit the women who provide the eggs. If such an agency functions as it should, it doesn’t tailor policy to produce an outcome favorable to one side or the other.

      My sense is that the HFEA is actually trying to obtain some balance and does have the concerns of all parties in it’s view. That doesn’t mean it always gets it right, of course. But it is a long way from a for-profit fertility clinic making the rules.

  2. I don’t have any problem with the practical step they are taking- increasing compensation to the donors. I just have a problem with the conceptual framework.

    This also makes me suspicious that the original motive behind keeping prices low was also that- to cater to the consumer, nothing so lofty as to prevent commodification.

    • I do think there has been genuine concern in the UK about commodification. That’s consistent with a lot of the UK regulations in place. At the same time, I don’t think setting low prices is necessarily consistent with an anti-commodification stance–as you suggest it is also consistent with providing cheap eggs to the market. It’s probably impossible to say what their “real” motive is–it’s an agency, not a single mind (and even single minds have mixed motives.)

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