Living Economics

About 6 million American women have fertility problems (Daily News 6/13/99). With the advance of in vitro fertilization (IVF), it is now possible for infertile women to buy eggs to be fertilized by the sperm of their husbands and transplanted to their otherwise healthy uterus.

And with more women seeking eggs than there are women willing to part with theirs, a bustling egg market has been born. Commercial egg banks based in the U.S. are springing up on the Internet, and they're counting Canadians among their clients and willing donors. Couples are spending up to $5,000 U.S. to get matched with a donor, and another $8,000 to $10,000 in drug and doctor fees to have the donor's eggs retrieved, fertilized and implanted in the recipient's womb (Ottawa Citizen 10/12/99).

The sellers are women as young as 18 seeking cash as eggs from younger donors could significantly increase success rates in IVF patients over 35 (Ottawa Citizen 10/12/99).

These transactions are taking place in a largely unregulated market that skirts legal bans on selling human organs and operates without full consumer protection. But fertility clinics and egg brokers characterize the process as egg donation. Fees are called compensation for the donor's time and effort. In New York, the practice has the tacit approval of the state Health Department and other regulatory agencies. (Daily News 613/99).

Unlike other nonregenerating human organs such as heart and kidneys, eggs are renewable resources. Selling of human eggs to infertile women with deep-seated reproductive desire seems to benefit both donors and recipients. But these exchanges are often frowned upon because of its ethical overtone. Few people would find fault with fertility doctors charging for performing the procedures involved. And since egg donation involves complicated and painful intervention of the donor's reproductive cycle, nobody can seriously expect a donor will do this procedure for free. So what are the ethical issues at hand?

Perhaps it is the circus atmosphere surrounding the whole industry. In a recent controversial example, a wealthy couple advertised in various American Ivy League newspapers for what they considered to be the perfect egg. The donor had to be at least 5-feet-10, athletic, with SAT scores of 1,400 and would be paid $50,000 for her services. In Toronto, this trend has prompted at least one student paper, the University of Toronto's The Varsity, to establish a policy prohibiting the placement of such ads (Toronto Sun 7/4/99).

Perhaps it is also the designer-children wishes of egg recipients that have turned a basically random process into an controlled eugenic experiment. Because all eggs are not equal, some buyers strive to find just the right donors, valuing qualities such as intelligence, beauty and talent in the hope that a child might inherit them (Daily News 6/13/99).

More seriously, because donors may know more about themselves than the screening agency, they may be tempted by the high fee to conceal or misrepresent their personal and genetic information. Such dishonesty is, of course, not uncommon even between marriage partners. But for married couples, there are nonreproductive bonds that can tide over reproductive disappointment. On the other hand, if an egg donor is selected for the specific reason of producing an ideal baby, any major disappointment with the result can be intolerable. Especially, when the baby comes with a no-return no-guarantee policy.

Although the industry has grown very fast, a mass market probably will not materialize. Because the success rate is at best 50%, the total expenses of multiple attempts for one successful outcome can rapidly multiply. And because the expensive procedure is not covered by health insurance, only very well-to-do families can afford it (Daily News 6/13/99). This may turn out to be a blessing as a recent Louis Harris poll reported that 43% of parents would use genetic enhancement to make their child more perfect if they could afford it.