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By Robin von Halle
Donor Agent Provocateur appeared last week in the New York Times Magazine column, The Ethicist, by Ariel Kaminer. The Ethicist responded to a reader’s questions regarding the ethical implications of a situation involving a fertility consultant hired by a Chicago couple interested in finding an egg donor sharing some of their ethnic background. The fertility consultant was ultimately unsuccessful in finding a donor of the particular ethnicity; however, she now refuses to refund their retainer. Did the fertility consultant behave ethically? ARR agrees with The Ethicist’s assertion that, as a professional consultant offering a service, it is unequivocally unethical to charge a fee for a service which, in reality, the fertility consultant did not intend to provide.
As a third party reproductive agency facilitating roughly 130 matches each year, ARR serves as an advocate and support system for donors, surrogates and intended parents alike. Our role is to be a resource, providing the tools and expertise to help intended parents to make informed decisions and navigate a complex process. As opposed to the fertility consultant, ARR does not ask for a deposit until we have successfully matched a couple and donor. We do not believe it is ethical to accept payment until all parties involved are ready and willing to move forward. Intended parents are under no financial obligations until an official match has been made, and if for some reason a donor is unable to move forward, the couple would be re-matched at no additional fee.
Above all, ARR never promises unrealistic matches. It is not uncommon for intended parents to request a donor that shares some of their own traits or cultural background. We do work with couples seeking a donor of a specific ethnicity. If we do not have a donor in our database matching the particular criteria desired, then we direct the couple to Donor Network Alliance to continue their search. That being said, in our twenty plus years of experience, an ethnic match is typically not deal a breaker. More importantly is finding a healthy, young, fertile donor with traits similar to that of the intended parents, if so desired. The majority of the time, when working with a reputable agency, a fertility consultant becomes a duplication of services, which add another layer of cost to the intended parents.
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By Mary Ellen McLaughlin
Between increased media coverage and openness by celebrity role models about their struggles with and solutions to infertility, egg donation has become more mainstream, and, as such, a more “acceptable” course for young women to take to gain financial and psychic rewards.
On the plus side, this is good for us and our intended parents, as it gives us a larger pool from which to choose. The downside, of course, is that news coverage is fairly superficial and may create expectations among prospective donors that are pretty far removed from reality.
This was brought home to me in a recent article in Jezebel entitled “Do Egg Donors Lie?”
In answer to the title question, yes, some prospective egg donors do lie, and I have caught a number of them doing so (on issues ranging like physical and mental health concerns, for example). It gets them bounced from consideration. I’ve developed a good radar for this, as a BSN who has worked with egg donors for 18 years and in women’s health for seven years before that. It helps to know what to ask and how to ask it, and our policy of interviewing egg donors face-to-face (in person and via Skype) is hugely beneficial.
Often, what they commit are sins of omission, not commission, but those still may be more plentiful because of the economic environment and, let’s face it, the prospect of “easy money” to offset the financial stresses.
And it doesn’t help that the increasingly competitive environment in our industry has driven compensation to, well, dangerous levels. The danger lies where it is less a reflection of time invested in the donation process (as per ASRM guidelines) and more one that’s essentially a bidding war for genetically ideal eggs. Is a girl who never considered donating until she wound up in dire financial straits being lured or coerced by the compensation? It’s an increasingly important ethical issue.
Of course, once prospective egg donors go beyond the media hype, they understand that egg donation may not be all so quick a buck. There’s a time commitment involved, from the medical and psychological screenings and legal consultations to medical checkups throughout the donation process, that can easily stretch past the three-month mark.
And even so, they may be accepted by the agency as a donor but still not pass the screenings. They may not get matched. They may stimulate poorly. There are no guarantees.
Egg donation is an important component of today’s fertility industry. It’s not something just any woman can do, for any number of reasons. Young women who are realistic with their expectations will happily reap both the psychic and financial rewards.
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By Mary Ellen McLaughlin
One of the common questions we see on the discussion boards of the surrogacy communities we follow is typically posed by women who are considering becoming surrogates for the first time: “Do I do it myself or go through an agency?”
Responses from others who have taken this path before vary, but lean toward recommending registering with an agency for the first time. At the same time, many say they have been do-it-yourselfers for subsequent surrogacies, recommending that route only after learning the ropes via the first agency experience.
Of course, I represent an agency, so forgive my bias. But the fact is that not all agencies are alike. And neither are all surrogacy journeys. There are many complexities involved and details to be managed in being a surrogate. The medical aspects aside, issues range from the legalities (contracts, compensation, meeting state laws over surrogacy arrangements, for example) to the surrogate’s emotional readiness to day-to-day dealings with the intended parents.
Frankly, once our surrogates begin the process, they’re happy to have an agency in their corner. If you’re thinking about embarking on this journey yourself, here are four reasons to consider an agency, and key points to keep in mind as you’re talking to likely candidates.
- The agency is your advocate in this process, representing your interests in everything from finding the right intended parents for you, helping to navigate issues that arise during your journey, to ensuring that you have someone in your corner with your best interests at heart. If you’re talking to an agency, ask for specific examples of how this role has actually played out with the surrogates with whom they have worked.
- As part and parcel of this role, the best agencies will ensure that their staff is available to you 24/7, to hold your hand, answer your questions and anticipate your needs.
- The agency has experience in dealing with all the aspects of the surrogacy journey. It knows what to expect for all the facets and, thus, can anticipate and effectively manage any bumps that may occur on the road.
- The agency also has developed the resources necessary to meet the surrogate’s interests, from legal specialists in family law to insurance programs to meet supplemental healthcare needs.
Anyone who’s considering becoming a surrogate knows it’s not a decision to be taken lightly. Once you’ve talked to several agencies using these points as a guide, go back to those message boards and ask members of the community to share their experiences, pro and con, with the agencies in question. You’ll benefit by extra careful due diligence in the long run.
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By Mary Ellen McLaughlin
It is kind of scary to think about the possibility that hundreds of people – thousands, even – are out there, innocently living out their lives and unaware that the guy who lives next door could be a half-sibling – genetically speaking, that is.
It’s a possibility that has the fertility field (and those with an interest in controlling it) fairly abuzz these days. The number of children who could be created by a single sperm donor during his fling with this particular brand of philanthropy is fairly mind-boggling, when you think about it.
One Toronto man tells a Canadian newspaper that he was born in 1952 with sperm from a donor who supplied his semen for over 30 years. It’s likely, he says, that his donor/father has between 500 to 1,000 children in Canada, the U.K., and who knows where else? “Freaky” is one word he uses to describe it.
Why is this cause for alarm? Well, the possibility of inadvertent incest, for one. For another, the possibility that these children might share disease-causing genes that might spread exponentially throughout the population.
Similar concerns have been voiced about children born through egg donation, though the scale of the issue there is far, far smaller – for practical reasons, if nothing else. Women produce far fewer eggs than men do sperm. The collection process entails a comparatively onerous medical procedure that’s a far cry from the “one and done,” if you will, of sperm donation. Women undergo a very comprehensive physical and family health history before qualifying as egg donors, which I’m not certain is as standardized for sperm donors.
There are very clear ASRM guidelines on how often a woman should donate her eggs, at least in the U.S.: No more than six cycles. For men, ASRM guidelines on sperm donation limit donors to 25 live births per population area of 850,000. (Some estimate that only between 20 percent to 40 percent of births are reported.)
In neither case, however, is there centralized tracking. While I can’t speak to sperm donor agencies, in the egg donor community, agencies like ours communicate locally and do a good job of monitoring. Yet there is nothing keeping (or to monitor) either sperm or egg donors from moving to new areas and starting all over.
It’s a concern that’s not going to go away, and has prompted calls for tighter regulations. The thought of more government regulation is always one for concern. Better yet that we, as an industry, revisit an idea that has been discussed for years and find a way to make it work: A centralized registry of egg and sperm donors that is scrupulously maintained. And where participation is a badge of honor.
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By Mary Ellen McLaughlin
The anonymity of egg donors – a norm of assisted reproductive technology here in
the United States – is steadily coming under question. And while those of use who
find donors to match with intended parents in need tend to worry that the trend will
result in a shortage of willing donors,, that actually may not be the case at all.
Last month, Washington state passed a new law guaranteeing children conceived
with gametes from Washington egg donation agencies access (when they’re 18) to
their donors’ medical histories and their full names— unless the donors specifically
opt out of being identified. It also applies to children born of donated sperm.
Twenty years ago, when we were just starting in this business, donor anonymity
was a huge concern to all of the parties . Today, we see fewer who need that
assurance. And a spot survey Alternative Reproductive Resources recently
conducted of our egg donor base gave us some data to back up the anecdotal
evidence.
Just over half the survey group was new (51.9%) and one-time (29.6%) donors. Of
the entire base, fewer than 10% said anonymity was “very important” in weighing
their decision to donate. A whopping 55.6% called it “somewhat important”; and
nearly 40% said it wasn’t important at all.
So it’s not surprising that over 80% of the respondents said they would still donate
their eggs if anonymous donations were disallowed, and fewer than 20% said they
would opt out of being identified if legislation like Washington’s was more broadly
adopted.
In their comments, it was clear that our donors understood and were comfortable
with the need of children born of donated eggs and/or sperm to know as much as
possible of their biological roots. Their “responsibility” as egg donors was a common
theme.
What was a greater concern was the potential for any legal responsibility.
One donor noted: “I value the anonymity, but I think children will always be curious
where they came from. Making a decision as big as donating eggs comes with a certain
responsibility, and I would give the child the opportunity to find out about me if that was
important to them.”
Another said: “Giving them the opportunity to easily understand where they came from
is potentially part of our duty as donors. However, I do not believe that this knowledge
should ever result in the pursuit of mandated legal obligation for care or finances without
the donor’s reciprocated agreement.”
This is an issue that is not going to go away. We find it interesting that donors, arguably
the group with the most at stake, have adopted a more open attitude toward anonymity in
recent years. Let us know what you think!
Conception Connections 