As scientists in California delve more deeply into stem cell research and reproductive science, it is essential that women donating their eggs for research not be exploited or put at risk. A bill on the governor's desk would do just that.
On July 1, the state Senate passed AB 926, a bill sponsored by the American Society for Reproductive Medicine that "will reverse the current ban on compensation for women providing human oocytes (eggs) for research." That ban was passed almost unanimously in 2006; Sacramento got it right the first time.
The new bill purports to "promote equity" for women as "research subjects." Since men can be paid for sperm to be used either for research or for assisted reproduction, supporters of AB 926 argue that prohibiting women from selling eggs for research is "unfair." The comparison is ludicrous.
A sperm donor is screened for psychological and medical disorders. Once accepted, he may visit the sperm bank regularly. In some repositories he is provided a bed to relax on, erotic videos and magazines. While sperm donors are asked to abstain from sexual activities for two to five days before making a donation, the process is risk-free.
Egg donation is invasive. Donors are injected with hormones to over-stimulate egg production. These hormones produce exaggerated symptoms of PMS, as well as more severe problems. Women are sedated during egg retrieval.
To date, there are no evidence-based long-term studies of the consequences, risks and side effects of egg donation on the donor, or on her own fertility. Nor is there any mandatory reporting of medical problems resulting from egg donation. The lack of scientific research and reporting does not mean that there are no risks. Malpractice suits and egg donors' narratives suggest that risks are real and can even be life-threatening.
As a college student, Sindy Wei, who now has a doctorate in biology, researched the medical literature and concluded that egg donation seemed to be safe. She decided to help infertile women create the families they so desperately desired. After hormone injections over several weeks, her blood estrogen levels rose to an exceptionally high level. She produced 60 eggs, which were retrieved individually through a trans-vaginal needle requiring 60 needle pokes to her ovaries.
After the procedure, doctors told her to go home. Weak, nauseous and short of breath, Wei could barely stand. Eight hours later after refusing repeated efforts to get her to leave the clinic she was finally admitted to the hospital, going into shock from blood loss. After emergency surgery and blood transfusions, she was kept in the ICU. The specialist who performed the egg retrieval had nicked her artery, causing internal bleeding. Later, she battled her own infertility.
Another side of the "equity argument" questions why we allow payment to compensate egg donation for fertility treatment but not for scientific research. The primary suppliers of eggs for assisted reproduction are young college women who meet certain criteria desired by fertility patients: elite education, socially prized looks, athletic abilities or creative talents. Allowing a market in eggs for research would reach beyond the current pool to target women who may be motivated by dire need. How many low-income women might consider selling their eggs, multiple times, to feed their children or pay the rent?
AB 926 supporters state that a thorough "informed consent" process is sufficient. However, without hard scientific data on the risks of egg donation, informed consent at present is impossible.
An infertility specialist from a major research university clinic described egg harvesting as "saving starving follicles" from dying. This medical fairy tale makes egg harvesting sound like a save-the-child campaign, as if follicles are proto-persons who could become babies in someone else's empty belly. There is no mention of the dangerous artificial stimulation needed to manipulate the endocrine system to produce many times the normal number of mature eggs. Women are taught to imagine their eggs as super-abundant (with medical help) and being "wasted" when they could be put to better use.
The "traffic" in new reproductive technologies calls for a cautionary flashing signal, not red perhaps, but amber: beware of the propensity to regard the human body as a site for the expansion of medical, pharmaceutical and technological markets.
If AB 926 becomes law, we will witness a disturbing national trend. Women's research eggs become the hot new bio-product, increasing the profits of the multibillion-dollar-per-year infertility industry at the expense of women's health, safety and possibly, their future fertility. Is this the "equity" we want for ourselves, our sisters and our daughters?
The late historian of science and technology, Ivan Illich, warned against the processes of medical industries which "create new needs and control their satisfaction and turn human beings and their creativity into objects." Before this bill becomes law, we need publicly funded scientific studies to determine the risks of multiple egg donations by women who are being financially compensated.
We call on Gov. Jerry Brown to veto AB 926.
Diane Tober is associate executive director at the Center for Genetics and Society in Berkeley. Nancy Scheper-Hughes is chancellor's professor of medical anthropology at University of California, Berkeley, and director of Organs Watch.