California bill seeks pay for women who donate eggs for research
03/10/2013 1:00 AM
03/10/2013 11:41 AM
Five years ago, Alice Crisci froze her eggs, knowing she could be left infertile after chemotherapy treatment for breast cancer.
Now, cancer-free and 10 weeks pregnant, Crisci is a passionate donor advocate and a vocal critic of a California law that some say has stymied fertility research. That law prohibits women from being compensated for donating their eggs for medical research, despite payments to subjects in other human research studies.
Women can be compensated in cases where eggs are donated for fertility treatments, with industry guidelines suggesting payments of $5,000 to $10,000.
Few women voluntarily go through the invasive and time-consuming procedure without compensation, leading to a shortage of healthy oocytes, commonly called eggs, for research.
That could change under a recently introduced bill that would allow women to be compensated for their time, trouble and inconvenience when donating eggs for research.
"Getting this research back on track will benefit a great number of women," said Assemblywoman Susan Bonilla, D-Concord, the bill's author.
Lori Arnold of the California Family Council has concerns, saying Bonilla's bill opens up "dangerous medical ground." The family council – an anti-abortion group that promotes Christian principles in policy – said eggs should be treated like organs and should not be sold.
"Eggs are a foundational element for life," said Arnold, the family council's research analyst. "We support legislation that honors that. In this case, we believe it dishonors life and is subject to abuse."
Bonilla said her bill simply lifts an unnecessary restriction against women and their eggs when it comes to being compensated like other research subjects. Human clinical trials will continue to have the immense restrictions and oversight already in place, she said.
"This is the only kind of research that goes uncompensated," Bonilla said. "I think women are able to decide for themselves if they want to participate in a clinical trial."
Human research protections programs and institutional review boards determine whether human subject participation is necessary and ethical.
Assembly Bill 926 would replace current law adopted in 2006 that stipulates egg donors be given "no payment in excess of the amount of reimbursement of direct expenses incurred as a result of the procedure" when performed for medical research.
Former state Sen. Deborah Ortiz, who co-authored the 2006 law, said there remains a sensitive balance when it comes to compensating a woman for her eggs so that women with modest means aren't lured by the financial incentive and ignore health risks.
"We don't want women producing eggs for survival," said Ortiz. "I think we have to be really careful."
The risk for exploitation is a real concern, said Jennifer Lahl, the founder and president of the non-profit Center for Bioethics and Culture. Lahl said that not enough is known about the long-term effects created by the "onerous egg harvesting procedure."
Lahl produced the 2010 documentary film "Eggsploitation," which highlights the stories of young women who feel they were exploited by the fertility industry, including some who developed serious complications.
Lahl, who is based in the Bay Area, travels to college campuses to show the film to the fertility industry's target market – young college-educated women. College newspapers are filled with egg donor ads, she said, with some promising payments of $20,000.
"A lot of people think this is like sperm donation," said Lahl, a former nurse. "But there is a real risk. The industry and research people hate my work. They don't think (egg donations are) harmful. But, until they've done the long-term research, they can't say that."
Lahl said she fears Bonilla's bill will create competition in the egg donor market between the researchers and fertility clinics.
"There will be two industries competing for a hot commodity," she said.
When eggs are donated to help an infertile women conceive, the ethics committee of the American Society for Reproductive Medicine recommends payments ranging between $5,000 and $10,000 for the inconvenience and discomfort of pre-screening, ovarian stimulation and egg retrieval surgery.
Bonilla said ASRM brought the need for AB 926 to her attention.
"This has a really profound impact on patient care," said Shannon Smith-Crowley, ASRM's legislative advocate.
Smith-Crowley said additional research could assist doctors in better understanding how to lower the rate of women having multiples instead of single births after fertility treatments.
Dr. Marcelle Cedars, director of the division of reproductive endocrinology and infertility at UC San Francisco, said the research being done now is typically on unhealthy oocytes that a fertility clinic patient chooses to donate instead of discard.
Under the current law, Cedars said researchers are unable to accept unneeded oocytes from an egg donor who has been paid to assist an infertile couple.
Cedars said, frustratingly, those eggs tend to be the most healthy but have to be discarded. With those healthy eggs, she said, more studies could be done on fertility and to better understand oocytes and how they age.
Crisci, the woman now pregnant with a frozen embryo created with her egg, said she hopes a revised law would allow for more research on the impact of cancer-fighting drugs on fertility. Crisci, 36, said she believes her inability to become pregnant naturally was a result of chemotherapy that helped her beat breast cancer.
"This is about research that will help women," she said.
Call The Bee's Melody Gutierrez, (916) 326-5521. Follow her on Twitter @melodygutierrez.
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