Equity in Egg Donation

Helane S. Rosenberg, Ph.D., Ovum Donor Coordinator, IVF New Jersey Fertility and Gynecology Center, Somerset, NJ and Associate Professor of Education, Department of Learning and Teaching, Graduate School of Education, Rutgers University, New Brunswick, NJ 08901. Helane.rosenberg@gmail.com.

Yakov M. Epstein, Ph.D., Professor of Psychology and Director, Center for Mathematics, Science, and Computer Education, Rutgers University, Piscataway, NJ 08854. Yakov.epstein@gmail.com.

I. Introduction

Egg donation, a relatively recent medical procedure, enables women to conceive by replacing their nonviable eggs with donated eggs.1 Young fertile women donate their eggs. The available supply of potential donors is far less than the demand for them. Many recipients report that they have been waiting for years to get a donor and are on waiting lists of several clinics.

Getting a donor depends upon many factors: the financial resources of the recipient, insurance guidelines, state mandates for age limitations, and place of residence. Many medical practices match recipients with donors on a "first come first served" basis. Recently, recipients have tried to take some control by seeking the services of a donor broker.

The time has come to begin developing a justice calculus for the allocation of this scarce resource. The purpose of this Article is to present cases that illustrate equity issues, to discuss those issues in greater detail, to embed those issues within an archetypical framework, to present some of our own decision making processes, and to invite readers to join with us in an effort to develop a justice calculus for the allocation of scarce resources.

II. History Of EGG Donation

Egg donation is a relatively new procedure. The first documented egg donor pregnancy was in 1984. In its early stages, egg donation was done in two ways. The first attempts at egg donation involved a procedure called a lavage,2 which means washing. During a lavage procedure, a woman, who provided the eggs, was inseminated with the recipient husband´s sperm. Several days later the embryos were washed out of her uterus and placed into the uterus of the recipient. Needless to say, this procedure was fraught with difficulties. Often, instead of washing out the embryos, the donor stayed pregnant. Or, because the lavage needed to occur so early in the pregnancy, the procedure took place needlessly, because fertilization had not occurred. Neither outcome was the desired one, since the recipient rarely became pregnant.

The next stage in the development of the modern egg donation procedure occurred just as In Vitro Fertilization (IVF) centers expanded but before freezing techniques had become widespread. IVF patients, who had cycled previously and were known to produce many eggs, donated their "excess" eggs to another couple, usually for a reduced cost for their own cycle. Because sy...

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