the fertility advocate

Talking, writing, educating, and change making in the field of fertility for more than twenty years

The Donor Egg Price Fixing Controversy Heats Up!

I love people who speak their minds and take no prisoners. That don’t follow  the pack consciousness,  but follow their own heart and their own mind.  These folks tend to be advocates  – and change makers. These kinds of people make my blood heat up.  I don’t have to agree with it all – or even any of it sometimes. But there is a  fearless courageousness of certain human being who  are not  willing to lie down because they are told to. Thank G-d for them!

Meet Darlene Pinkerton, Founder of A Perfect Match.  Darlene read the blog that I wrote yesterday and this is what she had to say about it!

“You are such a talented writer and I really do think you hit it on the head when you said people just don’t believe intelligent women can make intelligent choices for themselves.  I have even used the football example before.  It is so true though…men are still treated differently.

I beg to differ with the thought that ASRM/SART didn’t purposely try to price fix.  Not to take credit, but ASRM wrote this compensation guideline in 2000 as a knee jerk reaction to what I started in the industry…higher compensation to donors, and the big push to control IVF doctors came from ASRM and SART in 2005.  We all know that IVF centers treat the guidelines as though they are regulations. Doctors and agencies are forced to sign an agreement to abide by these guidelines if they want to be part of the professional group or they want to work with members of that professional group.   It isn’t law, but is certainly treated as such within the industry.    ASRM placed a ceiling on compensation that is arbitrary (at best)  by their own admission as written in the guidelines.   If they aren’t trying to control something or someone then why have an upper limit at all?  For the sake of the donor?   Definitely not!

The compensation issue with ASRM has not been about making sure the donor isn’t placing herself in harm’s way.  We can put many safeguards in place to make sure that she fully understands what she is doing so she is making a truly informed decision and not being coerced to do something she doesn’t really want to do.  We can make sure they have psychological evaluations and counseling (BTW: not even required by ASRM) and we can make sure they have legal counsel to go over the consent forms and to make sure their rights are protected (again not required by ASRM)…   If this is truly about protection of the donor, then why isn’t ASRM insisting on this for every single donor? Why isn’t ASRM actually protecting the donor regardless of compensation she is receiving?  Every donor should have counsel, because a donor who works at a fast food place may be more swayed by $5000 than the donor who is asking for more than $10,000 but is a medical doctor or attorney, like some of my donors are.   If they don’t evaluate each donor and allow her legal counsel how can they possibly set a dollar number and say that it is unethical?   They can’t, which is why I think the dollar amount is far more self-serving.

There are two things I have seen at play:

1. IVF centers can control their competition by setting a compensation amount.

2.  ASRM/SART want to be able to say they are able to self-regulate and don’t need any government interference.

I  believe there is some  price fixing going on in order to protect the IVF centers’ own donor pools so they can be competitive with agencies.  From  the very beginning of when I first started advertising these ‘in-house’ programs have said that allowing agencies to offer higher compensation dried up their own donor pool.  Once they raised the $$ amount they paid donors in order to be competitive with agencies, then their donor pool increased.  Viola!  Magic!   I have no problem with them being competitive, but I do have a problem with IVF centers setting prices and protocols  that  eliminate an intended parent’s ability to work with a specific agency or donor.  If everyone is counseled appropriately, then why would ASRM or the IVF center care?  The truth is that the IVF centers  that don’t have “in house” donor programs don’t care about compensation paid to donors…they don’t care and they don’t ask…that is the reality.    So let’s be real… the majority of physicians making these rules have their own in-house donor programs and stand to lose $$  if they can’t be financially competitive with compensation.  The ones that don’t have their own donor programs could care less how much a donor is paid as long as everyone agrees and has counsel.  Coincidence?  I think not.

Self-regulation:   Let’s start with how IVF centers “in house’ programs get away with paying a donor more than $5000, which according to ASRM guidelines requires “justification.”    Routinely the IVF centers throughout the country are giving their in-house donors $8-10,000 for local donations, but ASRM and SART don’t make them justify it…they just turn a blind eye.    When I’ve questioned the centers about the level of payment they pay and how they justify it, they  justified it by saying it is more expensive to live in NY, Boston, San Francisco…really?  The guidelines specifically say that you can’t pay a donor a higher amount for ethnicity, SATs, previous donor, etc….” Compensation should not vary according to the planned use of the oocytes, the number or quality of oocytes retrieved, the number or outcome of prior donation cycles, or the donor’s ethnic or other personal characteristics.” but we can justify paying them more because of where they personally live?

If the ASRM limits are really based on time spent, and risks taken, then where a person lives should have no impact on the amount of money they receive and these IVF centers should not be allowed to pay more than the $5000 ASRM says is justified.   But ASRM does nothing about that…nothing!     Bottom line is that ASRM/SART does not make anyone “justify” why they pay a donor over $5000, even though that is what it states in the guidelines, and they continually turn their backs on what is going on with compensation amounts paid to donors…unless someone dares to go over their “guideline” compensation.

And, why is $10,000 the magic number if they are actually basing it on time and effort?  If they are truly concerned with time spent and risks involved then they should not be  using the donation of a sperm donor as their rational for a compensation amount.  ASRM guidelines do not take into consideration that a sperm donor gets to go in a little room and watch porn for his donation, while an egg donor is injecting her body with medications for weeks, attending numerous doctor appointments, having surgery, and then having a recovery time that can take up to 2 weeks before their body  gets back to normal…in an ideal donation…they receive nothing more if they have complications, hyper-stimulate, require hospitalization, etc.    And, to top that they have to give up sex for the entire time!!!

What I hear when I talk with IVF centers and what I was told by the past SART president is that ASRM and SART are trying to keep the Federal Government out of their business and they don’t want any Gov’t regulation, and for some reason they think that setting a cap on donor compensation is going to keep the government out.   In fact, there is the group in San Francisco (I seem to recall it was started by PFC)  that was formed to try to set an example of how they can self-regulate.  It is called BARTS:  Bay Area Reproductive…something or other.   Interesting that PFC is being named as a primary defendant.    In my opinion ASRM/SART and IVF centers are running scared…they do not want Federal Regulation, and they have decided that using the smokescreen of controlling and limiting compensation may keep the government out of their business.

Sorry, I happen to think they are very motivated by self preservation and I am glad this donor is calling them out!”

Darlene has recently resigned from SART – deciding that she can no longer participate in what she feels is unfair dealings to the recipient client and the donor. It is ironic that A Perfect Match is also named as a defendant in this case! I think they got the wrong agency!

So let me leave you with a question. If the controls are lifted on the amount a donor can be paid for egg donation – will the price of eggs rise like gold in a cash crisis? Will less fortunate recipient couples be priced out of egg donation for family building?  If we put ethical price restrictions on egg donation – should we also be placing caps on what IVF Centers can charge for services?  I recently heard of a $60,000 IVF Cycle at a center in NYC.  Where does that play into the game of guidelines?

Love to hear your thoughts…..

About Pam Madsen
Talking, writing, educating and change making in the field of fertility for more than twenty years
2 total comments on this postSubmit yours
  1. Thanks for ending your blog with a reference to the other party in egg donation, the recipient parent. You close by asking a very important question, if the ASRM cap is revisited (I agree, it is time to do so) and the cap lifted or eliminated as the plaintiff in the lawsuit is asking when moving for an injunction, then will the recipient parent with limited funds be priced-out of this family building option? I don’t know the answer but do think it is a fair and appropriate question to raise.

    And thanks, too for the strong mention regarding independent legal counsel in ALL family building that also entails parentage, relinquishment of rights and other complex legal issues.

  2. I have found after 11 years of working with donors that as compensation increases, there is a paradigm shift in the way many donors view the entire process. They begin to feel that they are in a seat of power and negotiation and many times place ridiculous and unnecessary demands on the Intended Parents or the agency and I have found that their dedication is sometimes compromised as well.
    Since our agency recently signed agreements to serve over 35 countries through a new global program, we created a flat fee system for all donors where they receive $7000 for a first time donor, $8000 for a second time donation, $9000 for a third time donation, and $10000 for all future cycles up to 6 and we have found that this has been a tremendously successful platform as all are treated equal and it really is about compensation a donor for her time, energy, and efforts rather than how hot she is, where she went to school, etc. We found that each set of Intended Parents have their own individual set of criteria and no donor is more important or worth more financially than another.
    What I wish was further studied by ASRM is the number of cycles recommended for a donor. Currently the recommendation is that no donor perform over 6 cycles. I would like to know that actual research is backing this up as I am concerned for the donors health that we have solid medically researched and documented reasons for all recommendations.

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