California legislation to allow women
to be paid for their eggs for scientific research is sailing toward
final passage literally swaddled in motherhood and apple pie
arguments. Missing from the debate is a key reason behind
the bill – building profits for what some call the “baby
business.”
The legislation is touted as providing
equal treatment for women, permitting them to be paid for supplying
eggs for stem cell and other research, much as men are paid for
sperm. It also would put women who sell their eggs for research on an
equal economic footing with women who sell their eggs for fertility
treatments, which is currently permitted under state law. Payments to
those women range from an average of $9,000 to as much as $50,000,
according to
a legislative analysis of the bill.
Assemblywoman
Susan Bonillla,
D-Concord, author of the bill(
AB926),
says,
“It is time to let women, just as any
other research subject, make an informed decision as to
participation, and justly compensate them for doing so.”
She also says that the ban on payments
has had serious impact on fertility research. In a legislative bill analysis, she says,
“It has led to a de facto prohibition
on women’s reproductive research in California, adversely
impacting the same women that the ban intended to protect. With few
oocytes donated, fertility research and fertility preservation
research has been at a standstill. This greatly affects women
suffering from fertility issues and women facing cancer who would
like to preserve their oocytes.”
Little public information is available
on the Internet discussing the industry's economic challenges.
However, demographic studies show that the size of the key market
for fertility services is stagnating.
A 2012 report by the federal
government projects that the number of women in the 35 to 44 age
group, prime consumers of fertility services, is likely to grow only
0.5 percent from 2010 to 2020. And since that forecast was made, the
Census Bureau has downgraded its projections for total population
growth.
Bonilla's legislation effectively adds
a new, potential revenue stream for the industry. Fertility clinics
would be able to buy the eggs and then resell them to researchers,
adding premiums for eggs from women with special characteristics. The bill would also add a tool for bringing down the cost of fertility
treatments, which can run as much as
$12,000 to $17,000 a round or
more and require several rounds, according to the
NIH. Clinics could discount those prices for some women, bringing in
new customers, if they agree to authorize the use of excess eggs for
scientific research.
None of this appears necessarily
pernicious. What is pernicious is the absence of discussion of the
economics of the legislation. Without a full understanding of all
that is at stake, including economic issues and motivations,
legislators, the governor and the public are hard-pressed to make
good decisions about a significant change in California law.
Opponents of the legislation have
raised serious questions about the treatment of women by fertility
clinics, noting that the bill would turn egg providers into “vendors”
– not patients of the clinics. The
Center for Genetics and Society
in Berkeley has
captured the arguments in opposition including
testimony before a Senate committee hearing early in June.
Jennifer Schneider, a physician who
lost a 31-year-old daughter to cancer seven years after the younger
woman sold her eggs three times,
told lawmakers,
“Unlike infertile women who are
considered patients, egg donors are treated as vendors( (her italics).
When they walk out of the IVF clinic, no one keeps track of them.
My daughter’s death was not reported. The long-term risks of egg
donation are unknown."
Sindy Wei, a former egg provider and
now a physician with a Ph.D. in biology, testified that she wound up
in an intensive care unit after 60 eggs were extracted from her in
2001.
She said,
“I fear that cases like mine are
buried deep by fertility centers concerned about their image. An
industry thriving on profits and reputation has little incentive to
report adverse events, or protect the health and medical rights of
donors.”
Where is the $3 billion California stem
cell agency on all this? The agency has not taken a position on the
bill nor have any major research organizations. The measure does not
change the law affecting agency-funded research, which bans the use of
compensation for eggs in its research. Enactment of the law, however, would
create a two-tier stem cell research standard in California, one for
scientists not constrained by the payment ban and another for those
who could use the full range of research tools. Some stem cell
researchers may well think that they have become disadvantaged as a
result.
(Editor's note: An earlier version of this article said the IVF business generated $4 billion in revenues annually. More recent estimates place it at $5 billion.)
