Reasonable compensation for oocyte donation should include reimbursement of expenses directly related to the donation and compensation for the donor’s time spent and efforts made into the donation, according to a recent article published in the Journal of Medical Ethics.

To remove the associated with oocyte donation, the European Union (EU) allows for donors to be reasonably compensated. This reasonable compensation must follow the EU tissue and cell directive that states that donors do “. . .not gain money by making available [their] bodily tissue” and that their compensation is “. . .strictly limited to making good the expenses and inconveniences related to the donation.”

The compensation rates for oocyte donation vary significantly among different EU countries. To increase the transparency of this compensation and prevent the commodification of donor oocytes, the investigators proposed that a more detailed definition of “reasonable compensation” is needed. Using analogical reasoning based on the guidelines for reasonable compensation of medical research participants and living organ donation in the EU, the authors outlined the components for reasonable compensation in the context of oocyte donation.

The investigators identified 3 components of reasonable compensation commonly used in cases of living organ donation by medical research participants. These included reimbursement of (in)direct expenses, compensation for time spent and efforts, and additional (non)monetary benefits. These determinations were based on the financially restrictive and time-consuming nature of organ donation.  In the context of oocyte donation, the investigators determined that reimbursement of direct expenses and compensation of time spent and efforts made constituted reasonable compensation for the potential financial losses incurred during the process.

Multiple clinic visits over an extended period of time are part of the process of oocyte donation, thus reimbursement of direct expenses such as travel, food, accommodations, and childcare is accepted as reasonable. Since the time to recuperate from oocyte donation is relatively minimal (about 1 day), refunding lost wages after donation did not necessarily constitute reasonable compensation. However, if a serious injury were to occur as a result of oocyte donation, lost wages and care expenses could be justifiably reimbursed.

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Compensation for time spent and effort made in organ donation is often consistent with an individual’s willingness to accept medical risks but is not dependent on the level of risk. With oocyte donation there is the small risk of ovarian hyperstimulation and ovarian infection, and, as a result, donors are limited to 5 oocyte donations. This makes the substitution of oocyte donation for a “regular job” highly unlikely. Moreover, the extent to which oocyte donation causes inconvenience to the donor is highly arbitrary and variable, allowing compensation for donors’ time and effort to still be in line with the EU tissue and cell directive. The investigators also state that this component should be calculated using the wage-payment model in order to ensure that compensation is fair and transparent.

For oocyte donation, reasonable compensation should comprise reimbursement of direct expenses and compensation for time spent and effort made for the donation. The authors of this research concluded that if donor compensation is calculated transparently and consistently with these 2 components, altruism can remain the key value in women’s’ decisions to participate in oocyte donation without their being straddled with the significant financial burden associated with the process.

Disclosure: Several study authors declared competing interests with relevant industry partners. Please see the original reference for a full list of authors’ disclosures.

Reference

Kool E, van der Graaf R, Bos A, Fauser B, Bredenoord A. What constitutes a reasonable compensation for non-commercial oocyte donors: an analogy with living organ donation and medical research participation [published online August 2, 2019]. J Med Ethics. doi: 10.1136/medethics-2019-105474