Reflections on Egg Donation in Canada

Claire Burns recommends legal and practical changes for promoting the ethical treatment of egg donors within Canada.

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Have you heard? The Government of Canada plans to introduce regulations to support the Assisted Human Reproduction Act of 2004! Amazing! I’m jumping for joy! After more than 12 years, the government may finally make good on its promise to protect the interests of women involved in assisted reproduction.

I’m Claire, and I am an egg donor.  I am also an egg donor advocate. Much of my advocacy work is done through the We are Egg Donors website. As part of that work, sometimes I get asked to be speak on the radio or to talk to journalists. ALWAYS I am asked, “how much do you think egg donors should get paid?” Often the question is asked as if it’s news that women are getting paid to sell parts of their bodies. Yeah. That’s a real modern day news story.  Let me tell you Canada, illegal payments and reimbursement to so-called ‘donors’ is only the TIP of the ethical iceberg. Swim deep here with me friends, swim deep.

iv-armAccording to the Government notice from Health Canada, the Assisted Human Reproduction Act “was written to be a comprehensive legislative framework to help protect and promote the health, safety, dignity and rights of individuals who use or are born of assisted human reproductive technologies in Canada.” The problem with this statement is that egg donors don’t technically USE assisted human reproductive technologies. Rather, reproductive technologies are USED on us.

Back to the Health Canada notice: “There is a clear need to update regulations and create new ones concerning the safety of tissues used for assisted reproduction (i.e. donor sperm and ova).” What? Excuse me? The government is going to provide for the safe use of my tissues by others – but what about my safety? And, more generally, what about the safety of all egg donors? For too long our needs and interests have been ignored.  It is time for that to change.

This brings me to my MANIFESTO which builds on Vanessa Gruben’s excellent 2013 article “Women as Patients, Not Spare Parts: Examining the Relationship Between the Physician and Women Egg Providers.”

A PERSON FOCUSED APPROACH TO EGG DONOR CARE

  • Clinicians and lawyers should avoid real and apparent conflicts of interest in their dealings with potential and actual egg donors. For example, the physician caring for a woman or couple using the services of an egg donor, should not be the physician caring for the egg donor.
  • Clinicians should provide potential egg donors with adequate information about the procedures, side effects and after-care so that women can make an informed decision about whether to become an egg donor. This should include disclosure of the fact that there is no long-term research on egg donation and thus no robust data on potential long-term side effects.
  • Clinicians should provide proper patient care (which includes avoiding ovarian hyperstimulation syndrome and providing post-retrieval medical care).
  • Clinics should keep careful discrete medical records for egg donors. These records should document how many eggs are retrieved per stimulated cycle.  This information should be shared with the egg donors and be available for inspection by Health Canada  Records available for inspection should include information about the number of times a woman has been an egg donor.
  • Clinic inspections should happen on a regular basis (perhaps bi-annually) and could happen on an exceptional basis when problems are reported.
  • Clinicians should undertake long-term research on the effect(s) of egg donation on women’s health.
  • The practice of egg donation should be standardized. There should be a standardized application process for egg donors and standardized inclusion/exclusion criteria. As well, there should be standardized training for clinicians on levels of medication, standardized protocols for the frequency of appointments before and after stimulation and retrieval, and standardized rules for compensation.
  • With respect to compensation, there should be absolutely no clauses requiring that intended parents who have paid for expenses associated with egg donation be reimbursed in the event that the egg donor backs out for medical or non-medical reasons.

As Vanessa Gruben carefully explains, and as I wholeheartedly believe, egg donors are people and not just spare parts. Our “health, safety, dignity and rights” is no less important that the “health, safety, dignity and rights of individuals who use or are born of assisted human reproductive technologies.”

We desperately need to improve the ways that egg donors are treated in Canada. If you’re an egg donor, please speak up or get in touch with me and make sure that your voice is added to the conversation. And to all Canadians, please help support the health and well-being of egg donors by submitting your comments to Health Canada by November 29th, 2016.

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Claire Burns is a founding member of We Are Egg Donors (WAED).