Given the news about the conflict in the Middle East, “freebiegate”, and the potential vote on assisted dying, you could be forgiven for missing the news this week that the Human Fertilisation and Embryology Authority (HFEA) raised the cap on payments that could be made by fertility clinics to young women for their eggs.

It may come as a shock to many readers that you can be paid for your gametes at all

The news had been trailed in August, to the dismay of women’s rights campaigners, and on 1 October the change was made, with payments to women for their eggs rising from £750 to £985 per cycle. Supporters of the policy change say this has come about as payments hadn’t risen since 2011, and that an uplift was necessary to account for inflation. That being the case, we may ask why men are being paid a mere £45 for their sperm, which increased from £35 on 1 October. 

It may come as a shock to many readers that you can be paid for your gametes at all, raising as it does the concern that such high payments (for eggs at least) may incentivise young women on low incomes or those who are students to sell their eggs for the money. Indeed, reports have been seen in the media of women undergoing egg donation to pay towards holidays, or to go travelling. For a long time now, eggs and sperm have been tradable commodities. 

You can visit the websites of UK fertility clinics and browse online catalogues of “egg donors”. The donors can be filtered by height, age, educational attainment rate, eye colour, race and hair colour. Are you a single man who fancies selecting the characteristics of your dream baby? Go right ahead. Not enough eggs in the UK? Not to worry, one Cambridge clinic uses imported eggs from Spain, so you can add a Mediterranean flavour to your family without too much effort. Packages of six or ten eggs can be bought from fertility clinics, with prices starting from as little as £5750. 

The HFEA says payments to women are “compensation”; to reimburse women for their time, inconvenience and travel costs, and that donations remain “altruistic”. While train travel in the UK is fairly astronomical these days, a ticket from Edinburgh to London still won’t set you back £900. And if it is the case that the payments are to recognise expenses, why is the disparity with payments to men for sperm so stark? The view of many women’s rights campaigners is that payments should be banned completely, to remove the incentive to sell eggs from a point of financial need. 

Quite simply, claims of altruism and inflationary pressures are nonsense. There is, according to the fertility sector, a “shortage” of eggs and sperm. A market failure if you will. Demand outstrips supply. So, rather than sensibly concluding that most of us humans don’t want our own genetic offspring raised by total strangers, and explaining to those who want eggs that they may well just have to go without, the HFEA has decided to step in and encourage more women to come forward, for money; prioritising the wants of childless older adults, over the rights of young women, as they do so. Intervening in the market, to boost supply. Of human eggs. 

Egg “donation” has become increasingly normalised. In 2002 the HFEA recorded just 10 new egg donors, in 2022 there were 1650 in the UK. Adverts targeting women for their eggs, (adverts which many believe shouldn’t be legal), are everywhere. Adverts proliferate on social media, and are even being seen on posters at universities, and in shopping centres. If you are a young woman aged between 18 – 35 you will almost certainly have received an advert popping up on your phone encouraging you to become an egg donor, and do something “amazing, beautiful” or “miraculous”, complete with the statement “get paid £750”, or indeed £985 as the sum now stands. Women as young as 18 have become egg donors, and other donors report being contacted on Instagram by couples who want their eggs. 

Because of the age group targeted for egg donation, many older women and men will simply have no idea that this is happening. And yet it is precisely this latter group who are benefiting. Because egg “donation” reveals a huge power imbalance: younger, poorer women, often single, and who haven’t had their own children, having their bodies mined for the benefit of older, wealthier couples or individuals who may be in their forties or fifties, and who “need” (for which read, want) eggs; either because they are males who don’t have any (for obvious reasons), or because the woman in the couple (or she may be single) doesn’t have appropriate eggs of her own with which to create human embryos. The language of the public debate is constantly skewed towards those who want donor eggs, and who are desperate to have children: very little appears to focus on the 18 year old women whose bodies are effectively being strip mined for the benefit of people old enough to be their parents; to say nothing of the donor conceived child, and their right to know their own genetic families.

A woman’s egg reserve, and quality, declines with age. A woman is born with around two million eggs, indeed, all the eggs she will ever have: she does not make new ones. Eggs start to develop in the growing female foetus at around 8 weeks old, so a baby, or at least a significant part of the genetic origins of the baby, has been carried in the womb of their grandmother. In their early twenties women will still have hundreds of thousands of eggs. Enter the big fertility industry, with their offers of “get your own fertility health checked” while “doing something amazing” for another family. After all, at that age, your eggs are just going to waste aren’t they? Why not spare a few and make a few thousand pounds into the bargain? Handy in a cost of living crisis, or if you have huge student debts to pay off. Never mind that those eggs will, if fertilisation results in a live birth, lead to a donor conceived child, who will have thoughts and views of their own regarding what it is like to grow up without half of their medical history and family connections. 

For those of you who may never have given thought to how you harvest a clutch of eggs, and remove them from a woman’s body, allow me to enlighten you. For the process is not simple, painless, uncomplicated or in any way equivalent to sperm donation. Nor is it without long term health risks or dangers. I have seen images of repeat egg donors electing to have their fallopian tubes removed, to reduce cancer risk, and I have been inundated in recent months with testimonies from women who nearly died after egg retrieval, reporting complications such as ovarian hyperstimulation syndrome (OHSS) which can start to develop while the ovaries are sent in to overdrive, manifesting itself at collection.

Usually, the ovary will release one egg per month during ovulation. Other eggs which had begun to mature at the same time will die away, to be reabsorbed into her body. The ovary is naturally designed to release one; whereas egg donors often report donation rounds yielding dozens, often more, at a time. Egg harvesting deliberately attempts to yield a high number at once, as these can be sold on by private fertility clinics, and more eggs mean a higher rate of ‘quality’ embryos from which to choose. A woman in the UK may undertake ten cycles of donation, which, as any reader who has undergone this process will tell you, is a dangerous ask — bordering on medical malpractice. Donated eggs may be used in the creation of more than one family. The process sees a young woman put through the early stages of IVF; she must inject hormones (known as down regulation) which “switch off” the pituitary gland to stop the ovaries working temporarily and allows her cycle to be controlled by the clinic. In cases of fresh egg donation, her cycle is synched with the recipient’s. 

The woman then takes follicle stimulating hormones (FSH) to overstimulate the ovaries into producing an artificially high number of eggs at the same time. She later injects human chorionic gonadotropin (hCG) which helps eggs to mature, ready for retrieval. This maturation mimics the natural process which normally triggers ovulation. This step is essential for egg retrieval from the ovary.

On the day of collection, the woman is sedated or put under general anaesthetic; eggs are collected using a very long needle inside a speculum that’s passed through the vaginal wall and punctures each ovary repeatedly, gathering fluid from each follicle (the fluid contains the eggs). 

Some might consider this to be a form of gynaecological violence against women

And this is where OHSS can cause problems. The ovaries swell up to several times their usual size prior to retrieval. If fluid leaks out of the swollen ovaries during collection, it can spread around the body; blood clots can develop, which can be fatal. There’s no way to stop this once it starts. Two women in the UK died as a result in 2005/6. Complications experienced by women who contacted me include suffering from bowel perforations, sepsis, cysts and passing out from the pain of the procedure, with some even being held down by nurses to hold the ovaries in the right position during collection. To say nothing of the brain fog, depression, extreme moods and debilitating mental health problems which can descend during the initial weeks of hormone injections. 

Some might consider this to be a form of gynaecological violence against women; forcing the ovaries to do something unnatural, all for the benefit of others. It is one thing putting women through this to enable them to use their own eggs in IVF (and that is not to dismiss these shocking harms and risks which affect those women also), but quite another to ask young women to do this for the benefit of strangers. Younger women are at greater risk of OHSS; the very group targeted by egg donor adverts. 53 women developed severe or critical cases of OHSS last year, according to the HFEA, and an estimated 30% of women undergoing egg harvesting develop symptoms. 

But, I hear you say, surely the Department for Health and Social Care have seen or commissioned long term studies which prove egg harvesting is safe, and that long term risks are minimal? Not so, as they have previously confirmed to me. And the Scottish Government, which targets women and men as young as 18 in publicly funded adverts for their eggs and sperm, surely they undertook similar studies before launching their egg donor adverts in 2021? Again, they did not.

Adverts asking women to donate their eggs don’t even have to list health risks. Another question I asked of the Department for Health and Social Care, who, after some deliberation, got back to me to say they could find no trace of requirements to advertise risks in the Human Fertilisation and Embryology Act 1990. Nor do they apparently have any intention to mandate them; rather odd, when you consider if you advertise a financial services product or any manner of procedure you’re obliged to list risks and consequences in small print. Many people think payments for gametes, and adverts seeking donors, should be banned completely; I happen to be one of them. If adverts are to be allowed to continue, surely it’s not too much to ask that health risks are listed upfront. The minimum age for donation, 18, is low. One private fertility clinic in Scotland doesn’t accept donated gametes from under 21s. Is our society genuinely comfortable with 18 year olds being subjected to this? Has our Government considered their duty of care to young gamete donors? I don’t think so. 

So, in the absence of meaningful Government care and oversight, we now have yet another message for our daughters: don’t donate your eggs. 

The issue of gamete donation, whether for money or not, has crept up on us all quietly, and is targeting a new generation on social media. A generation groomed to “be kind,” above all other values. Those of us who take an interest in women’s and children’s rights owe it to these young women to ask questions, hold the government to account, and ask bodies such as the HFEA just whose interests they are pursuing. 

This is all sounding morbidly familiar. NHS clinics and organisations captured by group think pursuing untested harms against young people. We have been here before, quite recently. The only question is; how long will it take for Government to act this time? And how long have we got before the scandal breaks? For break, it surely will.