"Young Women's Bodies Are Not Resources To Be Mined": MPs Back Changes To Egg Donation Rules
There are fears that women – particularly students and others of low income – are being financially incentivised to donate their eggs amid a cost of living crisis (Illustrations by Tracy Worrall)
13 min read
The use of egg donations is increasing, giving people struggling with fertility a chance to start a family. But are young donors attracted to the compensation payments? Are they fully aware of the risks? And what are the ethical implications? Sienna Rodgers talks to the MPs demanding reform
Be a hero. Join the sisterhood. Do something amazing.
These are the cheerful messages emblazed on adverts by UK fertility clinics promoting egg donation to young women at bus stops and online. One in six couples in Britain is affected by infertility problems, these notices often go on to explain, and by donating your eggs you could help a family fulfil their dream, either via IVF or surrogacy.
As people wait longer to have children, demand for donor eggs is increasing. Live births using donor eggs in the UK shot up from 37 in 1991 to over 1,300 in 2019. In 2019, over 4,400 egg donation IVF cycles were completed, compared to just 160 in 1991.
But some MPs are now raising the alarm about the rules for egg retrievals in England and Wales, where donors can be paid a fixed sum of £985 in compensation per cycle, and women can undergo 10 donation rounds. The legislators are concerned about the advertising, compensation offered, and health risks involved – particularly because donors can be as young as 18.
Donations from under-25s have more than doubled in two decades, from 1,100 in 2001-10 to 2,803 in 2011-20, figures from the Human Fertilisation and Embryology Authority (HFEA) regulator show. These include 829 women aged 18 to 20 who donated between 2000 and 2022.
The House can also reveal that in England, between 2011 and 2020, there were 4,147 donors living in the three most deprived ‘multiple deprivation’ deciles – more than the 3,007 from the three least deprived deciles, according to HFEA data. The highest number of donors – 1,542 – were found to be from the third most-deprived group, ‘decile 3’, with donor totals in each decile declining thereafter, reaching 860 individuals by ‘decile 10’, the least deprived.
The numbers speak to fears that women – particularly students and others of low income – are being financially incentivised to donate their eggs amid a cost of living crisis.
Asked for comment, the HFEA pointed to its findings that the average age of donors is 31 to 32 years old. On concern over its data on multiple deprivation deciles, the regulator did not respond directly but pointed to its 2022 report, which found that egg donors lived in “comparable” socio-economic areas to the general population.
Although the compensation extended to donors is designed to cover their expenses only, it is typically paid directly to the donor’s bank account in a lump sum without any need for itemised receipts. The payment is capped at £985, increased from £750 by the HFEA last year to reflect inflation.
This sum can be prominently displayed on adverts, yet there is no legal requirement to state upfront the health risks of the surgical procedure involved. While the HFEA says egg retrieval is “generally very safe”, it is possible in rare cases for the collection to lead to sepsis, bowel perforations, abscesses and ovarian hyperstimulation syndrome (OHSS), as well as long-term damage to reproductive organs.
OHSS – when ovaries overreact to hormonal stimulation – can present as anything from mild bloating to vomiting and blood clots; younger donors are at higher risk but are more desirable as they produce a higher number of eggs. It can be fatal: in England two women died of complications arising from OHSS in 2005-06.
The HFEA stresses that in 2023-24, there were 53 cases of severe and critical OHSS reported by UK clinics, representing less than 0.1 per cent of cycles.
“A lot of women seem to be choosing to do this at a very young age, when they’re most vulnerable to the payment side of things. If you’re an 18-year-old, a brand can sell it as ‘just be a fertile woman’, and they may not be fully thinking through the consequences of there being children born from that,” says Labour MP Jonathan Hinder. (Notably, in the UK, those who are donor-conceived now have the right to learn the identity of their anonymous donors when they turn 18.)
“These are private companies making money out of this incredibly invasive process, and they’re doing adverts – just like any other profit-making company would – with lovely, smiley people looking like they’re very happy about donating their eggs. I just think it’s totally wrong. This should not be a profit-making enterprise – it’s unethical.”
“It’s a large amount of money in these hard times,” Labour MP Mary Glindon says of the £985 compensation. “In my constituency, that’s a heck of a lot of money if you’ve got nothing. People don’t understand what having nothing means.”
“It would seem these clinics are driven by profit. There’s big money to be made here,” she adds, contrasting the £985 received by the donor to the thousands of pounds paid by the would-be parents buying eggs. The London Egg Bank, which has over a dozen locations across the UK, sells six frozen eggs for £5,500. Another clinic supplies a cycle of IVF with eight frozen donor eggs for £11,000.
Illustration by Tracy Worrall
Conservative MP Rebecca Paul says: “I am concerned about the proliferation of adverts targeting young women to donate their eggs. For a young woman, it might sound like an easy way to help pay the rent when times are tough, but in reality, it’s a gruelling medical process that could harm their health and cause distress in the future when the reality of their genetic offspring being unknown to them hits home.”
She adds: “Any woman who does this should be doing it for truly altruistic reasons, not because they are in a desperate financial situation or being coerced. Like in the case of surrogacy, these adverts should be banned to protect the most vulnerable. And the amounts paid should be the bare minimum to cover actual expenses.”
In a Westminster Hall debate secured by Jim Shannon in June, the first time egg donation has been debated in Parliament, the DUP health spokesperson described the process required for egg retrieval.
First, the donor must be taking oral contraceptives. Hormones are injected to ‘switch off’ the pituitary gland, and the ovaries stop working temporarily. (For fresh egg donations, the cycles of the donor and recipient are then synched; this is not needed for frozen eggs.) Follicle-stimulating hormones then overstimulate the ovaries so that they produce a high number of eggs at the same time, and hCG (human chorionic gonadotropin) is injected to mature the eggs. The woman is put under anaesthesia for the ‘egg scraping’, where a needle is inserted to collect eggs from the ovary.
“It was making me feel ill, listening to the description of what donors go through,” recalls Glindon. “The advertising should carry greater description of the risks or highlight them more than the way it does now.”
“The whole thing needs tightening up, to be honest,” she adds. “We’re banning adverts for vapes as an alternative to smoking!”
Campaigners such as Surrogacy Concern, which also opposes any liberalisation of UK surrogacy laws, would like to see the minimum age of egg donors raised to 25, adverts banned, and all payments to donors ended. Hinder, a member of the socially conservative Blue Labour group of MPs, backs these demands.
He also flags the lack of research into the health impact of egg retrieval. “The health implications need to be looked into in more detail,” the Labour MP says. “I’m not sure how we got to the situation where it’s so accepted when there are these health concerns which haven’t really been explored in terms of the implications for the women’s bodies.”
“Young women’s bodies are not resources to be mined so that older, wealthier people can buy donor eggs for use in surrogacy or their own IVF. We have been inundated with reports from women who have been seriously hurt while undergoing egg retrieval. We need an urgent review by the government of this issue before another public health scandal develops,” says Helen Gibson, founder of Surrogacy Concern.
Gibson is concerned that the UK government has never undertaken, seen or commissioned any long-term study into the effects of egg retrieval on women’s bodies. She highlights that clinics do not undertake long-term follow-up checks on donors and do not hold data on long-term health outcomes.
The Scottish government has not seen such evidence either, yet it advertised for donors itself from 2021 to 2024, at a cost of over £186,000. While there is no compensation available to donors in Scotland, there are nonetheless concerns over donor awareness of health risks. Among the government adverts were videos of illustrated egg and sperm joining together to spell out “joy”, “love” and “hope”, but no risks were mentioned. Four NHS trusts in Scotland continue to advertise for donors.
“Some of the language is a bit disingenuous, so it doesn’t underline the health problems that may occur through egg donation,” says Scottish Labour MP Tracy Gilbert.
“Obviously, it’s targeting the younger women, and it can cause problems going forward for them.
“But it doesn’t say that upfront on the adverts – it just sounds like it’s altruistic, and it’s a nice thing for people to do without looking at the health risks. The advert says you’ll get some fertility knowledge and find out if you’ve got any genetic issues, so it hooks people in the wrong way.”
“It seems like easy money for people, and if they don’t understand the health risk and if people are in poverty, then it seems like a quick way of making money without any risk,” she adds, urging the Scottish NHS trusts to “be clear about what it is they’re asking people to do”.
“I think putting some money into research and what has happened to people, so that people actually know what the risks are, would be a wise thing to do,” Gilbert says.
Paul, the Conservative MP, agrees, saying the government “needs to conduct a proper study on the long-term health impact of such procedures on women – particularly in the case of women going through multiple rounds”.
“Egg donation is yet another way that women’s bodies are being commoditised. We are increasingly seen as either a source of sexual pleasure or baby-making machines to be bought and sold,” she adds.
Hinder shares his Tory colleague’s concerns about the wider ethics, saying: “The focus is always the middle-class parents who are chasing their dream, and how we need to let them realise their dreams. Of course, their perspective matters, but the framing is always about would-be parents, not the women who are donating their eggs or the child themselves and what their welfare needs might be.”
Illustration by Tracy Worrall
More unsettling still for these critics is the ability of egg buyers to screen for specific donor characteristics. The London Egg Bank, for example, offers the chance to scroll through an online catalogue that shows eye colour, hair colour, skin tone, height, education and ethnic origin alongside a description such as: “A confident donor with an oval face, almond shaped eyes, a button nose, long curled lashes and full lips.”
“It’s making children commodities,” remarks Glindon. “We’re into dystopian, designer baby stuff here,” says Hinder.
The House has found that the same egg bank provides an “AI matching service”. For £250, buyers can employ a “Fenomatch” tool that “uses facial recognition technology to help identify egg donors who resemble you”: “It analyses facial features from your photo and compares them to our donor database to support you in finding a donor with similar appearance,” the London Egg Bank explains.
Approached for comment, the London Egg Bank pointed to a report by its senior egg donation consultant, Dr Valentina Mauro, who wrote that donor catalogues “empower recipients to choose donors based on family needs and personal values”, noting that “most clinics offer dedicated donor coordinators” who “ensure a supportive and respectful matching process”.
Dr Mauro also argued that treatment costs reflect the “full complexity” of donor egg cycles, including “intensive screening” and more; and that donor welfare is central, with counselling offered as routine, which becomes mandatory “if a donor has complex medical, emotional or social history”. She defended the £985 compensation, writing: “The current system ensures that donors are not financially incentivised, but also not penalised for their generosity.”
Although MPs have raised concerns, the government says it has no plans to make an assessment on banning advertisement for egg donors, nor to raise the minimum age. The Department of Health acknowledges that it has not undertaken an impact assessment of the increase in compensation, but reasons that “academic research” has “consistently found that donating eggs and sperm is driven by altruism”.
In response to MPs’ questions about the lack of evidence base, in the recent parliamentary debate, health minister Karin Smyth said women’s health “is generally an under-researched area” and the government “would welcome studies in this area”.
Glindon wonders in response: “The government isn’t very proactive on protecting the health of these women. I was a bit underwhelmed. They said they would love for trials to happen. Can they not make them happen?”
Clare Ettinghausen, director of strategy and corporate affairs at the HFEA, told The House: “As the UK’s fertility regulator, we want to ensure that people are receiving correct information in the interest of patient safety and clarity. About one in 153 of all children now born in the UK are conceived through donation of egg or sperm. Without a donor, many families wouldn’t have been able to have a much-wanted baby.
“Donating eggs and sperm is an amazing altruistic act that helps create much-longed-for families. However, donating eggs, sperm, or embryos to someone else is a serious commitment with lifelong implications, such as the fact that donors must be comfortable that any children born from their donation can find out identifiable information about their donor when they turn 18.
“There are very good reasons behind making sure that donation is an altruistic act. A financial inducement, for example, may impact the safety of patients and the future child, if it motivated donors to make claims about their health or genetic background to successfully donate. The compensation rates aim to maintain these values.
“The process of donating eggs is generally very safe, but, like any medical procedure, it carries some risk, and takes around three to four weeks to complete. Patient safety is of the utmost importance, donors will go through rigorous medical screening and clinics should do everything possible to prevent and manage OHSS, with recent figures showing severe or critical cases occur in less than 0.1 per cent of UK cycles.”
