By Liz Ellwood (Mother through Egg Donation and Co-Founder and Director at Fertility Match Canada)
I want to respectfully respond to the article written by Dr. Caitlin Dunne of Pacific Centre for Reproductive Medicine (PCRM) out of Burnaby, British Columbia entitled “5 things you probably didn’t know about donor eggs” for Today’s Parent. I have some genuine concerns with the information provided. While we have great respect for the physicians at this fertility centre and have heard good things about Dr. Dunne, there is false information in this article, and we think it is important to breakdown the misconceptions for Intended Parent, Egg Donors and Fertility Centres. The first two points Dr. Dunne mentions in her article are particularly misleading and the information she provides to support them is not accurate.
1. You can’t pay a woman for her eggs
The prohibition is against the “purchase” of eggs from an Egg Donor. However, reimbursing a Donor’s expenses related to an Egg Donation is not illegal, and encompasses expenses beyond the “medications and travel costs” Dr. Dunne alludes to. Based on the Assisted Human Reproduction Act (AHRA) referenced in Dr. Dunne’s article, a Donor can be reimbursed for her expenses related to the egg donation.
For the past 15+ years since this Act was put in place in 2004, Canadian Egg Donation programs have been doing just that: reimbursing Egg Donors for their expenses incurred that are considered in relation to an Egg Donation. This includes items such groceries and prepared foods (research has shown eating healthy, organic foods, particularly lean protein and green leafy vegetables has a positive effect on egg health), wages for missed work due to appointments, a note taker for any classes missed, pet or child care required to attend appointments, massage therapy and acupuncture to alleviate IVF medication related symptoms as well over the counter medications and vitamins as required. The reason I say considered is because Health Canada has yet to define what these expenses are. While the government is somewhere in the process of defining the regulations, draft regulations have included the majority of the aforementioned expenses. They are most certainly not limited to “medication and travel costs”.
There is no shortage of healthy, educated and intelligent young women in Canada willing to donate their eggs to families in need, so long as they are able to have these expenses covered. Just over 8 years ago, I chose to use a Canadian Egg Donor willing to meet a child born from the donation, because I believe that this legal landscape combined with the knowledge that our Egg Donor population has access to Canada’s universal healthcare was the best option available to me. Typically, it works out to be a similar cost to the international egg bank option Dr. Dunne offers at her fertility centre. Add to this the fact that a fresh Egg Donor cycle is much more likely to lead to a viable pregnancy, as a fresh IVF cycle should result in more embryos than those created with frozen eggs, and this option just keeps looking better and better.
2. Egg Banks can ship frozen eggs to Canada
While this is true, it’s not all it’s cracked up to be (pardon the pun, I had to). Egg Banks in the United States, as well as overseas, have made hundreds of millions of dollars selling eggs to Canadians via their relationships with Canadian Fertility Centres like Dunne’s. “Cross Border Reproductive Tourism” is what we call this in the fertility industry, and is something that has been happening in droves since Egg Freezing was reclassified as “standard” and no longer “experimental” by the American Society for Reproductive Medicine (ASRM) in 2012.
So, while purchasing international eggs is an option, I believe it is imperative we address the major downfall of this that ultimately affecting the child more than anyone: the anonymity of international Egg Donors banks.The majority of these banks still trend toward anonymous egg donation exclusively, despite knowing that psychological research states that this is not in the best interest of donor conceived children.
I feel Dr. Dunne glosses over this issue in her article by saying “However, unlike sperm donation where open-identity is trending, frozen egg donation remains almost entirely anonymous”. This is a loaded issue and warrants more discussion than this one sentence. What are the psychosocial issues of this for the children and families they are creating? What do fertility doctors like Dr. Dunne plan on telling these donor conceived children at 18 years of age when they are trying to shape their identity and asking to know more about their biological origins? That this decision was made for them and this door was closed before they were even created? Who is to be held accountable for the realities of the choices being made for these children? I am raising one of these children; Trust me when I say she would be very dissatisfied if this was the answer I gave her.
Our agency, as an example, puts the children and the families first, and we strongly believe that everyone should follow stronger moral guidelines by providing these future adults the right to know their Donor if they so choose to.
Understanding that Canadians have a very viable option in Canada is critical both from financial and logistical reasons. A large proportion of clinics in Canada have been working with Canadian egg donation programs and agencies for years, yet there are still a number of fertility centres in Canada who refuse to work with these Canadian organizations, and simply tell patients it is “illegal”. This is simply incorrect, and one-sided advice. These fertility centres then offer the option to work with out-of-country, anonymous egg banks that they have pre-established relationships with or offer the patient(s) the option to bring a known Egg Donor to their fertility centre to do a donation cycle. The latter is not a realistic option for most people. Even at age 26, with lots of fertile friends, I didn’t have any jumping up and down offering their eggs to me. I would never have felt comfortable asking that of someone. Nor would I have necessarily been comfortable with using eggs from a friend.
A lot of patients often resolve to use the international egg bank option unless they think to google the topic, speak to a lawyer or a counselor, and start doing their own research. If they do, they find us, or one of the other Egg Donation programs in Canada. Then they discover the reality: aspiring parents have another option available to them; an option, that in my opinion (whether you work with our agency, or another Canada agency and select a Donor open to her identity being disclosed to a child born from the donation after he/she is 18 years of age. Because, at the end of the day, every decision we make in this field should be in the best interest of the child; and international, anonymous egg donation programs are crafted for the comfort and ease of these companies and uninformed patients; not the best interests of their future offspring.
While I applaud Dr. Dunne for trying to inform and educate the population about the option of growing their families through Egg Donation, I also encourage industry professionals to use transparency and discuss all of the options available to potential clients, even if it means these clients working with a different fertility centre who is open to offering this service. I feel very strongly that everyone in our industry should consider the best interests of the children we work so hard to create.
In 2007, when I was first looking to use a Canadian Egg Donor and Gestational Surrogate, most fertility centres would not even work with known Gestational Surrogates because of the AHRA. By 2010, two clinics in Toronto were willing. When we launched Fertility Match in 2017, agency Gestational Surrogates had become completely acceptable by almost all clinics. But almost 3 years later, we are still waiting for some of the more conservative fertility centres to open their doors to the amazing Canadian women willing to be Egg Donors. There are around 10 large sized fertility centres in Canada only offering the use of egg banks or a known Egg Donor as options for building their family with egg donation. But for the sake of the children being created, I do hope they consider option C soon. Because we already know better.