Altruism is important, but financial compensation a convincing reason for egg donation in some countries

Egg donation is now one of the major reasons why couples travel abroad for fertility treatment. Because this growing trend may circumvent regulations at home or raise concerns about financial inducement, it has also become one of the most controversial. Yet little is known about the women who provide the donor eggs in overseas clinics - their characteristics, their motivation and their compensation.

A study performed by ESHRE, which surveyed (by questionnaire) 1423 egg donors at 60 clinics in 11 European countries, has now found that the majority of donors are keen to help infertile couples for altruistic reasons, but a large proportion also expect a personal benefit, usually financial.(1,2)

The study was performed during 2011 and 2012 by ESHRE's Task Force on Cross-border Reproductive Care and European IVF Monitoring Consortium, with the results presented today by the chairman of the Task Force, Professor Guido Pennings of the Bioethics Institute Ghent, Belgium. The donor's age proved an important factor in her motivation to donate. While the overall average age of the donors in this study was relatively young (27.4 years, ranging from 25.6 in Spain to 31 years in France), there was a significant effect of age on altruistic motives: 46% of the donors under 25 noted altruism alone as their motive compared to 79% of those over 35; 12% of those under 25 were purely financially motivated compared to 1% of those older than 35. The younger you are, apparently, the more is money a motivation.

Among the donor groups identified in the study population were:

• Students (18% in Spain, 16% Finland, 13% Czech Republic)
• Unemployed (24% in Spain, 22% Ukraine, 17% Greece)
• Fully employed (75% in Belgium, 70% Poland, 28% Spain)
• Single women (50%+ in Spain and Portugal, 30% Greece)

Other findings showed that around one-third of all study donors had a university degree, and around one half all donors had a child of their own. Why do donors go through a demanding IVF treatment cycle to donate eggs? The study firstly found that, while altruism was the principal motive overall, the majority of donors did receive financial compensation. "The fact that a person receives compensation or money does not mean that she is motivated by that money," said Professor Pennings. However, the study made it clear that financial compensation is still an important motivation for many donors, especially in certain countries. For example, 40% of donors in Greece said their motivation was purely financial, and the dominant incentive in Russia and Ukraine was financial.

How much do donors get? The amounts varied greatly throughout Europe - from zero in France to 2000 euro in Belgium, with most countries noting sums between 500 and 1000 euro.

These sums were recalculated as purchasing power in individual countries - for example, multiplied by four in Ukraine or two in Russia to assess their real value. "In these countries egg donation may be very attractive to unemployed or poor women," said Professor Pennings.

For its final analysis, the study divided the motives for donation into five groups: pure altruism (helping infertile people, a family member or a friend), altruism and financial in combination, purely financial, altruism and for one's own treatment (as in egg sharing), and purely for one's own treatment. For all donors, results showed that:

• 46% were motivated by pure altruism
• 32% by altruism and financial combined
• 10% were purely financial
• 5% motivated by altruism and own treatment
• and 2% by treatment alone

In addition, high levels of pure altruism were found in Belgium (86%), Finland (89%) and France (100%), and high levels of purely financial motivation in Greece (39%), Russia (47%) and Ukraine (28%). Both Poland and UK had high proportions of egg sharers. Commenting on the results, Professor Pennings said this study shows the diversity of the donor population across European countries. "This differences can be explained by different reimbursement systems and different legal rules of the donation practice in payment and anonymity," he said. "In general, most European oocyte donors are motivated by the wish to help other women, but financial compensation surely helps persuade some of them to actually do it."