Introduction
A few years ago the thought of selling your gametes (eggs) was frowned upon. Now the transfer of gametes between women is becoming more common. Will, and should, selling your gametes to support yourself be accepted by law and by society in South Africa?
How it works
Donating gametes to women who cannot bear offspring of their own can be seen as an altruistic act. However, the issues are on what terms and at what cost?
Tamuuz is amongst 4 agencies that arrange egg donation abroad from South African women. The other three are Global Egg Donors, Fertility Care SA and New Life. These agencies recruit women in South Africa for donation in countries such as India and Thailand.
The donors are offered an all expenses paid trip to Mumbai. They are then given hormones, usually HCG (human chorionic gonadotropin). This is a hormone which stimulates a yield of a large production of gametes. This is followed by oral contraception and self-administered injections twice a day for two weeks. The donors are subjected to repeated trans-vaginal scans and blood tests which includes screening for HIV. Smoking, drinking and sex are forbidden whilst the donors are subject to such treatments
The gametes are retrieved on designated pick-up days, where a triggering agent will be administered to the donor and under general anaesthesia. A needle is then inserted through the vaginal wall and into the abdominal cavity to retrieve the gametes. The donor then usually spends a day in hospital.
Risks to donors
The hormones that the donors are given may cause hot flushes and menopausal symptoms initially. Bloating and mood swings may occur in the donors. Gamete hyperstimulation syndrome affects about 1% of the donors and usually occurs within two weeks of the treatment. However the bigger risk to donors occurs after the gametes are retrieved from the ovaries, when fluid may collect on the abdominal cavity and in severe cases around the heart and lungs. Ovaries may swell and are at risk of losing their blood supply. This requires urgent surgery and could result in the donor losing their ovaries. Ovarian hyperstimulation syndrome symptom (OHSS) can be fatal as there is no specific treatment for it. It can result in the donor dying of renal failure.
International law on gamete donation
In USA there is a lack of regulation when it comes to reproductive technology. Since federal funding is not involved, this regulation is a state responsibility.
Other countries have much more effective mechanisms or legislation that deal with egg donation. The UK has effective policies under the Human Fertilisation and Embryology Act of 1990 which limits a donor being compensated for gametes (which includes embyros). The donors may receive reimbursement for expenses up to 15 pounds (about R 269) in payment. There is also a regulatory body called the Human Fertilization and Embryology Authority (HFEA) which discourages clinics to use donors who they suspect have been paid and promotes altruistic donations.
UK is similar to SA in that SA also limits the compensation for donation. It allows for reasonable compensation and limits the donor to 6 gametes being allowed to be given up for donation. However, unlike the UK, SA does not define what reasonable expenses are.
In Israel, Denmark and Canada policies discourage the use of donors who have been paid for their gametes. They also have regulatory bodies which oversee the developments of reproductive technology.
In Australia, Spain and Greece there is a promotion of gamete sharing through ovarian hyperstimulation.
Where donors are taken from America and flown to India they can expect cash payment of $6 000 (about R 69 800) to $10 000 (about R116 400) for their gametes. South African donors are paid less. The recipients pay according to the country of origin of the donor and can pay anything from $99 200 (about R1 150 000) to $134,300 (about R1 560 000).
South African legislation
Under South Africa’s National Health Act, (NHA), Regulation no. 35099 of 2nd March 2012, regulation no. 6, states that a person shall not remove or withdraw a gamete or embryo from a donor if that person has information or suspects that a maximum of six gametes or embryos have already been removed.
Regulation 4 under this regulation states that a person from whose body a gamete has been removed or withdrawn may be reimbursed for any reasonable expenses incurred by them in order to donate such gamete as contemplated in section 60(4)(a) of the NHA.
However, foreign agencies which use South African women as donors pay these women. Since our Act does not define what reasonable expenses are, this leaves a loop hole in what can be received in exchange for donating your gametes.
Currently our regulations are not definite enough and they do not regulate what can be done abroad regarding such donations. One wonders today, what can we not sell? We look now at our bodies not as things that need to be treasured and guarded but as property that can be sold off in parts to the highest bidder. Doesn’t this reinforce the exploitation of women, particularly poor women, to sell their gametes to the highest bidder at the expense of health risks?
Altruistic donation should be allowed within the defined parameters. Then the body will not be viewed as a mere commodity.
Conclusion
There are agencies encouraging women to exploit their bodies. Some women are willing collaborators, with the poor being most vulnerable. There is a need to get better legislation in place not only in South Africa but internationally.
Arvitha Doodnath - Researcher
arvitha@hsf.org.za
NOTES
1. The brave new world of the egg trade, Martinique Stilwell, 17 May 2013 accessible on: http://m.mg.co.za/article/2013-05-17-00-the-brave-new-world-of-the-international-egg-trade
2. What Policies Govern Egg Donation? Accessible on: https://www.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/eggpol.htm.
3. National Health Act 61 of 2003.
4. GG R35099 of 2 March 2012.
5. http://www.tammuz.com/eng/
