Changes to UK egg donor compensation: What will be the impact?

In most parts of the UK, when someone donates their eggs or sperm at a fertility clinic, they receive financial compensation. Currently sperm donors receive £35 per clinic visit and egg donors receive £750 per cycle – rates that were last updated in 2011. At a recent meeting, the Human Fertilisation and Embryology Authority (HFEA) (the UK fertility regulator) decided to increase these levels to £45 for sperm donors and £986 for egg donors (see BioNews 1232).

Past decisions about increasing compensation rates for donors have attracted controversy; generating considerable debate in the UK. Part of the concerns expressed have been rooted in the fact that it is illegal for donors to be 'paid' directly for eggs (or sperm) – only compensation of expenses is permitted – and worries that overly high levels of compensation may act as an inducement to donors who would not otherwise offer their eggs. Debates have often focused on egg donation (rather than sperm donation) because it is more medically invasive: egg donors have to take powerful drugs to stimulate egg production and then undergo a medical procedure to extract the eggs, usually under sedation.

The recent changes in regulation have come about in response to calls for donor compensation rates to be increased in line with inflation, which in recent years has been considerable. In real terms, the compensation rates given to donors have gone down as the cost of living has increased, leading the HFEA to its current decision. But what does this change mean for donors and how might this affect their experience? Will an increase in the amount given to donors encourage more people to volunteer for donation? Especially when the cost-of-living crisis continues in the UK? Should we be worried about this?

For the past few years, we have been researching egg donation in the UK (as well as in other European countries) and have spoken to egg donors about their views on financial compensation. Our research shows that while egg donors often do describe the money being an advantage, this is usually because it is seen as necessary to cover their donation expenses. Egg donors told us that in some cases, they would not have been able to travel to the clinic to donate if their expenses had not been covered, especially if they donated to a clinic in another city, or if, for example they needed to cover childcare costs (donors must attend regular clinic appointments throughout the donation cycle). However other donors told us that they would still have donated if they had not been offered compensation or reimbursement of expenses, even though this might have left them considerably out of pocket.

Often donors found that, in reality, the £750 compensation was used in part to cover expenses associated with the donation cycle (e.g. travel, hotels, childcare), but they were also left some surplus which could be used for other things. Sometimes it was used for something one off or special – eg a holiday, Christmas presents or a second-hand car, but more commonly it was seen as being a 'help' towards the general household finances, especially for those who had children. So, while they might have not have donated in order to get this money – it was nevertheless valued. For donors who lived closer to the clinic where they donated, they could potentially benefit from not needing to use the money for travel costs.

Whether or not money might factor in the decision to donate is therefore complicated. Whatever rate is offered, financial compensation offered to egg donors will mean different things to different people who will view and use the money accordingly. For some potential donors £986 will seem like a considerable amount of money (especially in the current economic climate), while for others, this will not be the case. This is of course difficult to legislate for. What was clear from the interviews we carried out is that egg donation is not seen as something to be taken lightly, and people felt that the money (at current UK levels) is not enough on its own to encourage people to donate.

What is not part of the proposed regulatory change is the scope or status of egg sharing – that is the option for someone to donate their eggs in exchange for fertility treatment for themselves – either as reduced cost or free IVF or in exchange for freezing their own eggs. Donors in our study who had donated in exchange for free or reduced-price fertility treatment told us that this was an important part of the reason they donated and this therefore represents a potential on-going difference between the motivations and experiences of egg sharers and non-egg sharers. There is also often little debate or scrutiny about the profits made by clinics who provide IVF egg donation.

In light of our research, we welcome the HFEA's decision to improve and update compensation levels in the UK and to ensure that donors are not out of pocket when they donate. It will be interesting to see if other European countries make changes to their compensation levels in coming years as a response either to ongoing global financial pressures or in light of the UK's move.

Professor Nicky Hudson is one of the guests who discusses egg donation in the latest episode of the Progress Educational Trust podcast.

Donor conception will be explored at the next free-to-attend online event from PET – 10 Families and Counting: Time for Global Limits on Donor-Created (Half-) Siblings? – taking place online next week, on Wednesday 22 May 2024. Register here.