Egg donation: Why we need a culture of altruism

The Trustees of the National Gamete Donation Trust were interested to read Dr John Parsons' article on introducing payment for altruistic egg donors. In principle we support egg sharing, but are concerned about the discrepancy between what is effectively payment in kind, and the reimbursement given to altruistic donors.

There is a difference between being a patient and being a consumer - between giving a gift and providing a service. Once you create a market for gametes, it is impossible to go back to an altruistic system. In 1998 the average donor fee for clinics on the US East coast was $2500. Due to clinic competition for donors, within four years that had increased to $7500, with 'exceptional' donors commanding many times this amount. Now it is considerably more. Introducing payment means women who might otherwise donate altruistically no longer do - and the full cost is passed on to recipients.

To those who can't afford it, is it better that eggs are out of reach because they are too expensive or because there are few donors? In a culture of altruism, at least poorer recipients still have a chance of finding a donor.

Altruistic donors may not be under pressure for treatment, but they may have different pressures. We are in the middle of a recession; single person's Job Seeker's Allowance for six months is barely £1700. It is disingenuous to suggest that women with no fertility problems would not have a financial motive to donate: the American experience clearly shows this is not true.

It's an old marketing adage that what costs money has value; what's given for free is easily taken for granted. How ironic then that we are discussing the option of paying donors when some clinics can't even afford to pay travel expenses.

The Trust supports reimbursement of full, receipted expenses and uncapped reimbursement for loss of earnings. We also promote clinic best practice in treatment of donors - prompt responses, full information, helpful staff and a friendly welcome. Improved customer care costs next to nothing, and failures in this regard show a lack of consideration and respect for donors. In this area, we also need a change of culture.

We are lucky enough to have had several high-profile donor recruitment campaigns over the last four years. This is the main reason we're the only country that has increased donor recruitment without paying donors. Yes, let's open the debate about paying altruistic donors, but let's not forget there are plenty of other things we can improve on that also make a difference.