'We would like to see the £250 cap on egg and sperm donor expenses removed to ensure that lost earnings are reimbursed in full. People who are willing to donate for other people's treatment should not be left out of pocket', said Professor Dame Marilyn Strathern, who chaired the Nuffield Council on Bioethics' working party which produced the report.
The report considered the ethical issues of egg and sperm donation amid a shortage in the supply of donor eggs and sperm and long waiting lists for IVF. It also suggests that payment over and above expenses could be offered to women who are prepared to donate eggs for research in return for the discomfort and inconvenience they experience and recommends a pilot scheme be set up to explore the issue.
'Donating eggs for research purposes is different from donating to help someone else's treatment. You're not usually trying to help a particular individual - you are more a participant in a research exercise', said Professor Strathern. 'We think it would be ethically justified to offer payment to women who are willing to give their time and undergo uncomfortable procedures in order to donate eggs for research'.
Egg donors face health risks including ovarian hyperstimulation syndrome, infections, and bleeding. The report the states there is a 'lack of good quality data on the long-term risks of repeat egg donation' and further empirical research is necessary. It also recommends no changes to the current policy of egg sharing for women who are not able to access NHS fertility services, but cautions it is 'not appropriate' to use the policy as a basis for approving financial incentives for egg donation.
The Council rejected the idea of paying a 'purchase' price for the gamete itself - other than recompense for lost earnings and discomfort - and called for a national register of gamete donors to be established, endorsing the good practice guidance issued by the European Society of Human Reproduction and Embryology on the treatment of egg donors in the context of cross border reproductive care. It also recommended that the World Health Organisation should develop 'appropriate guiding principles to protect egg donors from abuse or exploitation'.
The Human Fertilisation and Embryology Authority (HFEA) is due to make a set of decisions concerning compensation or benefit in kind to donors later this month, following its recent consultation and review of gamete donation policies in the UK. The payment of donors in the UK is currently prohibited by the HFEA, but donors can claim 'reasonable expenses' for loss of earnings up to a maximum of £250 per course of sperm donation or cycle of egg donation.Commenting on the issue of gamete donation, Sarah Norcross - director of the charity that publishes BioNews, the Progress Educational Trust (PET) - said: 'Compensation for loss of earnings needs to be variable in order to reflect the fact that loss of earnings themselves vary depending upon the different circumstances in which people find themselves'.
Among its other recommendations, the Council's report suggests the NHS should pay for the funerals of organ donors to help address the current shortage of organs. It says this would be an ethical way of encouraging people to sign the Organ Donor Register.
The report, entitled 'Human Bodies: Donation for Medicine and Research', is a product of an 18-month inquiry led by a working party which included experts in medicine, ethics and law. The report concludes that the principle of altruism should continue to be central to approach all types of donation but says this does not preclude the possibility of permitting some form of payment in certain circumstances.