Inducements are commonly provided for competent adult research subjects and some argue that oocyte donation should be treated in a similar fashion and that it is inappropriately paternalistic to prohibit competent women from making an informed choice. Others believe that the reproductive context makes this special and that payment should be prohibited. Underlying those principled concerns is a more pragmatic debate about whether (and how much) payment is needed to ensure a sufficient supply of oocytes for stem cell research.

This recommendation is based, in part, on the recognition that payments to oocyte donors raise concerns that might undermine public confidence in the responsible management of hES cell research. Following the recommendation will ensure consistency between procurement practices here and in other countries that have major hES cell research programs, thus facilitating international collaborations and the sharing of hES cell lines across national borders. It also ensures consistency with the limitations enacted in California in Proposition 71, facilitating collaboration between California investigators and those in the rest of the country.

The committee recognizes the strengths of all the arguments surrounding this issue. The recommendation should not be interpreted as a commentary on commercial IVF practices, but as a narrow policy position specifically with respect to hES cell research. Further, as with all the policies recommended by the committee, this policy should be regularly reviewed and reconsidered as the field matures and the experiences under other policies can be evaluated.

Finally, it is important to note that oocyte donation is not without risks. Oocyte donors undergoing ovulation induction have a small risk of severe ovarian hyperstimulation syndrome (OHSS). OHSS may affect 2-5 percent of women undergoing stimulation and can sometimes require hospital admission (Orvieto, 2005; ASRM, 2004a; Endo et al., 2002). Careful monitoring and adjustment of the medication regimen during the stimulation treatment can reduce the risk of OHSS. Risks posed by donation must be clearly articulated and understood by the prospective donor. In the United States—where insurance coverage varies and often does not cover research-related costs—the donor must be informed of whether and how much compensation is available if she is injured as a result of research. In general, compensation is not assured.