The final uncoupling of sex from reproduction and the further development of assisted reproductive technologies since the 1980s has raised new concerns, as well as revisiting old ones, about making money out of people’s infertility.
The debates that deal with these matters are important, particularly claims about the commodification and wrongful use of persons, and have only been heightened by the impacts of COVID-19.
The commercialisation of gamete (egg and sperm) donation and surrogate pregnancy is prohibited under New Zealand law—specifically, the HART Act 2004—which means both debate over payment and the likelihood of invalid consents on the part of egg and sperm donors and surrogates are reduced.
Despite these protections, New Zealanders seeking fertility treatment identify a number of barriers restricting their access to services. Aside from the shortage of gametes and surrogates, one of the key constraints is economic (e.g. a single IVF cycle can cost an average of $11,500–$17,000). Cheaper fertility treatment and availability of donors in other countries means people who can afford it are travelling to destinations around the world to circumvent regulations at home. They are paying for surrogacy and gamete donation, which is allowed in a few jurisdictions (e.g. Russia, Ukraine, Georgia, Spain, Greece and some US states).
In New Zealand, affordability not only determines prospective parents’ ability to pay for services—it can also have an impact on the willingness of potential donors and surrogates to come forward and offer their services. That is because donors and surrogates are required to pay indirect costs such as loss of income, childcare and travel time for the privilege of being altruistic. In 2016, Fertility Associates, New Zealand’s largest fertility clinic, began offering egg donors $1650–$1690 and sperm donors $70 for each visit to the clinic to cover these costs. It was not Fertility Associates’ intention to offer financial inducement; in fact, by all accounts, egg and sperm donors are still in short supply.
Since I began sociological research on assisted reproduction 10 to 15 years ago, it has become increasingly apparent more and more people in New Zealand support the idea of compensating and/or paying gamete donors and surrogates.
The critics remain steadfast. One participant in my interview study with fertility industry professionals and ethicists said of surrogacy: “The minute you are paying someone to have a baby for you … it inevitably invokes even stronger expectations of return and promotes a logic of it’s yours. The minute she conceives, it is yours and she has no right to keep it because you are paying her to have it for you.”
Most of the participants in this study expressed support for compensation. The following remark is typical: “I do think there’s space for a kind of regulated compensation system, where the labour of the donors is recognised. So, with women donating eggs, for instance, that is a fairly major toll on one’s body, and to expect women to do that out of altruism, I think is misguided, and is a way of obfuscating the effects on women’s bodies, and mining bodies as a resource basically.”
Agreement for reimbursing gamete donors for their costs is likewise corroborated by a recent questionnaire survey with 434 respondents across New Zealand and Australia.
The matter of compensating local donors and surrogates is conceivably more pressing in the context of the coronavirus pandemic. We are no longer living in a global environment of fast reproductive capitalism: surrogates, donors, intended parents, eggs, sperm, embryos, doctors, medics, nurses, laboratory instruments and even babies literally cannot move or travel across national borders. Cost aside, importing from overseas jurisdictions reproductive materials such as frozen sperm or eggs, travelling overseas to enlist egg donors’ services or procure cheaper fertility treatment, or flying a New Zealand surrogate to the US or Canada for IVF, is no longer doable.
COVID-19 has entrained new logistics of reproductive politics. It will force New Zealand to confront the shortcomings of its legislative framework and the ethical issues this entails.
Labour MP Tamati Coffey’s Improving Arrangements for Surrogacy Bill is therefore timely.
Coffey’s Bill proposes numerous legislative changes, including affording legal parental status to the intended parents rather than surrogates and their partners once a baby is born, the creation of a register to make it easier to find New Zealand surrogates and donors, amendments to who can be named on the birth certificate, and the option for intended parents to be able to contribute to a surrogate’s living expenses when they cannot work.
While Coffey’s Bill serendipitously addresses the impact of COVID-19 on assisted reproduction and fertility travel, it also comes with its own set of challenges around compensation and what donor-conceived people might think about this.
If COVID-19 has impacted your access to fertility treatment and you would like to tell your story, please contact rhonda.shaw@vuw.ac.nz.
Associate Professor Rhonda Shaw is a sociologist in the School of Social and Cultural Studies at Te Herenga Waka—Victoria University of Wellington.
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