“I saw your ad in the Cornell Daily Sun, and I’d like to become an egg donor.”
No, Andrea Gurmankin wasn’t really interested in donating her eggs though she would have been the perfect recruit—a young college female attending an Ivy League school.
What she was really interested in was the quality of risk information provided to prospective egg donors.
Gurmankin was making the calls as part of her award-winning study on egg donation programs, written under the guidance of the Center for Bioethics’ Glen McGee, Jon Merz and Arthur Caplan and born out of an undergraduate honors thesis at Cornell University. Her paper, “Risk Information Provided to Prospective Oocyte Donors,” won the 2001 Association for Politics and Life Science Graduate Student Paper Award.
Gurmankin’s telephone persona may have been a little deceptive perhaps, but given her aim, she said, she could find “no other real way to do the study.” And before any phone calls were made, she made sure she had the Institutional Review Board’s approval for studying human subjects.
Gurmankin, a graduate student in the Masters of Bioethics Program and the Psychology Department, said she found it “disconcerting” that young, financially unstable women were participating in egg donation programs with little to no knowledge of the risks involved.
In the 49 ads that she collected from college newspapers, the promise of big bucks ranged in the thousands. One program even offered a $100,000 incentive.
“Egg donation programs want two things when they place an ad,” she said. “They want exposure in numbers, and they also want prestige—or good—genes.”
Reading from a script of 13 questions, Gurmankin phoned 19 different in vitro fertilization programs. In each call, she directly asked about three risks, one relating to medications, another to egg retrieval surgery and a third about ovarian cancer.
Getting the information proved difficult. “A good number of the programs were not being upfront about the risks even when directly asked,” she said.
One call representative even wondered why she was so “hung up about the risks,” said Gurmankin.
Why all the secrecy? “There’s been speculation that because there’s been a shortage of egg donors these programs have an incentive to minimize the risks,” said Gurmankin.
Gurmankin said that while the risks could be explained further down the line, it is important that participants fully understand the dangers right away, thereby avoiding what the world of psychology calls low-balling.
When risks are minimized initially, it becomes easier to elicit a commitment, said Gurmankin.
“People tend to be unrealistically optimistic about the risks that they face. I can only imagine that that tendency would be enhanced in the face of thousands and thousands of dollars.”
To ensure informed consent, Gurmankin said a governing body must regulate the programs. Requiring that each participant receive a standardized pamphlet detailing the risks is another possibility. She also thinks requiring prospective donors to have a conversation with an external gynecologist about risks is a possible solution.
It’s a simple matter of separating the sources of information, said Gurmankin.
“It’s problematic when the very people who have a stake in the women participating are the ones who are providing the risk information,” she said.
Originally published on March 7, 2002