Updates: The California Legislature and the Market in Human Eggs
A fertility industry-sponsored bill that would expand the market in human eggs is barreling through the California legislature, in spite of opposition from women’s health, reproductive justice, and public interest organizations. AB 2531 would overturn a California law that lets researchers reimburse women for their expenses incurred in providing eggs, but disallows payments beyond that. The 2006 statute that AB 2531 would eviscerate was authored by former state Senator Deborah Ortiz, known for championing both women’s health and stem cell research, and approved almost unanimously by both the Assembly and Senate.
In an April blog post, Will California Expand the Market for Women’s Eggs?, we summarized the reasons for opposing AB 2531 (see also this CGS letter) and reported that it had been unanimously approved by the Assembly Health Committee. In early June, the Senate Health Committee posted its analysis of the bill, including a summary of the arguments for and against it, and a list of its supporters and opponents.
The Committee passed the bill by a vote of 8-1 at a June 15 hearing. Testimony by CGS’s Elliot Hosman against it can be viewed here (starting at 52:35), or read at the end of this post.
The bill will go next to the Senate Appropriations Committee when the legislature returns from recess in early August, and then to a vote by the full Senate. Assuming it passes, it will then be sent to Governor Brown. The Governor vetoed an almost identical bill in 2013 with the following message:
Not everything in life is for sale nor should it be.
This bill would legalize the payment of money in exchange for a woman submitting to invasive procedures to stimulate, extract and harvest her eggs for scientific research.
The questions raised here are not simple; they touch matters that are both personal and philosophical.
In medical procedures of this kind, genuinely informed consent is difficult because the long-term risks are not adequately known. Putting thousands of dollars on the table only compounds the problem.
Six years ago the Legislature, by near unanimity, enacted the prohibition that this bill now seeks to reverse. After careful review of the materials which both supporters and opponents submitted, I do not find sufficient reason to change course.
I am returning this bill without my signature.
David Jensen of the California Stem Cell Report covered AB 2531 for the Capitol Weekly (Senate eyes human egg business), and Diane Tober discussed it at Undark (The Politics of Women’s Eggs). The notoriously under-studied risks of egg harvesting were also featured in a recent Washington Post article, Do women who donate their eggs run a health risk?
As those of us who support the existing limits on the egg market in California have pointed out repeatedly, without adequate health and safety information about egg harvesting, women can't give truly informed consent to undergo it in exchange for cash. And despite the claim of AB 2531 proponents, egg providers are very different from research subjects: Unlike clinical studies in which researchers follow the health outcomes of participants, egg retrieval supplies researchers with biological materials for other experiments, but without any study of its effects on those who provide them.
Elliot Hosman's testimony explains these and related points.
Testimony in opposition to AB 2531 by Elliot Hosman, June 15, 2016
Good morning, and thank you. I am Elliot Hosman, Senior Program Associate at the Center for Genetics and Society, a public interest organization based in Berkeley. We have long been concerned with the lack of adequate research on the health risks of egg retrieval. Our concerns are broadly shared by many others, including national and California women’s health and reproductive justice organizations you see opposing this bill, and including scholars and health professionals, and women who have themselves undergone egg retrieval.
The research that could identify the extent and frequency of health risks associated with egg retrieval has simply not been done. It’s been called upon to be done for decades, but it has not been done. Thus the information women would need to give informed consent does not currently exist. Unfortunately, this bill increases payments without providing mechanisms to bring about the conditions for substantive informed consent that women deserve.
The intent to treat egg providers as "human research subjects" may sound like a good idea, but in fact egg providers are not "research subjects" as we usually understand that term. They provide the cells that are used in research, not for their benefit, but no research is performed to ascertain the effects of egg retrieval on their own health outcomes.
While some Institutional Review Boards may review egg retrieval procedures, they are not required to do so. For example, if the eggs are anonymized, many reviewers may deem they are no longer required to evaluate retrieval protocols or informed consent forms, and eggs are often anonymized, so this is often case.
Even when IRBs do review, they typically do not provide adequate safeguards:
- They don’t require tracking short term outcomes, so we don’t have good data on how many egg providers are injured or hospitalized due to ovarian hyperstimulation syndrome from the drugs they’re on.
- They don’t require tracking long term outcomes so we have almost no data on the stimulation drug regimen’s impacts on their fertility, their short-term or long-term cancer risks, or other problems they may face.
- They seldom require follow up health care for egg providers. At best they cover treatment of short term injuries that can be directly and causally linked, but don’t cover any longer term harms.
- They don’t review the treatment outcomes of clinics or researchers to determine if any are using inappropriate protocols that harm egg providers.
We all support promising research that might provide broad benefits, and we all want to make sure that women’s health is not compromised in the process.
Unfortunately, this bill does not accomplish that, and we respectfully urge you to vote against it.
Previously on Biopolitical Times: