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<<   作成日時 : 2010/05/17 20:33   >>

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卵子提供者への報酬
 Wendie Wilsonは学生時代に卵子提供をして5,000ドルの報酬を得たが、その後4回の提供後、自らロサンゼルスに Gifted Journeys という卵子提供事務所を設立し、そこには現在300-400人が登録している。
 不妊治療や幹細胞研究の進歩もあり、最近数年で卵子の需要が増加している。有名大学の女学生は卵子提供の源とされ、学生新聞やウエッブサイトのみならずハイウエイ広告での募集がおこなわれている。しかしこうした宣伝にみられる報酬額がすでに倫理的なガイドラインを越えているという指摘がされている。
 63の大学新聞に100以上の卵子提供広告が載っていたが、その1/4が、専門家会議の自発的ガイドラインである10,000ドルを超えていた。ハーバード、プリンストン、エールの新聞には35,000ドルを約束する広告が出され、秀逸な卵子提供者には50,000ドルとするThe Brown Daily Heraldの広告もあった。
 卵子提供は先進国では制限されるか禁止されている。CDCによると米国では、2006年には2000年の2倍となる約10,000人が提供卵子により生まれた。
 精子提供では報酬は普通100ドル以下であるが、すぐに提供可能だ。卵子の場合は数週間かかる。1回に10個以上の卵を取り出すために、一連のホルモン注射が必要である。合併症として卵巣過剰刺激症候群(腹部膨満・腹痛、まれに血栓・腎不全などをおこす)を起こす可能性がある。
 去年の秋に、カリフォルニア州は、卵子提供者広告には健康危険リスクについて特別な警告を含むことを必要とする法律を制定した。全米科学アカデミーによって出されたガイドラインに従って国家はすでに研究目的の卵の販売を禁止している。対照的に、ニューヨークのエンパイア・ステート幹細胞審議会は、州の研究費で、卵の寄贈に対して最高10,000ドルを女性に支払うために使えると昨年決めた。
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不況下で卵子提供する女性が増加/米国医療事情
http://kurie.at.webry.info/200903/article_1.html
不妊治療クリニックへの疑問/米国医療事情
http://kurie.at.webry.info/200902/article_23.html
急拡大するインドの代理出産ビジネス
http://kurie.at.webry.info/200803/article_18.html
インドで代理出産の赤ちゃん、夫婦離婚で帰国困難に
http://kurie.at.webry.info/200808/article_16.html
精子ドナーの不足/英国医療事情
http://kurie.at.webry.info/200811/article_31.html
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Payment Offers to Egg Donors Prompt Scrutiny
By DAVID TULLER
Published: May 10, 2010
http://www.nytimes.com/2010/05/11/health/11eggs.html

画像Michal Czerwonka for The New York Times
Wendie Wilson eventually started an egg donation agency, Gifted Journeys, after being a donor herself.

As an undergraduate at the University of Washington in the late 1990s, Wendie Wilson noticed some striking ads in the campus newspaper: appeals to young women to sell their eggs for what seemed to her exorbitant sums of money. But she had no idea what was involved until she herself decided to go through the process a few years later.

To her surprise, Ms Wilson recalled recently, she discovered that helping an infertile couple conceive a child made her feel “fantastic.” And she certainly appreciated the $5,000 payment. “It seemed a relatively small amount of my time for what seemed to be pretty decent compensation,” she said. She found the experience so empowering, she submitted to it four more times and eventually founded her own egg donation agency in Los Angeles, Gifted Journeys, which maintains a registry of 300 to 400 potential donors.

Demand for human ova has been growing in recent years, fueled by infertility treatments and increased investment in stem cell research. Young women at top colleges and universities, long a prized source of eggs, are now being recruited not just through advertising in student newspapers but on Web sites like Facebook and Craigslist, even on highway billboards.

But a study in the most recent issue of The Hastings Center Report, a leading bioethics journal, found that the compensation being touted in ads aimed at young women often exceeded industry guidelines. The study is the latest development in a long-running debate over how much ― or even whether ― egg donors should be paid.

In the study, Dr. Aaron Levine, an assistant professor of public policy at the Georgia Institute of Technology, examined more than 100 egg donation ads from 63 college newspapers. He found that a quarter of them offered compensation exceeding the $10,000 maximum cited in voluntary guidelines issued by the American Society for Reproductive Medicine, a professional association.

The guidelines state that payments of $5,000 or more above and beyond medical and related expenses “require justification” and that payments above $10,000 “are not appropriate.” Ads in newspapers at Harvard, Princeton and Yale promised $35,000 for donors, Dr. Levine found, while an ad placed on behalf of an anonymous couple in The Brown Daily Herald offered $50,000 for “an extraordinary egg donor.”

“The concern is that some young women may choose to donate against their own best interests,” Dr. Levine said. “They’ll look at the money on offer and will overlook some of the risks.”

The study noted the possibility that the ads represented a “bait and switch” strategy, with large offers primarily designed to lure donors but with prices negotiated downward once they respond.

In addition to limiting compensation, the society’s guidelines forbid paying additional fees to egg donors for specific traits. But the study found that every 100-point difference in a university’s average SAT scores was correlated with an increase of more than $2,000 in the fees advertised for potential egg donors in the campus newspaper.

Fertility clinics, which maintain registries of potential egg donors, tended to observe the guidelines in their ads. Egg donation agencies or brokers, who act as middlemen by linking donors with prospective recipients, were far more likely to advertise the higher payments. Unlike egg donation agencies, fertility clinics are generally members of the Society for Assisted Reproductive Technology, which is affiliated with the A.S.R.M., and are therefore expected to abide by the guidelines.

Ruthie Rosenberg, who graduated from Brown last year, said the ads initially startled her but were so common that she became used to them.

“At first, it was totally shocking to me that people would target specifically what they were looking for, like religion, SAT score and hair color,” said Ms Rosenberg, 22. “But like anything else I was first exposed to at college, the shock wore off.”

Egg donation is restricted or banned in many industrialized countries. In the United States, by contrast, close to 10,000 children were born through the use of donor eggs in 2006, almost double the number in 2000, according to the Centers for Disease Control and Prevention. Critics say they fear that young women may not understand the potential physical and long-term psychological risks, including how they might feel years later about the experience.

Sean Tipton, a spokesman for the reproductive medicine society, said that the group had little authority over egg brokers and that concerns expressed about donation smacked of sex discrimination. “It’s interesting to me that people get upset about egg donation in ways they don’t get upset about sperm donation,” he said. “You never hear discussions about, ‘Oh, the sperm donor is going to regret it some day that they have a child.’ ”

A typical payment for sperm donation is under $100, and providing the sample is quick. The egg donation process, in contrast, takes weeks.

First, a series of hormone injections stimulate the ovaries to produce 10 or more ova in one cycle. Next, the eggs are extracted surgically, under local anesthesia. The fee received by the donor is for all the eggs produced in the cycle. Once the eggs are fertilized, one or more embryos are implanted in the infertile woman, while the rest are usually frozen for future use.

Donation can cause abdominal swelling, mood swings and hot flashes. The most significant risk is ovarian hyperstimulation syndrome, which can cause bloating, abdominal pain, and, rarely, blood clots, kidney failure, and other life-threatening ailments.

Despite the growth of egg donation as a fertility treatment, it is largely the use of human ova to create embryos for stem cell research that has galvanized opposition among conservative and anti-abortion campaigners ― leading to efforts to impose severe restrictions in some states.

Last fall, California adopted a law requiring egg donor advertisements to include specific warnings about health risks. The state already bans the sale of eggs for research purposes, in accordance with guidelines issued by the National Academy of Sciences.

In contrast, New York’s Empire State Stem Cell Board decided last year that state research money could be used to pay women up to $10,000 for donating eggs.

Ms. Wilson, 34, the egg agency owner, opposes regulation of the procedure, saying that in her experience, payments above $10,000 were rare and generally reserved for women who had previously donated and whose eggs resulted in pregnancy.

But some supporters of egg donation are concerned that if self-regulation falls short, government officials could feel forced to clamp down on the practice, as other countries have done. Marna Gatlin, of Scappoose, Ore., whose 9-year-old son was conceived through the process, said that would make it more difficult for others to benefit from the technology the way her family has.

“It’s a billion-dollar industry, and it’s supposed to be regulating itself,” said Ms. Gatlin, founder of an online community called Parents Via Egg Donation. “Is it regulating itself? Not so much. But do I want Uncle Sam making it illegal? No.”

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