Exploitation,structural injustice,and the cross-border trade in human ova

Global demand for human ova in in vitro fertilization has led to its expansion in countries with falling average incomes and rising female unemployment. Paid egg donation in the context of national, regional, and global inequalities has the potential to exploit women who are socioeconomically vulnerable, and indeed there is ample evidence that it does. Structural injustices that render women in middle-income countries – and even some high-income countries – economically vulnerable contribute to a context of ‘omissive coercion’ (Wilkinson 2003 Wilkinson, S. 2003. “The Exploitation Argument Against Commercial Surrogacy.” Bioethics 17 (2): 169–187. doi: 10.1111/1467-8519.00331Crossref], PubMed], Web of Science ®] , Google Scholar]) that is morally troubling. When egg brokers or fertility clinics take advantage of these background structural injustices and prospective ova providers’ vulnerability in order to pay them less than they need to meet their livelihood needs, they engage in exploitation. Analyzing paid egg donation as a form of reproductive labor, however, can direct our attention to reforms that would reduce exploitative instances of this practice. In contrast to those who see egg provision as inescapably commodifying and harmful, I argue that compensated egg provision can be made less exploitative. I defend my approach against commodification-driven analyses of egg donation and concerns about undue inducement, and conclude by discussing some of the ways in which policy-makers and medical practitioners might reduce the harms that may result from this global practice.