BARCELONA, Spain — As the Spanish economic crisis deepens and unemployment soars, those struggling to make ends meet are increasingly selling their eggs and sperm to bring in some extra cash.
"I'm doing this for the money," said Angela Fernandez, 25, who has donated eggs twice and is already in the process of donating again this summer.
Fernandez owes the bank 5,000 euros (about $6,275) in overdue mortgage payments. But with every egg donation she makes to a fertility clinic she receives 1,000 euros – a substantial difference to her family's income.
Fernandez and her husband, along with 47.3 percent of Spaniards under 30, are out of work. For over a year, they have relied on unemployment benefits of 600 euros per month – not enough to feed a family of four and make monthly mortgage repayments of 200 euros on their Barcelona flat.
Selling eggs and sperm is forbidden under Spanish law, but assisted reproduction centers are allowed to pay a "compensation fee" to donors for the inconvenience, transportation costs and time spent away from work.
"The money given to donors can make a big difference to the lives of certain people," said physician Buenaventura Coroleu, honorary president of the Spanish Fertility Association (SEF) and chief of Reproductive Medicine at Dexeus Clinic in Barcelona.
Once accepted as donors, men can give sperm once a week over three months and receive up to 50 euros each time. Women receive up to 1,000 euros per donation, but the process is longer, painful and carries risks, involving a series of tests, hormone injections, trans-vaginal ultrasounds and a final invasive "puncture" to extract the eggs. The level of fees is set by the SEF.
"In other times, that amount of money wouldn't have bought people's good will, but now, with people in situations of extreme necessity, things are different," said Maria Casado, director of the Bioethics and Law Observatory of the University of Barcelona.
And those "compensation fees" seem to be buying a lot of good will. Reproduction clinics report a 20 to 30 percent increase in the number of donors since 2009.
In some areas, the increase is even more pronounced. "I used to monitor one or two donors per week, but over the last three months I have monitored one every day," said Josep Lluis Ballesca, director of the andrology (the male counterpart to gynecology) department at Hospital Clinic in Barcelona.
Donors remain anonymous. Typically, they have been college students. Clinics mainly advertise at universities because the ideal age for donors is between 18 and 30.
But with the crisis, the donor profile has also changed. At Fertilab Clinic in Barcelona, between 80 and 90 percent of male candidates and between 60 and 70 percent of female ones are out-of-work adults, said spokesperson Josep Barrado.
"The economic compensation we offer is their key motivation, although we also observe a greater sensitivity to helping would-be parents in [female donors]," he said.
Eugenia Insagaray, from the northwestern city of Vigo, donated in December 2011 for the first time. "I had a business at the time and it went bust," said the 27-year-old who now works as a waitress. "I needed money badly."
Since then, Insagaray has donated again twice, although she insists her motivations have changed.
"I became aware of how much I can help other women," she said. "It is painful and you lose a couple of work days, but I would do it again even if there was no pay involved."
Still, the fact that many donors are now lured to reproduction clinics by financial reward has sparked an ethical debate in Spain. Some experts are calling for the elimination of any financial transaction – to bring egg and sperm donation in line with organ donations – as the only way to avoid emergence of "professional donors."
"It is hypocritical for the law to say that trading with human [organs or fluids] is forbidden and then put a price for egg and sperm donors," Ballesca said.
In some countries, including neighboring France, gamete donations are unpaid. In the UK, donors receive up to 750 pounds ($1,170) in compensation for any financial losses. In the US, where the market is less regulated, women can receive thousands of dollars, and some argue that even that isn't sufficient, given the risk and inconvenience.
Ballesca says the fact that Spain has the world's highest rate of organ donations, according to the Spanish National Organization of Transplants, points to a culture of altruism that would ensure a supply of donors even without the incentive of fees.
"Maybe there would be scarcity of donors for a while but if we educate people and raise awareness, we would be eventually fine," said Ballesca, who is also a member of the SEF.
But Coroleu disagrees, insisting that abolishing the fees would significantly impact the number of donors and clinics would be unable to meet demand from both Spanish and foreign women. Spain currently supplies 75 percent of all donated eggs in Europe, according to the SEF.
In clinics like Dexeus, 50 percent of would-be mothers come from abroad, attracted by lower prices and liberal Spanish laws. Single women and lesbian couples are permitted to access assisted reproduction procedures, unlike in countries such as France.
With such a high demand, there are also concerns that donors are not being monitored to ensure they don't engender more than six offspring – a limit set in Spanish law to avoid inbreeding.
Analysts are calling for national registry, which was first proposed in the 1986 Assisted Reproduction Law but never implemented.
Currently, clinics have to trust donors when asked if they have donated at another clinic, and how many times.
"A clinic would be held accountable if it exceeded that limit, but there are no tools for us to know if a patient is lying and we are breaching the law," explained José Antonio Castilla, a physician at the Mas Vida Reproduccion clinic in the southern city of Seville.
Without an official register, doctors point out that a man could theoretically donate sperm at each of Spain's 150 reproduction clinics and father hundreds of children.
The Ministry of Health declined to comment on why such a register has not been implemented.
In other European countries, including the UK and France, the limit for children of donors is set at 10, and in Germany at 25. The United States has the most permissive cut-off point, a guideline (not a law) of 25 children per every 800,000 inhabitants in a donor's area — meaning that a donor could legally father thousands of children.
Still, even as the economic crisis encourages some to become "professional donors," doctors believe that due to the limit of six children imposed by each clinic and the fact that the Spanish population tends to be less mobile, it is unlikely that Spain will see a case such as that which came to light in Washington area last year, in which at least 150 children were conceived with the sperm of the same donor.