Introduction
Infertility, the inability to achieve pregnancy after engaging in regular unprotected sexual intercourse for at least one year, is a global issue, as it impacts over 186 million people worldwide. Approximately 17 per cent of individuals will face infertility in their lifetime, irrespective of their income level or geography.Footnote 1 In sub-Saharan Africa, children are highly valued, and infertility carries a particularly acute social stigma.Footnote 2 In Nigeria, where motherhood is deeply tied to social identity, marriageability and familial acceptance, infertility can result in domestic violence and social ostracism.Footnote 3 This socio-cultural context has contributed to an increasing demand for assisted reproductive technologies (ART), largely within the private sector.Footnote 4 One of the earliest and most significant developments in ART is in vitro fertilization (IVF), a process involving the laparoscopic retrieval of oocytes (also referred to herein as female gametes, ova or eggs) from the ovary, which are then fertilized in vitro and subsequently transferred as embryos into the uterus, resulting in pregnancy.Footnote 5 IVF initially relied on the use of a woman’s own oocytes; however, for women unable to produce viable eggs, the technique evolved to include egg donation, a process whereby a donor’s eggs are extracted and fertilized in a laboratory before being transferred to the recipient’s uterus.Footnote 6
The introduction of egg donation, while expanding reproductive possibilities, raised distinct ethical and jurisprudential concerns, particularly regarding informed consent, the risk of donor exploitation and the commodification of reproductive material. Regulatory responses to egg donation were initially confined to professional self-regulation, notably through ethical guidelines which sought to govern consent procedures, donor remuneration and medical screening.Footnote 7 Statutory intervention was subsequently undertaken, first in the United Kingdom through the enactment of the Human Fertilisation and Embryology Act 1990, which established the Human Fertilisation and Embryology Authority (HFEA) to oversee the licensing of clinics, provide mandatory counselling to donors and restrict financial inducements.Footnote 8 Several other jurisdictions introduced similar regulatory frameworks governing egg donation, underscoring the necessity of formal legal standards to protect the rights and welfare of both donors and recipients, and to ensure that ART operates within ethical and human rights frameworks rather than being driven by commercial imperatives.Footnote 9
In contrast, Nigeria continues to experience the rapid growth of egg donation practices, despite the absence of comprehensive legal regulation. Young women, particularly students and those in precarious financial circumstances, are increasingly recruited to donate eggs under opaque arrangements, often without adequate medical information, counselling or follow-up care.Footnote 10 Iyanuoluwa, a 20-year-old university student, recounted how she sold her eggs to pay her tuition. After undergoing a high-risk procedure with little medical explanation or oversight, she was left with prolonged bleeding and ongoing trauma, receiving only a fraction of the promised payment.Footnote 11 Iyanuoluwa’s story reflects a broader systemic failure in which fertility clinics operate without regulatory oversight.
Nigeria’s National Health Act 2014 (NHA) offers limited guidance on egg donation. While section 53 criminalizes the receipt of financial reward for the donation of “tissue, blood or blood products”, the NHA does not explicitly include ova within its definitions. This legal ambiguity has been widely criticized for creating a permissive environment where fertility clinics compensate donors under the guise of reimbursement, escaping effective regulatory scrutiny.Footnote 12 Scholars such as Fiebai and Green observe that the NHA contains “little content related to ART”, while Haimes et al caution that, without clear statutory language distinguishing between altruistic donation and commodification, ART frameworks risk becoming vehicles for exploitative markets cloaked in medical necessity.Footnote 13 Ezeome similarly notes that this lack of a comprehensive legal regime renders egg donors particularly vulnerable, especially given the informal asymmetries and power imbalances that characterize ART in Nigeria.Footnote 14
Moreover, the regulatory disparity between the protection afforded to blood and organ donors compared to egg donors is stark. While Part VI of the NHA establishes a detailed framework for blood transfusion and organ transplantation, including protocols for informed consent, allocation and oversight, no equivalent protections exist for egg donation.Footnote 15 Key institutions, including the Medical and Dental Council of Nigeria (MDCN) and the National Agency for Food and Drug Administration and Control (NAFDAC), have not issued specific guidelines governing ART or egg donation.Footnote 16 This lack of implementing regulations, subsidiary rules or professional codes further broadens the regulatory vacuum. The legal and institutional silence has practical consequences.Footnote 17 As documented by Okafor et al, many women undergo hormonal stimulation and egg retrieval procedures without adequate understanding of the risks or access to post-procedure care. Compensation practices blur the line between altruistic donation and commercialized reproductive labour, exploiting financial vulnerability among young women while escaping formal regulatory mechanisms.Footnote 18
Internationally, best practices underscore the need for ethical oversight in reproductive technologies. Jurisdictions such as Australia and New Zealand ban paid gamete donation outright, and donation is permitted only under strict ethical review.Footnote 19 The UK’s Human Fertilisation and Embryology Authority limits donor compensation to fixed reimbursement and caps the number of donor cycles.Footnote 20 These standards reflect the global consensus that the donation of reproductive material requires careful balancing of autonomy, ethics and health rights.Footnote 21
From a human rights perspective, Nigeria’s failure to regulate egg donation practices contravenes its obligations under international law. The International Covenant on Economic, Social and Cultural Rights (ICESCR) enshrines the right to the highest attainable standard of health, which includes ethical medical treatment and informed consent.Footnote 22 The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) imposes duties on states to eliminate gendered practices that undermine autonomy and dignity, while the African Charter on Human and Peoples’ Rights (ACHPR) affirms the right to health, bodily integrity and protection from exploitation.Footnote 23 In failing to enact a framework that protects egg donors, Nigeria is in breach of these core obligations.Footnote 24
This article uses Iyanuoluwa’s experience as an entry point to examine the broader human rights implications of unregulated egg donation. I argue that the absence of legal safeguards facilitates a market dynamic where bodily integrity is traded for compensation in unregulated settings, thereby eroding core reproductive rights. I proceed by contextualizing Nigeria’s ART regulatory landscape, analysing relevant international human rights standards, and proposing legal reforms to promote accountability in fertility medicine while safeguarding donor welfare.
A framework of silence: Domestic regulatory gaps and the National Health Act
The legal vacuum surrounding egg donation in Nigeria is not the result of complete legislative neglect but of repeated failed attempts to enact regulatory oversight. In early 2012, a bill titled the Nigerian Assisted Reproduction Authority (Establishment) Bill was introduced in the National Assembly.Footnote 25 The bill aimed to establish a regulatory authority overseeing ART in Nigeria, including the regulation of fertility clinics, donor practices and adherence to ethical standards.Footnote 26 It was read for the second time on 2 May 2012 and was subsequently referred to the Committees on Health and Justice. However, the bill stalled in committee and was not enacted into law.Footnote 27 A second attempt was made in 2016, with the introduction of the Assisted Reproductive Technology (Regulation) Bill, designed to create a comprehensive statutory framework for ART, including explicit provisions for donor consent, clinical accountability and compensation.Footnote 28 Despite wide support among medical practitioners and human rights advocates, this bill also failed to progress beyond the preliminary stages.Footnote 29
The repeated failure of these legislative efforts has been attributed to a confluence of factors. Chief among them is the persistent lack of political will, as reproductive health legislation is often deprioritized in favour of more immediate public health challenges such as infectious diseases, maternal mortality and primary healthcare delivery.Footnote 30 Policy-makers have historically shown limited engagement with fertility medicine, viewing it as a niche or luxury concern rather than a public health imperative.Footnote 31 Furthermore, weak institutional lobbying from medical bodies has impeded sustained legislative advocacy; professional associations have largely failed to mobilize collective action or maintain consistent pressure on legislators to prioritize ART regulation.Footnote 32 Cultural and religious sensitivities surrounding ART further complicate the political landscape; assisted reproduction, particularly practices involving gamete donation and surrogacy, encounters significant resistance in a society where traditional notions of lineage, kinship and procreation remain deeply entrenched.Footnote 33 These combined factors contribute to a regulatory vacuum that leaves ART practices largely unregulated, raising concerns about the rights and welfare of all parties involved.Footnote 34
The NHA is often cited as the most significant general federal health law directly relevant to ART in Nigeria, as it is the only national statute that establishes a legal framework for managing, controlling and regulating health services at the federal level.Footnote 35 However, while the NHA appears to provide broad regulation for human biological materials, a closer reading reveals that its scope, definitions and regulatory mechanisms are structurally inadequate for addressing the unique ethical and legal complexities of egg donation. At the core of the NHA’s deficiencies lies section 53, which criminalizes the sale or trade of “tissue, blood or a blood product” in exchange for financial or other reward. On the surface, this clause might suggest a prohibition on commodifying human body parts, including reproductive materials. However, the Act does not explicitly define gametes or clarify whether human ova fall within the meaning of “tissue”. Section 48 defines tissue to include “human tissue, and any part or constituent of the human body, but excludes blood and blood products”. Given that ova are biological constituents of the human body, it may be argued that grammatically, they fall within the phrase “any part or constituent of the human body”. As living human cells involved in reproduction, ova could thus in a literal reading be encompassed within the NHA’s definition of tissue. Nevertheless, due to their distinct biological and ethical characteristics, many legal systems regulate gametes separately from other forms of human tissue.Footnote 36 Without an express provision for gametes, the Nigerian NHA creates a significant regulatory lacuna. This omission is not merely technical but legally consequential: the absence of precise definitions allows clinics to operate outside the NHA’s regulatory ambit, exploiting this loophole by offering cash payments to donors under the pretext of “reimbursement”, thus circumventing the NHA’s apparent ban on financial inducement.Footnote 37
Moreover, section 53 does not establish any oversight mechanism for enforcement. There is no licensing requirement for facilities involved in handling human tissues, no inspection regime and no penalties specified for clinics that operate outside the Act’s scope, other than the vague prohibition of sale. Crucially, there is no reference to ART, fertility clinics or reproductive technologies anywhere in the statute, despite the rapidly expanding fertility sector and its ethical implications. The absence of any institutional mandate to interpret or enforce section 53 in the context of ART renders the provision functionally inert.
This legal gap is further deepened by the structure of the NHA itself. While it includes detailed provisions governing the removal, storage and transplantation of organs (sections 51–56), including consent protocols, hospital licensing and cadaveric donations, these protections are not mirrored in relation to gametes. For example, organ and tissue transplantation under Part VI of the NHA requires written consent, state supervision and traceable documentation, but no such requirements exist for egg retrieval. Thus the law draws a sharp and arguably unjustified distinction between different forms of bodily contribution, privileging some (such as blood and organs) with safeguards while neglecting others (such as ova) entirely.
Other legal frameworks that in theory might have offered protection also fail to adequately address egg donation. The Code of Medical Ethics in Nigeria, issued by the MDCN, imposes general ethical obligations on medical practitioners; however, it does not provide specific rules on donor eligibility, compensation, anonymity or limits on egg retrieval.Footnote 38 The Code requires, under rule 44, that doctors obtain informed consent before any medical procedure and uphold patient autonomy, dignity and confidentiality, but it does not distinguish between therapeutic and non-therapeutic procedures like gamete retrieval, nor does it elaborate on the heightened vulnerabilities associated with egg donation, leaving fertility clinics with wide discretionary powers.
Similarly, the Constitution of the Federal Republic of Nigeria (2004) guarantees the rights to privacy and dignity, but does not regulate biomedical procedures such as egg donation. Section 34(1) guarantees the right to the dignity of the human person, prohibiting inhuman or degrading treatment, while section 37 protects the privacy of citizens, their homes and their correspondence. Nigerian courts have applied these provisions beyond their literal scope: section 34(1) has been applied to condemn degrading treatment in custodial and policing contexts, while section 37 has been invoked in cases involving the misuse of personal data and unauthorized disclosures, highlighting its protection of informational privacy and personal autonomy. By way of analogy, exploitative egg donation practices that compromise informed consent, intrude upon confidentiality or subject women to unsafe, degrading procedures could be framed within the ambit of these constitutional rights. However, no judicial precedent has yet extended sections 34(1) or 37 to assisted reproductive technologies.Footnote 39
Moreover, the Draft National Guidelines for the Regulation of Assisted Reproductive Technology Practice in Nigeria (2013), originally formulated by the Association for Fertility and Reproductive Health and presented to the Federal Ministry of Health in 2013, recommend professional standards but have no legal force and are not enforceable.Footnote 40 These Draft Guidelines propose best practices on issues like informed consent, donor screening and record-keeping. For example, they suggest that egg donors undergo psychological counselling and recommend that the number of donations per donor be restricted to avoid medical risks like Ovarian Hyperstimulation Syndrome. However, because the guidelines remain an ungazetted proposal that has never been formally adopted as regulations under the National Health Act, compliance among private practitioners is entirely voluntary.
General criminal and tort law, such as the Criminal Code Act of Nigeria 2004, only addresses egregious cases like gross negligence or assault, but cannot fill the regulatory vacuum for normal egg donation practices.Footnote 41 Under this Act, section 335 criminalizes acts that cause grievous harm without lawful justification, and section 343 punishes negligent acts leading to harm, particularly in medical settings. While these provisions could be invoked where an egg donor suffers serious injury due to medical negligence, they do not regulate the broader conditions of egg donation, such as ensuring voluntariness, setting compensation limits or providing post-procedure medical care. Tort law remedies (such as claims for negligence or breach of duty of care) similarly require proof of harm and do not address the systemic risks inherent in unregulated fertility practices.Footnote 42
These limitations in substantive law are compounded by an equally troubling absence of judicial interpretation, leaving critical questions unresolved. Nigerian courts have yet to issue any rulings clarifying whether gametes are included in the statutory language of the NHA. In the absence of precedent, clinics and medical practitioners are left to interpret the law on their own terms, often to the detriment of donor safety and ethical accountability. Building on earlier critiques, Fiebai and Green further highlight that this “regulatory ambiguity” enables ART providers to shape their own internal policies without any meaningful external oversight.Footnote 43
The failure to provide implementing regulations or interpretative guidelines further undermines the NHA’s applicability. Unlike in the UK, where the Human Fertilisation and Embryology Authority issues detailed codes of practice under statutory mandate, Nigerian authorities have issued no such secondary legislation.Footnote 44 The absence of such instruments effectively means that even if the NHA were interpreted to include egg donation, it would still be unenforceable in practice as it does not establish licensing, monitoring or sanctioning mechanisms necessary for practical compliance and accountability.
The legal ambiguities and structural exclusions of the NHA manifest in concrete harm to real individuals. Iyanuoluwa’s experience, introduced earlier, exemplifies this: recruited via Facebook and managed through WhatsApp, she was promised NGN 140,000 (about USD 92) but ultimately received just NGN 25,000 (USD 16). She underwent a high-risk egg retrieval procedure with no prior counselling, no meaningful explanation of risks and no post-operative support.Footnote 45 Crucially, she was never informed of the number of eggs extracted or the reason for her compensation being arbitrarily reduced. She was not provided with a copy of her medical records and was denied any pathway to challenge the clinic’s actions.
This lack of transparency, oversight or accountability is not an anomaly but a feature of the systemic failure to safeguard donor rights.Footnote 46 In contrast, jurisdictions such as the United Kingdom, where the HFEA imposes legal limits on donation cycles, maintains national donor registries and enforces robust consent procedures, offer a model of regulatory accountability.Footnote 47 While regulatory models must always be adapted to local legal, institutional and cultural contexts, such examples highlight the baseline safeguards that are entirely absent in Nigeria, where, by comparison, there is no legal requirement to disclose the number of eggs retrieved, no limits on donation frequency and no state-mandated documentation of donor outcomes.Footnote 48 These gaps render the egg donation process not only unregulated but also untraceable and unaccountable, depriving donors of transparency, safety and any meaningful right to redress. In this vacuum of legal protection and ethical oversight, what emerges is not merely a regulatory failure; it is a pattern of systemic abuse, one that implicates the Nigerian state in the ongoing violation of fundamental human rights.
Human rights violations and legal obligations
The legal and regulatory vacuum surrounding egg donation in Nigeria gives rise to a range of human rights violations that disproportionately affect young, economically disadvantaged women.Footnote 49 These violations implicate a range of human rights, including the right to health, the right to dignity and freedom from torture, cruel and inhuman treatment, freedom from exploitation and the right to an effective remedy. They manifest through lack of informed consent, medical neglect, economic coercion and violation of bodily integrity.Footnote 50 As established in the preceding section, this environment does not arise from the absence of law per se, but from the state’s failure to enact and enforce targeted protections for egg donors.
In addition to these legal gaps, social and economic conditions intensify how unregulated practices are resorted to. The intense stigma attached to infertility in Nigeria fosters shame and desperation among couples seeking reproductive solutions, often pushing them into informal markets outside legal oversight.Footnote 51 On the donors’ side, widespread poverty, particularly among teenagers and young women, renders financial inducement an overwhelming factor in their decision to participate.Footnote 52 These intersecting pressures sustain an underground system where both recipients and donors operate from positions of vulnerability, heightening the risk of coercion and exploitation.Footnote 53
In international human rights law, states bear not only negative obligations to refrain from violating rights but also positive duties to regulate private conduct that may undermine them.Footnote 54 As Sigrun Skogly argues, states that fail to regulate non-state actors whose actions result in rights violations may be implicated through what she terms “indirect violations”. Where private actors operate without oversight in sectors like reproductive medicine, the state’s inaction amounts to what Skogly terms “indirect violations” of human rights.Footnote 55 In the context of Nigeria’s fertility industry, where private clinics operate without oversight and where victims are left without recourse, the state’s inaction engages its responsibility under international law. It is therefore necessary to consider how specific rights are implicated, beginning with the right to health.
The right to health
Informed consent, a cornerstone of both medical ethics and international human rights law, is routinely compromised in Nigerian egg donation practices.Footnote 56 Donors such as Iyanuoluwa report receiving little to no information about the procedures involved, the risks of repeated hormone injections or the long-term effects on fertility and mental health.Footnote 57 Celine, another young donor, recalled being recruited through formal online channels, promised NGN 50,000 (around USD 33) and subjected to medical procedures without clear disclosure of the associated risks or the volume of eggs retrieved.Footnote 58 Similarly, Precious Ikechukwu and Theresa Obam, aged 17 and 19 respectively, were introduced to a fertility clinic by a church member and later threatened into silence after undergoing procedures they barely understood.Footnote 59 Ebimoboere Dan-Asisah described feeling emotionally unprepared and medically uninformed during her donation, noting the absence of any psychological counselling or transparency about the implications.Footnote 60
The principle of voluntary informed consent is firmly recognized in international human rights law: Article 12 of the ICESCR, as clarified by the Committee on Economic, Social and Cultural Rights in General Comment No 14, para 8, affirms that the right to health includes freedom from interference, such as the right to be free from non-consensual medical treatment and experimentation.Footnote 61 Similarly, the World Medical Association’s Declaration of Helsinki establishes that informed consent is a foundational requirement in medical research, underscoring the ethical obligation to ensure access to health that is both medically appropriate and respectful of patient autonomy.Footnote 62 Instead, in the Nigerian context, consent is structurally compromised by poverty, gendered power relations and the absence of regulatory safeguards. This also violates article 5 of the CEDAW, which requires states to eliminate harmful gender stereotypes and practices that undermine women’s autonomy.
The right to dignity
The neglect of post-operative care, the failure to provide access to medical records and the absence of redress mechanisms constitute violations of the right to dignity, a principle protected across domestic and international human rights instruments. Section 34(1) of the Constitution of the Federal Republic of Nigeria prohibits torture and inhuman or degrading treatment; similarly, article 5 of the ACHPR, article 7 of the International Covenant on Civil and Political Rights (ICCPR), and articles 1 and 5 of the Universal Declaration of Human Rights recognize dignity as the foundation of freedom from torture or cruel, inhuman or degrading treatment.Footnote 63 In Iyanuoluwa’s case, for instance, she was never informed how many eggs were collected, nor was she offered any post-procedure care despite severe bleeding that lasted for weeks.Footnote 64 Such practices amount to inhuman treatment, particularly when inflicted on vulnerable young women who lack access to medical transparency or avenues of redress.Footnote 65 More broadly, the systemic commodification of donors, where women are treated as anonymous sources of reproductive material rather than as patients with rights, devalues their personhood and undermines the constitutional guarantee of dignity.Footnote 66 Non-consensual penetrative procedures, the invasive surveillance of menstruation and disregard for pain or prolonged bleeding further illustrate how exploitative egg donation regimes erode dignity and bodily integrity. When clinics impose medical interventions without proper counselling, informed consent or respect for the suffering of donors, they engage in practices that fall within the ambit of cruel, inhuman and degrading treatment under both domestic and international human rights law.Footnote 67
Freedom from exploitation
The dynamics of egg donation in Nigeria reveal deep concerns relating to freedom from exploitation, particularly for adolescents and young women. The promise of NGN 140,000 (about USD 92), almost double the monthly minimum wage in Nigeria, lures students and underemployed women into clinics under the illusion of agency.Footnote 68 In reality, the asymmetry of information and power between donor and clinic renders consent illusory. The exploitation of financial vulnerability in exchange for significant bodily risk falls within internationally recognized forms of exploitation that states are obliged to prevent.Footnote 69 For donors under the age of eighteen, these concerns are even more acute. Article 19(1) of the Convention on the Rights of the Child (CRC) requires states to protect children from “all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation”.Footnote 70 The invasive hormonal stimulation, harvesting procedures and denial of post-operative care described in these cases clearly fall within the types of maltreatment and exploitation from which the CRC obliges protection.
This dynamic also raises concerns under article 5 of the CEDAW, which requires states to eliminate harmful gender stereotypes and practices that undermine women’s autonomy. The economic vulnerability of donors, combined with opaque medical practices, results in a form of structural exploitation that renders meaningful consent impossible. The unregulated commodification of reproductive labour thereby violates not only women’s reproductive autonomy but also their right to freedom from exploitation and degrading treatment.
Freedom from gender-based violence
The coercive and unsafe features of Nigeria’s egg donation industry, including non-consensual penetrative procedures, the invasive surveillance of menstruation and disregard for women’s pain or bleeding, fall squarely within the spectrum of gender-based violence.Footnote 71 Such practices are not merely ethical failings but inflict bodily and psychological harm on women and exploit their reproductive capacity. The Nigerian state’s inaction contravenes its obligations under the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (Maputo Protocol), particularly article 4(2)(a)–(b), which requires states to prohibit and punish all forms of violence against women. These obligations are reinforced by article 14(1)(a) and (c), which guarantees women’s right to control their fertility and to make informed decisions about whether, when and how many children to have.Footnote 72 Furthermore, the Committee on the Elimination of Discrimination against Women, in its General Recommendation No 35, has clarified that gender-based violence constitutes discrimination under article 1 of CEDAW and engages state responsibility when authorities fail to exercise due diligence to prevent or respond to such violations.Footnote 73 Nigeria’s tolerance of coercive, unsafe and degrading egg donation practices thus falls within the category of gender-based violence and reflects a breach of its binding international human rights obligations.
The right to remedy
In addition to breaching Nigeria’s obligations under international human rights instruments, the absence of regulation in egg donation also contravenes constitutional protections enshrined in the 1999 Constitution of the Federal Republic of Nigeria. Crucially, section 46(1) provides any person whose fundamental rights are “in any way contravened” with a direct right of access to a High Court for redress. Yet in the context of egg donation, where victims lack access to records, legal advice or formal complaint mechanisms, the right to remedy remains effectively illusory. This gap also contravenes Nigeria’s international obligations. Under article 2(3) of the ICCPR, states must ensure that individuals whose rights are violated have access to effective remedies, even when the violation results from the actions of private actors. Similarly, article 7(1)(a) of the ACHPR guarantees the right to have one’s cause heard, including the right to an effective remedy when rights are violated. Nigeria’s failure to establish mechanisms through which egg donors can seek accountability therefore represents a dual breach of both domestic constitutional protections and binding international law obligations.
The scale and pattern of rights violations outlined above point not only to institutional failure but to the urgent need for targeted reform. While the protection of reproductive autonomy must ultimately be grounded in Nigeria’s own legal and socio-cultural context, comparative experiences offer important insights into how states can balance reproductive innovation with ethical accountability. Examining international best practices does not imply the direct transplantation of foreign laws but rather highlights minimum safeguards that are conspicuously absent in Nigeria’s current approach. The next section considers regulatory models from jurisdictions such as South Africa, the United Kingdom and India, each offering instructive lessons for building a rights-based framework suited to Nigeria’s legal and institutional landscape.
International best practices and lessons for Nigeria
The regulatory vacuum surrounding egg donation in Nigeria stands in stark contrast to established legal frameworks in jurisdictions where assisted reproductive technologies are treated as matters of public health, ethics and law. Countries such as South Africa, the United Kingdom and India have enacted laws that explicitly define donor rights, impose clinical oversight and regulate compensation. These frameworks offer useful points of reference for Nigeria – not as models to be adopted wholesale, but as examples of how states have confronted similar regulatory challenges.
In South Africa, egg donation is governed by the 2003 National Health Act and its accompanying regulations. While the sale of gametes is prohibited, reimbursement for reasonable expenses incurred by donors is allowed.Footnote 74 Fertility clinics must be registered and inspected by the Health Professions Council of South Africa and adhere to protocols for informed consent, including mandatory medical screening and counselling.Footnote 75 Importantly, the law imposes eligibility criteria for donors, such as age, health status and limits on the number of donations, designed to safeguard both the donor and the recipient. These measures reflect a rights-based approach to ART, affirming human dignity while protecting against exploitation.
The United Kingdom’s regulatory model, developed under the Human Fertilisation and Embryology Act 1990 and overseen by the HFEA, is frequently cited as a gold standard for reproductive governance. Under this Act, the HFEA maintains a national donor registry, enforces mandatory counselling sessions and sets strict standards for informed consent, data retention and donor compensation.Footnote 76 Donors receive fixed compensation for their time and inconvenience, currently capped at GBP 750 per cycle, which helps avoid undue inducement.Footnote 77 Clinics that fail to comply with these standards may be fined or deregistered. Importantly, UK law explicitly recognizes the donor’s right to access information about the use of their gametes, fostering transparency and accountability.Footnote 78
India offers a particularly salient point of comparison due to its once unregulated ART sector, which, like Nigeria’s, is characterized by informal brokerage, lack of consent protocols and poor clinical accountability. In response to increasing reports of abuse and transnational exploitation, India enacted the Assisted Reproductive Technology (Regulation) Act 2021, which now mandates the registration of clinics, restricts the number of donations a woman may make in her lifetime and requires extensive screening and counselling.Footnote 79 Notably, it bans commercial egg donation and allows only altruistic donation from close relatives or friends under ethical review.Footnote 80 Though the law has been criticized for its overly restrictive framework, it underscores the role of legislative intervention in curbing unregulated reproductive markets and protecting vulnerable populations.
These jurisdictions demonstrate that regulatory frameworks can mitigate the commodification of reproductive labour while ensuring clinical transparency and donor safety. However, transplantation of legal frameworks must be approached cautiously. While Nigeria shares important socio-cultural similarities with India, such as strong familial expectations, a communal orientation and the social pressure placed on women to bear children, both countries differ significantly in regulatory capacity, institutional oversight mechanisms and enforcement infrastructure. These differences shape which elements of foreign regulatory models can be realistically adopted. Nonetheless, certain core elements, such as mandatory counselling, donor age limits, clinic registration and protocols for informed consent, are translatable and adaptable within Nigeria’s federal legal structure.
As Durojaye et al note, the development of reproductive health laws in Africa must be grounded in both human rights principles and contextual realities, including the patriarchal structures and weak regulatory environments that make young women particularly vulnerable to coercion.Footnote 81 The failure to establish a regulatory framework for ART in Nigeria reflects not only a legislative gap but a broader institutional disregard for reproductive autonomy and gender equality. ART regulation in Africa must confront the commodification of reproductive labour through the lenses of gender, class and access, especially in contexts where ART is a service primarily accessible to the elite.Footnote 82
Recommendations
The unchecked expansion of the egg donation industry in Nigeria is not merely a regulatory lapse; it constitutes a structural failure in protecting reproductive autonomy under both national and regional human rights law. Without a statutory framework, commercial egg donation operates in an opaque environment, enabling exploitative practices by private clinics, brokers and unlicensed agents.Footnote 83 This has led to systematic rights violations, including breaches of protocols for informed consent, the commodification of reproductive labour and inadequate medical oversight. These harms are not accidental; they are the predictable outcomes of legal silence and institutional neglect. To address these structural harms, Nigeria must adopt a human rights-based regulatory framework that centres donor welfare, bodily autonomy and informed consent.
First, Nigeria should enact a comprehensive law on ART that consolidates the regulation of fertility clinics, gamete donation, surrogacy and related practices into a single statutory framework. The two previous attempts in 2012 and 2016 failed to progress, leaving a legal vacuum that continues to expose women to exploitation and coercion. A dedicated ART law, designed through inclusive consultation with medical practitioners, women’s rights groups and legal experts, would provide clarity, uniformity and enforceable safeguards. Such a statute should establish an independent regulatory authority, set mandatory registration requirements for clinics and ensure donor protection through enforceable consent standards, compensation limits and transparent monitoring.
Although interim amendments to the NHA could in theory provide piecemeal protections, such as defining gametes as tissue or introducing minimum consent standards, such measures risk duplication and fragmentation once a comprehensive ART law is enacted. What is urgently required is not an incremental patchwork but a coherent stand-alone statute that balances reproductive innovation with ethical accountability and robust rights protection. However, as reproductive health legislation has historically been deprioritized in Nigeria in favour of more immediate public health concerns, any push for legislative amendment must be accompanied by a strategic advocacy campaign. Advocates for reform must reframe ART regulation as integral to maternal health protection, the prevention of exploitation and the fulfilment of constitutional rights to dignity and health. Building political momentum will require sustained, evidence-based lobbying and public sensitization that links fertility medicine to Nigeria’s broader public health and human rights obligations.
Comparative models from South Africa and the UK underscore the value of mandatory clinic registration, donor registries and the imposition of compensation ceilings.Footnote 84 These features promote transparency, discourage excessive financial inducement and enable long-term monitoring of donor outcomes. In Nigeria, these requirements should be binding on all licensed fertility clinics, which must operate under state-issued accreditation and be subject to periodic inspections, record audits and penalties for violations. This would align ART practice with the broader principles of health sector regulation and close the loophole that currently allows reproductive medicine to operate as an ungoverned commercial frontier.
Second, the MDCN, in collaboration with the Federal Ministry of Health, should develop and enforce national clinical guidelines on ethical practices in ART. These guidelines should include the mandatory documentation of informed consent, requirements for pre- and post-procedure health checks and detailed record-keeping for all donor procedures. Clinics should be obligated to provide donors with access to their medical files and information on the number of eggs retrieved. A donor registry, similar to the HFEA model in the UK, should be established to track donations over time, prevent over-donation and facilitate the retrospective study of medical outcomes. This registry should be governed by a data protection framework to ensure donor confidentiality while enabling transparency and accountability in clinic practices.Footnote 85
To overcome the historically weak institutional lobbying around ART regulation, it is essential to create a multi-stakeholder coalition involving medical associations, women’s rights NGOs, public health advocates and legal experts. Such a coalition would help sustain legislative and policy pressure, counteract political inertia and maintain ART regulation as a visible and urgent national issue.
Third, legislation should explicitly prohibit informal brokerage systems that operate through social media platforms and profit from recruiting young donors outside the purview of medical regulation. These systems thrive on anonymity, misinformation and the absence of legal consequences. To counter this, the law should criminalize the unauthorized recruitment of and advertisement for egg donors, making it an offence for any individual or organization to act as an intermediary without state licensing. As seen in India’s ART (Regulation) Act 2021, penalties should apply to both clinics and brokers that operate outside the approved legal framework. Furthermore, licensed fertility centres must be made legally responsible for any agents acting on their behalf.
Fourth, given the cultural and religious sensitivities surrounding assisted reproduction in Nigeria, reform efforts must also prioritize early engagement with key societal actors. Religious leaders, traditional institutions and cultural influencers play central roles in shaping public attitudes toward fertility, the family and women’s bodies, and their involvement is crucial to ensuring the legitimacy and acceptance of any regulatory framework. Targeted public education campaigns must be designed to clarify that regulation seeks to protect vulnerable women from exploitation and medical harm, not to undermine cultural values surrounding family and procreation. Effective messaging that frames regulation as safeguarding women, preserving community well-being and promoting ethical medical practices will help build broad-based support for reform and mitigate potential resistance rooted in misinformation or mistrust. In parallel, public education campaigns must be launched through universities, radio, television and social media to inform potential donors of the medical risks, legal rights and ethical implications of egg donation. Such campaigns should be state-sponsored but implemented in partnership with civil society organizations, medical associations and women’s rights groups. Empowering women with knowledge is not merely a policy gesture; it is a practical safeguard against coercion, manipulation and exploitation.
Given the socio-political challenges inherent in regulating ART, reform should be pursued through phased implementation. Immediate priorities should include regulating processes for informed consent, clinic registration and donor health protections, with broader regulation of surrogacy and third-party reproduction introduced gradually. Phased implementation, supported by continuous public education, will help mitigate resistance and ensure that reforms are sustainable.
Fifth, Nigeria’s judiciary must be empowered and sufficiently guided by statute to provide meaningful redress to victims of reproductive abuse. This includes enabling constitutional litigation under section 46(1) for violations of the right to dignity under section 34(1)(a) and the right to health as recognized in judicial interpretation and soft law instruments. However, constitutional provisions must be reinforced by clear legislation on the rights of egg donors, medical negligence standards and clinical accountability. Clinics must be required to retain and disclose donor records, thereby ensuring the evidentiary basis necessary for judicial review. Legal aid programmes must be expanded to ensure that low-income donors have access to representation when seeking justice for harm, coercion or fraud.
Strategic litigation under Nigeria’s constitutional and regional frameworks, such as the ACHPR, can catalyse reform, but only if supported by institutional infrastructure. Judicial officers must receive training on reproductive rights and bioethics, and litigation in the public interest must be encouraged through partnerships between law clinics, advocacy NGOs and academic institutions. Litigation should not be viewed as a last resort but as an integrated element of rights-based reform, capable of shaping jurisprudence, public awareness and policy development simultaneously.
Conclusion
Iyanuoluwa’s story is not an anomaly; it is a symptom of a broader pattern of institutional neglect, legal ambiguity and gendered vulnerability. The silence of Nigerian law on egg donation is not neutral; it legitimizes a space where coercion, medical opacity and bodily risk are routine. The state’s failure to act violates its obligations under the ICESCR, ICCPR, CEDAW, ACHPR, the Maputo Protocol and related international instruments. This article has demonstrated how the absence of legal safeguards enables exploitative clinical practices, obscures the rights of donors and exposes young women to avoidable harm. Through doctrinal analysis and comparative insights, it has identified essential regulatory elements, such as protocols on informed consent, mandatory counselling, donor age limits, clinic registration and post-procedure care, that are both feasible and adaptable within Nigeria’s legal system.
Transforming egg donation from a site of exploitation into one of ethical care and protected reproductive choice requires more than institutional reform. It demands an approach to reproductive justice that recognizes the structural conditions under which reproductive decisions are made. As Ross argues, reproductive justice encompasses the right to access reproductive health services and also the right to do so without coercion, stigma or structural deprivation.Footnote 86 In the Nigerian context, this means that ART regulation must not only focus on consent and safety but also on who gets access, under what terms and with what protections. Regulatory reform must be responsive to socio-economic realities, empower the most vulnerable participants and reflect a national commitment to health justice. Only through a rights-based, context-sensitive approach can Nigeria meet its legal obligations and ensure that its fertility industry serves medicine, not markets.
Competing interests
None
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