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The true cost of egg donation

February 1st, 2011

by Mary Rice Hasson

A pretence of altruism cloaks the mercenary and exploitative reality of this aspect of IVF.

“Melissa” is a college student, blonde, bright, and beautiful. A high achiever with a soft spot for other people’s troubles, she heads back to her Ivy League campus this week. First stop: the financial aid office to sign loan documents to secure this pricey education and coveted degree.

She’s exactly the type of young woman targeted by egg donor agencies, desperate couples, and fertility clinics. They want her eggs. Badly. And they know how to find her.

Using Craigslist.com, flyers posted in coffee shops and fitness centers, and ads in university newspapers, egg “recruiters” find young women to meet the exploding demand for human eggs. Roughly one in seven couples now suffers from infertility. Delayed childbearing and rampant sexually transmitted infections mean that many would-be moms have eggs too old or organs too damaged to support conception. So donor eggs are a hot commodity. (Indeed, many fertility clinics report more success with donor-egg IVF than IVF using a woman’s own eggs.)

The scientific clamor for embryonic stem cell research also drives the demand for more eggs. New York, for example, allows payments for donor eggs intended for stem cell research. Ethicists worry that payments for research-bound eggs may induce women whose eggs won’t pass muster at fertility clinics to donate eggs without fully realizing the risks involved.

Egg donation carries serious risks, no matter whether the eggs end up in a research scientist’s lab or an infertility clinic’s freezer.

Eggsploitation, a powerful, disturbing documentary, tells the heart-wrenching stories of egg donors who suffered devastating consequences, including lost fertility, serious disability, and near death.  This award-winning film sends a critical warning to young women thinking about donating their eggs: Don’t.

The film triggered my own search of infertility-related websites to analyze the messages aimed at prospective donors–young women like Melissa. Rife with competing interests, this results-driven industry offers few protections for the person most vulnerable to exploitation—the young woman who sells her eggs.

The fertility industry targets young women with an altruistic narrative: The “fulfillment from helping an infertile couple achieve the dream of having a baby is priceless.”  Recruiters flatter their donors, telling them they are indispensable (“women [can’t] realize their dreams of having a family…without you, the egg donor”) and validate their worth with an $8,000 check. Others “guilt” women into donating, telling them they represent an infertile couple’s last hope (“Without egg donors like you, couples… struggling to start a family would have little hope”).

Egg donation is portrayed as “one of the most powerful and rewarding decisions a woman can make.”

It’s a convenient myth. Coating the raw financial deal with the emotional gloss of altruism helps both would-be parents and egg donors feel better about the process—and themselves.

Lift the veil of altruism, however, and reality looks very different. If women weren’t paid, very few would donate eggs.  Countries that forbid or limit payment to egg donors can’t find enough donors to meet the demand. Women themselves admit that money matters: less than a third of donors claim their only motive was altruistic (e.g. to give infertile couples a baby). Nearly 60% say money motivated their decision, at least in part (18.8% say money was their only motive). Surely many egg donors are sincere and compassionate, but the industry would shrivel up without cash incentives to keep the pipeline flowing with donor eggs.

Paying healthy young women to undergo a medical procedure with significant risks and no personal benefit exploits them—especially when the sums paid are large and the risks poorly studied and ill communicated.  And that’s the case with egg donation.

Donors are typically students, like Melissa, or women with entry-level jobs. Dangle $8000-$10,000, per monthly cycle, in front of a cash-strapped college student or a barista struggling to live in an expensive city and you’ve got donors. It’s an effective incentive. (One agency even promises $50,000 to $100,000 to egg donors who meet stringent, personalized search criteria.) Students discover that they can easily cover tuition of $50,000 by becoming a repeat donor. The unofficial limit is six cycles, but money entices some women to exceed that limit.

No one really knows how egg donation affects a young woman’s future health and fertility. Small studies and scattered donor reports suggest links between fertility drugs and cancer, infertility, and other health problems. In the U.S, no one tracks complications or long-term health risks for egg donors. Most egg donors are anonymous (no registry) and receive no follow-up care once the donation cycle ends.

Industry players also routinely minimize the known risks. One of the few studies of past donors found that 20% did not recall being informed of any risks. Although 12.5% of past donors reported experiencing ovarian hyper-stimulation (a serious, potentially fatal, complication), donor agencies and fertility centers downplay the risk as “rare,” or present in “1-2% of patients,” or as a “5% chance in any cycle.” And prospective donors who wonder whether egg donation might affect their future fertility are flatly misled: “Donating eggs will not harm your future fertility.”

The industry has a collective self-interest in not researching the long-term risks of egg donation, lest they scare women from donating just as demand skyrockets.

The fertility industry exploits women by soft-pedaling the potential risks of egg donation while offering quick payoffs. But more appalling is the silence surrounding the human costs of IVF itself.

Donor agencies and fertility clinics erect deliberate smokescreens, obscuring what egg donors see of the baby-making process. They promote a mental image of the “results,” captured in happy photos of cherubic babies and ecstatic parents.

But this rosy picture of smiling babies and happy endings is one of the cruelest deceptions in egg donor recruitment. Agencies and fertility centers never give prospective donors a realistic picture of the human costs accompanying egg retrieval, fertilization, cultivation, storage, and implantation; at best they describe the processes in euphemisms, downplaying the loss of life.

What’s at stake is not whether the donor’s pain and effort are worth it, given the human cost; the real question is whether egg donors even see the moral implications of the process they set in motion.

Consider:

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  1. Mont D. Law
    February 1st, 2011 at 16:52 | #1

    It is amazing to me that you deny women any agency at all in this. They decide that the money is worth it and don’t share your religiously motivated moral horror so they are poor dupes that must be protected. I am all for more regulation if health concerns turn out to be valid but this view of young women as unable to resist the siren song of money is neither flattering nor true. Anymore than it is true that an 18 year old boy who signs up for military service for a $10,000 bonus is a dupe and a fool that needs to be protected. These are adults.

  2. February 1st, 2011 at 23:34 | #2

    @Mont D. Law
    I’m at a loss as to how you reached the conclusion that this article is about “religiously motivated moral horror.” Religious beliefs aren’t even brought up until the conclusion, after following the link at the bottom. Exploitation of women is deserving of moral horror. As for your example, if that 18 yr old boy signed up for the military after having promised cash waved at him while the risks and dangers were either downplayed or never disclosed, I’d call that exploitation, too. Most people joining the military, however, know full well they’re signing up to potentially kill or be killed in the name of their country. A woman being manipulated into selling her eggs by waving cash at her and not giving her enough data about the potential harm to give informed consent is a very differnt scenerio.

  3. Mont D. Law
    February 2nd, 2011 at 13:57 | #3

    A woman being manipulated into selling her eggs by waving cash at her and not giving her enough data about the potential harm to give informed consent is a very differnt scenerio.

    You have no hard evidence that egg donation causes any long term harm. If you have solid scientific evidence then regulations should be put in place to ensure women are notified. But until that is the case, what exactly are you warning these women against? As for the military analogy, it is very apt because not only are these poor boys not accurately informed of the risks, recruiters actually lie.

    “Last year, ABC News armed a group of high school students with hidden cameras and sent them into ten Army recruiting stations in in New York, New Jersey and Connecticut, posing as potential applicants.”

    “One recruiter was filmed telling the applicant that his chances of being deployed to Iraq or Afghanistan after basic training and job school were”slim to none.” One recruiter bluntly stated that the Army wasn’t sending people to Iraq anymore — in fact, they were bringing them home. One simply said, “War? What war? The war ended years ago.

    Another recruit was told he could quit the Army anytime he wanted to, just by asking, under a “failure to adapt” discharge. ”

    These people are adults, 10 minutes on the internet would give them, boys and girls, all the information they need to make an informed decision about egg donation or military enlistment. If they don’t take that time or if they decide in the money is worth the risk – so be it.

  4. February 2nd, 2011 at 16:20 | #4

    @Mont D. Law
    For the first part, the whole point of the story is that these women are not being given enough information; they’re being emotionally manipulated and sold a bill of goods that’s all sunshine and roses while having substantial amounts of money. This is a problem that’s endimic within the medical field (I’ve been a victim of it myself). That this also involves the buying and selling of, essentially, parts of her body and, potentially, future children and risking her fertility, this makes it exploitation.

    For the second part, I’m not sure the examples you gave would be considered exploitation (though I would agree it is exploitative) but I think it falls under fraud.

    To extend the comparisons; if the young man is convinced to join the military under false pretenses, he would have legal recourse to break contract, though I image it would be difficult to convince anyone that he was naive enough to go through basic training and not clue in that he might actually have to go to war at some point. At worst, he could refuse to be deployed, knowing he’d be jailed for it (or, like some have tried, head for Canada and claim refugee status).

    For the woman who discovers years later that she’s become infertile because of a proceedure she was assured was safe (how many people actually take those 10 minutes on the internet; especially after being convinced by an “expert” that it’s safe?), she might have legal recourse and even get compensation, but she’d still be permanently damaged. Meanwhile, a whole host of people have profited from causing that damage. I see a significant difference between the two, though in a more general sense, I would consider both having been exploited. That she got paid doesn’t really matter, either. Technically, sweatshop workers get paid, too and, after all, they accepted the risks of paying some shadey character their life’s savings, or going into debt to some human trafficker, to be smuggled into another country, didn’t they? Does that make them any less exploited?

    Actually, I need to correct myself. The fact that they get paid does make a difference. As the article states, in places that don’t pay the donors, there is a shortage of eggs. Which means money is being used to override normal objections to the proceedure. They’re taking advantage of these women’s need for money, which adds another level of exploitation.

  5. February 2nd, 2011 at 16:21 | #5

    @Kunoichi
    Ergh. Please excuse my horrible typos. :-P Not a good day for typing! *L*

  6. Mark
    February 3rd, 2011 at 15:26 | #6

    Is it any different than sperm donation?

  7. Heidi
    February 3rd, 2011 at 18:15 | #7

    If I still had my ovaries, I’d donate my eggs!

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