The true cost of egg donation
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.