As it is in most reproductive matters, donating a little DNA is more complicated for women than it is for men. But with college-newspaper ads offering payments of up to $100,000, more young women each year are following men to fertility clinics. Egg donation is a rapidly expanding part of the $2 billion-a-year fertility business that is unregulated and virtually unsupervised, critics say. No government agency or private association oversees the who, what, when and where for this procedure, or tracks health effects for the thousands of college-age women who each year trade their fertility for cash.
In the back of college newspapers across America, heart-tugging ads are turning up – like this one that recently ran in the Harvard Crimson: "Loving, infertile couple seeking a compassionate woman under thirty-two years old to help us have a baby." The job listings provided by the University of Colorado at Boulder's financial-aid office include an ad for an egg donor, offering $2,000. Sitting below an item seeking a Zamboni driver at $8.28 an hour, this ad must be pretty tempting. Thomas Pinkerton, a San Diego lawyer who places ads seeking donors in college newspapers around the country, claims he has arranged for women to receive up to $50,000 for their eggs. Pinkerton's donors are a select, brainy bunch: None has an SAT score under 1,300, and all graduated from or are currently attending top-level universities. He even checks their transcripts to see how good their grades are. The way he sees it, he's providing smart, infertile couples with a child that "fits into the family culture." Most women don't go through these egg hunters but through donation agencies, newspaper ads or online classifieds and get paid closer to $2,500.
What do you have to do for that $2,500? After passing a screening for psychological and physical fitness (and a host of tests for STDs), a donor gives herself a series of hormone injections. During this time she must remain abstinent because she is dangerously fertile – she may have ten or twenty eggs ready for fertilization. A doctor then places her under either local or general anesthesia and, with an ultrasound-guided needle, punctures each side of her vaginal wall to harvest the eggs from her ovaries. The procedure takes less than fifteen minutes, and while it's painless at the time, there is soreness afterward, for which most doctors write a painkilling prescription. Up to twenty eggs are fertilized in a petri dish and eventually implanted in an infertile woman.
The preferred age for a donor is under twenty-five, and some doctors say the ideal donor is around twenty-one, or even younger. Whether these donors will regret their decisions later in life is a question that cannot be answered, though in her book The Clone Age: Adventures in the New World of Reproductive Technology, Lori B. Andrews, a legal expert on reproductive technology, estimates that up to half of all donors eventually have second thoughts. It's not just the slim possibility that the children they give birth to later in life could unknowingly marry their genetic half-sibling some day. Or that their ovaries might be damaged by hyperstimulation, or that they might experience kidney failure or heart trouble – all uncommon but known possible side effects of the hormone regimen. Donors say they are warned of possible complications like ovarian cysts and hyperstimulation of the ovaries, signaled by bloating, nausea and shortness of breath. But several tell me that they were not warned about studies linking the fertility drugs to ovarian cancer.
"I don't remember if they said anything about that," says Tonya Hunt, a twenty-three-year-old donor from Vermont. Jennifer Mix, a donor from California, says that not only was she unaware of the risk, but it's especially disturbing to her, considering that an aunt of hers battled ovarian cancer. Andrews says this is often the case: "Egg donors are not always told the risks."
Egg donation has been around for less than twenty years, with a relatively small sample of donors, and few reliable studies have been done on things like ovarian-cancer rates among donors. (The study linking these fertility drugs to ovarian cancer has itself been the subject of controversy. Other studies found that only long-term use of these drugs resulted in increased cancer rates.) What's most striking about egg donation is the lack of oversight: "Science has outstripped society, and there are no specific laws [regulating this field]," says Dr. Arthur Wisot, executive director of Reproductive Partners Medical Group, a fertility clinic in Redondo Beach, California. That means no laws requiring full disclosure of cancer risks, or the risk that donors' future fertility could be compromised ... or that in the future laws could be passed that would jeopardize donors' anonymity. There is currently a bill pending in the California legislature that would require certain information on long-term risks of the drugs to be given to donors, but California is the only state considering this type of law.
What's even more shocking is the lack of information about donors in general. The Centers for Disease Control and Prevention admits freely in its latest report on fertility-clinic success rates that it "does not collect information on egg donors beyond what is presented in this report: success rates for cycles using donor eggs or using embryos derived from donor eggs." In fact, the CDC doesn't even know how many donors there are – only how many times eggs are retrieved. In 1997, the most recent year for which the CDC has figures, eggs were removed 4,498 times. In the early days of donations, a single woman would give eggs up to ten times. The American Society for Reproductive Medicine, the largest organization of U.S. fertility professionals, suggests five donations in a lifetime, but that is only a suggestion and is unenforceable.
Which leads to the next troubling issue: Individual fertility clinics and egg-donation agencies are the ones creating screening procedures and weeding out donors with troubling medical histories or who appear psychologically unable to go through with the procedure. But with the demand for eggs far outstripping the number of donors available, it is not in a clinic's interest to scare off potential top donors. And with larger and larger sums of money at stake (an infertile couple will pay $15,000 to $20,000 for a single attempt), will women be tempted to hide a blemish in their family history if it would put them out of the running? Egg donors provide an invaluable service to infertile couples, but the costs to the donors are, at this point, incalculable.