Doing Your Homework: College Girls and Egg Donation
Instructor’s Comment: I regularly read the ads in the UC Davis student newspaper The Aggie—hey, you have to postpone work somehow—so I had often seen the “Egg Donors Needed!” ads. But I never thought of the stories, the facts, and the issues this ad inevitably implied. Malinda Barrett did, and she did a remarkable job gathering these stories, which involved finding women who had been involved or seriously considered being involved in the egg donor program. She also brought out the facts and issues: the large and variable payment and the danger (moral, physical, and emotional). And she wrote the piece with remarkable style and grace, among other things making powerful use of Humpty Dumpty for metaphorical section heads. I’ll never look at these egg donor ads again without thinking about Malinda’s powerful article.
—John Boe, University Writing Program
Humpty Dumpty sat on a wall
At first glance, egg donation feels almost like it should be a black market: young college girls going into dark clinics in order to make some serious extra cash. The process is a little creepier than the experiments you can get paid to do on campuses and more socially accepted than standing on the corner.
“Egg donors needed!” This is how the miniscule ad reads smashed between “room for rent” and “tutor needed.”
“Healthy females ages 18–30. Donate to infertile couples some of the eggs your body disposes monthly.”
Wouldn’t that be my period?
In a college girl’s world that could be tuition for a quarter, backpacks full of new books, not having to worry about what items to buy at Safeway, and a nice buzz for all the Saturday nights till graduation.
On the other hand there’s the issue of how they are getting those eggs out.
According to the UC Davis campus newspaper website, “By the numbers, 35,000 students, faculty and residents read The California Aggie daily. We reach nearly 99% of the student population—over 30,000 students.” That’s a whole lot of girls out there perhaps considering donating these eggs they “shed naturally anyway.”
Della Duncan, a third-year UC Davis student, is one of these girls. She has yet to find the time to donate but has been seriously researching the possibilities since she first read about it in a Seventeen magazine while in high school. Della, with her blonde curly hair swept back by a flowered headband, spoke to me about how she would want to donate to help families in need but is worried about the possible health risks of the process.
Humpty Dumpty had a great fall: The process
So, in general, egg donation is the transfer of a donor’s eggs to the recipient’s uterus after they are fertilized with the sperm of the partner of the recipient. But being a donor requires a lot of paperwork. As Della described to me, she applied last summer to a clinic in her hometown of San Francisco. They had her fill out a large packet of forms detailing her medical and family history. She said, “It’s kind of invasive in a way. They asked if I had any STDs, how many people I have had sex with, if I had ever had sex with a woman, if I had ever had sex for money, or had sex with someone who had. I don’t know if some of those things are part of my medical history or my personality, and I don’t know if they were appropriate for them to be asking.”
What Della didn’t know is that according to some state regulations a woman cannot donate if she has injected drugs or been engaged in prostitution within the last five years. If she has had more than one sexual partner in the last six months she is also not eligible, and clinics will want to test any partners for the possibility of HIV. Programs also require extensive medical history of a donor and her family to try to prevent birth defects or serious inherited diseases. Some may even have her work with a genetic counselor to review all her history. If she does not have access to this information she will not be able to donate.
In the personal essay section Della explained her motivations and goals in life. They also had her include a picture of herself as a child between the ages of two and five. All of this information goes into a profile that gets created about each possible donor. Then when couples come in they can look through a binder of all the profiles, a type of catalogue of baby qualities. At the Davis Fertility Clinic, Donor Coordinator Leslie Taylan is the one who reviews donor portfolios. She said, “A couple looking for oocytes (an oocyte is another name for egg) will give me a portfolio of what they want and we see if their portfolio matches a donor’s.” As it turns out, only 20% of women who apply to be egg donors are chosen.
When a woman applies to be a donor, she must have a complete physical and gynecological exam. Since part of a donor’s blood will be transferred to another person, tests are run for gonorrhea, chlamydia, syphilis, hepatitis B and C, and HIV. She must also undertake a psychological examination. There are a lot of social and moral factors to consider. Religious organizations have differing views on the use of donated eggs and sperm. For example, according to the catechism of the Roman Catholic Church found on the Vatican website, “Techniques that entail the dissociation of husband and wife, by the intrusion of a person other than the couple (donation of sperm or ovum, surrogate uterus), are gravely immoral. These techniques (heterologous artificial insemination and fertilization) infringe the child’s right to be born of a father and mother known to him and bound to each other by marriage.” Program facilitators want to make sure a donor can handle the psychological implications of potentially having an unknown child in the world.
The process of egg donation involves something called in-vitro fertilization (IVF). A donor has to take a series of fertility drugs to prompt her ovaries to produce many eggs at once. They give her a medication that will synchronize her cycle with the recipient’s. At the Davis Fertility Center, according to Taylan, the process takes about three and a half weeks and donors come in about four times. They teach women how to administer the hormone shots on their own. Hormones were one of Della’s biggest concerns. She worries about the possible moodiness and weight fluctuations. But Della relaxed some after seeing the ease with which a coworker and five-time donor self-administered the shots.
Removing the eggs from the uterus is a surgical procedure. Donors are anesthetized and will not be able to remember anything. According to the Davis Fertility Center website, “The egg retrieval is performed using an endovaginal ultrasound with a needle guide attached. A needle is passed through the back wall of the vagina and into the ovary and the eggs removed. A typical egg retrieval takes 10–15 minutes.”
After about a half-hour recovery time, donors are allowed to go home but cannot drive or participate in any activity for the day. They are told to expect spotting and cramping. Because they might not be able to retrieve all the mature eggs a donor’s body has produced, donors are advised not to have sex until their next period because the risk of pregnancy is high.
This is the end of the process for a donor, which can be an emotional let-down after such intense involvement. The eggs are then taken, mixed with sperm, and transferred to the recipient. After donating, donors have no say in what happens to the eggs. Infertile or damaged eggs may be used in research or discarded as medical waste. The recipient may become pregnant, may miscarry, or may carry through term. The donated eggs may even be frozen to be used months or years later. Most programs keep donation anonymous. But some facilitate contact between the family and donor or allow the future child to contact their donor if consent is given.
All the king’s horses and all the king’s men: Do you pay by the dozen?
A lot of factors determine how much young women will get paid for egg donation: what country they reside in, what region, if they have had experience donating, and of course what agency they choose to go through. In the United States egg donors can legally accept payment, but in some countries such as New Zealand the process is more philanthropic. It is called “egg sharing” and no compensation is given. In the United States, the going rates are higher in larger cities such as New York, San Francisco, Los Angeles, Seattle, and Houston.
According to the American Society of Reproductive Medicine (ASRM), “Compensation should be structured to acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, and oocyte retrieval. Compensation should not vary according to the planned use of the oocytes, the number or quality of oocytes retrieved, the number or outcome of prior donation cycles, or the donor’s ethnic or other personal characteristics.” Also, “Total payments to donors in excess of $5,000 require justification and sums above $10,000 are not appropriate.”
When reading an ad for donation women should find out who placed it. Many fertility programs advertise, but there are also organizations called egg brokers who try to recruit women but don’t offer all the medical services. Some advertisements are for very specific qualifications: Ivy League education, height, athletic, or artistic abilities. These ads could be placed by searching couples but more often than not are placed by egg brokers who want to advertise these egg donor qualities to attract recipients.
Egg donation doesn’t guarantee that the recipient will get pregnant. As a result, if a woman has donated previously and gotten good results (good results being a live birth) she tends to receive higher pay in subsequent donations. Also, some agencies will even pay for her to recruit her friends.
Another major factor is how accomplished the woman is (which would explain the heavy advertising on a UC campus). Usually women who did not graduate from high school will not be accepted. For all the over-achievers out there with good-paying jobs, Ivy-league educations, or graduate degrees, there’s another gold star to add to their repertoires: “exceptional egg donor program.” Ladies who qualify for this program tend to be paid more than the average donor.
On the form Della filled out, she was even asked for her SAT scores. She knows about the pay benefits of being more educated and has considered waiting until after graduate school to donate. She is interested in the money but does have some qualms about the system. She said, “I know Harvard or Stanford eggs are worth more. UC Davis is considered not quite as good. It’s interesting to think that there is someone out there tallying all these points up. It can definitely hurt your feelings for your eggs to not be wanted.”
Just as someone donating an organ would not be paid for it, these women are not supposed to be paid for the actual eggs. Rather, compensation is supposed to be for the discomfort and risk they will be facing. But with all the different standards of pay, a lower price can feel like a personal rejection.
There also seems to be higher demand for certain ethnic groups. Many recipients want eggs with qualities similar to themselves both physically and culturally. Della’s coworker who donated five times also happens to be Asian-American, a quality she believes made her more desirable.
Recipients are mostly women in their late 30s or 40s. These are women who are unable to produce normal eggs but are otherwise capable of becoming pregnant. They may have entered menopause at an early age or have problems with their ovaries. Donation provides women with a greater than 65% chance of conceiving each cycle. Occasionally, egg donation is an option for couples who are capable of conceiving but who want to avoid a known disease risk. Clinics will often work with single women who are trying to get pregnant and require both egg and sperm donation.
Couldn’t put Humpty together again: The Risks
The business of egg donation is growing by almost 20% per year. In the year 1984, donors were paid an average of about $250, while now they are paid thousands of dollars. Many critics worry about the targeting of young girls strapped for cash. In Confessions of a Serial Egg Donor, Julia Derek tells how she donated twelve times after the promptings of an egg broker and in an effort to stay atop of her finances. As she dealt with the side-effects, Derek eventually became depressed and suicidal. Unsurprisingly, Derek does not recommend donating. In an online interview with Chick Lit Books Derek said, “[because] the business of egg donors is growing so quickly, it’s important that women are thoroughly informed about all aspects of donating your eggs and get a sense of how easy it can be to get caught up in all the money one gets compensated.”
A major concern is the very limited government regulation. In addition, since the process was only begun in Israel in 1986, there is very little knowledge about the long term effects. The New York State Department of Health’s website says concerns regarding long-term impacts on donor fertility remain unanswered.
All of these are factors college campus ads never seem to mention. And after donating, these girls technically have a child out there . . . .
For our girl in question, Della, an unknown child doesn’t seem to be a problem. She does not want the parents to contact her before the donation goes through for fear that “the littlest thing could rub me the wrong way and prevent me from going through with it.” But she is expecting a phone call eighteen years down the line. She said, “I want to see how they turn out. I don’t think there would be a problem since it’s not like a baby I gave up. I was doing it to help a family in need.”
Her family and loved ones are not quite as comfortable with the idea of Della donating. A past boyfriend was turned off of the idea for fear that Della would be putting her reproductive health at unnecessary risk. Her dad considers it a sell-out. He wouldn’t expect his college-educated daughter to work at a fast food restaurant and can’t understand why she would want to donate. The topic does seem to be taboo, and as Della said, “I don’t see a lot of people going for it. My friends are definitely not considering it.”
Elisa Tran is another UC Davis student who considered egg donation in her freshman year to gain some extra cash. Now a third-year Exercise Biology student with short black hair and sweeping bangs, Elisa spoke to me about why she no longer is interested in donating: “Basically I was interested in it for the money. As a college student I thought it sounded like easy cash. But I don’t think it’s such a good idea anymore because it might be a painful experience, especially with the surgery. Also, I would hate the fact that a replica of me was running around out there that I couldn’t have a relationship with. I want my own babies and the risks are just too high.”
One common risk is infection from the needle used to extract the egg from the ovaries. “A much more serious risk,” according to Taylan, “is ovarian hyper-stimulation syndrome. This is the overproduction of follicles in the ovaries. It can lead to a 5–10 pound weight gain in one to two days, vomiting, nausea, and bloating.” In other words, hyper-stimulation is what happens when thirty plus eggs leak out of blood vessels, building up in the abdomen. Ovarian hyper-stimulation syndrome can even lead to kidney failure or death.
A major concern for many girls is the unknown effects on their own fertility. As Della put it, “What if that was the one child you could have? It’s definitely like gambling. It’s a matter of fate.”
Still, donating is a gamble it seems many college-aged women are willing to take.