EDITOR’S NOTE: This article appeared in the September 1, 1998, issue of National Review.
Filling the waiting room to capacity and spilling over into a nearby conference room, a group of young women listen closely and follow the instructions: Complete the forms and return them, with the clipboard, to the receptionist. It’s all just as in any medical office. Then they move downstairs, where the doctor briefs them. Everything will be pretty much normal,” she explains. Women complain of skin irritation in the local area of injection and bloating. You also might be a little emotional. But, basically, it’s really bad PMS.”
This is not just another medical office. On a steamy night in July, these girls in their twenties are attending an orientation session for potential egg donors at a New Jersey fertility clinic specializing in in-vitro fertilization. Within the walls of IVF New Jersey and at least two hundred other clinics throughout the United States, young women answer the call to give the gift of life” to infertile couples. Egg donation is a quietly expanding industry, changing the way we look at the family, young women’s bodies, and human life itself.
It is not a pleasant way to make money. Unlike sperm donation, which is over in less than an hour, egg donation takes the donor some 56 hours and includes a battery of tests, ultrasound, self-administered injections, and retrieval. Once a donor is accepted into a program, she is given hormones to stimulate the ovaries, changing the number of eggs matured from the usual one per month up to as many as fifty. A doctor then surgically removes the eggs from the donor’s ovary and fertilizes them with the designated sperm.
Although most programs require potential donors to undergo a series of medical tests and counseling, there is little indication that most of the young women know what they are getting themselves into. They risk bleeding, infection, and scarring. When too many eggs are matured in one cycle, it can damage the ovaries and leave the donor with weeks of abdominal pain. (At worst, complications may leave her dead.) Longer term, the possibility of early menopause raises the prospect of future regret. There is also some evidence of a connection between the fertility drugs used in the process and ovarian cancer.
But it’s good money–and getting better. New York’s Brooklyn IVF raised its donor compensation” from $ 2,500 to $ 5,000 per cycle earlier this year in order to keep pace with St. Barnabas Medical Center in nearby Livingston, New Jersey. It’s a bidding war. It’s obvious why we had to do it,” says Susan Lobel, Brooklyn IVF’s assistant director. Most New York-area IVF programs have followed suit.
Some infertile couples and independent brokers are offering even more for reproductive material.” The International Fertility Center in Indianapolis, Indiana, for instance, places ads in the Daily Princetonian offering Princeton girls as much as $ 35,000 per cycle. The National Fertility Registry, which, like many egg brokerages, features an online catalogue for couples to browse in, advertises $ 35,000 to $ 50,000 for Ivy League eggs. While donors are normally paid a flat fee per cycle, there have been reports of higher payments to donors who produce more eggs.
College girls are the perfect donors. Younger eggs are likelier to be healthy, and the girls themselves frequently need money–college girls have long been susceptible to classified ads offering to pay them for acting as guinea pigs in medical research. One 1998 graduate of the University of Colorado set up her own website to market her eggs. She had watched a television show on egg donation and figured it seemed like a good thing to do”–especially since she had spent her money during the past year to help secure a country-music record deal. Egg donation would help me with my school and music expenses while helping an infertile couple with a family.” Classified ads scattered throughout cyberspace feature similar offers.
The market for reproductive material” has been developing for a long time. It was twenty years ago this summer that the first test-tube baby, Louise Brown, was born. By 1995, when the latest tally was taken by the Centers for Disease Control, 15 per cent of mothers in this country had made use of some form of assisted-reproduction technology in conceiving their children. (More recently, women past menopause have begun to make use of this technology.) In 1991 the American Society for Reproductive Medicine was aware of 63 IVF programs offering egg donation. That number had jumped to 189 by 1995 (the latest year for which numbers are available).
Defenders argue that it’s only right that women are compensated” for the inconvenience of egg donation. Brooklyn IVF’s Dr. Lobel argues, If it is unethical to accept payment for loving your neighbor, then we’ll have to stop paying babysitters.” As long as donors know the risks, says Glenn McGee of the University of Pennsylvania’s Center for Bioethics, this transaction is only a slightly macabre version of adoption.”
Not everyone is enthusiastic about the progress.” Egg donation represents another rather large step into turning procreation into manufacturing,” says the University of Chicago’s Leon Kass. It’s the dehumanization of procreation.” And as in manufacturing, there is quality control. People don’t want to say the word any more, but there is a strong eugenics issue inherent in the notion that you can have the best eggs your money can buy,” observes sociology professor Barbara Katz Rothman of the City University of New York.
The demand side of the market comes mostly from career-minded baby-boomers, the frontierswomen of feminism, who thought they could have it all.” Indeed they can have it all–with a little help from some younger eggs. (Ironically, feminists are also among its strongest critics; The Nation’s Katha Pollitt has pointed out that in egg donation and surrogacy, once you remove the delusion that they are making babies for other women,” all you have left is reproductive prostitution.”)
Unfortunately, the future looks bright for the egg market. Earlier this year, a woman in Atlanta gave birth to twins after she was implanted with frozen donor eggs. The same technology has also been successful in Italy. This is just what the egg market needed, since it avoids the necessity of coordinating donors’ cycles with recipients’ cycles. Soon, not only will infertile couples be able to choose from a wider variety of donor offerings, but in some cases donors won’t even be needed. Young women will be able to freeze their own eggs and have them thawed and fertilized once they are ready for the intrusion of children in their lives.
There are human ovaries sitting in a freezer in Fairfax, Virginia. The Genetics and IVF Institute offers to cut out and remove young women’s ovaries and cryopreserve the egg-containing tissue for future implantation. Although the technology was originally designed to give the hope of fertility to young women undergoing treatment for cancer, it is now starting to attract the healthy. Women can wait to have children until they are well established in their careers and getting a little bored, sometime in their forties or fifties,” explains Professor Rothman. Basically, motherhood is being reduced to a good leisure-time activity.”
Early this summer, headlines were made in Britain, where the payment of egg donors is forbidden, when an infertile couple traveled to a California clinic where the woman could be inseminated with an experimental hybrid egg. The egg was a combination of the recipient’s and a donor’s eggs. The clinic in question gets its eggs from a Beverly Hills brokerage, the Center for Surrogate Parenting and Egg Donation, run by Karen Synesiou and Bill Handel, a radio shock-jock in Los Angeles. Miss Synesiou recently told the London Sunday Times that she is interested in redefining the family. That’s why I came to work here.”
The redefinition is already well under way. Consider the case of Jaycee Buzzanca. After John and Luanne Buzzanca had tried for years to have a child, an embryo was created for them, using sperm and an egg from anonymous donors, and implanted in a surrogate mother. In March 1995, one month before the baby was born, John filed for divorce. Luanne wanted child support from John, but he refused–after all, he’s not the father. Luanne argued that John is Jaycee’s father legally. At this point the surrogate mother, who had agreed to carry a baby for a stable two-parent household, decided to sue for custody.
Jaycee was dubbed “Nobody’s Child” by the media when a California judge ruled that John was not the legal father nor Luanne the legal mother (neither one was genetically related to Jaycee, and Luanne had not even borne her). Enter Erin Davidson, the egg donor, who claims the egg was used without her permission. Not to be left out, the sperm donor jumped into the ring, saying that his sperm was used without his permission, a claim he later dropped. In March of this year, an appeals court gave Luanne custody and decided that John is the legal father, making him responsible for child support. By contracting for a medical procedure resulting in the birth of a child, the court ruled, a couple incurs the legal status of parenthood.” (John lost an appeal in May.) For Jaycee’s first three years on earth, these people have been wrangling over who her parents are.
In another case, William Kane left his girlfriend, Deborah Hect, 15 vials of sperm before he killed himself in a Las Vegas hotel in 1991. His two adult children (represented by their mother, his ex-wife) contested Miss Hect’s claim of ownership. A settlement agreement on Kane’s will was eventually reached, giving his children 80 per cent of his estate and Miss Hect 20 per cent. Hence she was allowed three vials of his sperm. When she did not succeed in conceiving on the first two tries, she filed a petition for the other 12 vials. She won, and the judge who ruled in her favor wrote, Neither this court nor the decedent’s adult children possess reason or right to prevent Hect from implementing decedent’s pre-eminent interest in realizing his ‘fundamental right’ to procreate with the woman of his choice.” One day, donors may not even have to have lived. Researchers are experimenting with using aborted female fetuses as a source of donor eggs.
And the market continues to zip along. For overseas couples looking for donor eggs, Bill Handel has the scenario worked out. The couple would mail him frozen sperm of their choice (presumably from the recipient husband); his clinic would use it to fertilize donor eggs, chosen from its catalogue of offerings, and reply back within a month with a frozen embryo ready for implantation. (Although the sperm does not yet arrive by mail, Handel has sent out embryos to at least one hundred international customers). As for the young women at the New Jersey clinic, they are visibly upset by one aspect of the egg-donation process: they can’t have sexual intercourse for several weeks after the retrieval. For making babies, of course, it’s already obsolete.