The Baby Factory
The advertisement was for a job that, at first, I dismissed entirely. I’d seen hundreds like it during my college career, posted on message boards and peppered throughout campus publications. But as I picked up the flyer and read over its bolded words, I started to believe that, in many ways, it sounded like the dream job: Earn $8,000 for what seemed would amount to little more than a few hours of my time.
I folded the paper in half, placed it on my dorm room desk and left for class, but I couldn’t get the idea out of my head.
“Why not?” I kept thinking. The qualifications seemed easy enough for me (and most girls sitting in my Columbia University lecture hall) to meet: We were all Ivy League students, young, healthy, intelligent and (I hope) responsible. But there was a catch: The ad wasn’t really asking for my abilities, my efforts or my time, but for a tiny piece of myself—a nearly microscopic cell growing inside of me—known biologically as an oocyte, but more commonly, an egg.
Egg donation is big business. Debora Spar, author of The Baby Business and a professor at the Harvard Business School, estimates that spending on donor eggs has reached $38 million a year, an ever-growing segment of the estimated $3 billion a year fertility industry. And many are cashing in to the largely unregulated industry. In addition to university medical centers and hospitals, hundreds of new businesses have opened, including egg brokers and donor agencies that solicit potential donors and work to pair them with infertile couples. According to the CDC, a total of 5,449 pregnancies resulted from the procedure in 2004—the result of 15,175 attempted cycles, up from just 1,802 attempts in 1992, making it the fastest-growing infertility treatment in the country.
As I would eventually come to discover, newspapers all over the nation are full of ads in search of willing egg donors. And young, fertile college students are their primary targets. Women in the 21 to 32 age group produce more eggs and eggs of higher quality, and advertisers know that they will appeal to couples who believe that intelligent, well-educated donors will pass on their traits to intelligent, motivated eggs. The advertisers also know that these women are often struggling under the burden of tuition and loan payments and looking for a quick financial fix.
It was enough to pique my curiosity. The deal sounded almost too good to be true. The eggs these couples were so desperately seeking were, to me, nothing but cells—barely visible dots tethered somewhere inside of me that I couldn’t even prove existed. And it wasn’t as though I were doing anything with them. Each month they were destroyed, flushed dismissively down the toilet. Why not put them to use? Why not cash in on my monthly discomfort?
That’s exactly what Julia Derek, the author of the self-published Confessions of a Serial Egg Donor, thought when she came across a similar ad in 1995. At 24, Derek came to the U.S. from Switzerland to attend George Mason University in Washington, D.C. Within three months, she had spent her entire life savings and was desperate for money—but had no green card and no working papers. One day, Derek stumbled on an ad in her campus newspaper that read, “Egg Donor wanted: Infertile couple searching for tall (5’8” minimum), athletic, green eyes, brunette egg donor between the ages of 18-30. Preferably from Northern or Eastern Europe. Very Discreet. Compensation: $3,500.” Out of curiosity, Derek called the number in the ad. Within four years, she had undergone 12 egg donation cycles, providing half the genetic material to dozens of offspring.
While Julia’s repeated donations were beyond anything that I could imagine, as a self-declared feminist, the idea of taking charge of my body was appealing. I would be desexualizing conception and motherhood and taking charge of my own fertility, which seemed like an empowering idea. To be honest, the thought of altruistically fulfilling the dreams of a desperate, infertile couple didn’t seriously enter my mind until a social worker at the fertility clinic I visited asked me why I was interested in donating my eggs “other than the money,” and I was forced to muddle together a heartfelt story about knowing a woman who had had difficulty conceiving and about how I wanted to bring joy to the world. Nonetheless, that all sounded good, too.
But my initial excitement and visions of empowerment soon began to fade as I learned that the process was far from the simple one promised on agency homepages. The risks were frightening, with potentially devastating consequences (see sidebar page 15). Most telling, however, were the pages and pages of photographs of young, attractive women who were featured on numerous online donor catalogues for potential recipients to choose from. The women’s names, heights, bodyweights, hobbies and IQ scores were listed, with price tags all but stamped onto their foreheads. Some even included asking prices and donor status. It was like flipping through a human Sears catalogue, and I felt uncomfortable with the idea of gracing its pages.
Even though I decided early on that if I were to go through with the procedure, I would want my identity to be kept completely anonymous, the selection process still made me cringe. As I viewed image after image of wholesome blonds, Catholic Southerners, sexily smirking brunettes and pretty faces topped with mortarboards, I couldn’t help but pick apart the women’s features like an insecure junior-high school girl. I kept trying to imagine whether I would want to give birth to that particular set of genes if I were in a recipient’s position. Only blondes with light-colored eyes, I found myself insisting. Tall? That would be nice. And, of course, she has to be smart. This one’s a little on the unattractive side, I noticed. And this one likes scrapbooking (out) and wants to be an accountant (out). Might as well choose the best if you’re paying top dollar, right? Might as well get the best genes I can afford.
Was this what potential recipients would be thinking when they inspected my information? If selling my body was so empowering, then why did I feel so degraded? Could there really be power in objectification?
To be clear, state and federal law prohibits direct payment for tissue or organs. Donors are allowed to receive reimbursements for expenses and costs incurred as a result of a procedure, including medical bills and lost wages. The difference between selling organs and donating eggs, clinics say, is that donors are not technically being paid for what’s being removed from their bodies, but for the time, inconvenience and discomfort associated with retrieval. But for critics—as well as some who have undergone the procedure—the technicality is irrelevant. “Of course they’re buying my eggs,” Derek laughed. “I believe that’s what it’s really about. I think it’s funny that people think of it any differently. It’s a transaction. But it sounds much better if it’s egg donation,” she said. Many even contest the term “egg donor” since women almost always receive payment.
The question of how much is too much is a difficult one. “How much do you think someone should fairly be compensated for eight weeks of work?” asks Dr. David Barad, the director of Assisted Reproductive Technology at the Center for Human Reproduction—especially when such work involves anesthesia, injections and medical risks. “I don’t think it’s fair to ask someone to do something like that for free.” And women won’t. A recent survey of previous donors by Northwestern University found that only 11 percent would have done so without compensation. In the U.K., where payment for donors has been capped at the equivalent of $24, infertile couples can expect to wait five or more years for donors thanks to supply shortages.
Guidelines established by the American Society for Reproductive Medicine (ASRM) Ethics Committee in a report released earlier this month state that donor payments of over $5,000 “require justification” and that “sums above $10,000 are not appropriate.” And according to a recent survey, the average donor compensation nationally is a modest $4,216. However, because demand for eggs far surpasses supply—and grows higher and higher each year—compensations are frequently much greater, especially in urban centers. A survey of the city’s major fertility clinics reveals that the going rate in New York City is now about $8,000, with higher sums frequently advertised in classified ads and online.
And not all eggs are created equal. It’s not unheard of for “exceptional donors,” especially those who have successfully donated before, to fetch $10,000, $25,000, or $50,000. One headline-grabbing ad claimed to offer $500,000 to one Ivy League student with an SAT score of at least 1400 who stood at least 5’10.” According to Lyne Macklin, Program Administrator at California-based Egg Donation Inc., “exceptional donors” are entitled to higher compensation because they have proven track records and experience. “You have medical records to substantiate what they’ve done,” she says. “That’s attractive to a couple.” Repeat donors are also easier to process. A first-time donor, she explains, “takes much longer” because the clinic is dealing with “an inexperienced body.”
Jewish and Asian donors, especially those with strong educational backgrounds, are also in high demand and can thus demand higher prices. At least one agency in the city, NY LifeSpring LLC, specializes in pairing couples with young Israeli women here on vacation. Many clinics also have long waiting lists for couples seeking donors of Chinese, Japanese, Korean and East Indian decent, placing infertile couples in a sort of bidding war against one another. These couples often have to wait years for a match and frequently turn to egg brokers, agencies and advertisements to help track down donors. However, other descriptors that come up again and again in high-priced offers are good health, high SAT scores, intelligence, attractiveness and athleticism, with blond hair and taller than average height frequently big-ticket items.
Barad insists, however, that the market for so-called “designer babies” isn’t a problem. “In general, people want to have a donor that replicates the self as much as possible,” he explains. That means that everyone’s looking for something a little bit different. “You would probably say there’s an idealized guy or girl you might want to find in a singles bar. But everyone’s looking for something else in the eggs … I don’t see anybody who’s trading up, who’s looking for the Nobel Prize or only the Ivy League eggs.”
According to ASRM guidelines, compensation shouldn’t vary depending on “the number or outcome of prior donation cycles” or “the donor’s ethnic or other personal characteristics.” And most well-respected medical clinics, including the one that I visited, do pay a fixed price to all donors. As long as a donor is chosen by a recipient—which is, of course, more likely the more desirable her traits—she will be paid. But, as Peggy Orenstein points out in a recent issue of the New York Times Magazine, the ASRM guidelines are unenforceable, even among the clinics and agencies that have pledged compliance.
According to one ASRM study, one in five clinics still considers donor history and ethnicity when establishing rates. And when the DNA begins setting prices, it becomes very difficult to contend that donors are being paid for their time and not directly for their eggs. “The discomfort one experiences would be the same, regardless of someone’s background,” Barad says. “To say that one person is worth more than another strikes me as inappropriate.”
Many countries, including France and Canada, have already banned payments for egg donation, fearing that financial incentives will blind young and desperate women to the risks associated with donation. After all, what wouldn’t you do for a couple hundred grand?
“I’m not against egg donation,” Derek insists. “But when there’s a lot of money involved, people’s minds get corrupted … I was very naive when I did it.” Derek says she’s in favor of egg donation if the women are well informed, but she’s concerned that doctors ignore donor needs and instead focus on the recipients—the paying customers. “They don’t keep track of anything,” she contends. “They’re guinea pigs.”
“It certainly raises ethical issues,” says Carl Coleman, a law professor at the Seton Hall Law School who specializes in bioethics. “I think a big issue is making sure that the donor understands what she’s getting into.” As the ASRM points out, the current payment structure is also problematic because it produces a situation where poor women serve as egg producers for wealthy couples who can afford to pay the donor, in addition to extensive agency fees, medical expenses and other costs.
Still, I was curious about the process. I was fine thinking of egg donation as a transaction—especially the part where I got paid—so I filled out an online interest sheet with my basic information and, two days later, I had an appointment at a reproductive center affiliated with one of the city’s major universities.
I admit, I was nervous the morning of my appointment. I’d barely slept the night before as my fears began to cloud my reasoned judgment: What if something went wrong? Was this what I wanted? Could I handle the injections, the hormonal rollercoaster? Did I really need that $8,000?
I made my way up the elevator and arrived in a bright, airy medical office waiting room. I was the only person in the huge space filled with 35 empty chairs and a large desk engulfing two very chatty receptionists. I was asked for my driver’s license and Social Security card and handed a clipboard with forms for me to fill out. It was all relaxed, routine and perfectly ordinary. There was no indication that I was there for anything beyond a checkup.
I begin filling out a grueling, 28-page questionnaire on everything from my physical characteristics to my interests to my goals in life. Describe your personality in three lines. Tell us all you ever hope to accomplish. It was daunting. Then came sections about my medical and psychological background and extensive accounts of my family members’ medical histories. One thing I quickly realized was that everything I was writing down was going to be judged for its desirability—and my paycheck would depend on those judgments. And I began wondering: If you knew you’d have to pass up eight grand if you admitted to having more than one sexual partner during the past year, would you conveniently forget that one-night stand?
Pretend that one toke doesn’t count? Recipients must rely on potential donors’ unverified answers about family medical history, lifestyle choices, personality and hobbies, leading me to wonder how honest wannabe donors really are. A 2006 NYU study found, for example, that donors frequently underreport their weights. What else is left unsaid?
After an hour and a half, potential recipients would know everything about their “anonymous donor,” from the freckles on my nose, to my mother’s brother’s weight and my aunt’s leadership potential. Finally, I was ready to meet the social worker with whom I had an appointment.
The woman, dressed in an officious white lab coat, led me into a small room, clipboard in hand. She told me briefly about the requirements of the program, what I could expect and potential side effects. But what struck me more than anything was just how little attention was paid to the psychological effects of the treatment. While I was informed of the potential medical risks, no one asked me how I would feel knowing that the product of my DNA could soon be walking down the street, serving me coffee or sitting next to me on the subway. Was that something I was ready to handle? Would the emotional toll be too great? I remembered how Derek had explained to me that “It’s an ego booster that somebody wants to use your eggs. You feel wanted.” For her, spreading her seeds was an exciting accomplishment, a point of pride. “I think it’s cool that I have kids running around out there,” she had said. But I wasn’t so sure that I wanted a legion of Mini-Mes populating the planet.
Unfortunately, my “social worker” was too interested in painstakingly diagramming the religiosity of every branch of the Jewish half of my family tree to have time for my psychological quandary. After 15 minutes, my Polaroid was taken and I was told that my information would be entered into a database—along with who knows how many others—until an interested donor comes along. Now it was time to wait.
One week later, I received a call from the clinic asking me to come in for blood work and an ultrasound. My eggs had been chosen. It was then that I decided not to go forward with the egg donation process. It turns out that the feminist who was so certain that her eggs were nothing but useless cells felt a little too uncomfortable with the idea of selling them, regardless of how much cash was on the table. Perhaps if it were a kidney—something that wasn’t so charged with emotion and meaning—I’d have felt different. But, at least for now, my eggs aren’t for sale.
Putting the ‘Home’ in Nursing Home
Lifelines in the neighborhood Op-Ed
From Dancer to C.E.O.
The Big Read on the West Side
Seniors Claim Their Street Space
Putting the ‘Home’ in Nursing Home
Lifelines in the neighborhood Op-Ed
From Dancer to C.E.O.
The Big Read on the West Side
Seniors Claim Their Street Space
New York’s Deadly Traffic Problem