‘Eggsploitation': The infertility industry has a dirty little secret

Eggsploit: “To plunder, pillage, rob, despoil, fleece, and strip ruthlessly a young woman of her eggs, by means of fraud, coercion or deception, to be used selfishly for another’s gain, with a total lack of regard for the well-being of the donor.”

The harvesting of human eggs is a booming, multi-billion dollar industry that is quickly becoming more prevalent throughout the world. Today, women can choose to become egg donors and receive handsome compensation. It is illegal for a woman to sell her eggs in all U.S. states except New York, so instead she “donates” them and is paid for her time and effort. These highly sought-after eggs are being used for both fertility problems and for scientific research, including stem cell research.

Despite the rapid growth of the industry, it seems to be operating out of the sight of most people. News reports are surprisingly absent. Ads like the ones on page 9 can be found on college campuses, subways, or Facebook, where the egg donation businesses hope to find attractive, fertile, and naïve young women, without drawing the attention of anyone else.

Jennifer Lahl, founder and president of The Center for Bioethics and Culture Network, became aware that there are women who have donated eggs and had problems that the public needs to be warned about. In an interview with ToTheSource.org, she says, “I’ve been writing and speaking on reproductive technology for close to a decade, and through my work, egg donors in the U.S. have found me and contacted me to tell me their stories. These were women whose stories had a negative outcome, and the donors had nowhere to go.”

As Lahl learned about what was happening to these women, she felt compelled to direct and produce the documentary Eggsploitation, which won the award of Best Documentary in the 2010 California Independent Film Festival. Eggsploitation exposes two disturbing problems with the egg donor industry:

1. The enticement of young women to donate their eggs without providing proper informed consent, and how they are treated as commodities.

2. The fact that no research or follow-up is done on women who donate their eggs, even when cases of severe health complications and death have occurred.

What is egg donation?

The process of harvesting eggs from a woman’s body is generally unknown to the public, including the young donors. To donate eggs, a woman must daily take different powerful hormones via pills and self-injections over a several-week timespan in order to complete the following process:

1. Hormones are used to stop the ovarian function, thus inducing temporary menopause. This is done so that the doctor can control the timing of the maturation and release of the eggs.

2. The ovaries are stimulated by medication (a process called “superovulation”) in order to produce and mature multiple eggs. Women normally produce one to two eggs a month, but donors are expected to produce several times that amount through superovulation.

3. Shortly before the retrieval, another drug is injected to release all of the matured eggs from the ovaries.

After all of this, the woman has a hopefully minor surgical procedure to collect the eggs from her ovaries.

Who are these egg donors?

As the ads with this story demonstrate, there is usually an appeal to the altruistic side of a potential donor, saying their donation could help infertile couples have children. Additionally, these ads typically sport high dollar amounts that would make any twenty-something woman who needs to pay for school and/or has found herself with a large amount of debt take a second look.

Fertility clinics and egg brokers are particularly looking for tall, physically fit, attractive, and intelligent women, and there is a high demand for specific ethnicities, such as Asian, Jewish, and Middle Eastern. There are great efforts to match a woman or couple with her or their ideal donor, but once the donation takes place, the donor becomes a nameless person who has no say over the eggs she has donated, nor is there any follow-up care or research.

The eggsploited

By Jennifer Lahl

“Human egg trafficking is the new frontier of human exploitation,” writes Lahl on The Center for Bioethics and Culture Network blog. “The industry and their brokers prey upon poor women and encourage them to do something which is not good for them.” In 2009, New York became the first and only state (so far) to legalize compensation of up to $60,000 for selling one’s eggs to be used for scientific research. Suzanne Parisian, M.D., former chief medical officer for the FDA, states, “Now I see a shift, where all of a sudden we have money entering in, in terms of research, and we see young women being looked at as a market for eggs. A woman has become a walking ovary.”

Eggsploitation highlights the stories of several women who experienced severe complications from donating their eggs, and who also had long-term health problems that they believe are related to their donation. Additionally, the film tells of one woman who died from a condition that was a direct result of taking the hormone drugs, and another who was healthy, but then died from colon cancer at the age of 34 after donating her eggs three times.

The women Lahl interviewed said they had tried to do research on egg donation before agreeing to participate, and at least two of them had access to online databases and research studies. However, they did not find anything stating that donating eggs involves risk or side effects, and they were assured numerous times by their fertility physicians that the process was completely safe.

Alexandra was a doctoral candidate in need of money so she could finish her dissertation, and she saw egg donation as a “win-win situation”—she would be helping a couple who was not able to have children on their own, and she would also be receiving much-needed funds.

Sindy found herself facing increasing debt while she studied in a combined M.D./Ph.D. program and was behind on bills despite living a frugal lifestyle. She saw an advertisement in her university’s newspaper, and was soon chosen to be the source of “designer offspring” when her IQ tests and desired characteristics matched up.

Once a contract is signed, the donor is obligated to follow the exact dosing instructions. When the women would voice a concern about a process or a symptom they were having, it went largely ignored. For many agencies, a minimum number of eggs are needed to count as a valid egg cycle.

When an ultrasound showed that she had as many as 50-60 follicles growing on her ovary and a blood test came back with abnormal hormone level results, Sindy questioned whether she should continue the procedure. Her concerns were dismissed, and she was told to stay the course; the doctors did not want to jeopardize the cycle.

Even though the egg extraction surgery is minor, it comes with risks, as Sindy and Alexandra both discovered. Immediately following her surgery, Sindy felt dizzy, and had abdominal pain that she suspected was from internal bleeding. She was told she was fine and that she should go home. However, her blood pressure kept dropping and finally, after about six hours, she was admitted to a hospital, where it was discovered that a small artery in her right ovary had been punctured, most likely caused by the extraction needle, and possibly because her ovary was over-stimulated, which makes the vessels very fragile.

Sindy’s body was in shock from the 1.5 liters of blood in her abdomen, and she had to remain in the hospital for several days on respiratory support. In the documentary, she says that the whole time she did not feel like she was being taken seriously, and that they were trying to get rid of her. At one point the doctor told her it was time to go home and asked her why she was still there.

Sindy had many complications following her emergency surgery, and still deals with health problems today that she feels are the result of her decision to donate her eggs. “Everything that happened to me was a chain of events where medical risks were not taken into account, and they didn’t look at the data objectively. They just kept pushing me on,” she said.

Alexandra woke up with extreme pain several days after her egg extraction, and went twice to the clinic for help, both times growing physically worse, and both times being told it was nothing serious. It was not until two weeks after the surgery, when she found herself vomiting feces for an entire night, that the clinic agreed that she should come in to be examined. Doctors discovered that one of her ovaries had become torsioned in her fallopian tube, a condition another doctor at the clinic had previously ruled out. Alexandra ended up losing that ovary, suffering intestinal failure among other things, and being hospitalized for two weeks.

The aftermath

The subject of egg donation is a source of controversy, with advocates claiming that it is safe and poses minimal risk, while others are concerned about the safety of the egg donors and warn that there have been no studies conducted to prove safety, nor has there been any follow-up with the donor either short or long term.

Short-term risks include those related to taking the hormonal pills and injections, as well as risks that come with the anesthesia and surgery. The most common and serious complication is ovarian hyperstimulation syndrome (OHSS). The drugs can overstimulate the ovaries, essentially putting them into “hyperdrive,” and cause symptoms that range from the mild—abdominal pain, pressure and swelling—to the life-threatening—kidney failure, fluid build-up in the lungs, blood clots, and even death. The procedure for extracting the eggs also comes with risk, as with any laparoscopic surgery.

Because no follow-up research has been done on egg donors, there is currently no way of truly knowing the long-term health risks of donating eggs. Just based on breast cancer numbers alone, it is astounding that no clinical trials or warnings have been set in motion.

“Nowhere in the world has anybody done any research on the aftermath of the drugs on women who have been donating—or often it’s not donating—selling eggs across any of the countries who are involved in this kind of trade,” says Josephine Quintavalle, founder and director of Comment on Reproductive Ethics in the U.K. “They become forgotten.”

Unfortunately, after her ordeal with donating eggs, Alexandra’s health problems were not over. At age 34, five years after donating eggs, she was diagnosed with breast cancer. A mastectomy was required, along with four months of chemotherapy and four weeks of radiation, and in the course of her treatment and five resulting surgeries, cancer was discovered in her other breast, which also had to be removed.

Alexandra said that while she cannot prove the relationship between donating her eggs and the cancer, she is certain there is a connection. She had no irregular family or personal health history aside from the complications from donating her eggs. The only irregular thing about her health history is her egg donation. While there is yet to be a doctor who will officially say that there is a connection between fertility treatments and cancers of various kinds, Alexandra encountered two that said, anecdotally, that they see more breast cancer in women who have donated eggs or have had in vitro fertilization (IVF) treatments.

Toward the end of the documentary, the narrator asks the audience, “Who can measure the value of one woman’s story? Some skepticism has arisen based on the suggestion that with so few instances of complications, the practice of egg donation remains a generally safe procedure. But this can’t be known. Without the benefit of medical research or tracking, we have lost decades of results.”

Brittany Klaus works in Communications at Samaritan Ministries. She graduated in 2009 with a degree in Bible and theology from Moody Bible Institute, where she also served as editor-in-chief of The Moody Student newspaper.