Egg donation offers thousands of U.S. couples the opportunity to start a family, allowing them to have children when their own eggs cannot be used. However, while the process makes many new parents happy, the egg donation industry has a dark side.
In her new book, Eggonomicsmedical anthropologist Diane Tober lifts the lid on the seldom-told truth about egg donation.
“When I started doing research with egg donors, about 10 years ago, I was surprised by how little information most donors had about the potential risks and benefits,” Tober said. Newsweek. “I was also surprised to hear from so many people who had unwanted side effects.”
Many donors we’ve talked to have been told by agencies and clinics that the risk is “less than 1 percent.” However, when Tober scoured the scientific literature, this statistic did not appear.
“In fact, some published articles have found that direct complications, for example for the common side effect known as ovarian hyperstimulation syndrome (OHSS), are higher – between 5 and 13 percent, depending on the article,” Tober. said. “I also found that there are no longitudinal studies that specifically look at the impact of egg donation on donor health and well-being over time.”
During his research, Tober spoke to more than 300 donors, and surveyed more than 1000. Of these, the majority said they felt they were poorly informed about the potential risks and long-term impact of this procedure.
It was this lack of information that inspired Tober to investigate deeper. But when he does, a more troubling reality emerges. Much of it is in terms of compensation given to donors.
“In the U.S., we have a very limited market in human eggs. The U.S. egg donation industry is driven by consumer demand and recruiting donor sources to meet that need,” Tober said. “Intended parents usually search donor profiles online for traits they hope to see in their future children. Some of these traits are more social, like being a good person, liking the same things, reading the same books or sharing hobbies , and actually find a parent that you can relate to or feel a connection with the parent.”
However, in the search for the perfect donor, prospective parents may find themselves focusing on physical traits as well.
“A lot of times, what drives the demand for some other donors includes physical traits, like hair and eye color, skin color, ancestry beyond just trying to find someone who resembles the intended parent,” Tober said. “Donor selection and marketing in the US, then, carries some disturbing eugenic overtones.”
This can also go beyond the donor’s background.
“Many intended parents consider donor education important and look for donors who attended Ivy League universities, or who have demonstrated high performance on standardized tests,” Tober said. “But these different traits come with a price tag.”
He then gave an example: “An Ivy League Chinese American donor can be paid up to $250,000 for one round of egg donation, while a donor with less education or a different ancestral background can only receive $8,000.”
Race is a factor in this two-tier system—in a comparison of more than 900 egg donors, Tober found that the top white donor in the US was compensated about $100,000, while the top tier for Black donors was only $12,000.
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In the book, one donor said: “From me, he was very, very specific, and I thought, ‘Oh my God. This is eugenics.'”
Despite these disparities, the price tag attached to egg donation, combined with student debt and economic instability, has motivated many to register and experience several rounds of egg donation, without having to understand the implications.
“Some clinics and agencies encourage donors to continue donating by exceeding the ASRM recommended cycle limit of six over a lifetime,” Tober said. “One donor in my study donated 19 times! If we had a system to track donor cycles, things like this would never happen.
“I have also seen donors hormonally stimulated to produce a massive number of eggs in one cycle. The target range should be about 15 to 20, instead of the normal one per menstrual cycle / ovulation, but some doctors aim to get as many eggs as possible from single donor cycle Some donors in the study have produced up to 80 eggs in one cycle higher the profit potential for the clinic.”
During the interview, Tober spoke to many women who experienced serious complications after the donation process.
“Four women in the survey part of the study had what is called Critical Ovarian Hyperstimulation Syndrome and suffered life-threatening complications, including one whose kidneys started to die, another who had a heart attack and had to be resuscitated, another who had a blood clot in her kidney and had to be on blood thinners more than a year after being released from the hospital, and another who suffered a stroke,” Tober said.
“Then there were also women in the study who suffered from a rare reproductive cancer… Do we know that this unfortunate situation occurred as a direct result of egg donation? No. But cases like this definitely show the need. for more research on donor health donation eggs, and longitudinal studies that follow donors throughout the donation cycle and beyond.”
Ultimately, egg donation can be a fun and rewarding experience, giving hope to approximately 16,000 couples each year in the US alone. But the industry needs to change to ensure protection and equality for all egg donors.
“I think it’s time to think about good evidence-based policy,” Tober said. “Obviously, egg donation helps many people create the family they want, and I really support the right of all individuals and couples to build their families using assisted reproduction when needed. At the same time, the experience and rights of egg donors. have been swept under the carpet.”
He continued: “I think developing a registry to track donor cycles, to stop donors exceeding the recommended cycle limit, and to enable follow-up research on donor health is important. donors with more ways to get help if they are injured, or when there is medical malpractice. “
At EggonomicsTober sets out the following recommendations to ensure safety and fairness for all parties involved in this life-giving procedure:
- Recognize the donor’s rights to true, complete and standardized informed consent, including how pre-existing conditions such as PCOS and endometriosis may affect the necessary hormonal injections.
- Reduce the potential for excessive donations by ruling on financial incentives in donor recruitment.
- Implement independent legal counsel for donors on the condition that they can act in the event of a breach of the donor contract or in the event of medical injury.
- Recognize the rights of the donor as the primary patient.
- Recognize that “no means no” when the donor states that they are not interested in doing another cycle.
- Implement practices to recognize all donors and intended parents have the right to be considered regardless of race, gender identity, sexual orientation, and status.
- Establish a three-branch donor registry to track donor cycles, implement immediate birth restrictions, and enable immediate and long-term follow-up of donor health.
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