[Paleopsych] Meme 047: Free Market Eugenics

[Premise Checker]

Meme 047: Free Market Eugenics
sent 5.10.20


$50,000 Offered to Tall, Smart Egg Donor
N.Y. Times, 1999 March 3
By GINA KOLATA

The advertisements started appearing last week in newspapers at the nation's 
top schools -- Ivy League colleges, Stanford University, the Massachusetts 
Institute of Technology, the California Institute of Technology.

"Egg Donor Needed," the advertisements said, adding, "Large Financial 
Incentive." The advertisements called for a 5-foot-10, athletic woman who had 
scored at least 1400 on her Scholastic Achievement Test and who had no major 
family medical problems. In return for providing eggs, she would receive 
$50,000.

Already, more than 200 women have responded to what is believed to be the 
largest amount of money offered for a woman's eggs. Darlene Pinkerton, who with 
her lawyer-husband, Thomas Pinkerton, placed the advertisement on behalf of an 
infertile couple, said that most respondents were from Ivy League institutions 
and that she was starting to get calls from women in countries as far away as 
Finland and New Zealand. Women from state colleges and universities were 
calling, Ms. Pinkerton said, as were women who were too short or whose S.A.T. 
scores were too low.

When she ran the same advertisement in October, without mentioning the price 
the couple would pay, Ms. Pinkerton said, she got only six responses.

Until now, ethicists argued whether $5,000 was too much to pay for an egg 
donor.  They debated whether it was coercive for couples to ask for S.A.T. 
scores or height or favorite books when they sought egg donors. But, some 
ethicists say, a $50,000 price, in a donor market that just a year ago was 
reeling from offers of $7,500 for donors, makes them wonder whether the 
business is getting out of control.

The couple offering $50,000 wants to remain anonymous, Ms. Pinkerton said. But, 
she said, they decided to offer $50,000 "because they can."

The couple also realized that it might be hard to find a donor who met their 
criteria. They are "highly educated," Ms. Pinkerton said, and want a child who 
can be highly educated as well. They are tall, so they want a child who is 
tall.

"We have heard that only one percent of the college population is over 
5-feet-10 inches with over 1400 S.A.T. scores," Ms. Pinkerton said.

Lori Andrews, a professor at Chicago-Kent College of Law, is taken aback by the 
heights that payments are reaching. "I think we are moving to children as 
consumer products," Ms. Andrews said.

"When prices for donors reach $50,000, it gets to be a meaningful, 
life-altering sum," she said.

Dr. Mark Sauer, who directs the assisted-reproduction program at Columbia 
University's College of Physicians and Surgeons in New York, said he found 
women, even Ivy League women, who were willing to donate their eggs for $5,000. 
And so, Dr. Sauer asks, why would a couple want to pay $50,000?

"I can understand the motive for the donor -- it's like winning the lottery," 
Dr. Sauer said.

After all, he said, it takes just three to four weeks to produce eggs. The 
donor takes fertility drugs to stimulate her ovaries to produce more than a 
dozen eggs, has regular ultrasound exams so a doctor can follow the eggs' 
development, and then is anesthetized while a doctor aspirates the eggs from 
her ovaries through a needle.

But, Dr. Sauer asked, what are the egg recipients thinking when they offer to 
pay so much for a donor with such specific traits?

"What genetic textbook did they read," he asks, that would tell them that they 
could order up a tall, smart, athletic child by paying $50,000 for a donor?

But other experts say they fail to see what is so wrong with looking for 
specific traits in a donor and paying $50,000 for them. Dr. Norman Fost, who 
directs the program in medical ethics at the University of Wisconsin in 
Madison, said it was not so crazy to ask for height and S.A.T. scores.

Dr. Fost said he worried more about parents who tried to engineer their 
children after they were born, pushing them to get perfect grades and to take 
endless S.A.T. tutoring courses.

"I don't think that genetic engineering is any more pernicious," he said.

As for the $50,000 payment to the egg donor, why not? "It's like offering 
someone a million dollars to play professional football,"Dr. Fost said. "You 
are perfectly free to walk away from it. People make these choices all their 
lives."

In the end, he said, "whether children are valued and how they are treated has 
very little to do with how they are conceived."

---------------

Stanford Magazine: November/December 2001: Egg Donors 
http://www.stanfordalumni.org/news/magazine/2000/novdec/articles/eggdonor.html

What Are the Costs?
   _________________________________________________________________

For infertile couples, a once inconceivable notion has become a
possibility through egg donation. But now they're bidding up to six
figures for blue-ribbon donors, and candidate-rich campuses make
fertile breeding grounds for picky parents-to-be. The question is:
what are the costs?
   _________________________________________________________________

by Joan O'C. Hamilton


Lynn Westphal
BABY STEPS: Lynn Westphal, director of stanford Medical Center's
   Oocyte Donation Program, has helped scores of infertile women become
pregnant via egg donation. Patients praise her attentiveness and
  caring approach toward both egg donors and recipients.
Mark Estes

FOR EIGHT AGONIZING WEEKS agonizing weeks last fall, Calla Papademas,
a 22-year-old Stanford graduate, slipped in and out of a coma in the
intensive care unit at Stanford Hospital while her mother, Nancy, kept
vigil. One day, seeking a distraction, Nancy began flipping through a
copy of the Stanford Daily she had spied on a hospital lounge table.
What she saw stopped her cold. The paper was peppered with
advertisements from agencies representing infertile couples seeking
egg donors, some promising $25,000 or more for candidates with the
right combination of intelligence, good looks and athletic prowess.

Seeing the ads seemed a cruel irony to Nancy, whose daughter fit the
advertised profile for an egg donor all too well. Months earlier,
Calla had answered just such an ad, eventually agreeing to donate her
eggs for a fee of $15,000. Now she was lying in a hospital bed,
fighting for her life.

Calla had an extraordinarily rare reaction to Lupron, a synthetic
hormone administered to prepare her body for egg donation. A few days
after Calla began the drug regimen, a benign, undetected tumor on her
pituitary gland--which Calla's doctors believe was stimulated by the
Lupron--grew at a furious rate and ultimately ruptured, causing a
massive stroke. Calla suffered brain damage and lasting weakness on
her left side. Her academic and career plans were derailed, and she
and her family incurred $100,000 in uninsured medical bills.

Calla's ordeal, while unusual, casts a shadow on the emotionally
charged, unregulated world of egg donation, where an influx of big
money is exacerbating the ethical, religious and legal dilemmas
associated with the practice. For years, the traditional donor fee
range has been $1,500 to $5,000, and the clinics involved have been
careful to characterize the money paid by recipients as "compensation"
for the donor's time and discomfort. But as the pursuit of genetically
select offspring has exploded, so have the fees--and concern that
human eggs have become just another commodity in a market-driven
economy. In the past year, couples have offered as much as $100,000
for eggs from bright, attractive donors like Calla--eggs that
statistics say will result in a live birth less than 40 percent of the
time and that may not convey the characteristics would-be parents
desire.

RESOLVE, a national association and support group for infertile
couples, has called for a fee ceiling of $5,000 and a national body to
oversee egg donation. And some ethicists are exasperated that the
fertility industry continues to gallop ahead as fast as technology
will take it. "When people want to [provide an egg] for altruistic
reasons, it's a wonderful gift," says Ernlé Young, director of the
Center for Biomedical Ethics at Stanford. "When donation becomes
commercialized, it raises all sorts of deep, philosophical questions
about using humans as a means to an end."

Young and others note that paying big bucks for über eggs goes well
beyond injecting supply-and-demand dynamics into the intensely
personal realm of fertility. The trend also complicates some of the
most elemental aspects of life and human relations, such as parents'
expectations of their children and the ethics of putting healthy,
young women at risk as commodity purveyors. And advances in unraveling
the human genome promise to increase debate about the issue of
manufacturing humans.

"Making babies" once was merely a euphemism for intercourse. But in
the late 1970s, fertility specialists discovered that they could
create a viable embryo by injecting sperm into an egg in the
laboratory, a process commonly known as in vitro fertilization.
Suddenly, couples with specific medical problems that prevented
natural conception, such as a low sperm count or Fallopian tube
damage, could hope to have a child. By the mid-1980s, doctors found a
way to harvest eggs from one woman, fertilize them, and implant an
embryo in a woman who could not conceive with her own eggs, but who
could carry a child and give birth. There are now more than 6,000
egg-donation procedures each year in the United States, and several
hundred babies at least are delivered to couples who could not have
children any other way.

For women who've successfully borne children via egg donation, the
procedure's stickier issues are easily overshadowed by their own joy.
"It's hard for many women to give up on their own ovaries, but my
happiest patients now are those who've had egg donations," says
fertility specialist Lynn Westphal, MD '87, who was recruited to set
up the Oocyte Donation Program at Stanford Medical Center in 1998. One
of Westphal's patients said that when she finally got pregnant and had
a child thanks to egg donation, "it was a wonderful, humbling moment
of healing. I had been so beaten up by miscarriages and treatments."

Egg donation works like this: The donor begins 10 days of daily
injections of a drug such as Lupron to suppress her own ovarian
function and synchronize her menstrual cycle with the recipient's.
Later, the donor is given another hormone to stimulate her egg
production, which can result in 10 or more eggs during one ovulation
cycle.

The donor's eggs are extracted using a large needle inserted into the
vagina while the patient is under light anesthesia. The eggs are then
inseminated immediately, and within a couple of days, a doctor
implants several embryos in a recipient to improve the chances of one
embryo becoming viable. Recent statistics from 300 U.S. clinics that
perform advanced reproductive-technology procedures indicate that live
births result from about 39 percent of these procedures. Payment to
the donor is made after the eggs are retrieved, however, and is not
contingent on either a pregnancy or a live birth.

How safe is this procedure for donors? As Calla Papademas's case
shows, powerful medications, anesthesia and surgical procedures always
carry some risk. However, Westphal--who did not work with Papademas,
and whose patients give her high marks--says most doctors monitor
donors closely throughout the process and she has "never seen any
serious complications." She does warn donors that researchers are
still studying the long-term safety of the procedure and that, in the
short term, donors can expect discomforts ranging from mood swings and
abdominal swelling to a very painful condition called
"hyperstimulation" in which ovaries produce an unusually large number
of eggs. This can force hospitalization of a donor to drain large
amounts of fluid.

But from the earliest days of in vitro fertilization, debate about the
procedure has focused less on patient safety than on the implications
of tinkering with life at so elemental a level. The Roman Catholic
Church has long condemned all reproductive technologies that
manipulate human embryos. It holds that life begins at conception and
therefore the risks to any one engineered embryo--some are discarded,
frozen or even ultimately aborted if multiple implantations
occur--outweigh any benefits to an infertile couple.

And then there is the specter of eugenics, about which the Stanford
community has some first-hand knowledge. The University's
controversial Nobel laureate, the late William Shockley, generated
massive criticism in the early 1980s when he publicly supported--and
donated to--a "genius" sperm bank in Southern California. Although
Shockley's view that intelligence and other important characteristics
were both inherited and race-linked was furiously condemned, there has
been little public outcry about egg donor programs unabashedly seeking
women with specific physical and intellectual characteristics.

Moreover, medical and ethical experts are quick to point out that
medicine cannot assure that any given trait will manifest itself in a
baby. "[Eggs from] athletic supermodels with high sat scores . . . may
produce dumpy kids who can't do math," notes Henry Greely, '74, a
Stanford law professor and co-director of Stanford's Program on
Genomics, Ethics and Society. "Most of us who are parents know that
the environment makes a difference, chance makes a difference, the
other parent makes a difference."

Westphal agrees. Ordering up special characteristics and paying large
sums to a select donor "creates unrealistic expectations for the
couple," she says. "You never know what kind of child is going to
develop from any egg or sperm. You can't guarantee that anyone will
have any characteristic."

To what degree could parental hopes backfire on the child? What if the
parents felt they "bought" specific characteristics that didn't play
out? "It scares me, putting these kinds of expectations on a child
before it's born," says Rabbi Michael Gold, author of And Hannah Wept:
Infertility, Adoption, and the Jewish Couple. "It's my opinion that a
child has intrinsic value and is not here to meet the needs of a
parent."

Yet, several women who've borne children thanks to egg donation offer
no apologies for searching out particular traits. "Mainly, I was
looking for a good spirit," says Lillian, a San Francisco mother and
eight-year veteran of infertility treatments. She recently had a baby
girl, after paying a donor the "going rate" of $4,000. But she admits
that she pored over donors' vital statistics in the binder her agency
provided and interviewed the woman she eventually picked. "I may be
the best mother in the world, but I'm still going to have some genetic
code to deal with," she says, explaining why she looked for signs of
an upbeat, appealing, generous nature in donor candidates. And she was
eager to improve the odds that her child would share her own tall,
blonde features, especially since she didn't tell everyone in her
family about the egg donation. "It's just going to fly better at the
mall than if my baby has a dark, Mediterranean look," she says of her
fair-haired daughter.

'GIVE THE GIFT OF LIFE & Love' read a full-page ad placed in the
Stanford Daily and in student newspapers at Harvard, Yale, ucla and
other schools last spring. It promised $100,000 to a Caucasian woman
under age 30 with "proven college-level athletic ability" willing to
donate eggs. Numerous other ads have offered between $10,000 and
$80,000. Many list highly specific requirements, ranging from sat
scores to religious orientation to eye color. Others are less
businesslike in their approach: "Bright, creative egg donor wanted by
loving, playful Boston couple," read one April ad in the Daily. "We
recycle, floss our teeth and respect our elders. . . . Anal
personality a plus."

Prospective parents occasionally take out their own ads, but the
splashiest displays offering the biggest dollars often come from one
of the hundreds of attorneys, agencies and fertility clinics that
broker the transactions between donors and recipients. In some cases,
those organizations amass profiles of donor candidates and post them
on websites, which hopeful recipients can peruse like seed catalogs.

STANFORD was unable to connect with any individuals or couples who
paid sums higher than the $15,000 offered to Papademas. Citing privacy
concerns, agencies refuse to discuss details about specific ads or
couples.

Some skeptics question the legitimacy of large payouts. "I'm a
suspicious guy," says Greely. "But why would you pay those amounts
when there are donors willing to do it for $3,000 or $4,000? If you're
in the egg-donation business, what better way [than a sensational ad]
to increase your rolls of donors?"

The Southern California law firm of Thomas M. Pinkerton had several
ads in the Daily offering donors as much as $50,000. Darlene
Pinkerton, who runs the donor-search program, insists that those
offers were real, sponsored by actual clients, and that several
Stanford students who were chosen received between $10,000 and $25,000
each. "After the media hype following our [$50,000] ad, we did have
other families calling us saying they were looking for the same type
of donor but were not able to pay the same $50,000 that we advertised
for," she says. "I contacted some of the [prospective donors] who said
they were still interested, and made them an offer of dollars that the
family could pay. Some said yes; some said no."

There is no way of knowing exactly how many Stanford students are
succumbing to the hard-sell pitch for eggs. Conversations with
students and local physicians don't seem to indicate that undergrads
are flocking to fertility clinics. However, it was not difficult to
find a half-dozen students or recent grads who've donated within the
past year (all for less than $5,000). Their experiences were mixed,
but mostly positive.

Calla Papademas, '99, acknowledges that in the spring of her senior
year, when she first answered an ad that offered $50,000 for a
donation, she had tens of thousands of dollars in student loans piling
up, grad school looming and a clunker automobile that kept conking
out. Her mother, who'd gone through several in vitro cycles herself
when she tried to conceive a baby after Calla, was supportive.
Although Calla wasn't picked for the $50,000 donation, the agency
called her back and said someone else was interested--a gay man
seeking a donor egg to be inseminated with his sperm, then implanted
in a surrogate mother. Calla met the man, and they ultimately agreed
on a fee of $15,000; but by then, Calla says, her primary motivation
was not the money. "He came from a big family and he loved kids, and
this was the only way he could do it," she says.

"Michelle," a recent Stanford grad from Southern California, says she
is thrilled with the $7,500 total she made from two egg donations, but
she insists the money wasn't the only factor. "It's nice to have a
little chunk of change in the bank from this, but it's not purely a
capitalist venture," she says. "A friend of mine did it, and afterward
she felt so good [about helping a couple have a child] that I decided
to try it."

Lauren Russell, '00, had quite a different experience. A veteran of
the varsity crew team, tall, intelligent and attractive enough to have
done some professional modeling, she answered a $50,000 ad that ran in
1999. When the candidates had been narrowed down to Russell and a
Harvard student, Russell was flown to Boston, asked to take an iq
test, interviewed and put right back on a plane home. After speaking
at length with the donation agent during that visit, she began having
second thoughts about participating. The agency focused on Russell's
looks, her high iq and her experience on the crew team, she recalls.
"That was all that was important to them and all they really wanted to
know about," Russell says. "I told them I was curious about why they
were looking for these specific qualities and they quickly changed the
subject."

Although the money was tempting, "my desire to help a family have a
baby became darkened with the realization that the child would be
brought into a world full of unfair expectations," says Russell. When
the agency notified her that she'd not been chosen, they asked if
she'd be willing to donate for a different family for $35,000. She
declined: "I've developed negative feelings about the whole idea of
paying for specific genes, and no amount of money could convince me to
do it at this point," she now says.

Berkeley artist Lisah Horner, one of Westphal's patients, has donated
four times, explicitly for the money. She says she's never wanted
children and feels no bond to the babies her eggs helped produce--even
to the one she actually met. Yet Horner was startled at how empowering
she found the process, and how she came away from it with much more
empathy toward mothers who desperately wanted children. During her 10
days of hormone injections, she kept a journal that she has
incorporated into a collage series. Reads one entry: "An interesting
contrast. . . . This procedure--methodical, intimidating, empowering,
and physically uncomfortable for myself as well as the other woman. My
conception--New Year's Eve 1964--manhattans, champagne, and a little
carelessness."

These donors' feelings about the high fees are also mixed. Horner
would have happily taken the higher amount had it been offered several
years ago when she began donating. Michelle adamantly opposes
exorbitant payment. "I know there's something wrong with those ads
offering $50,000 or that kind of money. It smells bad to me. I
wouldn't trust the kind of doctors in it for that kind of money," she
says.

Egg donation "is a classic example of how explicitly market-oriented
we are, even though we deny it," notes Linda Hogle, an anthropologist
and senior research scholar at the Center for Biomedical Ethics.
Despite attempts by the fertility industry to describe money paid for
eggs as "compensation" for the donor's inconvenience, says Hogle, many
Americans express a "yuck response" to the idea of selling human ova.
The fact is, says Hogle, "it's a sale if you get $5,000 or $50,000 or
$5."

Many European and South American countries prohibit paying for human
eggs and outlaw any kind of commerce in organs or blood. In the United
States, blood, plasma and sperm have been harvested and sold for
decades. However, the more invasive, more intimate nature of egg
donation raises a fundamental moral issue that Young says is at the
crux of why prostitution is prohibited--namely, that one should not be
able to contract to "use" another person's body, devaluing that
person's own humanity.

Stanford law professor Margaret Jane Radin, '63, who studies
commodification and the limits of the market, says the issues are
extraordinarily complex. Some feminists say, "Let's not degrade
ourselves by allowing parts of ourselves to be sold. On the other
hand, some feminists say, 'I should be able to sell anything I want
to. I don't want the state to tell me what I can sell or not.'" If one
takes that reasoning a step or two further, Radin says, the
implications escalate in entirely new directions. "Imagine, for
example, a student being told, 'Well, you don't need housing
assistance because you could just sell your eggs.'" Radin adds: "My
parents scrimped and saved to put me through Stanford years ago. Well,
what if I'm sitting on a $50,000 entitlement? Does that mean I should
just sell my eggs?"

And in a report issued in August, an ethics committee of the American
Society for Reproductive Medicine said that while donors should
receive some compensation--just as men receive money for donated
sperm--the amounts should not be so high that "women will discount the
physical and emotional risks of oocyte donation out of eagerness to
address their financial situations or their infertility problems." The
panel suggested a ceiling of $5,000 for one "donation."

Donors aren't the only ones with financial incentives to consider.
Increasingly, physicians whose incomes have been reduced by changes in
managed health care are gravitating toward the lucrative practice of
fertility treatment. "It's a cash business with affluent patients who
pay up front," shrugs one Menlo Park doctor. But Palo Alto
obstetrician/gynecologist Andrea Hutchinson cautions that although
there are many top-notch fertility practitioners in the Stanford area,
"some clinics have become factories, performing these treatments over
and over on patients who medically should not even be trying to get
pregnant."

Lauren Russell
JUST LOOKING: Lauren Russell, '00, was summoned to Boston for
interviews by a prospective egg recipient but eventually turned down
offers to donate: "I've developed negative feelings about the whole
idea."

IT'S NOT IMMEDIATELY OBVIOUS upon meeting Calla Papademas, poised,
attractive and articulate, that she suffered brain damage. She has
made what her mother calls a "miraculous recovery," but she is still
impaired. She has memory lapses. She had to leave school, at least
temporarily. And doctors have warned that she will probably have
difficulty conceiving her own children.

Although Calla says she is angry at the egg-donation agency and about
the quality of her medical care at the fertility clinic--(despite
severe symptoms that included a high fever and raging headaches, she
was advised to continue taking the Lupron, she says)--she is not sour
on the procedure. "I wouldn't want this option taken away from
someone. . . . I wish I had been better warned," she says.

Shelley Smith of the Egg Donor Program, a respected Los Angeles
agency, is concerned that "some of these doctors are treating donors
like commodities who are only there to help them get their real
patients pregnant." Smith says she has clients who've reported
unsettling experiences in egg harvesting, for example. "There are
about 20 offices doing this in Southern California, and I only work
with two of them," she says, citing concerns about "shoddy" practices
at the others.

Ernlé Young believes the time has come for formal regulation of
egg-donation procedures. Right now practitioners cannot even agree on
basic standards, such as how many times a woman might safely donate
eggs. He says even the risk disclaimers donors sign are suspect
because of the inherent lure of big dollars. "One of the fundamental
elements of 'informed consent' that people [sign in waivers] before a
procedure is not only that it is fully informed, but also that it is
voluntary," says Young. "You could argue that offering a college kid a
sum of money that is excessive is really coercive."

Clergy are grappling with how to advise people concerning egg
donation. Rabbi Gold says that, while he would not oppose a couple's
desire to use this method, the technology has created some important
questions. To begin with, he says, rabbis have been debating just how
to establish lineage. Conservative Judaism holds that one is Jewish
only if one's mother is Jewish. So, what if an egg donor is not Jewish
but the recipient--the birth mother--is? In Gold's opinion, it should
be determined by the woman who gives birth to the child.

Meanwhile, according to Smith, futuristic scenarios of
parents-in-waiting "constructing" a child already have arrived.
Scouring a website where they can select donors, hopeful couples can
quickly get caught up in comparison shopping, where physical features
are the stock in trade. "Couples who would have been looking for
someone with a lovely character before [the Internet] now say, 'Well,
we like No. 98, but haven't you got someone with a bluer eye?'"

A bluer eye could be just the beginning. Soon genetic analysis may
identify genes responsible for specific traits and make it possible to
create embryos "loaded" with the desired genetic material. Step right
up, folks. Here's an egg guaranteed to sidestep genetic illness,
assure a foreign-language aptitude, produce red hair and freckles and
that anal personality you requested.

Now, what am I bid?
   _________________________________________________________________

Joan O'C. Hamilton, '83, a Stanford contributing writer, is a
columnist on high technology for Business Week.

------------------

Detroit Free Press: Baby business
http://www.indystar.com/apps/pbcs.dll/article?AID=/20050923/LIVING01/509230301/1083

Baby business
Bright, attractive young women are sought as paid egg donors for
infertile couples.

By Robert Samuels
Detroit Free Press

Wanted: Healthy, athletic women. Under age of 29. 1300-plus SAT score.
Compensation: $10,000.
The ad above, from the University of Michigan newspaper, was placed by
an agency seeking women willing to donate their eggs to an infertile
woman. So-called donor agents are placing such ads across the country
and online, courting smart, responsible, beautiful young women.
One last hope: Rick Keehn of Rochester Hills, Mich., watches his wife,
Susan, prepare to inject a drug to put her body on the same cycle as
her egg donor's. The Keehns, both 44, have made many attempts to
conceive a child, and implantation of a fertilized donor egg is their
last resort. - Amy Leang / Gannett News Service
Some donor firms
Here is a sampling of egg donor agencies around the country and their
donor compensation. All have agreed to the ethical guidelines of the
American Society for Reproductive Medicine:

Alternative Reproductive Resources
Chicago
http://www.arr1.com
Average compensation: $4,000
Tiny Treasures
Somerville, Mass.
http://www.tinytreasuresagency .com
Average compensation: $5,000
Egg Donation Inc.
Encino, Calif.
http://www.eggdonor.com
Average compensation: $5,000
Fertility Futures International
Los Angeles
http://www.fertilityfutures.com
Average compensation: $8,000
A Perfect Match
La Mesa, Calif.
http://www.aperfectmatch.com
Average compensation: $10,000

Medical procedures are not the most difficult part of egg donation,
says Dr. L. April Gago, who oversees a donor program at the
university. Legal, business and ethical considerations must also be
navigated.
Tonight's premiere of NBC's fertility-clinic drama "Inconceivable" (10
p.m., WTHR ), is sure to draw attention to the procedure:
Doctors give a fertile young woman hormones that cause her to produce
multiple mature eggs. The eggs are surgically removed, fertilized --
most often with the would-be dad's sperm -- in a laboratory and
implanted into the uterus of the recipient.
Egg donation is generally safe, says Dr. Eric Surrey, a Denver, Colo.,
endocrinologist who is president of the Society for Assisted
Reproductive Technology. About one in 100 donors suffers ovarian
hyperstimulation syndrome, causing abdominal bloating. In rare cases
it temporarily shuts down her kidneys. A heightened risk of ovarian
cancer has been reported, but no long-term studies have been done, he
adds.
The Centers for Disease Control and Prevention estimates that, based
on the most recent (1995) data, about 10 percent of U.S. women of
childbearing age have fertility issues.
Six years ago, San Diego, Calif., residents Tom and Darlene
Pinkerton's A Perfect Match service, which placed the ad in the
Michigan Daily -- was criticized as being too specific about donors
and for paying them too much. The agency offered $50,000 to leggy,
thin blond donors with high SAT scores.
"We were one of few agencies then," Tom Pinkerton recalls. "We
wouldn't even dream about charging that much now."
Today, fees through A Perfect Match average $10,000, says Darlene
Pinkerton. The infertile couple sets the price; the agency seeks women
with the pair's desired characteristics. Couples also pay a fee,
usually around $5,000, to the company that matches them to a donor.
With the costs of doctor visits, medications and travel, the price can
top $25,000.
The donation process isn't easy. Potential donors at Alternative
Reproductive Resources must fill out an 18-page application detailing
their medical history, as well as a 500-question psychological test,
and undergo counseling.
Donors must inject themselves with hormones, take shots that get their
menstrual cycle in sync with the recipient's and have ultrasound tests
almost daily in the two weeks before surgery.
Federal law prohibits selling body parts, so donors can be compensated
only for their time and energy, but no one can agree on fees.
A 2000 report from the American Society for Reproductive Medicine
(http://www.asrm.org) said donors should receive about $5,000. More than
$10,000 is to be questioned, it said.

---------------

AlterNet: The High Price of Donation
By Jennifer Liss, WireTap
Posted on October 7, 2005
http://www.alternet.org/story/26469/

The ad in Jessica's college newspaper said that she could make $80,000
donating her eggs. But "Jessica"[1]* isn't the tall blonde the ad
called for. And her weight was a strike against her. A size 16, she
weighs well over what most egg donation agencies will accept.

What she did have going for her is that she is the grandchild of
Holocaust survivors. Jewish, Asian and Indian egg donors -- she would
learn -- are in great demand.

So at 21 she decided to ditch the agency route and try to sell her
eggs on her own. She said she loved the idea of helping infertile
couples fulfill their desire to become parents. And the money she made
would help her pay off credit card debt.

The first time she made $4,000 and had "the easiest donation of all
time." But after the fourth donation she ended up in the emergency
room with dehydration. It was her own fault, she says, and giggles
over irresponsibly planning a road trip after the donation procedure.
By the time she graduated, Jessica had earned $23,000 through egg
donation.

Do her parents know she donated eggs for cash? No. Does she plan on
donating again? Yes, this winter.

Jessica's story may be more common than we think, because little is
known about college students who donate their eggs. The Centers for
Disease Control (CDC) report that they do not collect information on
donors' age, race, income, or education levels.

But we do know that one in six American couples [2]struggle with
infertility, and the demand for viable eggs is increasing. Assisted
Reproduction Technology (ART) procedures performed in the U.S.
increased 78 percent from 1996 to 2002, [3]according to the CDC.

Outdoing Nature

"Caroline,"[4]* who used to model, earned a high G.P.A. at a reputable
liberal arts college. A three-time egg donor, she pocketed over
$20,000 for her efforts. Now 25 and living in New Jersey with her
husband and young child, she doesn't regret a thing.

In many ways, students like Caroline fit the description of a perfect
egg donor. The American Society for Reproductive Medicine (ASRM) says
that younger women respond more favorably to the hormone medication
used during the donor procedure, and their eggs result in higher
pregnancy rates. Caroline's good grades, hot looks, and spotless
health history, combined with her young age made her a highly
sought-after donor.

Darlene Pinkerton of the egg donation agency A Perfect Match says that
80 percent of her donors are college students. And Dawn Hunt, owner of
Fertility Alternatives, says that 90 percent of her donors are college
students.

Hunt used to advertise for egg donors in family and parenting
publications. But dissatisfied with the lack of response, now she
sticks almost exclusively with college publications.

A typical classified ad in a college publication will call for a donor
under 29, physically attractive, with an impressive S.A.T. score. It
will list a high dollar figure, but usually won't mention the
procedure or the legal, medical or ethical risks. (One ad awkwardly
and inaccurately encourages students to "donate to infertile couples
some of the many eggs your body disposes monthly.")

For about five years the Stanford Daily has run a special classified
section reserved for egg and sperm donation ads. Several years ago, a
Stanford student suffered a stroke due to a rare reaction to one of
the synthetic hormones used in egg donation. The current
editor-in-chief does not know if the newspaper received any complaints
about the classified section.

How It Works

How does egg donation work? First, a donor is screened for genetic
diseases and H.I.V. She then undergoes a psychological evaluation.
Once "approved," she is given synthetic hormones to self-administer
over a series of weeks.

During a normal ovulation, a woman releases one egg. But the hormonal
medication stimulates the donor's ovaries to produce many eggs --
sometimes a few dozen. This is called "controlled super-ovulation."

Once the eggs are mature the donor receives an injection that triggers
ovulation. Thirty-six hours later, the eggs are retrieved through the
vagina with an ultrasound-guided needle. The menstrual cycle of both
the donor and the recipient have been synchronized. After the eggs are
fertilized, the embryos are placed in the recipient's uterus.
Hopefully, a pregnancy will stick.

The sale of body parts in the United States is illegal, explains Lynn
Westphal, director of the Oocyte Donation Program at the Stanford
Medical Center and a professor. However, it is perfectly legal for
people to donate body parts -- like blood, sperm, eggs or organs --
and be compensated for their time, effort and discomfort.

Amy Turner also learned about egg donation through a school
publication. Turner, who lives in Waxahachie, Texas, is a 22 year-old
married mom putting herself through massage therapy school. She's
donated once, and her $2,000 compensation is going toward college
tuition.

Compensation is a controversial issue. In some parts of the world,
compensation for eggs is illegal. Typical compensation in California
used to be $2,500, says Mary Cedarblade, an attorney who specializes
in fertility issues. But as more people turned to egg donors to get
pregnant it became harder to find donors, she explains. Cedarblade
says that just last year the going rate in California was $5,000 per
cycle. And now, she says, the average is about $5,500.

"Because of how invasive the egg donation process is, it would be
unreasonable for someone to go through the process and not be
compensated," says Westphal. "But how to determine what is the right
compensation is a difficult thing."

"You have to look at it like you are helping someone who has tried
thousands of times to get pregnant. I'm giving them the joy I had when
I had my child," says Turner about her experience.

As professionals and donors point out, altruistic intentions can run
as strong as the financial motivations.

"Infertile women do not choose to be infertile," Pinkerton writes in
an email about her agency's work. "When they find a donor they relate
to and who resembles them they are transformed into women of hope."

Donor Risks

The first egg donation took place in 1984, but egg donation was
relatively rare until about 10 years ago. In the early years of egg
donation, there were a handful of studies indicating a possible
connection between the hormonal treatments given to egg donors and
certain cancers.

While it now appears that the risks are low, medical professionals are
still uncertain if there will be long-term consequences for donors.
Simply put, there is a lot we don't know. And compared to its male
counterpart -- sperm donation -- that involves a cup and a willing
hand, egg donation is much more invasive and risky.

Westphal explains that the most common health risks she sees are
bruising at the injection site and some bloating. Some women who "over
respond" -- meaning they produce too many eggs -- may develop Ovarian
Hyperstimulation Syndrome (OHS).

If untreated, a donor with OHS will experience significant swelling, a
sense of discomfort, dehydration, moodiness, or possibly difficulty
breathing. In a worse case scenario, her ovaries, under great stress,
could be damaged.

"In general it should not affect the future fertility [of the donor],"
she says. (There have been no documented cases.)

Julia Derek lived an egg donation nightmare, documented in her
self-published book "Confessions of a Serial Egg Donor." In four
years, Derek donated 12 times -- six times over the limit recommended
by the ASRM. She made between $40,000-$50,000. However, as a result of
the hormones and lack of care, Derek sunk into a severe, almost
suicidal, depression.

A Swedish student in Los Angeles, Derek couldn't legally work because
she didn't have a green card. She felt her only two choices to make a
living as a student were egg donation or being a server under the
table. She chose egg donation.

At first, the compensation got her out of a jam, but soon egg donation
was funding her "L.A. lifestyle." She describes in her book speeding
on the 405 freeway on her way to a comedy open mic while shooting
Lupron (hormone used to stimulate ovulation) into her bruised inner
thigh.

Derek found herself in a dependent relationship with her egg broker
who encouraged her to continue donating despite the health risks. Her
broker lied and misled her. "I'm lucky more things didn't happen to
me," she says.

How was Derek able to put herself at such a great medical risk?
Weren't there precautions in place to protect her?

Relying on "Good-faith" Regulation

The ASRM advises that "a good-faith effort should be made to avoid
accepting women who have already made a high number of donations
elsewhere." But if a donor chooses to travel to another clinic, her
donation history does not travel with her. It is up to her to disclose
that information. There is a concern that the higher the payment, the
more likely prospective donors -- like Derek -- will be tempted to
conceal crucial medical information.

And agencies, often referred to as brokers, play a controversial role
in the play of egg donation. There is a concern that there is a
conflict of interest if the broker is serving both the donor and the
couple and collecting "finder's fees."

An agency or a broker does not have to disclose all of the potential
risks to a donor. And an inexperienced donor, who has not been
properly advised or done her own research, could find herself in a
vulnerable position.

After Turner's egg extraction, she received a letter from her agency
stating that she would not be able to continue donating. After the
time she had committed to the first donation, she was shocked because
she had counted on donating again. She also had learned that her
agency's compensation was significantly less than other agencies in
Texas. She called to inquire about the letter and voice her
complaints.

"They said it was basically none of my business. Thanks for your eggs.
Screw you, bye," she says. (Her agency didn't respond to this writer's
request for an interview.)

But like the donors, many brokers are also driven by both the
financial reward and the desire to help a couple desperate for a
child.

"I help facilitate everything. I'm there to remind the donor of her
appointment and be her support system as well. I try to help out if
she has questions," says Hunt, who was an egg donor before she started
the agency.

She typically charges a fee between $3,000-$5,000 on top of what the
donor receives. Hunt says she makes a good faith effort to follow the
majority of the egg donation guidelines set by the ASRM. But some of
the guidelines, she says, are not up to date.

Long-Term Consequences

The donors interviewed for this article don't have ethical regrets.
They all share a healthy curiosity about what their DNA will produce,
but they are not preoccupied or haunted by the idea that there are
young people growing up right now who share their DNA -- young people
they will never meet.

Jessica's seen pictures of "her" children, and she's "totally curious"
how they will turn out. But she doesn't stay up at night thinking
about it.

Nevertheless, ethical concerns are still an issue in the world of egg
donation. Westphal says, "You don't want people just doing this over
and over, and you want to limit the number of children from any one
donor."

There are legal considerations too. "The most important consideration
is that a donor is not going to be held responsible for the child,"
says Cedarblade. (She does not know of this ever happening.)

It is also important, she says, that the donor not be held financially
responsible for associated medical treatments or any complications
that may arise.

A 21-year-old woman is able to vote, drink and be drafted, but many
people wonder if a young college student with pressing financial needs
(or wants) is in a position to make a responsible decision about
whether or not to donate her eggs.

The considerations -- medical, ethical and legal -- are daunting, and
the compensation is nothing short of seductive. But would a
30-year-old woman be prepared to make the same decision? In some ways,
so little is known about the long-term consequences, that even the
most cautious donor is still taking a risk.

Egg donation is a more complicated decision than choosing second
semester classes, securing an internship, or making Friday night
plans. College women need to be their own advocates, do their homework
and invest time and thought before they proceed with egg donation.

Or as Jessica says, "I think my advice to college women is to not
allow people to bully you through the process ... A lot of people get
pressured into things they aren't comfortable with. The language of
altruism ... resembles blood donation. It can lead vulnerable women
into a bad place. It is your life. You have to live with it for the
rest of your life. You don't want to be treated like equipment."

* The names of two donors have been changed at their request.

[5]Jennifer Liss is a writer living in San Francisco.

References

1. http://www.alternet.org/module/printversion/26469#note
2. http://www.4woman.gov/faq/infertility.htm
3. http://www.cdc.gov/reproductivehealth/ART02/section5.htm
4. http://www.alternet.org/module/printversion/26469#note
5. mailto:jennifer_liss at sbcglobal.net