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Two couples decided to look elsewhere after the agency revealed more details about my family’s medical history, which is rife with drug and alcohol abuse, but a third looked past every skeleton in the closet and gamely agreed to move forward. “Match!” read a message in my inbox, agency-speak for “Sold!” The parents wanted an anonymous donation, and so it would be, although I had indicated to the agency that I was open to a more intimate relationship with the recipients. E-mail messages from the agency referred to an “intended mother” and an “intended father,” so I knew I was donating to a heterosexual couple. I also knew that they were cheap. They asked that I lower my asking price after “reserving” me at the agency, not uncommon in a trade where the lines between commerce and altruism are left unclear. I refused.
“Match!”—that was how it started. The parents had chosen a Chicago-based fertility doctor, and the agency booked a September flight from D.C. to Illinois, where I would meet the man who would eventually perform the procedures on both of us. Before the parents signed a contract, he would make sure I was healthy, my ovaries normal, my egg-producing potential up to standard. When he gave the OK, they would ink the contract, a process not unlike buying a used car.
I had consulted the doctor’s Web site before flying off to Chicago. It informed me that “the feeling of fulfillment from helping an infertile couple achieve the dream of having a baby is priceless.”
I was the only patient in the place the Sunday morning I arrived at the Chicago clinic for the first time, but there was, as always, a wait. I passed the time by scanning the thank you letters and Christmas card baby photos tacked up all over the waiting room walls, effusive handwritten notes thanking the clinic for various children. The number of pictures was impressive, with photos covering the waiting room and bleeding down a hallway toward the examination rooms, as was the number of kids in each photograph; many came in twos, threes, even fours. Physicians usually implant more than one embryo to boost the chances of pregnancy. The National Fertility Directory, a non-profit organization that distributes information about reproductive technologies, estimates that IVF cycles average $12,400 a round, not counting the cost of a donor. At prices like that, you buy in bulk, and pray.
The doctor swept in later, a middle-aged Indian obstetrician who brushed past a nurse to shake my hand. He was friendly and talkative, but most of all paternal, a second father to the many, many kids he’d help conceive. We headed straight to the examination room for a quick ultrasound, where he chattered excitedly at the sight of young ovaries. That test passed, he jumped into our information session with Socratic zeal. “What’s the biggest risk to a donor?” he asked, falling into a routine. “Infertility?” I asked, half-hoping. He paused for effect before saying, “Pregnancy.” The Q&A serves two purposes: to reassure me that I will make it out of this process alive, and to scare me into celibacy. For donors hopped up on fertility medications, stray sperm pose a heightened danger of unintended pregnancy in the midst of protracted attempts to create a different child: right eggs, wrong womb.
When I suggested later that the egg-for-dollars swap is hardly a donation, he looked genuinely confused and changed the subject to my egg-producing potential. “You exercise,” he said, as if my ovaries made this obvious to him. We moved on; I’d been OK’d. He led me into another small room—this one crowded with books and diagrams—where two nurses would lay out the specifics of the donor drug regime. The “stimulation” would require four different injected pharmaceuticals over four weeks. From across a wooden desk, a woman composed a long list of dates to be kept and dosages to inject. Every instruction looped back to the importance of scrupulously following each step of the process, the danger of putting off a dose for an hour and imperiling the entire undertaking. A nurse beside her appeared to serve no purpose other than to nod in agreement with everything the first nurse said.
All of this sounded little more harrowing than taking vitamins until the first nurse pulled out a single, tiny syringe as she continued to provide monotone commentary on the importance of timing. She dipped the needle in water, pulled back to draw in the fluid, flicked it twice, and plunged it into a pink piece of rubber. I leaned forward as if to ask a question but said nothing. She pushed a DVD on self-injection across the desk.
Heather Has Two Mommies and a Daddy
The last paragraph on Page 13 of the 21-page contract I signed in November asserts, bolded and underlined: “It is expressly understood that this Agreement in no way constitutes payment for any genetic material, a child or children, or payment for relinquishment of parental rights to any child or children.”
The United States is one of many countries in which legislation and social norms proscribe the selling of body parts. It is also the world capital of the genetic material market: No other nation trades in DNA so widely and freely. Hopeful mothers and cash-strapped college students have been trading cash for eggs for 20 years, calling the ova a “donation” and the money compensation for time and discomfort, thus avoiding the ban on sales. Outside Food and Drug Administration mandates regarding the importance of testing donors for specific diseases and monitoring their progress, there are no federal laws restricting egg donors in the U.S.; elsewhere, the laws reflect a surprising lack of consensus on the issue. In Germany, Denmark, and Italy, egg donation is completely illegal. In Israel, payment for eggs can cover only the direct expenses related to the procedure. In the U.K., eggs are classified as organs, and payment is banned.
The birth of Louise Brown in 1978 was considerably less complicated, both logistically and ethically, than many in vitro births today. The researchers who oversaw Brown’s conception simply circumvented her mother’s damaged fallopian tubes—the most frequent cause of infertility—by combining her mother’s ova with her father’s sperm outside of the body, and implanting the resulting embryos in the womb. Had Mother Brown’s eggs been inadequate, due to age or abnormality, her daughter would not have been born. A live birth from a donor egg was first reported in Australia, a pioneer in fertility treatments, in 1984. It took time for doctors to use ova from other women, and more time for the offer to extend to strangers rather than sisters and best friends. American couples began advertising for healthy young eggs by the early 1990s.
The American Society for Reproductive Medicine (ASRM) estimates that each year 10,000 babies are born from donated ova in the United States. For the near future at least, it seems likely that demand for donor eggs will continue to grow alongside the fertility industry. In 1985 there were 30 fertility clinics in the United States, and that number has grown to more than 400 since.
The mainstreaming of fertility treatments contributes to a larger concern among cultural conservatives, who worry egg donation is a step on the way to the much-feared designer baby. “Do you really want to pick a kid the way you shop for a car?” Reader’s Digest asked in 2001. Feminists, too, find the mixture of capitalistic enterprise and female bodies disturbing. The Nation’s Katha Pollitt has called surrogacy “reproductive prostitution.” Sexual anxieties make for strange bedfellows: In 2004 National Review’s Kathryn Jean Lopez wrote a column slamming egg donation, approvingly quoting Pollitt.
While egg prices range from a few thousand dollars to $30,000 or more, ASRM guidelines recommend donors receive a maximum of $10,000, above which compensation is deemed “inappropriate.” Paradoxically, such guidelines are sold as being in the interest of the donor, usually portrayed as cash-strapped and naive. In the words of the President’s Council on Bioethics, such women tend to be from “financially vulnerable populations,” which implies they need protection from the temptation of incurring bodily risk for profit. Keeping prices low might seem to be a compromise between banning sales and embracing them, but half measures defy the logic of both extremes. The same people who complain ova are too valuable to be sold complain that the market price is obscenely high.
Infertile women, too, are not infrequently portrayed as helpless before their desires and vulnerable to a fertility industry selling false hope at exorbitant prices. Women are “desperate” to conceive; they will “do anything” to have a child. Infertile couples “will mortgage their houses, sell their cars, deplete the family savings,” warns Harvard economist Debora Spar, author of the 2005 book The Baby Business. The prevailing narrative of the infertile woman is that she will sacrifice health, career, and life savings at the altar of childbirth. It is pregnancy as suttee.