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As one would expect, where compensation is prohibited or capped, “donations” dry up. Waiting lists in Britain, where donors are compensated with £250 for expenses, reportedly stretch from two to eight years. California clinics claim to regularly help British, Canadian, and Australian women—reproductive tourists fleeing egg shortages.
The range of regulatory regimes in Western nations with roughly similar legal traditions suggests there are no obvious or intuitive answers. The questions being raised are entirely new ones, but they provoke old anxieties about female sexuality and the commercialization of the human body. Even longtime supporters of IVF sometimes draw the line at egg donation, suddenly voicing objections as the technology barrels forward to its logical extension. When a British talk show host asked Louise Brown how she would feel if she found out she were the product of a donor egg, she replied, “I would be disgusted.”
Harvesting a Dozen Eggs
The fertility drugs arrived in a small brown box, packaged crisply with clear tape and bearing the name of the pharmacy that had sent them. Above my apartment address, the box read “Donor #15.” I cut it open carefully, dipped my hand into the styrofoam, and pulled out vial after vial, ice cold from the freezer pack that lay at the bottom of the box.
There was more, buried under packing peanuts: dozens of translucent syringes with orange plungers and a thick, stapled wad of receipts indicating the $1,622 all of this had cost someone else. The nurse’s assistant had said to keep most of the pharmaceuticals chilled. Not knowing what else to do, I placed each vial in the fridge, next to a half-empty bottle of diet Sprite.
The drugs would manipulate the menstrual cycle into an obedient and predictable pattern. Over the course of 14 days before ovulation, ova start as invisible cells and bubble into highly complex systems barely visible to the naked eye. Two weeks after it has begun to mature, a single ovum will burst out of its skin, float through a spaghetti-sized tube, plant itself in the uterus, and wait. But once the egg is released, it is useless to another woman. A fertility doctor hoping to transfer it must capture the egg when it is fully mature but just before the follicle erupts.
It’s no easy thing to predict when an egg will escape, and there are no guarantees that an egg will respond to sperm outside the body. Subcutaneous injections induce the donor to “superovulate,” producing not just one mature ova but as many as 20. They also help the donor and doctor gain control over the process. No one can say exactly when the eggs will be fully mature, so as the date approaches, the donor must be monitored for progress almost daily. I would have to fly to Chicago a week before the extraction so the doctors could watch the follicles multiply and expand before removing an egg from each one.
Three days later, the intended mother would take my place on the operating table and the doctor would implant a number of fertilized embryos. There would be a 50 percent likelihood that none would “take”; IVF is always a risky investment. Because doctors usually implant a large number of embryos, the opposite danger applies as well: The risks were laid out right there on the doctor’s wall of thanks. More than half of IVF babies are multiples, and are therefore more likely to be born prematurely and abnormally small. Parents worried about the risks inherent in carrying a litter of children sometimes opt for selective termination, usually between 9 and 12 weeks. The weaker ones are selected out in hopes of keeping a stronger one or two healthy.
Because the mother’s womb must be prepared to accept the fertilized embryo shortly after the ova are extracted, her menstrual cycle is timed in tandem with the donor’s, a strangely intimate harmony of bodies between strangers. Beyond cycle synchronization, the anonymity in such relationships is oddly asymmetrical; the donor is a prisoner in front of a one-way mirror. The mother knew what Donor #15 looked like, her exact age, the addictions that plague her family. She knew that her blood type was O and that her undergraduate major was philosophy. About the future mother of my genetic children, I knew just one thing: She was on day three of her cycle.
In situations this unmapped, the instinct is to follow cues both verbal and psychological, to slip into the behavior of white-coated experts who treat the situation as unremarkable. I certainly didn’t know what to call the woman who had recruited my genes for the generation of her fetus; I used the agency’s term, Intended Mother, IM for short, even among friends. I had no words for the cornucopia of pharmaceuticals to grow the ova or the surgical procedure to remove them; soon the terms stim med and retrieval were part of my daily lexicon. Miss Manners has naught to say on social niceties between women who have contracted for a surgical procedure; the etiquette of egg donation is protean. Some agency Web sites suggest mothers send donors an “appreciation gift” of flowers after the retrieval.
Halfway through, the agency e-mailed to say the donor mother was uncomfortable saying “the donor” and wished to know my first name; could they share it? The agency was trying to preserve the illusion that this was a completely natural pregnancy, and anything so intimate as a first name risked chipping away at that facade. I had no such illusion to maintain; there was nothing remotely normal about this process on my end. Sure, I said—if she tells me hers. We traded first names through the agency, which felt, even through our convoluted e-mail chain, like whispering secrets behind a locked door. Our mediator, party to the indulgence, even threw in a terse description of the IM: “She is very sweet.”
By late November I was injecting three times a day, and I’d moved from one drug onto what I’d started calling “the hard stuff.” I experienced no side effects, and the precisely timed injections were painless. The only evidence of progress appeared in black and white in the office of a D.C. fertility doctor, who counted and measured the eggs as they appeared on the ultrasound.
On screen the follicles were roundish black holes tightly packed and framed in white, something between monochromatic honeycomb and a bunch of grapes. On my second visit, the nurse stared at the screen and mumbled “five” with a frown. Five eggs.
Five was not enough. My flight to Chicago and hotel stay there for the harvesting were already booked. But despite weeks of injections, celibacy, and sobriety, the ova were few enough to cancel the entire cycle. Hours later, the agency e-mailed that the mother “is really upset right now (as I know you are as well).”
By this point, the intended mother had already spent perhaps $10,000; she had paid the agency to find me, paid for my drugs, paid for a visit to Chicago, paid for a lawyer to represent me in our contract negotiations. Had I not known her name, it might have been possible to write off the loss of time and money as the price of doing business, easier not to feel guilty in the name of a woman who had bet on me and lost. Instead, I obsessed over every meal, every workout, every injection from the previous weeks, searching for something that might have weakened my—her—ova.