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But we forged ahead. An unnamed nurse in Chicago called and told me to ratchet up the drug dosage and get on the plane. This was in violation of clinic policy, which sounded vaguely alarming, but I obediently injected and began packing for Chicago in December; scarves, thick socks, snow boots. In my purse I carried a handwritten note from the doctor to the airline, explaining why my carry-on was stuffed with syringes.
Once there, I spent five mornings being poked, prodded, monitored, and ordered to inject. I appeared at the clinic every morning at 9, extended an arm, and watched translucent tubes turn dark red with my blood. I followed a nurse technician into an examination room, where she counted and measured each oocyte; by now there were a dozen. According to the technician, they would only “take the larger ones.” In the afternoons, after my blood work had been processed, I called an automated system for instructions before injecting again.
The retrieval would take place at precisely 10 a.m., just before the follicles would burst. My last visit to the clinic was my first visit to its operating wing, which is physically shut off from the warm waiting and examination rooms. Walking through the door felt like walking from a home into a hospital, the carpet replaced by spartan white flooring, pictures of pink babies replaced by a bare wall and a ticking clock. A nurse’s aide led me to a wheelchair, touching me as I sat down, an oddly delicate gesture.
A small, nervous-looking anesthesiologist sat next to me and carefully asked a number of direct questions, as if speaking to a child. When she was satisfied with the answers, she held my arm and gently inserted an IV. We both watched a clock on the opposite wall. At 10, a nurse wheeled me into the operating room, where the doctor waited at the foot of the bed with white surgical gloves on his brown hands. The nurses helped lift me out of the chair and onto the same table the mother would lie on, unconscious, in three days’ time.
I caught a glimpse of the probe before I fell asleep, the plastic sheath hiding a needle that would pierce the vaginal wall, plunge into each follicle, and suck in each egg. The doctor would take only the big and promising ova, leaving those that were unlikely to survive their test tube futures. The whole procedure, from start to finish, took 20 minutes.
When I woke up outside the operating room, I asked the doctor how many of the 12 he’d taken. Pleading confidentiality issues, he said only, “I can’t tell you.”
Here’s My Gift, and Here’s the Bill
The most remarkable thing about the egg trade is that it exists. The market takes place within what is arguably the most heavily regulated economic sector in modern America—health care —in a society that regularly chooses prohibition over individual autonomy. The impulse to ban extends from soda in schools to card games in cyberspace; it hovers over abortion and stem cell research. For whatever reason, infertile women have not been held hostage to this impulse: Thousands buy eggs every year, and no one expects that to change.
Yet this extraordinary permissiveness operates within a constrained and misleading language of altruism, barriers erected to hide the reality of commerce behind narratives of womanly generosity. The immediate concern of egg donors—most probably, money—is downplayed in order to emphasize an improbably abstract, universal desire to help other women conceive.
The idea that money taints whatever it touches probably has less hold on the human psyche than it once did, but the myth is most powerful in the realm of female sexuality and reproduction, where discussions of exchange inevitably devolve into those of exploitation. “Infants and babies are indeed being sold,” the Harvard economist Debora Spar insists in The Baby Business, illustrating a not uncommon failure to distinguish between the sale of genetic material and the subjugation of human beings. Listening to fears about the intersection of babies and markets, it is easy to forget that bearing a child is always costly. Virtually no part of a pregnancy exists completely outside the market, yet no one asks obstetricians or even midwives to have purely humanitarian motives when they provide their services, or faults them for benefiting financially from the business of human life.
As far as I can tell, there is only one group of people who talk openly and honestly about assisted reproduction: those who would prefer it be stopped, or at least regulated. The Leon Kasses and Debora Spars of the world articulate the technologies of reproduction in cold, sterile, and impersonal terms that can seem both dehumanizing and unsettling. But so can the embryology lab.
The strongest response to such opponents is not that IVF is natural or altruistic, but that it can be neither of those things without detracting from the dignity of the child-to-be. My experiences bear no resemblance to the nightmarish scenarios thrown out by those who portray egg donation as a clumsy eugenics scheme. Strip away the nexus of fertility doctor, donor agency, and donor, and two would-be parents were hoping for a kid who would look something like them. They weren’t looking for a “designer baby,” so much as a close approximation of the homegrown variety.
Before we ask IVF opponents to accept the implications of new reproductive technologies, though, we might ask the same of IVF supporters. From the recipient’s side, the egg donor process can be an extended effort to pretend that the donation never occurred. Straddling the natural and the artificial, egg donation embodies a contradiction. It glorifies the experience of natural pregnancy and the gift of biological children, while it in fact produces neither: Egg donor babies are the product of foreign genetic codes, and the “natural” pregnancy is manufactured in the lab. The approximation of natural pregnancy also entails a studied psychological distance from the donor who made the pregnancy possible.
Opponents of IVF have long warned that the bond between mother and child will be eroded by further advances in assisted reproduction, the implication being that mothers will eschew the time and labor of traditional pregnancies once they can outsource to the lab. In practice, IVF seems to demonstrate the opposite extreme: Women value pregnancy to such a degree that they will spend lavishly to approximate the experience, adding expense, discomfort, and ethical quandary to the already burdensome ordeal of childbirth. The desire to stick to the traditional script of family is surprisingly robust, and reproductive technologies allow potential parents to follow that script even when nature erects barriers. Though IVF entails risk, discomfort, and the prospect of having to abort multiple fetuses, many parent apparently prefer it to what might seem a far less ethically complex response to infertility: adoption. Natural motherhood is not obsolescent, as The Atlantic once predicted, but ascendant, in vogue to an almost disturbing degree.
Those who worry reproductive technologies will destroy the family probably haven’t had much contact with parents who will spend many thousands of dollars to create one. If there is a risk, it is that IVF might instead ossify the definition of family, stressing insularity above openness, the appearance of a “natural” pregnancy over adoption, genetic legacy over less rigidly defined familial bonds. For all the otherworldliness of egg donation, parents who choose the process cling to the traditional: children who appear to be their own, who are born through what appears to be a natural pregnancy. It’s a bold new path to very familiar territory.
Perhaps unblinking honesty is too much to ask of IVF's early adopters, who are breaking sacred taboos even while conforming to norms of the nuclear family. And given that donor agencies are in the business of selling illusions, the blurring of economic exchange and altruistic venture is unlikely to disappear anytime soon. That’s not reason to object to technologies consumers increasingly want, but it’s enough for me to want my eggs off the auction block. I never objected to being grist for the pregnancy mill or considered it dehumanizing to sell body parts for profit. But there is something strangely degrading about being lauded as a humanitarian and paid handsomely on the side.
Shortly after the procedure, I e-mailed the agency to ask that they remove my picture from their gallery of donors and asked in passing whether my genetic children were developing somewhere on the other end of our e-mail chain. “I’m sorry to say that your donation did not result in a pregnancy,” read the reply. It reassured, “Your gift was very precious.”