Egg providers play a key role in international commercial surrogacy. While intended parents may use their own eggs in surrogacy arrangements, third-party egg providers are also commonly solicited. However, the stories and experiences of egg providers are rarely discussed.
Marketing and Recruitment
Providing eggs is a significant process that can have both short-term and long-term health effects, yet clinics or agencies rarely offer or provide the comprehensive information needed for egg providers to make fully informed medical decisions. Many egg providers report that they were given inaccurate or misleading information about what is known about the safety of the process during the recruitment or informed consent process. They are also not informed that there is insufficient research to determine the long-term health effects of the hormonal stimulation.
Known and Unknown Health Risks
There has been very little systematic study of the long-term risks associated with the drugs used in egg retrieval. However, a number of concerning side effects have been reported. These include skin rashes and non-inflammatory joint pain, hypertension, and liver function abnormality. A large number of serious long-term health problems have been reported to the US Food and Drug Administration by individuals who believe the adverse effects are associated with Lupron, one of the drugs used in the process. Insufficient research has been conducted to determine whether egg provision is associated with certain cancers such as uterine, colon, breast, ovarian, or endometrial cancers. More research is needed on the links between egg donation and endometriosis, Polycystic Ovarian Syndrome (PCOS), and infertility.
Short-term risks associated with egg retrieval include infection, bleeding, and anesthesia complications. Another risk, Ovarian Hyperstimulation Syndrome (OHSS), causes ovaries to become swollen and painful and fluid to collect in the patient’s abdomen. The symptoms of OHSS range from mild to severe, and may include bloating, abdominal pain, vomiting, shortness of breath and, in rare cases, death.
Egg providers often do not have legal representation to represent their rights and best health interests in a contract, rated as a top red flag in an article by We Are Egg Donors. Some agencies in the US encourage egg providers to “share” a lawyer with the recipients. However, for an attorney to represent both sides of a contract is a breach of professional ethics.
Egg Retrieval Process
The egg retrieval process requires several weeks of injections, frequent clinic visits, a final shot to maturate eggs and trigger ovulation, and surgical egg retrieval using ultrasound aspiration or laparoscopy.
Retrieving between 18 and 20 eggs per cycle is considered safest for egg providers; however, there are trends of clinics and egg banks overstimulating egg providers and retrieving far more eggs, sometimes into the 80s. Practices like cycle sharing – where clinics encourage different sets of intended parents to share eggs from one donor cycle – also put egg providers at greater risk. In these cases, egg donors have reported experiences in which the clinicians altered cycle protocols to generate higher numbers of eggs in such arrangements.
Cross-Border Egg Donation
Hiring egg providers in other countries is touted as a “cost-saving” alternative but presents additional health risks to the donor. If they are flown into the country where embryo transfer will take place for surrogacy, they may receive remote care (via video, for example) prior to travel and after they return home, which is insufficient medical care. The egg provider may also face legal uncertainties, denied entry, or criminalization in countries where compensated or international egg donation is prohibited. Some egg donors, in both international and domestic circumstances, also report being treated as if they were a commodity rather than a patient.
Researchers and Organizations Tracking the Health and Experiences of Egg Donors
- We Are Egg Donors
- The Infertility Family Research Registry (IFRR)
- Dr. Diane Tober’s publications on egg donation
Resources for Egg Providers
- “Considering Egg Donation? Here are Six Common Red Flags to Watch Out For” by We Are Egg Donors Co-Founder Liz Scheier
- Is Egg Donation for Me?
- The Ovado Project, seeking participants around the world for a research study on egg donation