Young women are increasingly being recruited to provide eggs for people using reproductive technologies, such as in vitro fertilization and gestational surrogacy. According to a study in The Journal of the American Medical Association, the number of donor eggs used for in vitro fertilization between 2000 and 2010 increased about 70 percent per year.
Who Is Targeted?
Ads on public transportation or in media aimed at college students are common: If you’re a healthy young woman in your 20s, you can get paid for helping someone realize their dreams – a child of their own.
Most egg providers are in their 20s, and many are college students in need of tuition money. It is a big decision that can have lasting effects on their health, yet the clinics that solicit their services rarely provide all the information needed to make informed medical decisions.
Egg Retrieval Process
Few people are aware of the risks to egg providers, or the fact that long-term safety data on the egg retrieval procedure and its outcomes is inadequate.
The procedure spans several weeks of drugs, hormones, and frequent clinic visits for ultrasounds and to check blood. It involves three steps:
- First, normal functioning of a woman’s ovaries is suppressed using one of several drugs. One drug – leuprolide acetate or Lupron – is not approved by the U.S. Food and Drug Administration for this purpose.
- Next, the ovaries are (hyper) stimulated with drugs like clomiphene citrate and/or gonadotropins in order to produce and mature more eggs than usual. These drugs are usually administered daily, via injection.
- Finally, a hormone called hCG, also administered via injection, helps final maturation of eggs and trigger ovulation. The eggs are retrieved from a woman’s body using ultrasound aspiration or laparoscopy.
Known and Unknown Risks
While the long-term risks associated with Lupron are unknown, side effects have been reported. These range from skin rashes and non-inflammatory joint pain to hypertension and liver function abnormality. According to the National Women’s Health Network, the National Institutes of Health (NIH) and the Occupational Safety and Health Administration (OSHA) have categorized Lupron as a “hazardous drug,” recommending that health care professionals who intend to conceive or father a child avoid handling Lupron for three months before conception. Others have cited it for potential fetal and birth abnormalities.
A known side effect of hyperstimulation (the second step) is a painful condition called Ovarian Hyperstimulation Syndrome. In OHSS, the provider’s abdomen swells with fluid and needs to be drained with a needle. A small number of women with severe OHSS can experience side effects such as rapid weight gain, abdominal pain, vomiting, and shortness of breath.
Two important research studies on risks related to egg retrieval include: “The incidence of both serious and minor complications in young women undergoing oocyte donation,” published in Fertility and Sterility (Vol. 90, No. 6, December 2008), and “Risk disclosure and the recruitment of oocyte donors,” published in the Journal of Law, Medicine, and Ethics (Summer 2014).
Groups Tracking the Health and Experiences of Egg Donors
Infertility Family Research Registry
The Infertility Family Research Registry (IFRR) based at Dartmouth-Hitchcock Medical Center in Hanover, N.H., is a voluntary national registry that tracks the health of egg providers who choose to enroll.
The IFRR also tracks the health of sperm donors and women undergoing in vitro fertilization, and yet most fertility clinics do not provide information about the IFRR to clients. As a result, most people using fertility services do not know it exists.
Groups such as Our Bodies Ourselves and the National Women’s Health Network are trying to increase awareness about the IFRR, including direct outreach to egg providers and fertility clinics to participate in the IFRR’s effort to gather deeper and more transparent data.
We Are Egg Donors
We Are Egg Donors is the first advocacy group for egg providers created by egg providers, and among those calling for more research and greater participation in the IFRR. The group conducts interviews with egg providers and collects information about their experiences.
In a personal account, co-founder Raquel Cool describes the organization’s commitment to ensuring egg providers are informed, supported, safe, and connected to agencies that will advocate for them.
In international commercial surrogacy, eggs from women in the United States, Eastern Europe, and select countries are used to create embryos that are implanted in women from other countries. These gestational mothers are typically hired by agencies and fertility clinics that broker arrangements. Like egg providers, these women go through extensive hormone treatments, not for their eggs, but to artificially prepare their bodies to receive and carry embryos to term.
Connection Between Egg Donors and Gestational Mothers
In international commercial surrogacy, eggs from women in the United States, Eastern Europe, and select countries are used to create embryos that are implanted in women from other countries.
Gestational mothers are typically hired by agencies and fertility clinics that broker arrangements. Like egg providers, these women go through extensive hormone treatments, not for their eggs, but to artificially prepare their bodies to receive and carry embryos to term.
Surrogacy360 aims to bridge information gaps by documenting how international commercial surrogacy is practiced and how it affects everyone involved in the surrogacy relationship.
We hope all parties will join our efforts to promote best medical practices and transparency. Without collective involvement, there is no way to ensure that expanded reproductive options are available for everyone — and, at the same time, guarantee sound medical care and fair work conditions for those who make these options possible.