The high cost of eggs
Donors At Risk
It is illegal in the United States to buy or sell human body parts--but an exception has slipped through some legal cracks: eggs. In ads placed in campus newspapers, so-called egg brokers dangle riches of tens of thousands of dollars before young women with the right pedigree of looks, talent, and SAT scores. Their eggs, carrying that pedigree, are wanted by infertile women. To the donor it might sound like a deal; in fact it's an ordeal.
For about a month, the donor actually turns her body over to the process. She must inject herself daily with hormones that stimulate her ovaries to produce up to several dozen ripened eggs rather than the usual one. These mature eggs are sucked out of her swollen ovaries with needles inserted through the vaginal wall. That is not especially pleasant. But the major risks relate to the heavy-duty drug treatments. In about 1 in every 100 women a "hyperstimulation" condition balloons the ovaries to the size of grapefruits and the belly fills with fluid, requiring hospitalization. There is a real but rare danger that an ovary will rupture or be irreversibly damaged, or even that a heart attack or stroke will occur. Brokers that solicit donors don't have to talk about this.
Safety warning. One Stanford student had a stroke while being treated for egg donation. Faced with student loans, she was one of many girls attracted by a broker's ad in the Stanford Daily offering $50,000 for the right eggs. A year ago, she told Stanford Magazine, "I wish I had been better warned." Warning patients of risks is a basic commandment in medicine. The American Society for Reproductive Medicine has developed guidelines that call for independent medical and psychological counseling about these risks. It also recommends a cap of $5,000 on donor compensation. The group is concerned that heftier payments might tempt donors to downplay risks. Jeffrey Goldberg, the head of Reproductive Endocrinology and Infertility at the Cleveland Clinic, believes the guidelines are on target, but "not all centers adhere to them." Unless the profession finds ways to enforce its standards, Goldberg believes, the government will step in. But even if standards are forced on the clinics, egg brokers and their anonymous clients are not subject to any of these professional constraints.
The use of egg donors is increasing at nearly 20 percent annually, as more women delay childbearing to the point where their own eggs are in trouble. (If human cloning, which relies on ripe eggs, becomes a reality, it will call for even more donors.) Though some years off, new technology might help. Scientists are finding ways to ripen eggs in test tubes rather than in women's bodies, eliminating the risk of ovary-stimulating drugs. And frozen egg technology will enable women to store their own eggs for later use--rather than look to vulnerable students in search of tuition payments. -Bernadine Healy, M.D.
This story appears in the January 13, 2003 print edition of U.S. News & World Report.
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