Wanted: Smart, healthy and operable women's eggs
What would you do for $20,000?
That was the question many Dartmouth women were forced to ask themselves Monday morning when they opened The Dartmouth and saw a large, color ad that began, "EGG DONORS NEEDED -- $20,000.00 -- PLEASE HELP US GIVE OUR PRECIOUS BABY BOY A SIBLING."
Such ads are now commonplace in college newspapers -- and the more elite the college, the more frequent the ads are and the more money is offered.
Many of the ads request donors with very specific characteristics, like minimum height, a certain hair and eye color, personality traits or even minimum SAT scores. The ads are typically placed by middle-aged, professional couples in which the woman is infertile and usually seeking a young, healthy and intelligent woman to "donate" her eggs for artificial in vitro insemination with the husband's or a donor's sperm -- often for a large compensatory fee.
Not surprisingly, the spectrum of public opinion on the issue is wide. Some feel egg donation is fundamentally wrong; others have no qualms about it. Still others fall somewhere in between. A common view in the medical world is that the procedure can be both beneficial and ethical, but only if strict guidelines are followed.
No female Dartmouth students contacted by The Dartmouth said they would consider donating their eggs. Some, like Tara Chozet '03, said they were opposed to egg donation on moral grounds.
"I don't think it's ethical at all," Chozet said. "I don't like the idea of having my own little kids running around [without knowing them]."
Chozet also said she was opposed to publications' running ads seeking egg donors. "I don't think it's right," she said. "You're basically selling somebody's life."
Other students said they would not donate eggs themselves, but not for ethical reasons. While having no major philosophical problems with egg donation, they still said they would never donate their own eggs.On the opposite end of the spectrum, unsurprisingly, are the egg donation agencies. They claim to view egg donation as a purely altruistic act, in which the donor simply tries to help a couple in need. They say the money paid as compensation is not unreasonable for the amount of physical and emotional stress the donation procedure causes.
If that indicates to you that the donation process isn't easy, you're right. To begin with, the American Society of Reproductive Medicine mandates that all U.S. fertility clinics and egg donation agencies require a lengthy screening process to determine whether a woman may donate. This typically includes a health history investigation, physical exam, blood work, checks for sexually transmitted diseases and even a search for genetic disorders.
In addition, prospective donors undergo psychological screenings, in part to determine if they have thought through their reasons for donating. If a candidate gives money as her sole reason for donation, she will be rejected, according to Dr. Misty Porter, the Dartmouth-Hitchcock Medical Center's Director of Assisted Reproductive Technology.
Once a donor has been selected, she must take drugs to encourage egg production. The process begins with three weeks of daily injections of Lupron, a drug that shuts down ovaries to prepare them for artificial stimulation. Then injections of fertility hormones are administered. Side effects of the drugs include mood swings, nausea and bloating. The injections continue until the egg develops, which can take up to two weeks. During this
time, the donor's hormone levels are measured daily by ultrasound and blood tests. Finally, when the eggs appear, the drug Profasi is given to the donor, which causes the ovary to release the egg.
Eggs are "harvested" immediately. The woman is anesthetized, and an ultrasound-guided needle is inserted to show doctors the location of the eggs. A second needle with a suction device at the end removes the eggs.
The intrusiveness of these procedure can vary, as can the amount of compensation -- but there is often no correlation between the two. Fees are decided before and are often related to the perceived "quality" of the egg clients hope to attract. An ad run in Ivy League newspapers, for example, is targeted at a very specific kind of woman.
"Young, healthy, college-educated women are what [recipients] are looking for," said Beth Cohen of Creating Families, Inc., a Denver-based agency that matches recipients with donors, in part through an Internet data base of donors. "They do look at things like SAT scores and athletic level."
Creating Families, Inc. does not attract many college students as donors, though, because it does not advertise in college newspapers and because its minimum donor age is 21.
Of course, there are other companies eager to fill that niche. One of these is Options, a Colorado-based company similar to Creating Families, Inc. which regularly runs ads in The Dartmouth and other college newspapers on behalf of individual clients.
Options advertising representative Ericka Bellavia said about one-quarter of Options' clients inquire about running ads. If they decide to buy an ad, they can choose from a list of newspapers, and Bellavia will create the ad and submit it for them. This is a service Options provides as part of its normal fee for matching a recipient with a donor. Bellavia said that some newspapers restrict what qualities in a donor they allow to be listed. Options allows its clients to offer up to a $7500 compensatory fee.
The response rate from the ads is relatively high. Bellavia said five percent of the women who see a given Options ad decide to call for more information, and of those, 20 percent end up submitting an application to the company.
Sometimes egg-donor ads are not what they appear to be. One ad that ran in The Dartmouth last year was in fact placed by a journalist (from another publication) who was seeking potential donors to interview for a story. And Porter said she knows of cases where companies have run ads offering large sums, but when prospective donors call, they are told a donor has been found, but another recipient is looking for a donor and offering a significantly smaller amount. Through this "bait-and-switch" process, Porter said, donors can be tricked into settling for less compensatory money than they deserve.
Another company that runs legitimate ads in college newspapers is the Law Office of Thomas Pinkerton, the California-based firm that placed the ad in The Dartmouth on Monday.
Potential recipients who go to a firm like Pinkerton's go to great lengths to attract desirable donors. Although many states have a minimum donor age of 21, the firm's clients fly college-aged donors to California, where the minimum age is 18, for the "harvesting" procedure.
Pinkerton's firm is part of a growing phenomenon: the emergence of law firms that specialize in representing a small number of wealthy couples seeking elite egg donors. Most of the firm's clients are educated couples in their 40s, according to Thomas Pinkerton's wife and assistant, Darlene Pinkerton.
"Our clients are high-end, high-intelligence," Darlene Pinkerton said. "Most of them have Ph.D.s. Intelligence is important to them."
In order to attract such high-ability students, most of the firm's clients place ads mainly in newspapers at schools like the Ivies, Stanford University or the Massachusetts Institute of Technology, Pinkerton advertising assistant Barbara Brown said. The recent ad in The Dartmouth also appeared in four other Ivy papers, she said.
Some clients have offered up to $50,000, Darlene Pinkerton said -- but not just any smart, outgoing, good-looking woman can make the cut.
"When it really comes down to it, [the clients will] find someone that looks like them," she said. "The child has to fit in. They don't want someone who's going to stick out like a sore thumb."
Porter is wary of practices like those of Pinkerton's firm. She said she believes the best place for college-aged women to donate eggs is through a hospital fertility clinic that is a member of the American Society of Reproductive Medicine -- not through a commercial egg brokerage like a law firm or the many businesses that have popped up online.
When a profit is involved, Porter said, "We have a hard time with the ethics of that."
She said the standard fee for an egg donor on the East Coast is currently $2,500 to $5,000. When substantially more money is offered, she said, young women who may need the money often donate their eggs for the money alone, rather than for altruistic reasons. "We have a hard time with the ethics of that. They have to view this as a biological gift."
When more money is offered, Porter said, "That, in our minds, is a form of coercion." She believes fertility clinics like DHMC's have a responsibility to weed out those who may want to donate for monetary reasons alone. "Our intent is that someone should look out for the donor."
An example of the mentality Porter might look out for is found on Options' website. Although elsewhere it claims the company's expectations are otherwise, at one point the website states that "... it is unrealistic to suggest each registrant's sole motivating factor be altruistic ..."
Up until now, DHMC has conducted only direct donation, where a recipient receives an egg from a known donor like a sister or a friend. Would a Dartmouth student be allowed to donate there?
So far, none have, Porter said. "We wouldn't necessarily turn them away," though, as long as they met New Hampshire's 21-year-old donor age requirement, she said.
If a Dartmouth student came looking for DHMC to prepare her eggs for donation to a client of a private egg-donation company, she would be refused, Porter said.
But now DHMC is about to launch its own anonymous egg donor program, Porter said. This is not the perfect opportunity for a Dartmouth woman to donate her eggs, though.
"We're not going to be advertising around here," Porter said with a laugh.