Contents | December 2002
More on science and technology from The Atlantic Monthly.
From the archives:
"Cloning Trevor" (June 2002)
Granted rare access to the labs of Advanced Cell Technology, the only U.S. group openly pursuing human cloning research for medical purposes, our correspondent spent six months tracking highly experimental work on the cells of a young boy with a life-threatening genetic disorder. By Kyla Dunn
"What Price Valor?" (June 2002)
Bravura displays of reproductive technology may shortchange the children. By Caitlin Flanagan
"Jack or Jill?" (March 2002)
The era of consumer-driven eugenics has begun. By Margaret Talbot
From Atlantic Unbound:
Web Citations: "Be Fruitful and Multiply" (February 25, 1999)
When it comes to modern reproductive technology, many are turning to the Web for a helping hand. By Toby Lester
The Atlantic Monthly | December 2002
arly in the spring of last year a classified ad ran for two weeks in the Yale Daily News: "EGG DONOR NEEDED." The couple that placed the ad was picky, and for that reason was offering $25,000 for an egg from the right donor.
Grade A: The Market for a Yale Woman's Eggs
When a Yale undergraduate explored becoming an egg donor for a wealthy couple willing to pay top dollar to the right candidate, she didn't realize how unsettling the process of candidacy would prove to be
by Jessica Cohen
As a child I had a book called "Where Did I Come From?" It offered a full biological explanation, in cartoons, to answer those awkward questions that curious tots ask. But the book is now out of date. Replacing it is, for example, Mommy, Did I Grow in Your Tummy?: Where Some Babies Come From, which explains the myriad ways that children of the twenty-first century may have entered their families, including egg donation, surrogacy, in vitro fertilization, and adoption. When conception doesn't occur in the natural way, it becomes very complicated. Once all possible parties have been accounted for—egg donor, sperm donor, surrogate mother, paying couple—as many as five people can be involved in conceiving and carrying a child. No wonder a new book is necessary.
The would-be parents' decision to advertise in the News—and to offer a five-figure compensation—immediately suggested that they were in the market for an egg of a certain rarefied type. Beyond their desire for an Ivy League donor, they wanted a young woman over five feet five, of Jewish heritage, athletic, with a minimum combined SAT score of 1500, and attractive. I was curious—and I fit all the criteria except the SAT score. So I e-mailed Michelle and David (not their real names) and asked for more information about the process and how much the SAT minimum really meant to them. Then I waited for a reply.
onating an egg is neither simple nor painless. Following an intensive screening and selection process the donor endures a few weeks of invasive medical procedures. First the donor and the woman who will carry the child must coordinate their menstrual cycles. Typically the donor and the recipient take birth-control pills, followed by shots of a synthetic hormone such as Lupron; the combination suppresses ovulation and puts their cycles in sync. After altering her cycle the donor must enhance her egg supply with fertility drugs in the same way an infertile woman does when trying to conceive. Shots of a fertility hormone are administered for seven to eleven days, to stimulate the production of an abnormally large number of egg-containing follicles. During this time the donor must have her blood tested every other day so that doctors can monitor her hormone levels, and she must come in for periodic ultrasounds. Thirty-six hours before retrieval day a shot of hCG, human chorionic gonadotropin, is administered to prepare the eggs for release, so that they will be ready for harvest.
The actual retrieval is done while the donor is under anesthesia. The tool is a needle, and the product, on average, is ten to twenty eggs. Doctors take that many because "not all eggs will be good," according to Surrogate Mothers Online, an informational Web site designed and maintained by experienced egg donors and surrogate mothers. "Some will be immature and some overripe."
Lisa, one of the hosts on Surrogate Mothers Online and an experienced egg donor, described the process as a "rewarding" experience. When she explained that once in a while something can go wrong, I braced myself for the fine print. On very rare occasions, she wrote, hyperstimulation of the ovaries can occur, and the donor must be hospitalized until the ovaries return to normal. In even rarer cases the ovaries rupture, resulting in permanent infertility or possibly even death. "I must stress that this is very rare," Lisa assured prospective donors. "I had two very wonderful experiences ... The second [time] I stayed awake to help the doctor count how many eggs he retrieved."
David responded to my e-mail a few hours after I'd sent it. He told me nothing about himself, and only briefly alluded to the many questions I had asked about the egg-donation process. He spent the bulk of the e-mail describing a cartoon, and then requested photos of me. The cartoon was a scene with a "couple that is just getting married, he a nerd and she a beauty," he wrote. "They are kvelling about how wonderful their offspring will be with his brains and her looks." He went on to describe the punch line: the next panel showed a nerdy-looking baby thinking empty thoughts. The following paragraph was more direct. David let me know that he and his wife were flexible on most criteria but that Michelle was "a real Nazi" about "donor looks and donor health history."
This seemed to be a commentary of some sort on the couple's situation and how plans might go awry, but the message was impossible to pin down. I thanked him for the e-mail, asked where to send my pictures, and repeated my original questions about egg donation and their criteria.
In a subsequent e-mail David promised to return my photos, so I sent him dorm-room pictures, the kind that every college student has lying around. Now they assumed a new level of importance. I would soon learn what this anonymous couple, somewhere in the United States, thought about my genetic material as displayed in these photographs.
nfertility is not a modern problem, but it has created a modern industry. Ten percent of American couples are infertile, and many seek treatment from the $2-billion-a-year infertility industry. The approximately 370 fertility clinics across the United States help prospective parents to sift through their options. I sympathize with women who cannot use their own eggs to have children. The discovery must be a sober awakening for those who have always dreamed of raising a family. When would-be parents face this problem, however, their options depend greatly on their income. All over the world most women who can't have children must simply accept the fact and adopt, or find other roles in society. But especially here in the United States wealth can enable such couples to have a child of their own and to determine how closely that child will resemble the one they might have had—or the one they dream of having.
The Web site of Egg Donation, Inc., a program based in California, contains a database listing approximately 300 potential donors. In order to access the list interested parties must call the company and request the user ID and the password for the month. Once I'd given the receptionist my name and address, she told me the password: "colorful." I hung up and entered the database. Potential parents can search for a variety of features, narrowing the pool as much as they like according to ethnic origin, religion of birth, state of residence, hair color, eye color, height, and weight. I typed in the physical and religious characteristics that Michelle and David were looking for and found four potential donors. None of them had a college degree.
The standard compensation for donating an egg to Egg Donation is $3,500 to $5,000, and additional funds are offered to donors who have advanced degrees or are of Asian, African-American, or Jewish descent. Couples searching for an egg at Egg Donation can be picky, but not as picky as couples advertising in the Yale Daily News. Should couples be able to pay a premium on an open market for their idea of the perfect egg? Maybe a modern-day Social Darwinist would say yes. Modern success is measured largely in financial terms, so why shouldn't the most successful couples, eager to pay more, have access to the most expensive eggs? Of course, as David illustrated in his first e-mail, input does not always translate perfectly into output—the donor's desirable characteristics may never actually be manifested in the child.
If couples choose not to find their eggs through an agency, they must do so independently. An Internet search turned up a few sites like Surrogate Mothers Online, where would-be donors and parents can post classified ads. More than 500 classifieds were posted on the site: a whole marketplace, an eBay for genetic material.
"Hi! My name is Kimberly," one of the ads read. "I am 24 years old, 5'11" with blonde hair and green eyes. I previously donated eggs and the couple was blessed with BIG twin boys! The doctor told me I have perky ovaries! ... The doctor told me I had the most perfect eggs he had ever seen." The Web site provided links to photographs of Kimberly and an e-mail address. Would-be parents on the site offered "competitive" rates, generally from $5,000 to $10,000 for donors who fit their specifications.
About a week after I sent my pictures to David and Michelle, I received a third e-mail: "Got the pictures. You look perfect. I can't say this with any authority. That is my wife's department." I thought back to the first e-mail, where he'd written, "She's been known to disregard a young woman based on cheekbones, hair, nose, you name it." He then shifted the focus. "My department is the SAT scores. Can you tell me more about your academic performance? What are you taking at Yale? What high school did you attend?"
The whole thing seemed like a joke. I dutifully answered his questions, explaining that I was from a no-name high school in the Midwest, I couldn't do math or science, and my academic performance was, well, average; I couldn't help feeling a bit disconcerted by his particular interest in my SAT score.
Michelle and David now had my educational data as well as my photos. They were examining my credentials and trying to imagine their child. If I was accepted, a harvest of my eggs would be fertilized by the semen of the author of the disturbing e-mails I had received. A few embryos would be implanted; the remaining, if there were any, would be frozen; and then I would be out of the picture forever.
he modern embryo has been frozen, stolen, aborted, researched, and delivered weeks early, along with five or six instant siblings. The summer of 2001 was full of embryo news, and the first big story was President Bush's deliberation on stem-cell research. The embryos available for genetic research include those frozen by fertility clinics for later use by couples attempting in vitro fertilization.
Embryos took the spotlight again when Helen Beasley, a surrogate mother from Shrewsbury, England, decided to sue a San Francisco couple for parental rights to the twin fetuses she was carrying. The couple and Beasley had agreed that they would pay her $20,000 to carry one child created from a donated egg and the father's sperm. The agreement also called for selective reduction—the abortion of any additional embryos. Beasley claimed that there had been a verbal agreement that such reduction would occur by the twelfth week. The problem arose when Beasley, who had discovered she was carrying twins, was told to abort one, but the arrangements for the reduction weren't made until the thirteenth week. Fearing for her own health and objecting to the abortion of such a highly developed fetus, she refused. At that time she was suing for the right to put the babies up for adoption. She was also seeking the remainder of the financial compensation specified in the contract. The couple did not want the children, and yet had the rights to the genetic material; Beasley was simply a vessel. The case is only one of a multitude invited by modern fertility processes. On August 15, 2001, The New York Times reported that the New Jersey Supreme Court had upheld a woman's rights to the embryos that she and her ex-husband had created and frozen six years before. A strange case for child-custody lawyers.
Nearly ten years ago, at the University of California at Irvine's Center for Reproductive Health, doctors took the leftover frozen embryos from previous clients and gave them without consent to other couples and to research centers. Discovery of the scam resulted in more than thirty prosecutions: a group of children had biological parents who hadn't consented to their existence and active parents who had been given stolen goods. Who can say whether throwing the embryos away would have been any better?
Even if Michelle and David liked my data, I knew I'd have a long way to go before becoming an actual donor. The application on Egg Donation's Web site is twelve pages long—longer than Yale's entrance application. The first two pages cover the basics: appearance, name, address, age, and other mundane details. After that I was asked if I'd ever filed for bankruptcy or ever had counseling, if I drank, what my goals in life were, what two of my favorite books were, what my paternal grandfather's height and weight were, what hobbies I had, what kind of relationship I would want to have with the parents and child, and so forth. A few fill-in-the-blanks were thrown in at the end: "I feel strongly about___. I am sorry I did not___. In ten years I want to be___." Not even my closest friends knew all these things about me. If Egg Donation, offering about a fifth what Michelle and David were offering, wanted all this information, what might Michelle and David want?
ichelle and David were certainly trying hard. On one classified-ad site I came across a request that was strangely familiar: "Loving family seeks exceptional egg donor with 1500 SAT, great looks, good family health history, Jewish heritage and athletic. Height 5'4"-5'9", Age 18-29. We will pay EXTREMELY well and will take care of all expenses. Hope to hear from you." The e-mail address was David and Michelle's familiar AOL account. Theirs was the most demanding classified on the site, but also the only one that offered to pay "EXTREMELY well."
I kept dreaming about all the things I could do with $25,000. I had gone into the correspondence on a whim. But soon, despite David's casual tone and the optimistic attitude of all the classifieds and information I read, I realized that this process was something I didn't want to be a part of. I understand the desire for a child who will resemble and fit in with the family. But once a couple starts choosing a few characteristics, shooting for perfection is too easy—especially if they can afford it. The money might have changed my life for a while, but it would have led to the creation of a child encumbered with too many expectations.
After I'd brooded about these matters, I received the shortest e-mail of the correspondence. The verdict on my pictures was in: "I showed the pictures to [my wife] this AM. Personally, I think you look great. She said ho-hum."
David said he might reconsider, and that he was going to keep one of my pictures. That was it. No good-bye, no thanks for my willingness to be, in effect, the biological mother of their child. I guess I didn't fit their design; my genes weren't the right material for their chef d'oeuvre. So I was rejected as a donor. I keep imagining the day when David and Michelle's child asks where he or she came from. David will describe how hard they both worked on the whole thing, how many pictures they looked at, and how much money they spent. The child will turn to them and say, "Ho-hum."
What do you think? Discuss this article in the Science & Technology conference of Post & Riposte.
Jessica Cohen is a senior studying history at Yale University. This essay, which took first place in the Essays category of The Atlantic's annual student writing competition, appeared in a somewhat different form in an undergraduate publication, The New Journal.
Copyright © 2002 by The Atlantic Monthly Group. All rights reserved.
The Atlantic Monthly; December 2002; Grade A: The Market for a Yale Woman's Eggs; Volume 290, No. 5; 74-78.