Uneasy About the Ethics of Egg Donation

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

The following reader tells the story of her long battle with infertility that culminated with the successful use of donated eggs. But despite the happy ending, she struggles with uneasy questions about the ethics of the donor industry and the “massive resentment” she harbors toward her husband. She prefers to stay anonymous here “in order to protect my daughter’s privacy”:

I met the love of my life late, at age 36. Two years later, we were married and trying for a baby. In retrospect I wish we had started to try as soon as we decided to spend our lives together, but hindsight is 20/20. I had several friends conceive without difficulty in their late 30s, so I was confident that we still had time and that it would happen.

But it didn’t. For three years we did the usual fertility treatments, including three rounds of IVF, with one heartbreaking early miscarriage. The treatments just didn’t work.

Early on we had discussed backup plans, though we weren’t crazy about any of them. Adoption was potentially just as expensive, difficult, and heartbreaking as fertility treatments and it could take years, particularly if we wanted infant adoption. The thought of starting from scratch with a whole new cycle of hope and disappointment was daunting. But we didn’t much like to face the prospect of childlessness either, since both of us had long dreamed of having a family and desperately wanted to raise children together.

A friend in her mid-40s told us about donor egg programs. She had a successful pregnancy using donor eggs and strongly recommended it. Our initial reaction was “no way, no how.” We wanted our own genetic child, and my husband balked at the idea of “having a child with another woman.”

But as the years wore on, and after our final disastrous round of IVF, we weren’t ready to give up yet, so we faced a choice: start from scratch with the long complicated process of adoption, or go with donor-egg IVF.

The upside of donor eggs was a massively increased chance of success, since the donor would be under 30. So long story short, we went with donor eggs. It held the highest chance of success with the least chance for heartbreak (a huge consideration given that we were already worn out by the stress of the previous attempts). It would allow our child to have a genetic relationship to one parent. And, I would be able to have the hoped-for experiences of pregnancy, childbirth, and breastfeeding.

We now have a beautiful daughter who gives us joy every day. I wouldn’t trade her for anything. But at the same time, I still have very mixed feelings about the process:

  • I worry about the ethics of the situation. I can’t get around the fact that we effectively “bought” a baby. The only reason we have a child is because we could afford the costs. I also worry about the financial pressure on the donors, who are generally young women trying to pay off student loans.
  • Being walked through the donor database was surreal and icky. Much like a dating site, we could review donors’ photos, medical histories, eye colour, height, etc. As we searched the list—trying to find a donor who bore at least a vague resemblance to me—I felt like I was in a sci-fi movie picking out a designer child. Reviewing the list I knew that hundreds of potential donors had been rejected for not being worthy. I knew full well that I wouldn’t have been considered worthy due to a bouts of depression in my past. It just felt too much like eugenics for comfort.
  • I struggled with massive resentment toward my partner—resentment that he would get the chance to see himself in his child and that I never would. To see all those little resemblances: his dimples, his sister’s eyes, his father’s laugh. I will never get a chance to see how the random magic of genetics came together to make a child out of the two of us. It’s a huge grief, and one that I bear alone. Only our closest friends and family know the details of our daughter’s conception. I still have pangs whenever someone tells me she has my eyes or asks which one of us she looks like.

I still sometimes grieve the ideal of parenthood I thought I would have. But I am also grateful every day that my daughter exists. It’s an astonishing thing to bring a life into the world and see her become more and more herself. And if this is what it took for this unique little person to exist, I can make peace with that.

For more reading on the ethical quandaries of egg donation, check out this 2015 Atlantic piece by Jacoba Urist. She addresses a key question: How much money do donors typically get—and how much should they get?

In the [American Society of Reproductive Medicine] guidelines, issued in 2007, the organization’s ethics committee considered—and then rejected—a pricing structure based on an outright comparison to sperm donation. If the average payment for sperm donation was $75 for an hour’s worth of work, the committee members reasoned, then a woman paid the same hourly rate should get $4,200 for the 56 hours it typically takes to donate eggs—but “because oocyte donation entails more discomfort, risk, and physical intrusion than sperm donation,” they wrote, “sperm-donor reimbursement rates are reasonably considered to underestimate the amount that is appropriate for women providing oocytes.”

The committee members also argued, however, that the space between too little money and too much is a narrow one. The ideal payment is up to $5,000, the ASRM believes; higher fees “require justification,” while more than $10,000 is always inappropriate. The possibility of more money, the guidelines say, could create an opportunity for donor exploitation in the egg market: Women may provide eggs “in response to financial need,” leading them “to conceal medical information relevant to their own health or that of their biological offspring.” [...]

Is the money for a donor’s eggs, or her services, or her discomfort? It’s virtually impossible to decide how much a woman should be paid for the process, and how open the egg market should be, without confronting the underlying issue of what she’s being paid for in the first place.    

Urist also mentions the documentary The Perfect Donor, whose trailer is below. It begins with a young woman relaying what an agency told her about her prospects for donating: “You’ll probably get picked pretty fast, because you’re blonde, you’re blue-eyed, and you’re white”:

Catherine Lacey sounded a similar note in a personal essay for The Atlantic:

Dr. Greene [at the donor agency] asked about my parents’ and siblings’ bodies: average-height, average-weight, fair skin, and blue eyes, and she makes an approving expression at the last fact. This is like a sunroof on a car you might buy or a washer-dryer in a potential apartment. Grad school is a leather interior, a pool in the backyard.

Lacey was compensated $8,000 for her eggs. Jessica Cohen, while an undergraduate at Yale, responded to an ad in her college paper to donate her eggs for a whopping $25,000. From her 2002 Atlantic account:

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. [...]

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.” [...]

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.”