Egg-donor business booms on campuses

BERKELEY, Calif. -- Five years after a trade group tried reining them in, fertility clinics and brokers are bidding up prices for eggs sold by cash-strapped college women with top test scores and picture-perfect looks.

Advertisements in campus newspapers and on websites plead daily. "Egg Donors Needed. $10,000," says one in The Daily Californian, the student newspaper at the University of California, Berkeley. The ad, from a San Diego broker called A Perfect Match, seeks women who are "attractive, under the age of 29" and have SAT scores above 1,300.

Eggs have been traded almost since the fertility industry started 30 years ago. But now, new technologies tied to the Internet have turned the business into a global bazaar of egg merchants, with little regulatory oversight.

Classified-ad website Craigslist publishes 150 ads on a typical day. A Web search for "egg donor" at Google produces dozens of links to advertisers. As other nations curtail the practice -- Canada did so in 2004 -- the USA is becoming the industry's last bastion.

"We are selling children," Harvard Business School professor Debora Spar says in a new book, The Baby Business. Spar wants a national debate on bringing order and safety to an industry in which spending on everything from fertility drugs to eggs has mushroomed to an estimated $3 billion a year.

Donors typically are 18 to early-30s, when women are most fertile and eggs are healthiest. They must pass medical and psychological tests before brokers and clinics shop their information among prospective parents.

Donors take hormone-boosting shots for about a month to stimulate production. Ten to 15 eggs are extracted with a needle from the donor, under sedation, and combined with sperm to create an embryo that is later inserted into the would-be mother's womb.

The pressure on college students -- the most coveted donors -- is likely to grow. A sharp increase in embryonic stem-cell research programs across the USA in the past year created a new market for more donors as scientists use eggs to find medical cures.

States step in

State lawmakers, citing health and ethical concerns, are now stepping in.

In Arizona, the House just passed bills that would ban donor payments and require doctors to tell women about health risks that in rare cases include death. The legislation is now before a Senate panel. Republican Rep. Bob Stump, who wrote the bills, says he worries the industry is taking advantage of vulnerable young women burdened by student loans.

In California, Democratic Sen. Deborah Ortiz is pushing a bill filed last month that would limit payments to donors for the state's fledgling embryonic stem-cell program. Her bill also would require doctors to inform women about dangers.

Stump and groups such as the American Society for Reproductive Medicine (ASRM) -- a leading trade group composed largely of fertility doctors -- say they do not know of any similar legislation pending in other states or at the federal level.

Still, ASRM spokesman Sean Tipton says, "I suspect it's going to be a popular topic for discussion."

ASRM and other fertility organizations say donating is safe when women are properly screened and treated. They say donors offer a vital service to women who can't produce enough eggs on their own.

But ASRM acknowledges potential risks, including nausea and diarrhea, from a condition known as "ovarian hyperstimulation syndrome." More severe cases can result in shortness of breath and abdominal bloating. At the most serious, the group says, there is a "remote" risk of death. Donating may also create future fertility trouble for donors. And there is the possibility of emotional problems after donors relinquish parental rights to children conceived with their eggs.

The number of paid donors is unknown because no one keeps statistics in the lightly regulated industry. Spar estimates that spending on donor eggs is now about $38 million a year. ASRM in Birmingham, Ala., says about 10,000 babies a year are born from donated eggs.

Donors are mostly U.S. women because most industrialized nations ban paid donation, Spar says. Canada joined a list of countries whose residents -- dubbed reproduction tourists -- now flock to the USA for eggs. Commercial egg donation, once uncommon, became more routine in the 1990s when entrepreneurs launched brokerages, many online.

'Practically everybody gets paid'

Donor is a misnomer because the women who contribute eggs are almost always paid. Fees are for women's time -- not for the eggs. That's why ads in college newspapers and on Craigslist often appear in the help-wanted section.

"Practically everybody gets paid," says David Adamson, a prominent fertility doctor in San Jose, Calif. Adamson supports fees recommended by ASRM in August 2000: Payments above $5,000 need justification, and "sums above $10,000 go beyond what is appropriate," the group's ethics committee said in a report.

Critics fret about ethical pitfalls in a self-policed industry that doesn't gather enough data to expose emerging problems. "It's all in private hands," says Jesse Reynolds of the Center for Genetics and Society near San Francisco. The center has been a critic of California's embryonic stem-cell research program, which it says will drive demand for egg donors higher. The center's backers include small family foundations and the Ford Foundation.

The fertility industry is regulated by the Centers for Disease Control and Prevention under a 1992 federal law that requires clinics to disclose success rates of treatments, including births from donor eggs. The CDC does not control prices paid to donors.

Reynolds says that as bounties for eggs rise, more students and other financially strapped women will be tempted by a procedure they'd otherwise reject. He worries about women such as Berkeley graduate Kristen, 24, who expects to get $8,000 the next time she donates. One couple she worked with already got pregnant.

Kristen spoke about her experience only if her last name was not published because she worries her employer would disapprove. She has already donated once in the three years since she saw an ad in the Californian when she was a Berkeley student. She also heard stories of women earning as much as $65,000 -- enticing because she and her fiance have $20,000 in student loans.

Searching the Internet, she landed on broker Fertility Alternatives in Murrieta, Calif. Like other recruiters launched in the past decade, it matches women with clinics that treat infertile couples. The Southern California company did not return calls seeking comment.

Kristen isn't worried about health risks and doesn't have moral qualms. "What makes a child your child is that you raise it," she says. Her eggs are "just DNA."

Donors get paid regardless of whether a pregnancy occurs. Fees are often higher for donors with a track record of producing lots of eggs resulting in birth. Kristen, for example, says she expects to get $10,000 for a successful third donation.

Women generally are told by clinics and brokers to donate no more than six times. But the industry relies on an honor system, Spar says, so there's nothing to prevent a woman from exceeding the limit. Demand for donors is keen, giving rise to more elaborate marketing by brokers and the in-vitro fertility clinics that do most of the work. Would-be parents also appeal directly in college newspapers.

Five-figure offers -- and, rarely, six-figure bids -- are sometimes attention-grabbers to generate leads, says Adamson, the fertility doctor.

One of the biggest clinics, Genetics & IVF Institute near Washington, D.C., offers an online catalog of 100 donors in a database searchable by race, height, eye color, blood type and education. Profiles feature snapshots of donors taken when they were children to better visualize babies their eggs might produce.

There's audio, too: Downloadable recordings of donors interviewed about, say, a favorite gift. Donor No. 583 -- a 5-foot-4 day care provider with a criminal justice education -- recalls a pair of barrettes her son made for Mother's Day. "I had to wear them all the time," she says, laughing about the memory in her digital interview.

Sites adorned with photos and vital statistics create "a sense that you are choosing a person, rather than genetic material," Spar says. "It feels a lot like online dating."

Prospective parents want donors who look and behave much like the baby they dream of, even though there's no guarantee. The result: escalating fees for beautiful women with perfect grades -- a "morally troubling" development akin to eugenics, the ASRM warned.

Genetics & IVF says women generally get paid $5,000 for each donation. Yet, reflecting the auction-like atmosphere, its website notes some donors with "special characteristics" may get more. Medical director Stephen Lincoln says the clinic avoids price wars. "It does make one queasy," he says.

At the Baby Steps brokerage in Raleigh, N.C., donors are reminded about guidelines limiting fees. But it says experienced donors are paid up to $8,000 -- and possibly more. "You are free to request whatever compensation you deem reasonable," it says on its website.

Baby Steps did not return calls seeking comment.

Asian women are especially in demand, say Spar and other industry experts, partly because the population is small. On Craigslist's Los Angeles site, a couple offered up to $10,000 to Asian donors 21 to 25 years old who are 5-foot-2 or taller and "highly intelligent." The couple -- he's 37, she's 42 -- said in the ad: "Donor ideally has artistic skills as intended mother is a talented oil painter and piano player."

Blond hair and blue eyes are big sellers. A 28-year-old lawyer near Washington with those very looks plus a good education says she earned a total $7,500 from Genetics & IVF last fall for 15 eggs. She agreed to an interview if her name was not published because her contract requires anonymity.

She has started a second cycle and expects another $7,500. The payments will help pay $175,000 in school debt, she says. She says she would give eggs for free to a friend or relative. But not strangers. "I am going through injections daily and all sorts of medication," she says. "I should be compensated."

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