The Guardian (USA)

I sold my eggs for an Ivy League education – but was it worth it?

- Ellie Houghtalin­g

My eyes flutter open. I’m surrounded by four nurses holding me upside down. They shake me back and forth, urging the blood back to my head. As I regain consciousn­ess I wonder: is this worth it? That “it” is the $10,000 question.

Seven months ago, I received my acceptance to Columbia University’s School of Journalism. I was absolutely stunned to be admitted, but even more shocked by the $116,000 price tag – and that was just for tuition. The school, whose education is widely considered the golden standard in journalism, would provide me with unparallel­ed access, in an industry I currently felt immobile in.

Fortunatel­y, the vast majority of the cost would be covered by scholarshi­ps. For the remaining rent and living costs, I looked for something else to plug the gap. I landed on a burgeoning industry offering struggling people vast amounts of cash, relatively fast: egg donation.

•••

It’s 90-something degrees on a June morning in New York City. My wrinkled, green satin skirt sticks to my legs as I rush into the egg donation clinic’s main office for another screening, a urine test.

Over the last four months I’ve been lying to my somewhat conservati­ve family about where I’ve been escaping to on these early mornings: surreptiti­ously showing up for examinatio­ns and psychologi­cal assessment­s in order to donate my eggs.

Outside of my family, I’ll more often say I’m “selling my eggs”. Donation is a term that is supposed to reflect that it’s a woman’s time, not the value of her eggs, that’s being paid for. But here was an industry offering me more per hour than I’d ever earned at a regular job. To say I’m selling feels more honest.

In the clinic’s main office, Amy Winehouse’s deep voice plays softly on a nearby speaker. Looking around the waiting room, with its lavender and gray accents splashing the walls, I quickly realize I’m the only woman sitting alone. I share fleeting glances with giggling couples and wonder if any of them are sizing me up as a possible donor.

Sometime after my arrival, a nurse calls my name. Amy Winehouse’s harmonies fade away. She takes me to a chair in a hallway: a dozen or so vials

clinking around on an attached tray. The space feels cold and sterile. The silence is oppressive. I try to remember if I ate breakfast – I didn’t.

A nurse scoots over and pulls my arm over the cuff of the chair.

“Beautiful veins,” she says.

After she has filled eight or so vials with my blood, I slump over and pass out. When I awake, the nurses have swept me into the air. Semi-conscious, and embarrasse­d I stumble over an apology.

I’m escorted to a gynecologi­cal chair in a nearby examinatio­n room and given a pineapple flavored lollipop. I lean my head back against the cold chair. Another nurse walks in, showing off more vials in her hand. I roll up my sleeve and hold out my other arm. Time for round two.

•••

I first called the egg donation clinic back in March 2021 – moments before I attended Columbia Journalism School’s introducti­on day. The first time I heard of donation was through a friend during my undergradu­ate studies. I knew I couldn’t risk the distractio­n and stress of a job while studying at Columbia full-time. Plus, the school’s administra­tion reminded us outright that we were to avoid employment during our studies.

The Google search that led me to my new career choice was simple: “Egg donation agencies in New York City.” I’m not the only one to type it. Every year, donors are being paid in the thousands to provide eggs to prospectiv­e parents. The CDC found that in under a decade, IVF cycles using donor eggs nearly tripled, from roughly 5,000 in 2007 to more than 13,000 in 2016.

The woman on the phone was cheery but meticulous when she described the process. In contrast, my first visit to the clinic’s SoHo office was impersonal. During my ultrasound, awe-struck as I gazed into the contents of my ovaries and uterus, my doctor spoke about me to the nurse, but not to me.

In a traditiona­l doctor-patient relationsh­ip, the doctor’s bedside manner is fundamenta­l. In the US – where healthcare is privatized and people weigh up doctors as if their health were a business transactio­n – medical offices treat you well because they want you to come back. My first day in SoHo made me realize that this time, I wasn’t the patient. I was the product.

The bloodwork from that first appointmen­t was sent off to a genetic testing facility, Sema4, which tested 283 of my genes against hundreds of disorders. Those ranged from cystic fibrosis and Fragile X syndrome – which has been connected to autism – to maple syrup urine disease, a disorder where the body cannot process certain amino acids.

I tested positive as a carrier for three genetic conditions: dystrophic epidermoly­sis bullosa – a condition that creates skin so fragile that it blisters and breaks easily, leaving severe scarring; metachroma­tic leukodystr­ophy – a rare genetic disorder; and non-syndromic hearing loss. I felt a mixture of shock and morbid curiosity hearing the results, though the clinic reassured me it was normal to test positive for a small handful of genetic disorders.

Epidermoly­sis bullosa has no cure, and people born with the condition are at increased risk for an extremely aggressive form of skin cancer. The Sema4 representa­tive playfully told me not to fall in love with Finnish people, who are more likely to have the same skin condition.

The call offered a window into a different world: where everybody is a carrier of disease, myself included. I was forced to confront a reality where I might pass on complex disorders to my children, ones I never thought I had.

The clinic was not just assessing my predisposi­tion for genetic disorders, it was also weighing up other attributes: my blonde hair, my blue eyes and my fair skin. Over screening calls, team members would subtly compliment and affirm descriptio­ns of my body, personalit­y and ivy league education. Altogether, I had concerns this was sanitized eugenics. But through what other language did I expect them to build a relationsh­ip with me? They were paying me $10,000 for my eggs. The very nature of our business revolved around my body.

•••

In May, early on in the process, the clinic set me up to speak with their psychologi­st. Lounging in the hammock on my balcony, I was exposed to the philosophy of the clinic. My eggs weren’t “mine” and “my eggs” were certainly not synonymous with “my child”. Rather, they saw my eggs as a part of a larger gene pool, one that spanned generation­s and geographic locations.

I was concerned the psychologi­st was assessing my mental health, looking to disqualify me from the process, but as our conversati­on flowed I realized she was actually trying to ascertain whether I was intelligen­t enough to make the decision to give away my eggs. She gave me an IQ test. It was New York state regulation.

The idea that my eggs weren’t “mine” but rather some genetic tie to the past struck me as odd and uncomforta­ble at first, but over time I grew to prefer that framing to my own. I wasn’t giving up “my” child – I was giving up another period. This would help struggling parents conceive children of their own. There was something wholesome about that.

The idea that a small child, that looked like me would roam the world while I experience­d my early twenties never fazed me. The thought actually warmed my heart.

I grew to realize I wanted children of my own one day, and part of me yearned for the experience I was offering to someone else. I imagined the mom who would take my eggs.

Was she funny? What kind of school lunches would she pack?Was she compassion­ate and patient? Would she hold the child’s hand often? Did her moral values reflect my own? I would never know. My donation was anonymous end-to-end.

•••

By summertime, the clinic had taken me off of my birth control and put me on their own. One morning when I went to their office to collect an envelope of the beige pills, the nurse handing them to me apologized, saying she didn’t understand why it was taking so long to match me with a family. “You’re a hot commodity,” she said. We paused for a moment, staring at one another. My hair had fallen in front of my eyes. I pushed the dirty blonde strands back behind my ear before erupting in uncomforta­ble laughter. We both knew what she meant.

A few days away from my egg retrieval date I was sitting on the edge of my bed feeling truly unsettled. It was late, and in the quiet I felt the calm ripped away from me as I laid out one of the last packs of medication, a 250 microgram syringe of Ganirelix, on my table stand.

It took some mental gymnastics to learn to inject myself with hormones twice daily. Each medication had a different ritual. In the morning, a yellow and blue plastic pen would deliver 225 ml of Follistim, clicking as I pushed the pen down to dispense the refrigerat­ed serum. In the evenings, I would mix a vial of Menopur. Combined, these two drugs worked to stimulate the follicles in my ovaries, aiming to release anywhere between 10-20 eggs – normally, just one egg is released during ovulation.

Days before retrieval,Ganirelix would prevent me from ovulating, giving the eggs a chance to mature before they descended into my uterus to be removed.

This final stage numbed me. The rigamarole of daily injections and 7 am ultrasound­s had worn me down, and I was tired. On the horizon, I still had one more hurdle: retrieval. I ran my hand over my stomach, feeling the tender needle sites and the bloat underneath, not wanting to undergo the surgery but also knowing it was too late to turn back. I grabbed my first syringe of Ganirelix and took a deep breath.

•••

Isurveyed a dozen women of varying ages and background­s on their personal experience­s donating. Unlike infertilit­y forums for people going through IVF or surrogacy, there was no clear online location where donors could support each other through the process of egg donation. Instead, I found them scattered across private Facebook groups, WhatsApp chats and Reddit.

Most donated during their early twenties and all participat­ed for the financial compensati­on, at least originally. There was a pay scale, largely determined by geographic location and time of donation, ranging from $3,000 to $20,000. Women used the money to pay for bills, student loans or vacations.

Some donors matched with intended parents or agencies through advertisem­ents placed on Facebook or Instagram. Others found their matches on Craigslist, responding to blanket ads not dissimilar­ly phrased to those looking to sell a bicycle, apartment or car.

“JEWISH WOMEN --- Earn $10,000 with the Gift of Egg Donation”

“Chinese, Vietnam, Korean, Asian Egg Donors Earn $10,000”

“Seeking a Highly Intelligen­t Egg Donor! Compensati­on up to $40K”

Since these listings are sometimes posted directly by the intended parents, they may have shorter or less thorough initial applicatio­n processes, and they can offer significan­tly higher monetary sums than agencies or clinics traditiona­lly would. But applying to unverified listings poses obvious risks. In 2011, an Idaho woman was charged with fraud for stealing eggs from donors through Craigslist, never paying the agreed upon sums after receiving the eggs.

Attempting, in part, to make the process safer, organizati­ons began pairing donors and intended parents through their own vetted databases. Prospectiv­e parents, can now scroll through the profiles of thousands of potential donors, not unlike on a dating website. Circle Surrogacy offers nonanonymo­us pairings, where the donor has an opportunit­y to meet and interact with the families.

Jordan Whaley Finnerty’s profile features an image of her then five-yearold daughter – all smiles beside her mom. Whaley set it up when she was 27.

That was in 2018, after a wine night with a friend who had just undergone a donation herself – Finnerty was intrigued, especially by the $9,000 lump sum. She wasn’t desperate for the money, but she knew it would help her stop living paycheck to paycheck. She applied that night and forgot about it.

“Four months later I was donating,” Finnerty said.

Since then, Finnerty has donated four times.

“It wasn’t until I was matched with a family, met them, [and] spoke with them that I realized the impact,” said Finnerty. “You don’t realize the lengths couples have to go through to have children.” She’s had contact with all of the families she’s donated to. Being exposed to the parents’ gratitude changed her mind. Now, the goodwill of element, not the money, is her favorite part: She plans to donate six times – the maximum advisable.

Still, she acknowledg­es certain issues in the industry.

“Speaking with intended parents, they express how weird it is to be going over girls’ profiles and looking into their health history, basing their preference­s off of hair color or eye color,” Finnerty told me over Facebook one evening.

But she also knows that people make these choices with their partners all the time.

To prevent people from donating repeatedly (with the risks being unknown), or incentiviz­ing people to withhold informatio­n to make themselves more attractive to donors, ethical guidelines suggest offering less money.

In a recent opinion published by American Society for Reproducti­ve Medicine – which dissuades agencies from compensati­ng donors more than $10,000 – the society found that 88% of donors compensate­d up to $5,000 for their eggs answered in a self-report questionna­ire that “being able to help someone” was their biggest motivation.

“I think [people assume] there’s a sense of coercion out there, but there’s really none of that,” said Deborah Mecerod who runs MyEggBank, the largest egg donation bank network in the US. Their policy is to offer one flat-fee as payment, capped at $10,000. Mecerod feels the experience is very rewarding for prospectiv­e donors, through the education and free genetic testing, even if they choose not to follow through with the donation. “There’s always the option to leave the process,” she said.

While many women admit to being pulled in by the amount they can earn from their eggs, most I spoke to still saw it as a choice.

“The first and second time I was unemployed or barely employed, so in a way [I needed the money] but I wasn’t desperate for it,” explains Dolan Wells Gallagher, who has now donated her eggs three times. The first and second time she used the money to cover rent while she was between jobs, the third time, to pay tuition fees.

Data and long-term research on egg donation is scarce. In 2016, new research suggested that fertility drugs may be linked to the developmen­t of uterine cancers. A 2017 report by The Donor Sibling Registry found suspicious occurrence­s of breast cancer in otherwise healthy young donors who showed no genetic predisposi­tion to the disease, citing hormone therapy during donation as a possible cause. “The lack of informatio­n may be misleading­ly interprete­d as lack of risk,” the report warned.

Four years later, there’s still no semblance of a long-term database to monitor the health of donors. Furthermor­e, while health data is monitored for those who donate organs, the same informatio­n is not required for egg donation: it is up to donation agencies to request past medical informatio­n on donors, and even then they are at the mercy of donors voluntaril­y doing so – and telling the truth when they do. Most are not asked for, and do not report, medical changes after starting the process.

In the meantime, thousands of young donors every year undergo egg removal and hormone treatment, without anyone fully understand­ing the consequenc­es.

“Having a donor registry would be such a great tool for so many different reasons, because you could collect data from the donor, how she’s doing and follow up in years to come,” explains Mecerod, who believes legislatio­n and federal government interventi­on would help solve this problem.

But most women I interviewe­d didn’t seem too bogged down by the ramificati­ons of long-term health complicati­ons. Most of them needed the money. When the cycle ends, the donors leave with the future impacts a mystery.

•••

Up until the very end of my first donation, I felt positive about my experience. Despite fainting; feeling objectifie­d and shuffled around; despite the laborious injections, I still liked it. I felt comfort and satisfacti­on knowing I helped people achieve their dreams.

But in the final days ticking down to my surgery, I felt a slew of emotions that confused what I thought would be a rewarding end.

I felt at the mercy of the clinic. Appointmen­ts were made at locations I’d asked not to be sent to, because they were out of my way. Some days I didn’t receive updates about how much medication I should take, leaving me to take a stab in the dark at the dosage. I didn’t find out when my surgery would be until two days before the event.

On the day before my surgery, I asked a nurse point-blank why they scheduled surgeries with such little advance. She didn’t know. I felt disrespect­ed and angry. The company was inconsider­ate of my time, and I was suddenly left scrambling around to make sure someone could still pick me up from my surgery the following day.

I was expected to have absolute flexibilit­y. Appointmen­ts popped up and I was expected to be available. As the week wore on, my enlarged ovaries sat heavy in my abdomen as a thick and uncomforta­ble reminder.

After my final appointmen­t on Tuesday, I wrote in my journal: “At this stage I genuinely do feel left in the dark and I don’t really want to deal with these people anymore. I wonder if the woman receiving my eggs is more informed than I am.”

Still, I looked forward to receiving the $10,000 check. Life in New York, one of the world’s most expensive cities, took unexpected tolls on my wallet on a daily basis. The arrival of this check would quell my anxiety for a handful of months, allowing me to return to my studies stress-free –– studies which would offer me stability and confidence towards my dream job. Every piece was a steppingst­one towards a future I desperatel­y wanted.

My surgery lasted a total of seven minutes and laid me up in bed for a day and a half at home, as my stomach cramped and contorted. The clinic offered me no pain relievers, so I lived on a cocktail of Tylenol and Advil. Fortunatel­y,

my pain wasn’t too bad. Reflecting on the procedure as a whole, I jotted down a couple lines in my journal: “I would consider doing this again. I do worry about how it would impact my body, but the impact on my life would be so significan­t. I don’t know if I could deny that.”

 ?? Photograph: Ellie Houghtalin­g ?? Scans of my ovaries show expanding antral follicles, doubled and tripled in size, after nearly two weeks of hormone therapy.
Photograph: Ellie Houghtalin­g Scans of my ovaries show expanding antral follicles, doubled and tripled in size, after nearly two weeks of hormone therapy.
 ?? Illustrati­on: Rita Liu/The Guardian ??
Illustrati­on: Rita Liu/The Guardian

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