By Kathleen Sloan

A new term has entered the lexicon of the 21st century with the explosion of the fertility industry: eggsploitation. Jennifer Lahl, a San Francisco-based nurse, used the term as the title of her documentary on the subject. She defines "eggsploitation" as follows: "to plunder, pillage, rob, despoil, fleece, and strip ruthlessly a young woman of her eggs, by means of fraud, coercion or deception, to be used selfishly for another's gain, with a total lack of regard for the well-being of the donor." 

Since 1978, when the first test tube baby was produced through in vitro fertilization, and just five years later when the first embryo was created outside the uterus using a donated egg, the fertility industry has mushroomed into a multi-billion dollar global business. Nearly every college campus in the United States is blanketed with advertisements for egg donors from fertility clinics and brokers. A Wild West, anything goes climate prevails in the U.S. where there is virtually no regulation or oversight of this $6.5 billion annual business. Young women are lured by ads offering them up to $50,000 for their eggs; up to $100,000 for Harvard or Yale eggs. The numbers speak for themselves: in 2007, the Centers for Disease Control & Prevention reported 17,405 fertility treatment cycles. What is generally unknown is that approximately 70% of Assisted Reproductive Technology cycles fail.

Despite the industry's great PR and effusive media stories of celebrity parents having babies through donated eggs and surrogates, there is an alarming absence of published, peer-reviewed medical research and data on egg extraction and the risks posed to women who serve as donors. As Drew Moffitt, MD, a fertility and reproductive endocrinologist stated in testimony before Congress, "In medicine, there tends to be a desire to publish positive findings and not publish negative findings." 

Who are these egg donors? Young women in their 20's, struggling to finance college and graduate school educations. As young women interviewed in the film explain, the industry uses bait-and-switch tactics whereby they are enticed by the money offered and then pressured to continue with the often brutal procedures with appeals to altruism and without information provided regarding the health risks involved. The brokers and clinics exploit the patriarchal culture's psychological conditioning of females to be of service to others and employ guilt-inducing tactics to ensure their compliance. In essence, the donors are nameless, faceless women, too often used and left forgotten.

Jennifer Lahl, who wrote, directed and executive produced the film, is among a growing number of advocates for women's health and rights arrayed against a massive industry of physicians and researchers who have every incentive to avoid both disclosure of health risks and protection of donors when the profits involved are so high. In addition, industry lobbyists will quickly rally to prevent regulation and oversight of this enormous cash cow.     

So what are the risks associated with egg extraction? The powerful drugs donors must take contain the short-term risk of ovarian hyperstimulation syndrome along with surgical, anesthetic, emotional and psychological risks. Additional risks include pulmonary infarctions, fluid imbalances, stroke, clotting, perforation of the bowel or bladder, bleeding, production of adhesions which cause future infertility, and death. Long-term risks include breast, ovarian and endometrial cancers and future infertility.

Women normally ovulate one or two eggs a month but egg donors are administered self-injected synthetic hormones to produce dozens of eggs, so-called superovulation. The drug Lupron (leuprolide acetate) is frequently used to stop the donor's menstrual cycle, inducing a menopausal state, in order to be synchronized with the surrogate's so a successful pregnancy can result. Lupron, however, is not intended for fertility use and is unapproved by the U.S. Food & Drug Administration for that purpose. One donor featured in the documentary experienced a stroke after taking Lupron which paralyzed her left side and caused brain damage.

Other horror stories include the death of Jessica Wing at the age of 34 who was diagnosed with colon cancer after selling her eggs three times during her twenties. Angela had a history of migraines whose health concerns were dismissed by the fertility clinic. After consulting with a neurologist, she was told that the hormones used could trigger a seizure when combined with birth control pills and migraines. When she reported this information to the clinic, she was told that backing out was unacceptable; in Angela's words:  "I was no longer in control." Cindy, a combined MD/PhD student, began hemorrhaging after surgical extraction and her blood pressure dropped to dangerous levels. An artery had been punctured by the needle and the situation was exacerbated by the hyperstimulation which weakens blood vessels.

The young woman who had a stroke revealed that her General Practitioner told her mother that "The industry knew that this would happen sooner or later; they've just been rolling the dice and it fell on your daughter." As with so many corporate practices, when the profits generated far exceed the harms caused, it is considered a risk worth taking. In other words, greed combined with impassioned desires for parenthood trump public health concerns of the most vulnerable.

As Suzanne Parisian, MD, former Chief Medical Officer of the FDA states in the film, without the benefit of medical research or tracking, it is simply impossible to know what all the risks are. "It's one thing to say they don't know the risks; it's another to know that nobody's going to look either and so you're (the egg donor) really alone." The situation is summed up succinctly by Jennifer Lahl:  "Until action is taken to protect potential egg donors, we will continue to hear more stories about the reckless endangerment of vulnerable young women." The message of the documentary is that if you are a young woman thinking about donating your eggs, think again.


Kathleen Sloan is Program Coordinator at CRG.

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