The below article has been excerpted from the forthcoming book, Having Your Baby Through Egg Donation 2nd edition by Ellen Sarasohn Glazer and Evelina Weidman Sterling (June 2013), published by Jessica Kingsley Publishers.
Egg donation—how did it all begin? There are published records from as early as the late 1800s of experiments conducted on women who lost their ovaries at young ages. However, it was not until the arrival of in vitro fertilization in 1978 that physicians had a means for enabling a woman to become pregnant with another woman’s eggs. The first child born through egg donation was born in Australia in 1983.
In its early years, egg donation, though possible, was not readily available. The first donors were either sisters or cousins (of their recipients) or they were infertile women who were undergoing IVF. Since cryopreservation of embryos was not available to all, some of these women had “extra eggs” for which they had only two options: discard or donate to other infertile women. Another group of early egg donors were women seeking tubal ligation who were invited to donate their eggs in exchange for the cost of their procedure. Either way, donated eggs were relatively few and far between and for the most part, came from women whose donation was based more on practicality or expediency than on an affirmative decision to help an infertile couple. The scarcity of eggs made the experience challenging for would be recipients who had little way of knowing if and when donated eggs would become available to them. One mother of a now 23-year-old through egg donation recalls taking medications over an extended period of time to ensure her uterus was ready for implantation should a donated egg come along. She was literally “on call” for news that an egg was available. When the call came, there was no asking about who the donor was or what her genetic history revealed. The recipient was instructed to go immediately to the fertility clinic, where she underwent a full laparatomy (a surgical incision in the abdominal area) and a gamete intrafallopian transfer (GIFT procedure). The donor’s eggs were mixed with the recipient’s husband’s sperm and placed in her tubes.
Much has changed. Not only has IVF fully replaced GIFT as a vehicle for egg donation, but beginning in the late 1980s, women were actively recruited for voluntary egg donation. This began in medical clinics, some of whom continue to recruit donors. However, in the United States, independent “Egg Donor Agencies” rapidly replaced medical programs as the main source of donated eggs. By the late 1990’s it was common to see adds like the following in college newspapers:
“Make a dream come true. Help a childless couple become parents. If you are under 34, healthy, a non-smoker, please consider donating some of your eggs. You will be compensated for your time and effort.”
The arrival of these programs transformed egg donation from something extremely difficult to arrange to something that, with financial/health insurance resources and access to medical treatment, can be launched with a few visits to internet web sites. One need simply type in “Egg donation” to be connected to agencies with names ranging from “Precious Wonders” to “Tiny Treasures” to “An Angel’s Gift” to “Peas in a Pod” and “Our Fairy Godmother.” As of this writing, there are 94 Egg Donor Agencies listed on the website of the American Society for Reproductive Medicine. Most have tantalizing websites that offer hope to infertile couples many of whose journey to parenthood as so far been filled with only disappointment and loss. They also offer the promise of financial and emotional reward to young women who are invited to undergo ovarian hyperstimulation and egg retrieval.
Just as there have been changes in the availability and accessibility of donors, so also have there been shifts in the way people think about egg donation. In the early years there was a real sense that the science was advancing far more rapidly than our understanding of what it means for a person to be physically born to three people. Instead of taking note of what a seismic shift this marked in human reproduction, physicians presented egg donation as a treatment for female infertility. In so doing, they missed the opportunity to examine, make sense of and ul†imately celebrate what egg donation means for identity formation and our understanding of kinship. Sadly, egg donation was pushed into the shadows, spoken of in hushed tones and burdened by secrecy.
The experiences of parents through egg donation, their children and their donors changed significantly with the arrival of the Donor Sibling Registry in 2000. This US based worldwide registry was founded in 2000 by Wendy Kramer and her son, Ryan, who was conceived via sperm donation. The registry helps people connect with donor relations. In the 12 years since its founding, the DSR has helped connect over 9200 individuals with their donor relations. Wendy Kramer reports there are on average two new matches every day. For egg donation families, this has meant that parents have connected with donors, donors with offspring and as the name of the DSR suggests, offspring with other offspring. As word of the DSR has grown and with it, people’s appreciation of the significance of genetic connections, families have been turning to the DSR in new ways. As of this writing, there are several egg donor agencies in the US that include the DSR in their donor-recipient contracts, making it possible for people who want anonymity (or at least to start out with no identifying information) to remain in touch and share photos and updated medical and social information.
Where Are We Today?
Looking at egg donation today we see a very different picture from what we saw even as recently when we prepared our 2005 edition of Having Your Baby Through Egg Donation. In addition to the changes noted above, we see changes in the way ED parents feel about their path to parenthood. The secrecy that prevailed in the past has lifted and been replaced with honesty and privacy. True, there are some ED parents who still feel they have something to be secretive about, but increasing numbers are treating their child’s story as an open but private matter. They don’t go around saying “my egg donor baby” etc, but acknowledge donor conception when there is a reason to do so. In talking about it in a natural and appropriate way, most find that others are fully accepting of and comfortable with egg donation. Accompanying this more open approach to egg donation in general has been increased comfort with the donors. As one mother through egg donation put it,
“When I first heard about egg donation, I did not want to meet my donor because I thought that I would see her face in my child and it would upset me. Now I feel the opposite. I have twins and one looks just like the donor. I love it because it is a constant reminder of the remarkable woman who helped make us a family.”
With increased comfort and familiarity with egg donation has come increase use of this option. Or perhaps it is the reverse—as more people have become parents through egg donation, more of them have become comfortable speaking openly about it. Either way, the use of egg donation is on the rise. In 2010, the most recent year for which the SART (Society for Assisted Reproductive Technology) statistics are available, there were 9, 321 transfers using donated eggs. Over 55% of these result in live births. This is the official SART number. Wendy Kramer of the DSR found, in surveying parents through egg donaton, that 42% were never asked to inform their clinic whether they had a live birth. Some did so voluntarily and others did not. If we add in the pregnancies that resulted from frozen embryo transfers, there were over 8,000 births in the US alone (in 2010) from donated eggs.
So egg donation in the US is accepted. It is also common. And it is available. All that said, it can still feel overwhelming to embark on a path to egg donation. Recipients must identify a medical program that they have confidence in, figure out how they will afford the medical treatment and often, donor and other fees and they must find and secure a donor. All of this is do-able but it takes time, wherewithal, money, stamina and information.
Although egg donation has enjoyed widespread acceptance and relatively little scrutiny in the United States, this is not the case throughout the world. In Italy, for instance, a law was passed in 2004 completely banning oocyte donation, banning as well use of donor sperm and helping women past childbearing age becoming pregnant via ARTs. The road to this law started in 1994 when Italy made headlines when Dr. Severino Antinori used donor eggs to get 63 year old Rosana Della Cortes pregnant. Robin Marantz Henig’s New York Times article (2004) states,
“We are learning the wrong lessons from our earlier misadventures. Things got a little out of hand, yes, but that is because governments around the world adopted a hands-off policy towards the whole affair. It was too complicated to reach consensus about what steps were too intrusive, about when human life begins, about what risks were worth taking for the sake of having one’s own biological child. So governments turned their backs on reproductive technology and allowed the field to be taken over by cowboys.”
Still, unable to come to a consensus about exactly what should be accepted and what should not as far as egg donation, countries like Italy, Austria, Norway, Sweden and Switzerland have also nearly eliminated ovum donation. While such strict laws serve to call everyone’s attention to the potential for ethical abuses in egg donation, they also create new social problems. There now exists what has been termed “fertility tourism”—people living in countries that ban oocyte donation are traveling to other countries to obtain eggs.
Visit our website to get additional information or to order a copy of Having Your Baby Through Egg Donation 2nd edition by Ellen Sarasohn Glazer and Evelina Weidman Sterling.