Egg Donation and Surrogacy

Discussing Madonna’s adoption of another child from Malawi with Jane Velez-Mitchell, around 7:25 PM.

Go to CNN.com for a transcript.

See the article, “Egg donors rise as U.S economy falls“.

“Remember that egg donation helps a lot of people; it is safe if done by a professional, medically-ethical clinic.  It helps the donor, and it helps the recipients have a child.”
- Kathy Benardo, Northeast Assisted Fertility Group

CNN has run an article, “Six embryos?! How to avoid a fertility fiasco” which spotlights the birth of octuplets to Nadya Suleman last month, and the picture this has painted of fertility clinics.

This article demonstrates how important the ASRM’s guidelines are in keeping fertility treatment safe as well as free of government intervention. Make sure your clinic and/or egg donation agency is a member of ASRM and follows its recommendations.

It was a shock to learn that “Octo Mom” got pregnant with all those babies through IVF (in vitro fertilization) rather than just IUI (intrauterine insemination): what doctor would transfer all those embryos? Unfortunately, there are a few unethical doctors out there who make the industry look like a freak show.

An excellent article in today’s New York Times (“Birth of Octuplets Puts Focus on Fertility Clinics“) explains the issues very accurately: the ASRM’s recommended limit on the number of embryos transferred, versus the financial pressure to keep the number of transfers low (and therefore the number of embryos transferred high).

This story gets to the bottom of the conflict: the need for better insurance coverage for infertility treatment.

Saturday’s feature of Northeast Assisted Fertility Group’s egg donation program on CBS’ The Early Show (“As Economy Falls, Egg Donations Rise“) was not unlike other coverage we’ve seen about the “surge” in egg donation… the faltering economy compels more and more young women to consider becoming egg donors – and as the manager of the egg donation program, I remind them of the other realities involved:

“There’s definitely an increase in the number of people interested in donation, but most people aren’t qualified. Of course the economy has spurred people to be interested, but also it’s an expensive undertaking for the recipients, and keep in mind this is a treatment for infertility; it’s not just about making money for women.” – Katherine Benardo

Read the full article here.

Tonight, Cindy Hsu of CBS New York contributed yet another story about the growing popularity of egg donation, featuring Northeast Assisted Fertility Group’s egg donor program.

“If you’re motivated you can do a wonderful thing and help somebody and help yourself at the same time, but do not think that this is a way to walk into $10,000 and pick up your check,” said Northeast Assisted Fertility’s Sanford Bernardo.

“In fact, the payment is not for your eggs. You’re not selling eggs. It’s for the time and suffering involved.”

Click here to see the video.

This time it’s in the Boston Herald. Sanford Benardo is quoted:

“Benardo said the egg donation and surrogacy agency has seen applications from potential egg donors double — the [egg donation] agency pays female donors a flat rate of $10,000 after a woman’s eggs are retrieved.”

The article acknowledges that making money through egg donation is not quick and easy. Furthermore, the depressed economy is diminishing the demand for egg donors, making it even harder.

I have praised Dr. Gupta on the blog before ["Egg Donation and the Economy", October 28] as the only journalist to point out the biggest flaw in the “egg donor surge” story: most women who apply for egg donation, about 9 out of 10, do not qualify.

He was able to get the story right because he is a doctor as wellas a journalist.

Some people are reacting to his nomination as if Obama asked General Hospital’s Dr. Alan Quartermaine to be Federal Reserve Chairman. But the Surgeon General is really a spokesman, basically, and Dr. Sanjay Gupta really is a doctor, and I think he is a great choice. People know him and will likely listen to him. He appears enlightened and independent. He is also younger and better looking than the average Surgeon General, but let’s not hold that against him.

I couldn’t imagine Obama attempting to politicize the position the way that Bush did with Richard Carmona. Maybe Dr. Gupta could make a real impact on the public awareness of stem cell research, reproductive rights, assisted reproduction and infertility, and other controversial issues. During the conservative Reagan era, C. Everett Koop bravely and sensibly took on the AIDS epidemic when there was a great deal of public fear and misunderstanding. It would be great if Gupta could keep public health issues focused on good science rather than politics, religion, and prejudice.

CNN video: “Egg Donors on the Rise” – click the “Play” button below to watch:

The CNN segment on egg donation (“Egg Donors on the Rise”) was pretty fair, but it left some large components out of the story:

• The Doctors.
  • The reporter did not speak to any fertility doctors who perform these medical procedures to get their opinion on the alleged surge in egg donation. This may be because doctors are probably not seeing any actual increase. As we’ve said many times on this blog, any woman can apply to be an egg donor, but the majority will never actually donate because they are not qualified, or cannot find an egg donor recipient to be matched with. Fertility treatments are expensive, and the economy may affect patients’ ability to pay for them just as much as it motivates women to donate.
  • Doctors could also speak to the efficacy of egg donation (about 50% of embryos transfers result in a live birth), as well as the risks, which I believe were overstated in the piece. The chance of hyperstimulation is about 1%, and since it is always treated, it is not severe.
• The Donor Egg Recipients.
  • Infertility is why egg donation exists in the first place. Maybe it would have been hard to find a family willing to admit on national TV that they used an egg donor, but they could have acknowledged the disease of infertility (I was able to, briefly). It affects millions of people.

I was also surprised to see Debora Spar (an economist who is now president of Barnard College) express such a negative view of compensated egg donation. It seems at odds with the attitudes expressed in her book, The Baby Business, which describes the need for political debate and regulation. She is extremely knowledgeable, but her five-second sound bite left a bad taste in my mouth. Fertility treatments are indeed highly regulated by the FDA and professional organizations (the ASRM, for example), yet analogies to the “wild west” persist.

Nothing in the story was new, but the background of the bad economy makes the headline “Women Sell Their Eggs for Money!” all the more sensational. Commercial egg donation has been around for at least fifteen years. If it weren’t for the compensation, it would be difficult to get donor eggs for infertile couples. So egg donors are paid, according to ASRM regulations. In the United States, it’s legal and safe. As usual, most journalism is not particularly interested in the reality of egg donation and surrogacy, which is indeed fascinating but too complicated for a three-minute story.

I would recommend Liza Mundy’s Everything Conceivable (Knopf, 2007) for a multifaceted, intelligent, and compassionate journalistic treatment of the subject.  (See also Randi Kaye’s “Eggonomics” entry on the CNN site.)