Egg donation has become an increasingly popular practice at many campuses across the United States. College women are inundated with advertisements requesting their services as potential donors. University Students are no exception.
Donating in Charlottesville
According to Chris Williams, reproductive endocrinologist at the Reproductive Medicine and Surgery Center of Virginia, more than 100 donor treatments have been completed in Charlottesville since the procedure was introduced in 1990.
RMSCV egg donor coordinator Christie Aderholt said she has advertised in local newspapers and weekly newsmagazines to attract potential donors.
"What we look for are young healthy women between the ages of 21 to 32 ... [who are] non-smokers within a normal weight range for height," Aderholt said. "I'm finding that a lot of people are much more aware of egg donation now [than in years past] and that's a helpful thing for recruitment."
Many of the women who apply as potential donors are college students from schools throughout the area, Aderholt said.
Becoming a donor
Before being considered for donation, candidates must have a "pretty long initial encounter" with the donation coordinator during which they discuss their motivations for donating, Aderholt said.
During this meeting, Aderholt said she tries to find out if a donor is responding to the advertising for altruistic reasons or solely because of the monetary compensation for the procedure, which varies from region to region but in Charlottesville amounts to $3,500.
Prospective donors are usually anonymous women who never interact with the recipients of their eggs; some, however, are relatives or friends of a couple who cannot conceive.
Williams explained that many couples seek egg donors because of infertility resulting from poorly functioning ovaries or early menopause. The possibility of genetically inherited diseases also spurs some couples to visit reproductive centers.
Donor candidates have to go through numerous screenings that analyze their physical, genetic and psychological health. Some of these screenings are required by Food and Drug Administration regulations, Williams said.
According to Catherine, a third-year College student and egg donor who asked that her last name not be disclosed to protect the anonymity of the recipient family, numerous blood tests checking for sexually transmitted infections and uterine exams are completed about six weeks before the actual extraction procedure.
Catherine said she also was asked to create a "genetic family tree," listing any diseases or inherited medical complications in her family in addition to having a complete genetic screening.
"They want to be able to see what kind of potential problems were in my genetic code," she said.
Eniko Pivnick, a genetic specialist at the University of Tennessee, said a detailed genetic "pedigree" would help to decrease the chances of hereditary X-linked disorders or mitochondrial diseases that are passed through the egg.
Donors also have to meet with a licensed clinical social worker to discuss their psychological health, Aderholt said.
"They were looking for whether I was depressed and [if] I have any chronic mental issues," Catherine said, adding "They talked about the repercussions of my actions."
After a final round of blood tests, the donor is placed on birth control to synchronize her menstrual cycle with that of the recipient mother. The donor then begins hormone therapy, Catherine explained.
This hormone therapy can affect a woman's emotions, reproductive endocrinologist Michael Doody said.
Catherine said she experienced emotional changes, felt fatigued, gained five pounds and experienced some cramping and headaches during the hormone therapy.
Donors are also put on gonadotropin hormones to stimulate ovarian follicle growth that helps make eggs develop to peak fertility, Williams said.
During the process, donor fertility levels are heightened and any sexual activity is strongly dissuaded until about two weeks after the process, when the donor has menstruated, Catherine said. Donors are also not allowed to drink alcohol, she said.
"It was a huge lifestyle change ... I do have a boyfriend," Catherine said. "I'm 21 and I'm in college and basically for a month I was pregnant."
When the eggs have reached a certain size, they are removed using "ultrasound-guided needle aspirating of the ovaries" while the donor is under intravenous sedation, Williams said.
While Williams said egg donors in Charlottesville have not experienced any serious medical complications, he said problems theoretically are possible.
Donors could contract ovarian infections, experience ovarian hyperstimulation as a result of medication or potentially develop scar tissue in their ovaries, which could affect fertility, said Doody.
Though various programs have different success rates for recipient fertilization after donation, Williams said donated eggs tend to be about 60 percent effective.
This form of in vitro fertilization has the greatest rate of success because of the young age of the women supplying eggs, Williams said.
Reasons for donating
Catherine said she initially became interested in egg donation through a friend who tried to donate but found out through the screening process that she was infertile.
She said she eventually decided to become a donor because she wanted to help people start families.
Coming from a "split family," with numerous biological and step siblings, Catherine said she was aware of the significance of her "gift."
"Just because you're genetically bound to someone doesn't mean they're more important in your life ... Genetics don't make a family, it takes a community," she said. "My motherly instincts are comforted by the fact that this family [who received the eggs] is very well off and is so desperate to have a child of their own."
Williams said recipient families typically pay about $17,000 for the procedure, including medication.
The ethics of donating
Though Williams and others cite altruism as the rationale for donation, the monetary aspect of the process causes concern for some.
University Bioethics Prof. James Childress said egg donation in the United States should be viewed as a "commercial enterprise."
Childress said the reason why women are donating eggs has to be considered.
"We do have people who engage in all sorts of uncomfortable and risky things for work for money," he said.
Setting a value for eggs is also an issue, Childress said, noting that if donors receive an inflated price for their eggs -- as some students do in relation to their particular academic and inherited traits -- the end result is "commodification."
Conversely, Childress said, if women are paid too little, exploitation occurs.
Debora Spar, Harvard Business School professor and author of "The Baby Business: How Markets are Changing the Future of Birth," said attention on the "upper end of the market" is probably higher than necessary, as it is a relatively tiny niche -- people should not discredit the importance of the money involved in the donation process. Spar explained that in Britain, where donors are only given enough money to meet medical costs, there is "basically no egg donation."
College-aged women often get "excited" about the prospect of donation, as it is "an awful lot of money [to receive] in a relatively short period of time," Spar said.
Catherine said she used the compensation she received to pay for a study abroad trip that she would not have been able to fund otherwise.
Non-monetary concerns also need to be taken into consideration with egg donation, Childress said.
"The question is what sort of social practice are we developing and are we regulating it?" he said. "The answer is we are not regulating very well."
Pastor Joey Petty of the Fresh Fire Church of Charlottesville echoed these sentiments, highlighting the importance of balancing technology and medicine with morality and religion. He noted, however, that the chance to help couples who cannot conceive is hard to pass by.
"I think these [donations] are gifts that doctors and people are giving," he said.
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