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More young women than ever are donating their eggs to help other people become parents, according to a new report in the Journal of the American Medical Association. From 2000 to 2010, the number of donor eggs used for in vitro fertilization, or IVF, increased about 70 percent, from 10,801 to 18,306.
The increase in egg donation is more likely due to advances in assisted reproductive technology, and more acceptance of the idea culturally, Dr. Jennifer Kawwass of Emory University, who led the study.
“I think that there are more 40-year-olds who are more comfortable with the concept. I think that the concept of donor eggs is becoming more acceptable," Kawwass says.
The report includes some great news for women who want to be moms but have had trouble getting pregnant using their own eggs: Donor eggs reduced some of the complications often found in pregnancy as women get older. For example, the numbers show a low risk for premature birth, and a higher rate of single births vs. multiple births when using a donor egg.
But some doctors and advocates worry that too little is known about the long-term health and psychological impacts on the egg donors themselves — young women, usually between the ages of 21 and 35.
“It’s true that using donor eggs reduces the risk to babies and mothers of having pregnancy complications, and if we’re able to avoid the risk of multiple gestations, that might be an argument to use donor eggs more frequently,” says Dr. Evan Myers, a professor in the department of obstetrics and gynecology at Duke University, who wrote an editorial accompanying the report.
“But if that’s going to happen, then we really need to be able to give the donors better information about how to make the decision."
The findings were based on data reported to the Centers for Disease Control and Prevention from 443 clinics — that’s 93 percent of all fertility centers in the U.S. Researchers found that the number of women donating eggs has increased, and so has the number of women using those eggs intending to become mothers.
The easy explanation behind the increase would be that more young women are donating eggs because of the challenging economy. And, anecdotally, fertility center workers do say they see more interest from potential egg donors in tough economic times.
“Especially in times of recession, we get way, way, way more calls from donors. It’s definitely monetary-based,” says Robin von Halle, president of Alternative Reproductive Resources in Chicago. “But most people do have altruistic reasons that motivate them, because it’s not a quick buck. Just for the money, it’s kind of a lot to go through.”
Kawwass doubts this. She notes the rate of compensation stayed the same throughout that decade, and there wasn't any spike in donors in 2008 or the years that followed. “I honestly think it’s more that there’s a higher demand than that there’s a higher supply,” says Kawwass.
Undergoing the hormone treatments and the surgical treatments required to donate the eggs does carry some risks, both physically and psychologically, and some doctors argue these risks are not well understood.
“There’s certainly information available about motivation for egg donors and different psychological aspects, but nowhere near as robust as for the women who are using those eggs,” says Dr. William Schlaff, professor and chair of obstetrics and gynecology at Jefferson Medical College in Philadelphia.
And, Myers says, while it’s wonderful that this new report suggests that pregnancies that result from egg donations go well, we don’t know much about what happens to the egg donors themselves.
“What we don’t know is, are there long-term impacts of undergoing this for somebody’s future fertility? Particularly if there’s someone who’s an egg donor in her 20s and herself waits until her 30s to try to get pregnant,” Myers says. “I think this whole area, it’s also one of the areas in medicine where it’s as close to a free market as possible. It’s a wide open area, and there really isn’t much research.”
That might be at least in part because the idea of paying someone in exchange for their biologic property makes many people really, really uncomfortable. The American Society for Reproductive Medicine recommends that payments to donors higher than $5,000 "require justification," and that anything above $10,000 is inappropriate.
When Raquel Cool donated her eggs in 2011, she was 26, and, it's true, she was initially attracted by the money: $7,000.
But she also loved the idea of helping a family have a child, and she was also fascinated by the technology.
After her eggs were harvested, however, she developed a moderate case of ovarian hyperstimulation syndrome, or OHSS, which occurs when hormones overstimulate the ovaries, causing them to become very swollen -- sometimes softball-sized, Myers says. Fluid leaks out of the ovaries and into the belly and chest. In severe cases, the young woman will need to be hospitalized in order to drain the excess fluids; in mild cases, the symptoms go away with rest. “But we don’t have great details on how common it is,” Myers says.
It was uncomfortable, but Cool recovered at home, and she’s healthy now. Throughout the entire egg donation process, though, she says she mostly just felt really alone. It was a difficult ordeal, both physically and emotionally — and although she believed in what she was doing, there was no one to talk to about what she was going through.
“I think I really underestimated the extent to which being a donor would have a lasting impact on my identity,” she says. So earlier this year, Cool began collecting stories from other women about their egg donation experiences. So far, she and her colleagues have spoken to 50 women. Every experience is unique.
“I think in the 30 years that donor eggs have been used, that very few questions have been asked toward us donors about how we feel about the experience,” says Cool, who is now 28 and lives in Santa Cruz, Calif. “It’s sort of dizzying and it can be very, very isolating.”