A few years ago, Alexandra, a doctorate student, decided that selling her eggs to a fertility clinic was the perfect way to get an extra $3,000 she needed to pay for her tuition.
But then "things went south," she recalls in "Eggsploitation," a new documentary on the health hazards of paid egg donation. Alexandra and two other women, identified only by their first names, say their experiences with egg donation led to hospitalizations, ovary loss, stroke and possibly cancer.
College campuses are filled with ads offering to pay young women large sums of money — as much as $100,000 — for their eggs, which are the "main commodity" of the multibillion-dollar fertility industry, film director Jennifer Lahl said at a recent screening of her film at the conservative Family Research Council.
But no one is speaking out on behalf of these young women when problems and complications arise, said Ms. Lahl, a registered nurse and founder of the Center for Bioethics and Culture Network, which released the film. The "dirty little secret" of the industry is that life-threatening complications can occur with egg donation, she said.
The documentary is likely to fan a long-running controversy over the ethics, finances and health risks of the procedure. Unlike collecting sperm, egg donation is an involved and drawn-out process involving weeks of hormone injections designed to stimulate the ovaries, followed by a surgical extraction conducted with the use of a local anesthetic.
In its defense, the fertility industry points to decades of experience it has built with egg donation and says it knows the risks of short-term complications — such as abdominal discomfort and nausea — as well as more severe, longer-term dangers.
The risks "are primarily related to the stimulation drugs that we're giving," said Dr. R. Stan Williams, president of the Society for Assisted Reproductive Technology.
About 1 percent of the time, the process can lead to severe ovarian hyperstimulation syndrome (OHSS), he said. OHSS can lead to other complications, such as thrombosis, stroke or a heart attack. "These [OHSS complications] are extremely rare, but they do occur," he said.
"Smaller but still significant" risks include internal bleeding from the egg-retrieval procedure and pelvic infection, Dr. Williams said.
But, he added, "there's no connection between fertility drugs and ovarian cancer or any kind of cancer."
Information about these rare complications "may or may not be visible" on websites, Dr. Williams said. But "certainly by the time a woman reaches the physician's office," she will hear about them, "as it's the physician's duty to counsel the patient about the risks of any procedure, and that includes the egg donor."
The federal Food and Drug Administration has "absolute oversight" of the screening of the donors "so that infectious diseases are not transferred," and has "an inspection process in place, where they send inspectors out to a random number of clinics each year" to monitor adherence to FDA regulations, Dr. Williams said.
The fertility industry also sets standards and guidelines on egg donation, including payment, he said. It is acceptable to compensate egg donors $5,000, and possibly as much as $10,000 in special circumstances. But advertisements offering $35,000 to $100,000 for egg donations? "We consider those unethical."
But a study last year published in the Hastings Center Report, a leading bioethics journal, found that a fourth of the egg-donation ads culled from more than 60 colleges offered compensation that exceeded the recommended $10,000 ceiling. In another apparent violation of ethical guidelines, the offered pay went up in tandem with the SAT scores of the average incoming freshmen.
Clinics say they adhere to the guidelines laid down by the American Society of Reproductive Medicine, but that so-called egg "brokers" — who link donors and clinics — are far more likely to skirt the rules.
Egg donors also testify about their experiences, usually happily, on fertility websites or social networking sites. For instance, a graduate student named "missjamiesue" posted a 10-part video on YouTube describing how she donated 15 of her eggs. "It was not that big a deal. Well, it was — but it isn't something you should be scared of if you are considering doing it," said the young woman, who said she received $5,000 in compensation.
Young women are the targets for this procedure and yet there's not enough clear or unbiased information about its pros and cons, said Kierra Johnson, executive director of Choice USA, a reproductive advocacy group. As a result, she said, Choice USA is working with Generations Ahead, a social justice group, and the Health Equity Institute at San Francisco State University, to survey egg donors and launch a website on the procedure.
Kristan Hawkins, executive director of Students for Life, said her organization is "keeping our eye on" the issue as well.
Campus ads on egg donation are reaching young women "right when they need that money most, so we've got to be out there saying, 'Look, you need to take a second look at what you're about to do,'" said Ms. Hawkins.
"The women interviewed in "Eggsploitation" underscore that warning.
Alexandra, for instance, said she read up on egg donation before agreeing to it, but "didn't see the risks."
She eventually produced 28 eggs and felt fine for a week. But then came a searing pain, followed by doctor visits and prescriptions for painkillers.
When she saw a doctor two weeks later, "his face went white" when he saw her distended abdomen. She went in for surgery but lost her ovary.
When she reached her 30s, Alexandra said, cancer was diagnosed in one of her breasts and then in the other breast. She had no known risk factors for cancer, and — except for donating eggs — her health history was unremarkable, she said.
Another egg donor named Sindy landed in the hospital, too: She responded powerfully to the fertility drugs, resulting in a harvest of between 50 and 60 eggs. Pain soon drove her into a hospital, where doctors discovered she had a puncture in an artery, either from the harvesting process or from hyperstimulation. Sindy said she has since endured more surgeries.
Calla, a third donor, said she signed up for egg donation to help someone have a family, but said she regrets it now. She said she suspects the drugs she took interacted with a hidden, benign tumor in her pituitary gland, leading to a massive stroke. In addition to suffering from several disabilities, "I can't have my own children now," she said.
"Eggsploitation" also suggests that two women who donated eggs died directly or indirectly as a result of the procedure.
These donors' stories "need to be told," Ms. Lahl said.
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