PaloVerde
The Arizona State University West
Literary Magazine

May, 2001
Volume 9, Number 1

 

Nonfiction

 


Carrie Miner 
Ad Manager, ASU West Express

Carrie Miner graduated from ASU West in May 1998 and since has taken graduate classes at ASU Main. A frequent contributor to Arizona Highways and Phoenix magazines, she writes magazine journalism and has contributed to two books, Confessions of a Disobedient Girl and Glendale: Century of Diversity. Her feature "Romancing the Rails" won the Arizona Highways bronze award for Best Story of the Year. Miner is working on a collection of short stories and lives in Glendale with her five-year-old twin boys.

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From Here to Maternity
by Carrie Miner
photography by Michael Mertz

Pen in hand, I begin a journey of self-discovery. Completing a comprehensive questionnaire, I dwell on my health history, answer questions about my talents, hobbies and personality, then move on to information about alcohol and drug use, surgeries and sexuality. After a phone call to my mother, I finish the last eight pages detailing the health history of my family, including my sister, parents and grandparents. I tuck the completed profile and a photograph of myself into an envelope and pop it into the afternoon mail, knowing I have now officially entered the ranks of women across the nation offering a piece of themselves to help other couples conceive a child.

The evolution of the technology that brings me here is a short one. In 1978, the first test-tube baby was born. From there, it was only a short jump to using donors to replace the failing eggs of women suffering from such difficulties as premature ovarian failure, age or genetics. The first baby conceived from donor eggs was born in 1984, leading to more than a decade of marked controversy over genetic material and maternity. Critics of the burgeoning field worry about the ethical implications of prospective parents who may be shopping for the "perfect" genes, and the money that has dominated the practice, with prices as high as $150,000 being offered over the Internet for eggs donated by top models.

"Our culture just hasn't caught up with the reality of it," says Diana Thomas of X and Y Consulting, the only independent consultation firm in the state that matches donDiana Thomasors and recipients. A successful career woman, Thomas found herself facing infertility, a problem common to more than 6.1 million couples in the United States. When the options dwindled and it became obvious that using donated eggs was her last chance, Thomas took matters into her own hands. She decided against having a nurse play matchmaker and set off on a search for her own donor. "I wanted to know bigger-picture stuff than eye and hair color," she says. "I wanted to know what her spirit was like."

A year after she delivered her son, Thomas started helping others. "Patients heard about what I did and started calling," she says. "I figured if people wanted me to help them, maybe I should be doing it." Thomas picked up a packet of contracts and got going. Since she began in 1997, Thomas has made nearly 100 matches.

My packet complete, I wait for a couple to pick me from the pack. One couple narrows it down to two of us and in the end chooses my competitor because she looks more like the recipient than I do. Feeling like a horse on an auction block, I am contemplating the wisdom of my application when another couple decides I'm the perfect donor. Thomas sends their profiles to me and I begin the long process.

Thomas says most couples who seek her help are relatively young, averaging 35 to 40 years of age. Although many women suffering from infertility find age a major impediment, many others find their problems related to other circumstances, such as endometriosis, premature ovarian failure, loss of eggs from cancer treatments, and attempts at having second families. "The complexity is reality," says Thomas. "Nothing related to infertility is black and white." All the same, she concedes that the monetary issues related to egg donation only fuel the controversy.

In November 1999, Arizona State University's campus newspaper The State Press The dream... displayed a classified advertisement placed by a private couple offering $25,000 for an egg donor. The ad asked for "a healthy intelligent college student or college graduate age twenty-one to thirty-three with blue eyes and blond or light brown hair."

"It's scary," Thomas says. "It's like someone advertising $25,000 for a heart. It crosses all moral and ethical boundaries." Concerns like these were behind the decision in the United Kingdom to pass legislation prohibiting donor fees. Canada is following suit, causing a shortage of donors there and sending more couples to the United States where college students can still cash in on their youth and beauty. "I'm looking for people with some altruism but it's the money that gets their interest," Thomas says. "It's a fine line to walk."

Thomas has standardized egg donor fees for X and Y Consulting at $2,000, but rates vary elsewhere. Fees tend to be higher on the coasts, especially in states mandating that insurance companies cover donor fees. The going rates range from $1,500 to $5,000.

"Fees are not intended as reward money but as compensation for potent hormone injections and minor surgery to retrieve eggs," says Dr. Benjamin Younger, head of the American Society for Reproductive Medicine. But some feel that the trend toward increasing fees means that human eggs are being turned into a commodity, transforming participants from donors into vendors.

The idea of prospective parents shopping for the "perfect" genes also makes critics wary. Thomas claims to have had only one instance in which she felt that this was occurring. She responded by canceling the contract. "I know when someone's doing that," she says. "Most people are so grateful for the chance to conceive that many don't want to even see the photographs."

But last fall, infertility groups were in a furor over the auction of models' eggs to the highest bidder. Longtime fashion photographer Ron Harris still runs the Web site Ron's Angels, where people looking for boutique babies can enter a bidding war, paying as much as $150,000 in the hope of having a beautiful child. Harris says it's a natural response to society's emphasis on beauty and brains.

Thomas disagrees. "In reality, genetic engineering is a non-issue," she says. "Most people are just looking to match their own qualities. They're not out to create a master race." She adds that the profiles give prospective parents a way to find connections. They want their children to blend in with their families.

But it's not just college students who sign up as donors. Thomas says only 30 percent of her donors fit the stereotype of full-time college students looking for a way to earn extra cash. They quickly discover that the cash may look like a windfall but in actuality it barely covers the time commitment, discomfort, and side effects that can be brought on by the fertility drugs.

I fit into Thomas's account of the 40 percent of donors who work full-time, and the 20 percent who have families. Before I embarked on this journey my fear of needles sent me white-faced to the floor each time I had my blood drawn. After two months of being poked and prodded, oftentimes by myself, I saw blood donation as an easier way of helping others.

A double standard also exists in the donor world that has some feminists up in arms. Most agencies require no psychological evaluations for sperm donors but the process is standard for egg donors. Dr. Marilyn Kieffer-Andrews says psychological evaluations help determine whether donors are dependable. "The investment in female egg donors is much bigger than sperm donors," she says. "We want to make sure that they'll follow through or if there's an indication they would not be able to honor the anonymity of the process."

A visit to Kieffer-Andrews' office is my first stop. A standard psychological profile test, the MMPI-2 demonstrates a lack of mental illness or personality disorder. Afterward, I spend an hour with her discussing my motivation for egg donation and my role in the process. Kieffer-Andrews says she's noticed a change in the donors sent to her office for evaluations. "I've seen more donors motivated by the money in the last six months," she says. "It's certainly changing."

After passing the screening for inheritable diseases, adverse lifestyles, and mental illness, I undergo a physical examination and a series of blood tests to document my general health, hormone levels, and lack of sexually transmitted diseases. A clean bill of health announces me as prime donor material. The doctor and I discuss the procedures and possible complications before I sign away my rights to the eggs produced from the process.

Pregnancy tops the list of complications related to ovum donation. Because fertility drugs increase the likelihood of pregnancy, donors are encouraged to abstain from intercourse during the donation cycle. Other possible problems include a 2.5 percent chance of ovarian hyperstimulation, a 7 percent chance the cycle might be canceled for a variety of reasons and a minute (1 in 3,000) possibility of injury to the bowels, bladder or surrounding blood vessels during egg retrieval.

Sent home with a large bag of drugs, needles and instructions, I wait for the day to begin my Lupron shots. The daily injection suppresses my egg release cycle so the doctor can match my cycle with that of my recipient. After eight days of Lupron injections, I quit wearing shorts because of the bruising on my legs. I also notice that I feel fatigued most of the time. Four days later, the practitioner reduces my Lupron injections, and I start taking gonadotropin, the hormone that signals the ovaries to mature a number of eggs, injecting it into my hip or thigh.

My first attempts leave me with bloody fingers from snapping off the bottles' glass  tops. After fastidiously checking for bubbles and preparing the injection site, I have to talk myself into stabbing Preparing the hormone shots an inch-and-a-half needle into my leg. I finally close my eyes, hold my breath and jab myself. Then the hard part—pushing in the plunger and pulling the needle back out of my thigh. I have to remind myself what a beautiful gift children are, but it almost isn't enough. Each day it gets a little easier, though, and soon I enjoy showing my needles and bruises to friends who never fail to stare at me in abject horror. Although the injections quickly become routine, the side effects leave me moody, tired, and bloated. Water weight sends the scale to numbers I'd rather not repeat, and the hot flashes make me vow off menopause.

Five days into the hormone injections, I go into the clinic for an ultrasound so the doctor can ascertain my reaction to the dThe hard part...rugs. With only a total of seven follicles, each containing an immature egg, the doctor decides against dropping the dosage in hopes of stimulating more eggs to mature. The average donor yields an average of fifteen to twenty eggs, which affords the couple one or two attempts at conception.

My slow response to the fertility drugs and, at thirty, my place at the top of the age bracket for donors make me realize how quickly I am approaching the end of my own reproductive years. When it comes to egg donation, youth pays. According to the Center for Disease Control, age really does matter. Success rates are tied to the age of the woman who produced the egg. Women thirty-six and older are also more likely to have success with assisted reproductive technology when using donor eggs.

After twelve days of taking gonadotropin, the ultrasound shows sixteen follicles, with the largest measuring a size indicating maturity. That night I give myself an injection of human chorionic gonadotropin, which stimulates the final maturation process. Thirty-six hours later I enter the laboratory for the last procedure―oocyte aspiration―during which the doctor retrieves fourteen eggs.

Success rates with donated eggs have been increasing. Only three years ago, a 40 percent success rate was considered good. Technology has increased success rates to nearly 80 percent and all but eliminated problems with multiple gestations. But that still leaves 20 percent who suffer the cycle, only to have to make the decision of whether or not to try again.

Infertility remains big business despite concerns. By and large, the field remains uncharted territory. Currently more than 350 infertility clinics in the United States operate with little oversight. Unlike the United Kingdom, practitioners in the United States need no special license beyond their medical degrees, nor are there regulations governing how procedures are performed. And no limit has been determined for the number of times donors can participate.

The specter of regulation in the United States looms on the horizon even though many couples dealing with infertility are unconcerned about the risks. The painful discovery of a failed reproductive system can easily become the center of depression and emotional frailty. Couples are turning to advancing technology for answers. But many couples remain veiled in secrecy, preferring the cover of anonymity. Until perhaps the United States follows suit with the United Kingdom and Canada. Until donors refuse to donate without the monetary motivation.

I've had my family. I'm one of the lucky ones. Now I'm just left to wonder if my recipients will become lucky as well.


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© Copyright 2001 Carrie Miner, Michael Mertz, and Arizona State University West
Last Updated: April 26, 2001