On a recent Tuesday evening, I applied to be an egg donor. "Help create a family," read the two-inch-square ad ripped from the Chicago Reader's classifieds. "$7,000 to all healthy women to be anonymous egg donors." I have textbook-good blood pressure. I've been hospitalized just once, for a few hours, when I had a tonsillectomy. And I'm on the low end of the target 21 to 28 age range. I completed a short online questionnaire quite pleased with myself. I'd taken a practical step toward monetary independence, so elusive to my demographic during this recession. A mostly selfish act –- taken to help silence student debt collectors -– could result in selfless consequences. Maybe I could give a couple the family they desire. I have healthy eggs but no upcoming plans to use them –- why waste a good thing?
Around noon the next day, while scrutinizing Old Navy clearance racks with my mom, I received the follow-up phone call. A woman from the agency wanted to know about my ethnic make-up, my birth control method, and my family members who had suffered from depression (one of the boxes I checked off on my medical history). I was very blasé as I listed relatives –- with such a bad job market and so many foreclosures, depression seems de rigueur. That was the end of my foray into egg donation; I was immediately rejected from continuing in the process. My online profile is currently singed with a red bar the color of a teacher's correction pencil; the verdict: "Application Denied."
I accept that I'm not meant to be an egg donor. However, I can't help thinking that in a country with so many anti-depressants prescribed, where so many people live long enough to develop cancer (and survive), some women will lie to donate their eggs for guaranteed compensation. As the founders and directors of egg donation agencies I spoke with confirmed, there is no such thing as a donor with a perfect family history. But the agencies are aware of the times we live in, and their screening processes try to assure that huge ethical consequences don't arise because a woman happens to be financially strapped.
"How can you ensure that a woman honestly fills out her medical questionnaire?" I asked Robin von Halle, president and founder of Alternative Reproductive Resources in Chicago, where I unsuccessfully applied. "Well, we can't," she responded. "It's a matter of having the experience, being able to meet and see them, get a gut feel. It could happen. They forgot to tell us they had two deaf sisters. They don't have medical records –- they're 22, 23. We do what we can." Mary Fusillo, the founder and executive director of The Donor Solution in Houston, seems more confident: "I know when a 23-year-old is trying to pull my leg." At Circle Surrogacy in Boston, licensed social workers meet with prospective donors about their goals and motivations. Rachel Campbell is one of them, and she believes that accidental lies by omission are more frequent than outright deception. "It's very, very uncommon that there's nothing in someone's family history –- it definitely does tip us off, it makes us press forward. My take is that the donor doesn't know or hasn't asked those questions," Campbell says. "The majority of donors really are very honest –- that's why our rejection rates are so high."
In recent years, many agencies have reported an increase in interest from potential donors, attributed to both the economy, and –- as suggested by Souad Dreyfus, founder and director of Open Arms Consultants in Brandenton, FL –- the improved awareness of egg donation thanks to scientific breakthroughs and media coverage. While there are a lot of inquiries from women looking into donate, the number of women accepted remains very low. At Alternative Reproductive Resources, von Halle says that although she receives up to 40 or 50 inquiries a day, perhaps five percent of those women go on to donate ("You have to be accepted and you also have to follow through" with the estimated three month process, she says.) Part of the reason the rejection rate is so high is that women may not know what factors will make them ineligible to donate their eggs — clinics don't necessarily make the information public. "If the secret is out, then no one will tell the truth on their applications," says Fusillo. Dreyfus has another take: "If you put this list out there, a lot of people will disqualify themselves," as I would have done. But this lack of transparency may cause women to get their hopes up in vain. This is especially troubling given that many women consider egg donation after a life setback –- job loss, unexpected expenses, or a family tragedy might leave them emotionally and fiscally vulnerable. "A lot of young women, when they make that decision, there's no room for rejection," Dreyfus says.
The American Society for Reproductive Medicine (ASRM) has a set of guiding principles for agencies to consider in donor selection. Red flags include a family history of psychiatric disorders or substance abuse, risk factors for HIV and other STIs, ongoing stress, and marital instability. Still, some variance exists among agencies. "The people who are usually screening potential donors do not have a medical background," explains Fusillo, a former fertility nurse. "For depression, I don't automatically reject someone," Fusillo adds, noting that about 20 to 30 percent of her donors have some depression in their families. Fusillo asks each applicant in-depth questions to ascertain if a person is describing chronic depression or "garden variety living in the United States."
"It would be a complete lie to say donors are not motivated by financial motivation," says Campbell. "But for the donor who gets through the process" -– medical screening, psychological screening, genetic testing, being matched with a couple, interfacing with the egg donation agency and the couple's fertility clinic, legal counseling, hormone injections, egg retrieval –- "their motivation is something bigger, they're doing something more meaningful than just trying to make a quick buck." Of the five donors I interviewed for this story, four of them said money was the catalyst but that they did not turn to egg donation as a "last resort" (the fifth donor waived her fee –- she donated her eggs to secure her brother-in-law and his wife a place at the front of the line to get matched with their own donor). Katie, a 27-year-old in Los Angeles, sought out egg donation two years ago because she was uninsured and anticipating high medical bills after slipping, suffering a concussion, and being taken to the hospital. She answered all questions honestly and was forthright about her father's alcoholism, but she didn't mention her recent concussion. "They asked for health records, records of surgery, nothing about accidents," Katie said, admitting that she understands why a woman might be inclined to lie about her medical history. "The possibility of rejection can really mess with your self-worth," she said. "If you were to get denied at a certain point, you'd be like, "‘God, what's wrong with me?' It was interesting to me how much your ego ended up getting involved."
A 27-year-old graduate student in San Diego was as straightforward on her questionnaire as she could be: "I didn't know a complete medical history of my father's side of the family –- we're no longer in contact. With my mom's side, I was fortunate." In Oregon, a now 30-something law student was able to complete four donation cycles while earning her master's, even after telling her agency, "I was anorexic and I had some experimental drug use in college. My sister's bipolar. Our grandfather died of an undiagnosed heart thing in his 30s." She continues, "It was so validating to know that my body worked that way –- to know my body had eating disorders, I thought I did irreversible damage." Jessica, who's 25 and studying abroad in Asia, was a taken aback that her agency didn't ask more questions. Her older sister has a disease that can cause developmental delay and epilepsy; according to a test, her sister's illness is not genetic. "But it was [taken] in the 80s, it was rudimentary. What I thought was really weird was that they didn't ask to see the results."
Souad Dreyfus sees a pattern among the women who contact her at Open Arms Consultants. "They come to us very excited about the idea, but you have to tone them down. ‘Oh I want to become an egg donor. I want to help someone.' Great, that's a good start," she says. First off, the agencies must make sure would-be donors recognize the magnitude of their decision. "This is not like being a sperm donor, or like donating blood. It's not a quick process –- the implications of the process are far-reaching," says Circle Surrogacy's Rachel Campbell. Selected donors seem to understand for the most part, accepting their contract as pact to tell the truth. "The first step in helping is being honest, period," says Dreyfus. "Ninety percent of the time, they get that."
Jenna Marotta writes for Time Out Chicago and New York magazine's website. Her journalism school thesis was called, "Ladies and the Tramp Stamp: The Stigma Behind Lower Back Tattoos," and she once played an extra on Saturday Night Live named Eileen Dover. This is her first story for Jezebel.
Image via Makc/Shutterstock.