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Extraordinary Conceptions

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article from signonsandiego.com [Feb. 12th, 2007|03:52 pm]
Extraordinary Conceptions
infertilitytalk
[blog_conception]
Trade in human eggs thrives as infertile couples travel the world seeking donors


By Emily Withrow
ASSOCIATED PRESS
9:22 a.m. January 27, 2007
PARIS – Chemotherapy beat back her ovarian cancer, but took Sophie Valot's fertility with it. Her doctor said she had just one option to start a family of her own: Find an egg donor, have children and get a hysterectomy – in five years or less, or risk relapse.
But French fertility clinics were in crisis, unable to meet the demand for donated eggs. Strict egg donation laws have caused a severe shortage of donors, and backlogs at clinics reach five years. So Valot took her search abroad.
Advertisement After two trips to Spain in 2002 and 2003, Valot has two young boys and the family she always desired. She is among thousands of women and couples willing to travel and pay for eggs. A thriving global fertility industry welcomes them with open arms, promising babies.
Belgian, Spanish and Greek clinics court women on the Internet, flashing images of pregnant bellies, nursing mothers, and frolicking families. They boast large donor pools and competitive rates.
Online forums buzz with women discussing the reputations of foreign clinics and offering advice and support. Associations have sprung up across France that, for a small annual fee, help women connect with clinics abroad and provide discounts to certain centers.
American women use seasoned French organizations to hook them up with clinics in Greece or Spain. Even with air fares and hotels, the costs can be just 10 percent of treatments in the United States.
Couples looking for black donors, a rarity in any country, fly to African clinics in Cameroon or Burkina Faso.
Frozen sperm and eggs can be bought online, ordered from U.S. storage banks by phone and shipped to clinics.
Experts caution that buyers need to be careful about the sources of eggs.
“Women need to do a little checking into the background of the donor. I feel confident that there is deception out there on the part of some people who misrepresent themselves to brokers, and then brokers who don't do a thorough job checking their donors,” said Dr. Arthur Caplan, professor of bioethics at the University of Pennsylvania. “We see a wide variability in success rates, which aren't always explained to customers.”
In France, treatment is free. The state foots the bill for recipients and donors, who get only the satisfaction of having helped a couple become pregnant. The government has taken a firm ethical stance against payment for eggs, arguing that human parts are not commodities.
But the ethical high road comes at a cost. French women wanting donations wait years with no guarantee they'll end up pregnant and no clear indication of where they are in line. Doctors give patients priority at their discretion. Recruiting a donor is a known strategy for jumping ahead on the list – an incentive aimed at alleviating the shortage.
In 2004, just 144 women volunteered to be egg donors in France, according to the Biomedicine Academy, the French government agency that oversees egg donation. By contrast, more than 2,000 women traveled to Greece and Spain alone for donated eggs in 2005, paying $3,300-$8,000, according to an Associated Press tally of figures from about 20 clinics in those two countries.
Spain and Greece have looser laws, allowing payment to donors. Clinics insist the compensation is not for the eggs, but for donors' time.
Donating is a lengthy commitment. It requires taking hormones every day for a month and numerous appointments, followed by an invasive, potentially painful and risky procedure to extract eggs from the ovaries. Outside of France, donors are compensated for time lost at work, transportation costs and child care. These criteria define payment, but clinics usually offer a blanket amount to any donor, regardless of individual circumstances.
Where payment is the norm, the amount varies and is largely unregulated, allowing clinics to compete for both patients and quality donors. Standard payment advertised online for donors in New York recently jumped from $5,000 to $7,000 per donation. Chicago clinics quickly followed suit. More money is sometimes offered to donors with a proven track record for producing highly fertile eggs, or for donors with hard-to-recruit ethnicities like Indian or Arab.
“I made a donation, and I hope that it resulted in someone's pregnancy,” said a French donor, Marie, who didn't want her last name published because her donation was anonymous. “I don't want to know who or where. It would bother me to know how it went, and if there were another child of mine out there.”
Donor eggs are inseminated with the partner's sperm to create embryos. Two to four of the most viable embryos are transferred into a woman's uterus. She waits two weeks, then takes a pregnancy test.
If it works, she carries the baby to term, becoming the biological – but not genetic – mother. When donations are anonymous, clinics carefully protect the secret from both sides. Many doctors hire lawyers to legally preserve the anonymity of the transaction, and some clinics even get a third party to keep their documents on file.
American clinics typically receive more applications than they can accept from women wanting to be donors, allowing them to be selective. Doctors and egg brokers offer patients eggs from educated, attractive women and an array of ethnicities.
Donors are matched with recipients by physical attributes like hair and eye color, but clinics are divided on the details women should get about their donors. American clinics offer more information, with some even allowing women to shop for donors who offer pictures and personal statements.
In Europe, clinics tend to be more restrictive. They keep more of the donors' details private, leaving mothers to play a guessing game as they watch their children grow up.
Elodie Thebaud knew nothing about her donor when she traveled to Greece from her rural home in western France. She had three embryos transferred in hopes that one would work.
“I went from nothing at all to almost too much!” joked the mother of 18-month-old triplets who cry and fight for a place in her lap. But Thebaud is all smiles and laughter.
“With three already, we'll stop here,” she said. “I think that's enough for now.”
Thebaud plans to tell her children that they came from an anonymous donor. The growing number of women turning to egg donation has helped to break down social taboos surrounding assisted reproduction technology. Self-help and children's books aim to ease family conversations on the subject.
One French association, Child of Hope, holds an annual party so egg- and sperm-donor children can meet. However, most children and their parents will never learn the identity of the genetic parents.
Thebaud figured her donor must have had blue eyes – the one physical trait common to her two daughters and son. At first she thought the eye color came from her boyfriend, whose sperm fertilized the donated eggs. Later she figured the donor must have had them as well.
“But we'll never know, will we?” she cooed to one daughter, Romane, as she hoisted the toddler onto her hip.

Associated Press Writer Jessica Bernstein-Wax in Madrid, Spain, contributed to this report.
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