How desperate women around the world are risking their lives to feed a booming - and deeply disturbing - trade in donor eggs.
Somewhere in the world, Nastya Kanatova has three children. She doesn’t know if they’re boys or girls, she has no idea if they have her blue eyes and button nose — and she never will. Five years ago, the Russian was so poverty stricken that she cashed in on the one commodity she had left of any real value — her fertility.
Her husband had left her, she had two young children to feed and little income. In desperation she sold her eggs, on six occasions, receiving £200 a time from a local IVF clinic. The resulting embryos were implanted in British, German and Russian women.
‘I was told three babies were born,’ she says of the transaction. ‘At the time, I had no special feelings towards them — I was giving my genetic material, nothing else.
'I was happy to know that my eggs would help someone who was desperate to have the joy I get from my own children. But, as time went on, I found myself tormented by questions. ‘In dark moments, I feel a sense of loss about them, an emptiness. I have children I will never know. I ask myself: “Are these children OK? Are they happy? Will they ever feel deprived by not knowing fully about themselves, never knowing their biological mum?” Because, in the end it’s not just biology, is it? It’s human emotion, too. I gave them life, yet I feel consumed by guilt.’
Her emotions are not unusual. Around the world, demand for human eggs far outstrips supply — a situation that can lead to women such as Nastya being exploited and then left to deal with the mental and physical consequences. And with the global market booming, things are unlikely to change.
Kylie Minogue recently announced that egg donation was an option she and her partner, Spanish model Andres Velencoso, were now considering, fearing that treatment for breast cancer will have affected her ability to conceive naturally. And only last week the Mail revealed how Carole Hobson, a single 58-year-old former barrister, is expecting twins after becoming pregnant with eggs donated by a 24-year-old Indian woman.
But what Carole, Kylie and thousands of desperate women like them often don’t realise, is that there can be a dark side to the joy of conceiving by IVF with donor eggs, a side that involves desperately poor women around the world being exploited for their youth and fertility in countries where there are scant regulations. Private, UK fertility clinics are only allowed to reimburse donors up to £250, even though they might need to take several days off work to donate. As a result, not enough volunteers come forward.
The fact that donors can now be identified when the resulting child turns 18, has shortened the supply still further. Therefore, many UK clinics have links to foreign centres with a ready supply of donors. No wonder hundreds of British women aged over 40 are flying to places such as Spain, the Czech Republic, Russia, Ukraine or Cyprus where there is no waiting list. And, to further add to the appeal, their treatment is often a fraction of the cost they would pay in the UK, if they self-refer.
In Russia and Ukraine, where poverty is rife and wages pitifully low, donors can receive up to £600, with £200 bonuses for extra eggs. When Nastya became a donor she was earning less than £300 a month at a chemist’s shop, a sum that was entirely eaten up by her rent and food bills.
‘I saw an advertisement from a clinic wanting women to sell their eggs,’ she recalls. ‘They were helping couples who couldn’t have children, some from abroad, others from the old Soviet countries. ‘They gave me a medical which includes blood tests and a sexual health screening, and phoned me to say I’d been accepted. ‘I had to have a course of injections, which led to some unpleasant side- effects. I felt exhausted. ‘There were headaches, and pains in my lower abdomen. After each injection I suffered reduced blood pressure, giddiness, and sometimes it was hard to walk afterwards. Nobody told me how bad it could be.’
In fact, donating eggs can be very dangerous. In the UK, it is considered inadvisable for a woman to donate more than three times in her life, compared with Nastya’s six in just a couple of years. Donors are injected with ‘follicle stimulating hormone’, or FSH, which puts their ovaries into overdrive, producing more eggs than during a normal cycle.
But in one to two per cent of women, this can result in ‘ovarian hyper-stimulation syndrome’ or OHSS. Symptoms in mild cases include nausea, diarrhoea, vomiting and weight gain, and in serious cases shortness of breath, chest pains, blood clots and death. According to a 2006 article in the scientific publication Nature: ‘Specialists in reproductive medicine say there is insufficient information about the long-term risks of drugs used to stimulate ovulation, a practice that has become more common in the past 25 years, with the proliferation of IVF and assisted reproduction. ‘But some studies have suggested the drugs may be linked to the development of certain cancers.’
Advice issued by the NHS says there is also ‘inconclusive’ evidence that a donor’s risk of developing ovarian cancer during her lifetime is multiplied from 1 per cent to 4 per cent. Then there is the risk that by helping others conceive, donors are risking their own fertility.
Hillary Green became an egg donor in the autumn of 2002. She was studying for a PhD at a university in the American midwest. In the U.S., clinics regularly advertise on college campuses and in student newspapers, offering enticements up to $100,000 for good looks and high IQs. However, according to one expert, the amounts actually paid are usually below $10,000. When Hillary was 29, and needed money so she could spend three months finishing her dissertation, she agreed to become an egg donor. ‘I got paid $2,700,’ she says. ‘It was the worst decision I ever made.’
Hillary developed OHSS and ovarian torsion, where the ovary becomes twisted — yet twice she returned to the fertility clinic and was told there was nothing wrong. On the third visit, she was rushed into surgery and had to have the ovary removed. ‘I was in hospital for two weeks and lost 25 lb,’ she says. ‘I nearly died and felt I had done something stupid in donating, but I thought that at least I had got away with it. Then, almost five years to the day of donating, I was diagnosed with breast cancer. ‘Neither my mother, grandmother or aunts had breast cancer. I was tested to see whether I had a breast cancer gene and I didn’t.
‘It turned out to be a hormone-dependent cancer and I’m convinced the drugs I took during the donation procedure in some way caused this.’ Hillary eventually had to have both breasts removed. In spite of the potential dangers, no research has been conducted into the long-term physical or psychological effects on donors.
The Centre for Bioethics and Culture Network, in the U.S., recently produced a film entitled ‘Eggsploitation’ in which a series of women describe terrible side-effects from egg-donation. The centre’s president, Jennifer Lahl, says: ‘None of these women show up in any statistics anywhere, because nobody cares. ‘The fertility industry in America alone is worth £5 billion. Why would they do follow-up work on donors if they might find bad news? It is nothing short of scandalous.’
In the UK, the Human Fertilisation and Embryology Authority confirmed that no follow-up research has been conducted on the physical or psychological effects of donating eggs. Dr Tony Rutherford, chairman of the British Fertility Society, argues there is ample evidence to suggest donation is safe, and he says respectable UK clinics make every effort to ensure the foreign clinics they send patients to are careful about the provenance of eggs and the welfare of donors.
Nevertheless, concerns over exploitation remain. In one case under investigation in Cyprus, police discovered three young Ukranians who said they had been selling eggs to the Petra Fertility Clinic near Limassol four times a year for three years. The clinic has been used by many British women. But, alarmingly, when police raided the clinic in May, there were no medical records kept of donors or recipients.
One shocked officer, investigating the case said: ‘In short, these women were turned into egg producing machines.’ For this battery production, the women were paid just £400 for handing over around 100 eggs each. But when you consider that the minimum wage in the Ukraine is about £40 a month — it’s easy to see the appeal. The problem for many IVF couples in the UK is a lack of information offered by overseas clinics. The issue of egg donors is often shrouded in mystery.
‘You are just sent over there by your clinic in the UK and you have to take everything on trust,’ says Jane McDonald, 36. She and her husband Tom, from Birmingham, went to Spain for three courses of treatment costing £25,000. None was successful. ‘We asked all sorts of questions about the egg donor, about her welfare and background, whether she’d had counselling, but we just got general non-specific answers.
We were assured genetic testing had been carried out and that she was healthy and hadn’t donated only because she needed money, but we only had the clinic’s word for it. ‘You’re desperate for a baby so you believe what they tell you. Looking back, I feel that the way the whole system is structured leaves the potential for exploitation wide open. There are desperate people at each end of the transaction, in the middle there are people getting rich.’
Dr Francoise Shenfield, of University College London, is Britain’s top authority on fertility tourism and an executive member of the European Society of Human Reproduction and Embryology (ESHRE). She is convinced the donation procedure is safe, but has concerns about donors’ long-term mental well-being.
‘If you can avoid OHSS then there are no long-term physical side-effects that we know of,’ she says. ‘However, we can’t say the same about the psychological effects. It’s very possible that five or ten years down the line some of these women could be having regrets.’ That is a sentiment Nastya and Hillary can certainly identify with. Nastya remains haunted by her lack of knowledge about her ‘children’. ‘I know some women in their late 50s and 60s are being implanted with embryos. What if such a woman died, leaving the baby I have helped to create with no mum? I will never know. ‘There’s another feeling, too — that I’ve been used, I’ve sold my body. I have a friend who worked as a prostitute to pay for her studies. She said how she felt dirty and, sometimes, I feel the same way.’
Hillary’s torments are physical ones: ‘The irony of all of this is that it looks as if I can’t have children. We’ve seen doctors and they have recommended egg donation and IVF, but I’ve told them they must be crazy. I wouldn’t expose my body to that again. ‘Besides, I wouldn’t want another woman to take that risk for me.’ Some details have been changed to protect identities.
Article: 16th December 2010 www.dailymail.co.uk
Ever considered donating eggs to a known couple, enabling you to keep in touch with any child born of the donation?
Looking for a known egg donor? Visit www.prideangel.com