Egged On: The commodified altruism of the assisted-reproduction industry

Illustration by Katherine Streeter

This article appears in our Summer 2016 issue, Money. Subscribe today!
 
The demand for egg donation in the United States has increased precipitously since the first birth via donor egg occurred here in 1984. America, after all, is among a dwindling list of countries where it’s legal to let aspiring parents handpick donors according to factors including height, weight, hair color, and educational accomplishments—which is why thousands of far-flung “fertility tourists” annually seek American dna to complete their families. And then there’s the fact that people tend to wait a good deal longer to have children nowadays, a cultural shift that human biology, alas, has not matched.

Egg donation, or the process through which fertility drugs are used to produce extra eggs in fertile young women—eggs that are then surgically extracted, made into embryos in a lab, and implanted into the womb of a “birth mother”—generally costs intended parents (IPs) upwards of $30,000, only $5,000 to $10,000 of which is typically compensated to the donor. It’s a big business for egg brokers—the donation agencies and fertility clinics facilitating such transactions—that hinges on well-oiled marketing and recruitment practices. Donors, after all, are the scarce resource in this supply/demand equation.

Hence, the flyers papered across college campuses seeking “extraordinary females with high SAT scores, athletic backgrounds, and emotional resiliency” to help “make someone’s dream come true,” as seen in the Google AdWords campaigns targeted toward young, educated women scrolling popular social media sites like Facebook. Such pleas almost uniformly frame the egg-donation process as miraculous, the paid act as selfless. Young female patients are invited to become altruistic heroes by giving “the most precious gift.” Gestational carriers, i.e., surrogates, are also recruited via this honeyed language, urged to help strangers realize their “ultimate dream” of bringing a child into this world. In screening donor and surrogate candidates, brokers typically grill young women about their motivations—and it’s a system that rewards those who cite a willingness to bestow “the greatest gift.” In fact, it’s considered taboo to mention student loans or rent as a motivating factor.

In 1991, when Los Angeles–based actress Shelley Smith launched the Egg Donor Program—one of the country’s first such agencies—she marketed to potential donors through acting journals. “I figured actresses were pretty, and liberal, and smart sometimes too,” she says. “My ads read, ‘Extremely rewarding, emotionally and financially!’”

Smith says little has changed in terms of how she assesses donor candidates. First, they must show humanitarian motives, followed by evidence of a reasonable health history and a responsible nature. “And, let’s be honest,” she says, “if you’re not attractive and bright, you probably won’t be chosen.” Okay, fair. But why necessitate altruism? “We need to know that someone won’t back out once they’ve been matched with IPs and have begun the process,” Smith says. “Once a family is invested, it’s a serious commitment. We need to know she’s not merely interested in getting out of a financial bind.”

Tiffany Thompson, a mother and two-time surrogate based outside of San Francisco, says surrogate candidates, too, are grilled extensively for their motives, and that those who cite the $25,000 to $50,000 fee as a primary factor will most likely be turned away. “The thought is that someone coming for the money hasn’t given thought to the emotional toll it may take,” Thompson says. “We’re straight-up asked why we feel we’ll be able to give up a baby—of course, the right answer is, ‘It’s not giving up a baby; it’s giving a child back to its parents.’”

The demand for donor sperm, like eggs, has mounted since sperm banks took off in the 1970s. But sperm banks use very little altruistic language to recruit donors—nor do they penalize men for, well, straight-up doing it for the Benjamins (okay, for the $100 or so a pop). Sperm banks also post flyers on college campuses and in neighborhoods hosting young, upwardly mobile residents. Some such posters read, “These women want to have your babies!” beneath photos of conventionally attractive females. Still others advertise, “Trade your sperm for an iPhone 6s!” Others depict college-aged buddies, piling en masse into a sperm bank.

This article appears in our Summer 2016 issue, Money. Subscribe today!

Joe Black, a New Jersey teacher, applied to become a sperm donor more than 10 years ago, his curiosity piqued by an ad featured in Swarthmore College’s newspaper. It depicted a cartoon sperm in a hat asking, “Interested in earning extra money?” “I thought it was a joke,” Black says. “But then I got curious about how fertile I was, so I went in and gave my sample and did the bloodwork, and they called me back and said it was really good, and that, as a young white guy in college, I had the ideal profile.”

Sperm donation is not a one-time gig; rather, it requires men to make a 6- to 24-month-long commitments to come in on a weekly or twice-weekly basis and produce specimens. Why? Because sperm samples must be incubated for six months—the amount of time it would take for hiv or hepatitis to surface—and banks must have sufficient sperm to compensate for the cost of this medical testing. Also, IPs interested in any particular sperm donor are encouraged to purchase multiple specimens, so as to increase their chances of pregnancy. And sperm brokers like to give IPs the option of siblings sourced from the same donor.

On his first visit to a Philadelphia-area cryobank, Black was never asked about motives for donating. He was simply told he had to commit for several months, and that he could earn extra money by supplying additional materials, such as a transcript—“so IPs would know what kinds of classes I was taking and grades I was getting”—and childhood photos. Egg donors, meanwhile, are required to supply photos. Shelley Smith notes that imagery is important because “we as women connect visually with other women, and men connect that way with women, too.”

Black says he agreed to become a donor before “100 percent thinking about what it all meant.” Early in the process, he sent an email to the lab tech coordinating his visits in which he joked about the whole gig being a “Craigslist scam.” “I immediately sent an apology email, explaining, ‘It is for the love of the game; I just wanted to know I’d get paid,’” Black says. In reply, the tech quoted the film Wall Street, assuring Black, “Greed is good.”

Interestingly, research shows that women and men are drawn to become egg and sperm donors for the same reasons—finances, primarily. So why exactly is the marketplace such a hotbed of double standards? Rene Almeling, PhD, an associate professor of sociology at Yale and the author of the 2011 book Sex Cells: The Medical Market for Eggs and Sperm, says the rhetoric of payment for reproductive services—wherein it’s a “gift” if you’re a woman, and a “job” if you’re a man—traces back to the industry’s explosion in the late ’80s and early ’90s. “The focus for men has always been on production, whereas for women, it’s on helping someone have a family,” she says.

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Such rhetoric, unsurprisingly, reflects larger cultural ideas about each sex’s relationship to reproduction in general. “When sperm donation started in the ’70s,” Almeling says, “there was this assumption that men could blast sperm and walk away, and that it wouldn’t be that big of a deal. Meanwhile, the assumption for women was, ‘This is gonna be a big deal for you, and you really need to think about it.’ After all, we associate women and children much more closely than we do men and children. There’s this deep-seated cultural belief that because women get pregnant and have babies, they’re predisposed to feeling much more connected to their eggs than men are to their sperm.”

Almeling adds that since the early days of sperm banks, most personnel have avoided talking to men about the recipients of their sperm. “The belief is that it’ll make them feel uncomfortable, might freak them out,” she says. “They frame it as, ‘You are coming here to masturbate for money,’ and never as, ‘You are coming here to create children.’”

Alice Ruby, executive director of the Sperm Bank of California, based in Berkeley, notes that logistics, too, play a role in this gender dichotomy. “Our donors work with us for between 6 and 18 months,” she explains. “Our men have typically been in the program for nine months before their sperm even goes out into the world. Due to the structure, it’s hard to frame sperm donation as a gift to a single person.” Ruby adds, “You can’t get over the job aspect of sperm donation—it requires regular attendance, and it requires men to be comfortable with the idea of coming into a little room and masturbating with the knowledge that all the techs in the hall know exactly what they’re doing.”

Egg donors and surrogates, on the other hand, have more intensive, more time-limited, and more medical relationships with their specific IPs. Even when the egg transaction is anonymous—as it is in 90 percent of cases in the United States—egg donors often receive thank-you notes and gifts from the strangers with whom they were matched. Their IPs know when donors start birth control, how their appointments are going, and the moment their eggs are extracted. But still, as Elizabeth Reis, PhD, a professor of gender and bioethics at Macaulay Honors College, CUNY, points out, the larger notion of motherhood still plays a key role in women’s assisted reproductive roles. Motherhood, asserts Reis, is central to our cultural understanding of womanhood. “It’s part of why people are a little uneasy about assisted reproductive technology,” she says. “We don’t want to think of young women going through arduous and potentially complicated processes, it helps if we all think they’re doing it for a really good reason—to help someone become a mother. Anything in our culture can be acceptable if it’s for a cute little baby.”

According to this logic, putting an altruistic spin on the months-long endeavor of egg donation or surrogacy removes its “crass capitalism,” as Reis puts it, and secures it in the woman-centric realm of helping, of serving, of niceness. “It’s more pleasant for us all to think about it that way, rather than entertain the notion of an ip buying a baby from a young woman who’s going to use that money to get a new car. In many ways, we lump assisted reproductive technology in with the American Dream—there’s the fantasy of immigrants making a life for themselves, and of women getting their babies. No one wants to think, ‘Was the surrogate pressured into this?’ or ‘What exactly did the donor go through?’”

With men, Reis says, we don’t expect them to care so much about the outcome. “Rather, we expect them to be getting rid of their sperm left and right.” Black, for one, says no one at his bank ever used the word “father.” “They never sold it like, ‘There’s some couple out there that can’t have a baby and you’re gonna be the way,’” he says. “I didn’t get the sense I was supposed to have any connection like that at all.”

The alternative-conception market may very well be exploitative of all its young players, regardless of gender. “We’re the commodities, not the clients, not the products,” says Carter Smith, a former egg donor who now works as an event planner at MIT. “Not only is the intensity of the donation experience greater for women, but our decision to donate is more socially controversial,” says Smith. “Throughout time, men have been dropping babies through sex—consensual and otherwise—without looking back. We as women have only just gotten the ability to spread our genes without actually spending nine months with the child inside our bodies.”

Living in college-saturated Boston, Smith sees plenty of egg donor-seeking flyers and public transit ads. “Mostly they feature dollar signs, happy faces, and quips about how easy it’ll be,” she says. “Some even include quotes from women claiming they went right back to work the next day. You never see phrases like, ‘A month of shots!’ You never see birth control pills, nor any mention of abstinence or ovarian hyperstimulation. I sometimes want to take a marker and write LIES.COM over the web addresses they encourage young women to visit.”

Indeed, there’s a big difference in how donor and surrogate women and their male counterparts are targeted. Back when she launched her egg donation agency (which is now also a surrogacy agency), Shelley Smith advertised in acting and student journals. “But today, of course, it’s all about social media and Google,” she says. “We spend a fortune every month on advertising, by which we mean securing the seo necessary to pop up right away in web searches.”

Jonathan Poston, president of an online marketing firm called Yiveo, says he helps egg broker clients use Google AdWords to direct recruitment searches to players on both sides of the equation. “We target donors who are geographically close to egg-donation monitoring centers,” he explains, “and try to attract potential IPs who are affluent, and who are likely to have insurance that will cover assisted reproductive technology.”

While targeting strategies may vary, Poston says egg-donor ads’ motivating messages are fundamentally the same. “They’re two-pronged,” he says. “‘Hey, you can get paid,’ and ‘Hey, you can feel good.’” Poston says bigger agencies drop a lot of money on campaigns that get into psychographics—meaning those that target educated, politically liberal twentysomething women via popular sites like Facebook and NYTimes.com.

Tiffany Thompson says she started researching surrogacy online out of a desire to help two-father families procreate. “I’d studied gestational surrogacy in college, I identify as bisexual myself, and I found my own two pregnancies rewarding,” she says. Once she began researching agencies, targeted surrogate ads followed her around online. “There’s always a happy pregnant woman in their pictures, or else a woman with happy children behind her, and they all say, ‘Help another family,’ or ‘Be the angel completing someone’s family.’”

Lynn Collins, author of Sperm Tales: An Informative Guide Through the Challenges of Infertility, notes that even for agencies with smaller budgets, it’s easy nowadays to promote a Facebook or Twitter post to “whatever demographic you want.” Collins, who previously worked as a laboratory supervisor for a leading national sperm bank, notes that IPs always want “smart sperm,” and because men are most virile in their twenties, sperm banks almost always advertise on and adjacent to college campuses. “However, fathers and babies are rarely, if ever, featured in such ads,” Collins says.

Almeling believes that because men are less likely to hear how wonderful they are for donating, they can end up feeling much more alienated than egg donors and surrogates. “Sperm donors don’t get thank-you notes and gifts; they aren’t handed a script that allows them to say, ‘I’ve made a difference in someone’s life.’ They don’t report having [the kind of] positive experiences women do.”

Almeling adds that while what sperm donors do is framed as a job, there’s the idea that egg donors are doing a lot of thinking and caring about whether the recipients of their eggs get pregnant. “Meanwhile, men are rarely asked to think about recipients, to consider whether their sperm was successful in creating children.” Interestingly, Almeling suspects that norms shifting in the domestic sphere will start to affect assisted-reproduction rhetoric as well. “Men do a lot more work around the house and take on more childrearing these days,” she explains. “We’ll eventually see that shift reflected in the industries of alternative conception.”

Compounding Almeling’s theory? The notion that gendered cultural beliefs are changing—or rather, merging. “While there’s been 150 years of research on how women’s bodies matter for reproduction, the role of men’s bodies has largely been ignored,” she says. “New research shows that what men eat and drink affects their fertility, as does their age. It’s showing that they too have a biological clock. All this is bound to change the way we think about men’s roles in reproduction.”

She also notes that increased regulation in the egg-and-sperm-broker sphere may result in a different, more honest rhetoric. “There’s a lot of suspicion from medical professionals toward egg and sperm agencies,” she says, explaining that many reproductive endocrinologists—doctors who facilitate the transfer of donor eggs and sperm into IPs—with whom she’s spoken are not happy about the commercialization of all this dna. “They believe the brokers are all about money, and that they thus don’t do a great job of screening in general.”

Carter Smith notes that brokers’ recruitment pitches, as they stand, are airtight in that they’re “pointedly used on young people, many of whom need money to pay for school.” She adds that the remuneration is “for performing a service they may not feel comfortable discussing with or seeking advice about from family members and friends.”

Elizabeth Reis advocates for increased openness, honesty, and transparency when it comes to the business of alternative conception and how it’s marketed to everybody involved—sperm and egg donors, surrogates, and intended parents. “I don’t want to sound against all this stuff from a bioethical point of view,” she says. “I just want everyone to know exactly what they’re getting into, so they can make the most informed decisions possible—money aside.”  

This article was published in Money Issue #71 | Summer 2016
by Katie O'Reilly
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