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COVER:
Egg Donor Ethics
September 1, 2006    Episode no. 1001
Read This Week's July 18, 2008
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BOB ABERNETHY, anchor: Now, the second of our two-part series examining moral issues raised by reproductive technology. For 20 years, women have been donating their eggs so infertile women can conceive. Tens of thousands of the procedures are now done every year. Critics say the rapid growth is creating safety concerns and moral dilemmas. Lucky Severson reports.

LUCKY SEVERSON: Amber Tope is not a model, although she's pretty enough to be one. She says she first became interested in donating her eggs when she took a part-time job with an egg donor agency.

AMBER TOPE: I think working at the office at the agency and meeting couples and experiencing their stories first hand -- I thought it was pretty inspiring, and I thought I really want to help somebody like that.

SEVERSON: Three couples have chosen Amber's eggs, which mean there are three children in the world who bear Amber's characteristics, presumably living with parents who are very pleased to have a child.

Photo of Smith SHELLY SMITH (The Egg Donor Program, Studio City, CA): Most people want someone who's rather like themselves. That's what we're hoping for. But everyone wants a donor who is attractive and bright, in that order.

SEVERSON: Shelly Smith runs her own egg donor agency, is a pioneer in the business and, at times, has as many as 350 girls who have signed up to donate their eggs.

Ms. SMITH: They are all going to be attractive. They will not get chosen if they are not attractive. It's very competitive. If a young woman has an Ivy League background, and she's beautiful, and she's athletic, she's the person who's more likely to get chosen.

SEVERSON: Finding a donor is as easy as plugging into the Internet. It is one of the reasons the fertility business is booming. Debora Spar wrote a book called THE BABY BUSINESS, and she estimates that, including donors, surrogates, doctors, clinics and lawyers, it adds up to about $6 billion a year.

Photo of Spar Professor DEBORA SPAR (Harvard University and Author, THE BABY BUSINESS): What we have in the United States right now is pretty much an extreme market, sort of a Wild West of reproduction where everything's for sale and that may be okay and it may not be okay, and I think we have to ask ourselves some tough questions about the extent to which this does raise moral concerns.

SEVERSON: Professor Spar's moral concerns are shared, in part, by Jennifer Lahl, national director of the Center for Bioethics and Culture. Lahr worries that it's getting too easy to interfere with what she calls "God's goodness."

Photo of lahl JENNIFER LAHL (National Director, Center for Bioethics and Culture): Wherever you're going to find beautiful, young women, you know, sun tanned, educated -- we've got Stanford, we've got USC, we've got UCLA, we've got Hollywood, and, you know, there's always an undertone here of eugenics anyway.

Prof. SPAR: Then I would be worried, because then we are moving to a fairly frightening world where people are trying to produce super-children.

SEVERSON: But Shelly Smith says she would not represent a couple trying to create super-children.

Ms. SMITH: I look at the child as one of my clients. It's not born yet, not even conceived, but it's my client. So rightly or wrongly, I have an issue with eugenics. Will they love the child if the child isn't perfect?

SEVERSON: Many countries restrict the donation of human eggs. Some don't allow it at all. But in the U.S. the business is virtually unregulated, and here in California, with the dozens of fertility clinics and so many beautiful donors, the egg business is bustling, and the state is rapidly becoming the reproductive tourism capital of the world.

Dr. Vicken Sahakian operates one of the largest fertility clinics in Los Angeles, with a growing segment of his business coming from overseas. The doctor says he has helped thousands of couples conceive healthy young children.

Photo of Sahkian Dr. VICKEN SAHAKIAN (Pacific Fertility Center, Los Angeles, CA): More and more women now, you know, delay child bearing. So you're seeing women in their late 30s and 40s desiring children. Second, technology that is available today was not 15 years ago. So now you're going to see many couples who otherwise they couldn't do any treatment, basically seek help and achieve pregnancies.

SEVERSON: There are eight million infertile women in the United States and many are willing to do almost anything to give birth to a baby.

Dr. SAHAKIAN: They look at you not only as a medical provider, but kind of as a savior or somebody special who brought to life something that they couldn't do without you. I don't feel that special, but they do feel that way. So it is rewarding -- yeah, definitely.

SEVERSON: The financial rewards for a fertility specialist go without saying. What is causing an outcry among critics are the financial rewards for young egg donors.

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SEVERSON: Because she has been so successful donating eggs, Amber likely receives more than the typical $7,500 fee but says she doesn't do it only for the money.

Ms. TOPE: I don't believe that donors get paid enough. It's a lot that you have to go through. But you have to want to do it for the right reasons or else you could regret that later.

Unfortunately, I have seen some donors that come into the program and they do just want to do it for the money.

SEVERSON: Professor Spar says the huge costs of fertility, which can easily top $50,000 when donor eggs are required, make it an option for only the affluent.

Prof. SPAR: I think that's a really important piece of this story, that basically if you're infertile and rich in this country, you have lots of options. If you're infertile and poor, you have very, very few options.

Ms. SMITH: And that's kind of sad, because they may be wonderful parents but they can't afford to pay for it, and they want it more than anything. So many people we find are refinancing their home, mortgaging, going into debt.

SEVERSON: What also troubles critics are the potential side affects on the young women.

Ms. LAHL: Women think that they're helping other women have babies, but they're not really realizing the implications for their own health.

SEVERSON: Amber Tope says the side affects during the time she was on hormones were mild -- some headaches, bloating and moodiness.

Photo of Tope Ms. TOPE: You really have to be willing to set aside that month of time just for this and be on call for the doctors if they need to call you in.

SEVERSON: And then you have to inject yourself?

Ms. TOPE: Yeah, you have to self-administer hormone injections twice a day for four weeks straight.

Ms. LAHL: Guys subsidize their college education. They're sperm donors. They show up every Friday night. But can a woman do that? I mean, can she do it one time, 12 times in a year?

SEVERSON: In order to get enough eggs to be fertilized, the young women inject themselves with powerful hormones that can cause ovarian hyperstimulation -- a painful condition that is potentially dangerous when the ovaries produce too many eggs. Dr. Sahakian says it's a condition that can be controlled, but he admits the hormones themselves have not been thoroughly tested.

Dr. SAHAKIAN: I don't think we know if ultimately these drugs are 100 percent safe. Until you can give me proof that they are going to cause significant harm, at this point I have no other choice but to use these medications.

SEVERSON: The 20 to 30 eggs removed surgically from the donor are fertilized, and many become embryos. The more embryos implanted in a woman, the greater her chances of getting pregnant. But this raises an ethical question for Dr. Sahakian, who has been storing embryos for the last 15 years.

Dr. SAHAKIAN: I have so many embryos that have been abandoned that I can't track down the parents. They don't call, change of address. We've tried. I dread the day when I retire, because I don't know what will happen to those embryos.

SEVERSON: What the fertility business needs more than anything, in Professor Spar's view, is some good old-fashioned regulation.

Prof. SPAR: It's all being left to the egg brokers and the fertility clinics, so there's just been no demand from any corner for regulation, and so the industry sort of falls through the cracks and continues to develop on its own in a very commercial way.

SEVERSON: But Dr. Sahakian says he would welcome some oversight.

Dr. SAHAKIAN: I would rather somebody tells me you can't do this rather than, you know, every time I become God -- to decide if this is right or wrong.

SEVERSON: No matter how commercialized the baby business has become, Debora Spar thinks the couples who have paid so much still look at that new baby as a religious experience.

Prof. SPAR: Even people who aren't religious and who see reproduction as a fairly, you know, scientific or mechanistic process, at the end of this process, when they have the child, they do believe that God somehow played a role in this.

For RELIGION & ETHICS NEWSWEEKLY, I'm Lucky Severson in Los Angeles. Did you like this story? How can we improve our program or Web site?
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