CAMBRIDGE, Mass. — “Exceptional egg donor needed,” said a recent ad in the Harvard Crimson. The couple looking for that donor, it said, is working with a “prestigious Los Angeles IVF clinic,” in search of a “100% Korean woman” with an excellent education, “outstanding” test scores, “extremely healthy family history,” plus an “altruistic nature,” and a “slim build.” The Nobel Prize in Physics is only optional, I guess, since the ideal candidate sought in such notices must also be under 28.
It’s eugenics on steroids, a friend observed, though actually, it’s eugenics on Lupron and other hormones. Today, the word “eugenics” rightly summons Hitler, and in this country, forced sterilizations. It also calls to mind what Ruth Bader Ginsburg referred to several years ago as the expectation, at the time Roe v. Wade became law, that abortion would curb “growth in populations that we don’t want to have too many of.”
But at the turn of the last century, the idea of keeping “mental defectives” — and often, one qualified for this designation simply by being black and/or poor — out of the gene pool was as widely accepted as the rationalization for our march into Iraq was a decade ago. “More children from the fit, less from the unfit,” said the early feminist Margaret Sanger. “That is the chief issue of birth control.”
In “The Case against Perfection: Ethics in the Age of Genetic Engineering,” the moral philosopher Michael J. Sandel wrote that champions of “the new eugenics” see it as not only ethically superior to the bad old days of forced sterilizations — this time, it’s optional — but perhaps even morally required.
I certainly have friends who see it that way: Wouldn’t we be negligent, one of them reasoned, not to lay the best possible foundation for the health, intelligence, and blue-eyed enjoyment of our children? Sandel says no: “To appreciate children as gifts,” he writes, “is to accept them as they come, not as objects of our design, or products of our will, or instruments of our ambition.”
The ads I find so creepy have run for years in student newspapers at the country’s top schools. “We are an Ivy League couple,” said another recent one in the Crimson, “seeking the help of a special woman who is a healthy, Caucasian, with highest percentile ACT/SAT scores” — very democratic, that ACT option — “tall, slender, dark to light blonde hair, blue eyes, and under the age of 28.” But isn’t the barely unstated subtext that anything other than that would be a crashing disappointment?
For the ‘donor,’ the going rate seems to be 20k, plus “all expenses paid,” and all women have to do to cash in is get so pumped up on hormones that they produce not one egg but many, and are chemically thrown into reproductive sync with the surrogate.
But I hope these super smart young altruists who want to help an infertile couple while also scoring enough money to (almost) pay for a semester’s tuition know the risks, which according to the Our Bodies, Ourselves Health Resource Center have too long been under-played. Lupron, the drug used to shut down the ovaries before they’re revved up again with other drugs, has been reported to cause everything from hair loss to amnesia and bone pain, and is not even approved for this use.
The drugs used to jump-start the ovaries again can cause Ovarian Hyperstimulation Syndrome, which is always serious and in rare cases can cause strokes and even death; the literature says this happens in a small number of cases — between .5 and 5 percent — though on the high side of that range, one in 20 is not small at all.
Cancer risks are also among the longer-term effects suggested in some, though not all studies. But even the low doses of hormones used in estrogen replacement therapy have been linked to an increased cancer risk, so I won’t drop my spoon in surprise if further research makes the danger clear.
Jennifer Lahl, who’s spent the last three years traveling from college to college showing her documentary film “Eggsploitation” — interviews with women who did have serious complications as a result of egg donation — says she often feels like a latter-day opponent of Big Tobacco, outmatched by an lobby that’s “strong, wealthy and powerful.”
What she wants is what Big Tobacco finally had to provide: A warning label. A major survey of egg donors in 2008 found that one in five was unaware of any health risks, though with cash on the table, it’s easy to understand how the small print might have been overlooked. Can you even have informed consent with money at stake?
I put that question to a friend who used an egg donor several years ago — with a highly adorable result — and she sighed and said the class-based aspects of the transaction definitely bothered her and her husband. “The people who do it do have a consumer attitude about it.”
At the “posh” clinic they used, she said, the doctor was taken aback that they only had two requirements: that the donor be healthy, and college educated. The doctor told her that couples typically have a long list of requirements, specifying, for example, that they want a donor who skis or does fencing, and is multilingual.
Of health risks to the donor, though, not a word was spoken, my friend said, either in or outside the clinic: “In hindsight, I’m a little embarrassed at how little I felt about the donor. It is apparently more emotionally taxing than I realized, and not a walk in the park medically.”
What technology has made possible, we will do, but the lack of regulation is frightening, and the least we can ask is that the risks be spelled out, perhaps especially for the non-blue-eyed, non-Ivy women who “donate” eggs for stem-cell research for a lesser fee.
When I told my friend who used a donor that I didn’t know what to conclude beyond that, she laughed and said hey, join the party: “I don’t know, either,” she said, beyond that she loves her child.