For more than 18 fruitless months, Regina and Dennis Joyner searched for an Asian woman willing to donate her eggs. They were on the waiting list at two Washington area fertility clinics. They placed an online classified ad, but the most promising response came from Africa. Finally, they gave up.
"I knew it would be hard, but I did not think it would be that hard," said Regina Joyner, 40, who is Chinese American. "I wish I would have just adopted. . . . I would have had a baby by now."
Egg donation, often the last resort for women who cannot conceive, offers a sort of miracle: the ability to choose a donor who has not just a good résumé but also physical traits similar to the prospective mother's. For many minority or immigrant recipients, it is a treasured chance to pass on an ethnic bloodline and physical characteristics, perhaps helping the child fit in seamlessly. A Korean couple, for example, can request a Korean donor, and doctors say they usually do.
But as egg donation has surged over the past two decades, clinics and donor recruiting agencies say the supply of ethnic minority donors, especially Asians, has not kept pace with demand. For reasons probably involving complex cultural attitudes about fertility and basic marketing principles, Asian eggs are hard to find.
"Oftentimes, it's not good enough for the Asian groups to even have somebody of half-Asian, half-Caucasian descent," said Frank Chang, a reproductive endocrinologist at Shady Grove Fertility center. "Generally, we're lucky if we can find even one potential donor for that person."
For recipients, that can mean lengthy waits, intensive searches or additional expense; donor agencies usually charge finders' fees of several thousand dollars. The demand has spawned a small niche industry of agencies that scour the nation -- and sometimes the globe -- for ethnic donors.
Critics of egg donation cite recruiting and donor payments as evidence of a fertility industry that has become brazenly commercial. But doctors and donors insist that donors are justly compensated for their time and the discomfort of the donation process, which is far more invasive than sperm donation.
Donors are usually in their fertile 20s. After passing medical and psychological tests, they inject themselves with hormone stimulants for about one month. They are then anesthetized while a physician removes the eggs with a needle. Most clinics in the Washington region pay donors about $6,000.
The Web site of the Washington Fertility Center asks for "urgently needed" Chinese, Ethiopian, Indian, Japanese, Korean, Middle Eastern, Filipino and Vietnamese donors. Recently, its online donor database featured 152 donor profiles. Among the donors were two of Middle Eastern descent and 10 Asians, of whom one was part Indian -- one of the rarest donor ethnicities, doctors say.
Recipients at Shady Grove Fertility, about 15 percent of whom are Asian, can page through a book filled with donor profiles but will find that fewer than 5 percent are Asian, Chang said. Recipients seeking hard-to-find ethnicities might wait two years, he said.
Some clinics say they can usually meet recipients' needs, if they are willing to be flexible.
"All they want is a baby to love, and if it looks like [them], great," said Diana Broomfield, a fertility specialist at Washington Fertility Center.
After seven years of frustrating infertility, Manassas residents Marcel and Elaine, who is Chinese American, set out to find an Asian donor. It took Shady Grove, their clinic, a month to find one -- a Korean woman -- but Elaine and Marcel were second in line. The eggs went to another couple.
On a recent evening, Elaine and Marcel sat in their red-walled dining room cuddling the product of their search: their 5-month-old son, a smiley baby with big, brown eyes. Like most other donors and recipients contacted, they agreed to an interview provided that their last name not be used to keep the donor-recipient relationship anonymous.
Elaine, 38, an IT worker, and Marcel, a Hispanic construction manager, agreed that it was important that their donor be Asian. Marcel, 39, wanted their child to see something of himself in Elaine's face. Elaine wanted to push a stroller down the street without strangers asking if the baby was hers.
They turned to Creative Family Connections, the Chevy Chase law firm that had found them a surrogate -- Elaine had had a hysterectomy for medical reasons -- and performs specialized donor searches. Diane Hinson, the agency's founder, contacted an Asian donor she had recruited previously by posting fliers in Asian markets. Two months later, that donor came through with a willing Cambodian friend.
Elaine scrutinized a photo of the Cambodian woman. Her skin was darker than Elaine's, and her nose was pointier.
"She didn't look Chinese," Elaine said. "But it didn't matter at that point."
Nor does it now. Recently, the family went to a restaurant and ran into acquaintances, who cooed over the baby.
"The ladies there were like, 'He has the mom's nose,' not knowing he wasn't really mine, which is nice," Elaine said.
Although there has been little research on the topic, doctors, donor recruiters and donors cite cultural factors for the paucity of Asian donors.
Some say there is less awareness and more skepticism in ethnic communities about egg donation, which many countries ban or restrict. Clinics on the West Coast report less trouble finding Asian donors, perhaps because Asian communities there are more established and open to the idea.
Because infertility is seen as failure in some cultures, and because adoption is uncommon among Asians and Muslims, some observers speculate that despairing infertile couples opt for egg donation without telling anyone -- which also prevents them from asking relatives or friends to be donors. That secrecy makes a donor of the same ethnicity even more crucial, doctors say.
The Joyners, who live in Fredericksburg, hoped for a Chinese donor so their second child would resemble their 5-year-old daughter, Kayla. Their online ad drew about 10 responses, most of which Regina Joyner deemed "really strange." Some sent sexy photos. Others wanted more than the $3,500 the Joyners had offered. Many lived in other countries.
Now they are trying to save money, so the egg donation plan is off. Regina Joyner, a lab technician, is trying acupuncture in hopes of rekindling her own fertility. If that fails, the Joyners plan to adopt a baby in China.
"I would love to be pregnant," said Regina Joyner, a petite woman with a broad smile. "If it's not meant to be, it's not meant to be."
Some say the supply-demand gap comes down to marketing and language. Clinics and agencies usually place donor ads in mainstream, English-language publications. Many clinics have staffs that speak only English.
Some new ventures are tapping into the need. Satty Gill Keswani, a Livingston, N.J., physician, recently began working with New Delhi clinics to find donors for Indian patients. By flying to India, they can find donors from their own caste and region.
"A Punjabi couple would want a Punjabi donor," Keswani said. "A Bengali from Calcutta would want a Bengali donor."
Serena, a New York City student from China, was surfing the Internet when she saw an ad for an egg donation agency. Allured by the compensation, she contacted a New Jersey broker called Asian Egg Donation.
Serena, 28, spoke to Helena Qi, who is Chinese. Qi, who had worked in fertility clinics, launched an agency targeting Chinese donors this year. Persuaded in part by Qi's Chinese language skills, Serena signed up. She said she is now motivated by altruism. But she has yet to tell her family in China.
"Chinese people pay very much attention to the blood relationship," Serena said. "They think that's a very, almost sacred thing. So they cannot allow that their blood is somewhere else."
Helen, a Chinese immigrant, worked with three clinics and four donor agencies in a nearly two-year search for a Chinese donor. Three months ago, with a bit of regret, the Hoboken, N.J., resident and her husband settled on a Caucasian donor whose profile said she had a Chinese grandfather.
Then Helen's husband spotted an Asian Egg Donation Internet ad. They have since switched to a Chinese American donor and are thrilled.
"In a way, she kind of looks like me a little bit. But she's better-looking than me," Helen, 44, said with a laugh. "That's the good part."