A good egg is hard to find
When a glowing 39-year-old Jennifer Lopez appeared in People magazine in March with her new twins, insisting that they had been conceived naturally, she was just the latest in a string of high-profile fortyish Hollywood women to pop out multiple babies.
In 2007, at the age of 45, Desperate Housewives’ Marcia Cross delivered a pair of daughters. That same year, Nancy Grace, host of an eponymous tabloid legal-analysis program on CNN, announced she was pregnant with twins—at the age of 47.
These stories may make for good gossip fodder, but for Beverly Hanck, executive director of the Infertility Awareness Association of Canada, which is organizing a cross-country Infertility Awareness Week May 18 to 24, they are a slap in the face.
“I think it’s nonsense to lead people to believe that these women are conceiving naturally,” she says. “It’s safe to say that anyone over 40, in all likelihood, is using donor eggs.”¦They are only having children because they are, in most cases, using donor gametes. And what’s more, they are spending a fortune to realize their dreams late in life.”
If you’re in the U.S. and have the money, finding an egg donor couldn’t be easier. Companies such as California’s the Donor Source and Nevada’s Heartfelt Egg Donation actively recruit young women for donation, while many clinics, such as Seattle’s Pacific Northwest Fertility, run their own donor programs. Prices paid for eggs range anywhere from US$2,000 to $10,000 or more, and in-vitro fertilization (IVF) treatment to implant the eggs adds approximately another $10,000 to $20,000 to the cost.
In her 2006 book, The Baby Business, Harvard business professor Debora L. Spar estimated spending on donor eggs in the U.S. at $38 million a year and pegged total spending in the fertility industry at $3 billion annually.
In Canada, the landscape is drastically different. In March 2004, the federal government enacted Bill C-13, the Assisted Human Reproduction (AHR) Act, which specifically bans human cloning, paid surrogacy, and the sale of human embryos, eggs, and sperm.
In a statement, Health Canada spokesman Stéphane Shank told the Georgia Straight, “In consultations leading up to the creation of the Assisted Human Reproduction Act, Canadians were clear that commercializing the human reproductive capability was not in keeping with Canadian values....The Government of Canada encourages clinics, physicians, and others in the assisted-human-reproduction community to help promote the altruistic donation system in Canada.”
It’s a noble thought, but when the Straight spoke to doctors at the three fertility clinics in the Lower Mainland—UBC Centre for Reproductive Health, Genesis Fertility Centre, and Pacific Centre for Reproductive Medicine (PCRM)—they all reported referring patients to clinics in the U.S. for the purposes of procuring donor eggs.
“We send a good steady stream of women to programs in Washington and beyond,” said UBC Centre for Reproductive Health director Dr. Tim Rowe, who estimated he referred between 50 to 100 patients outside of Canada every year. Dr. Beth Taylor of Genesis estimated that her clinic refers about 150 patients a year to Seattle, while Dr. Jon Havelock, founder of PCRM, said he refers patients two to three times a month, “typically down to the U.S., but there are other women who go to Europe, Spain, often, and Mexico.”
At Bellingham IVF & Fertility Care, director Dr. Emmett Branigan estimated that of a total of 150 IVF patients a year, 25 are Canadians using donor eggs recruited by the clinic.
“We actually put ads in the paper locally and at the colleges, asking for women who are interested in donating their eggs,” he told the Straight. When a donor is accepted into the program, she is matched to a client and their menstrual cycles are aligned. The donor is given hormones to stimulate her ovaries to release more eggs, which are retrieved, fertilized with sperm (usually from the client’s partner), and transferred to the client’s uterus. If all goes according to plan, the result is a successful pregnancy.
Finding a perfect donor match is not always possible, according to Branigan. “There’s certain ethnicities, like East Indian or Chinese or Japanese, that are very, very difficult to find those donors,” he said. But that doesn’t mean all hope is lost: “In those we might substitute, like for the East Indians a Native American or Mexican. They come out close enough.”
Branigan said his donors are paid $2,000 for their trouble. “Two thousand dollars is a fair amount of money,” he said, “but, you know, in California, Seattle, and some of the East Coast places, their compensation starts at $5,000 and probably is averaging close to $10,000. I have a strong sort of bias against that. I think that we really want people donating eggs for the right reasons.”
At Seattle’s Pacific Northwest Fertility, donor coordinator Stephanie Frickleton said donors are paid $4,000 for their eggs, adding that the clinic works closely with both Genesis and PCRM. “Probably half of our donor-egg patients are Canadian,” she said.
Branigan reported that his clinic’s pregnancy rate with donor eggs is between 60 and 70 percent; Frickleton said that last year her clinic achieved a pregnancy rate of 78 percent using donor eggs. Success rates for IVF using a patient’s own eggs are dismal in comparison. According to the Canadian Fertility and Andrology Society, the live birth rate per IVF cycle in Canada for 2005 (the most recent year for which figures are available) for women under 35 was 39 percent. For women 35 to 39, the pregnancy rate was 32 percent. And for women 40 and over, the rate was 17 percent.
PCRM’s Havelock said that his clinic will not perform IVF on women who have reached their 45th birthday. By age 44, he said, “The success rates of IVF are two to three percent at best, and above 45 it’s virtually zero.”
It’s because of those statistics that Beverly Hanck would like to see Canada’s laws regarding payment for gametes opened up. “I’m not talking an astronomical sum.”¦they can cap it at $3,000, but I just know we will not have any sperm and we will not have any eggs if we do not pay for them.”
As it is, Hanck said, there is now a black market in Canada for eggs. “It’s all gone underground.”¦Now eggs, instead of being $3,000, they’re $5,000 or $7,000.”
Genesis’s Taylor admitted that she operates under a “don’t ask, don’t tell” policy. “People will come in and say, ”˜This is a friend of mine.’ My job is not really to pass judgment.”¦I don’t really ask if they have a financial arrangement.” She concurred with Hanck that the AHR Act should be updated.
“The demand for donor eggs is going up. And we need to look at it as Canadians, and politicians need to look at this and say, ”˜What do people want? What is right for couples and for children?’”¦I personally think we should open it up a little more in Canada and regulate it and make it honest.”
UBC geneticist Patricia Baird, who in 1993 chaired the Royal Commission on New Reproductive Technologies, strongly disagrees. “Just because it’s available for sale in another country doesn’t make it ethically acceptable,” she told the Straight. “I think you can’t just think of the person who wants to have an egg.”
Hanck is holding out hope that when the obligatory parliamentary review of the AHR Act takes place in 2009, changes can be made. “It is enough of a blow for young couples—or single people, for that matter—who are dealt the blow of infertility,” she said. “I think they should have every possible option available to them, including being able to purchase eggs.”
Just like they do in Hollywood.
For resources on infertility and information on Infertility Awareness Week, visit www.iaac.ca/.