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Spar+The+Egg+Trade - T he N EW ENGLA ND JOURNAL of M...

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Perspective The NEW ENGLAND JOURNAL of MEDICINE march 29, 2007 n engl j med 356;13 www.nejm.org march 29 , 2007 1289 debt. In the fall of 2005, frustrat- ed by her economic straits, Anna answered an advertisement in her university’s magazine promising $25,000 to a “tall, athletic woman” willing to “give a gift of life and love.” Anna visited the agent who had placed the ad, underwent medical tests at a fertility clinic, and met the couple that was search- ing for eggs. Through the agent, they offered her $20,000 plus med- ical expenses. Six weeks later, af- ter 2 weeks of hormone injections, mood swings, and bloating, Anna returned to the clinic and had eight healthy oocytes removed. The cou- ple took them, and Anna took her money. She will probably never know whether her eggs resulted in a successful pregnancy. Encouraged, Anna went back to the agent in February 2006, offer- ing to donate again. This time, as a “proven” donor, she received $22,000 from another couple, enough to eliminate her debt and pay for a Caribbean vacation. Then, in September 2006, Anna saw another ad seeking healthy young women for egg donation. But this time, the oocytes were for research: using somatic-cell nu- clear transfer (SCNT), scientists would attempt to use her eggs to generate a line of infinitely repro- ducing embryonic stem cells. Intrigued, Anna answered the ad and learned that medically, the procedure was identical to what she’d already experienced. But there was no couple to meet this time and no baby to be produced. There was also no money. Instead, Anna was told apologetically, she would be reimbursed only for actual ex- penses — the bus fare, in her case, for trips to the in vitro fertilization (IVF) clinic. Anna Behrens is not a real per- son. But her story plays out thou- sands of times annually in the United States. According to the Centers for Disease Control and Prevention, in 2003, at least 5767 babies were born after being con- ceived with donated eggs — an 11% increase from 2002. Since success rates for IVF using do- nated eggs averaged 30 to 50% in 2003, the number of IVF cycles performed that year using such eggs was considerably higher: 12,996. Some small fraction of the eggs were probably truly “do- nated,” given by friends or family members out of love. The rest were sold, for an average of about $5,000 per harvest. Eggs like Anna’s were relatively rare, bought by would- be parents willing to pay a premi- um for particular genetic traits. For stem-cell science, however, the numbers and market were en- tirely different during the same The Egg Trade — Making Sense of the Market for Human Oocytes Debora Spar, Ph.D. A nna Behrens is 24 years old. Tall and slim, she is working toward her Ph.D. in art history at an Ivy League school. During her undergraduate years, Anna accumulated $27,000 in credit-card Copyright © 2007 Massachusetts Medical Society. All rights reserved.
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