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The Market for Eggs

A third area of supply is newer, more complicated, and far more controversial. This is the market for eggs, a market that emerged only in the early 1990s but rapidly became the most differentiated and competitive link in the supply chain.

The market for eggs was a distinct and almost certainly unplanned offshoot of IVF technologies. Initially, as described earlier, IVF was a miracle technology for couples like the Browns—couples who were capable of producing both sperm and eggs and lacked only the fallopian tubes to bring the two together. For couples having other reproductive problems, IVF was essentially useless. Over time, however, both couples and their doctors began to contemplate another use of IVF, a use that was technically quite similar but socially astounding: they began to think about taking the eggs of one woman and transferring them to the womb of another. They began to think, in other words, of sourcing donor eggs for infertile women just as artificial insemination relied on donor sperm.

Medically, the move was simple. Once doctors knew how to fertilize eggs and transfer the resulting embryo back into a womb, the only additional complexity came from the need to coordinate two women’s reproductive cycles. This they did with hormones, using Pergonal or its equivalent to cause superovulation in the donor, and progesterone to prepare the recipient’s womb for pregnancy. The greater complication came from finding these donors—women who were willing both to give away their eggs and to undergo a fairly rigorous medical procedure to do so.

At first, most of these women came from the intended recipient’s friends and family. A healthy sister, for example, would donate her eggs to a sibling who had lost her ovaries to cancer. Or a college roommate would offer eggs to a friend whose ovaries had ceased to produce. In all these cases the donation was just that—a donation. And the donated eggs, combined with IVF, could allow an otherwise infertile woman to carry and bear a child. Genetically, of course, the child that resulted from borrowed eggs wasn’t related to his or her mother. Yet for women who had no other way of conceiving, the combination of IVF and donor eggs was a godsend. They could undergo pregnancy, bear their husband’s offspring, and give birth to a child who otherwise could not have been conceived. It was another medical marvel. As one recipient reported, “I have just given birth to a miracle child.” [31]