Over the past few months something strange has happened to my social media feeds. Rather than the relentless flow of ads for Shein, the all-mighty algorithm has decided that what I really need to see is endless posts telling me that I can be compensated 750 for donating my eggs.
Most of the adverts feature a happy couple (sometimes straight, sometimes gay) cooing over a baby. The captions are along the lines of Do an amazing thing and help others to start their family by donating your eggs! You will receive 750. Another ad features a grid of photos of a diverse range of women asking: Could this be you? as if theyre trying to recruit me to their gang of giving girls.
Typically, I scarcely pay attention to whats being pushed at me as I scroll, but this sudden overload of ads calling upon me to become an egg donor did have an impact. I stopped and questioned whether, actually, this indeed could be me.
And it turns out, thousands of women have wondered the same and decided that yes, it was the right choice for them. The UKs fertility regulator The Human Fertilisation and Embryology Authority (HFEA), is still collecting data for the past two years but in 2019, 4,433 IVF cycles were completed using donor eggs, with the figure doubling since 2009. The demand for eggs is high and social media posts are a quick and cheap way to reach potential donors, particularly from under-represented communities.
In one respect, the ads are spot on. Donating your eggs is an amazing thing to do and evidently helps thousands of people start a family. But, as with all ads, I was sure that the reality of donating was a little more complicated than a beautiful baby for a deserving couple, plus a 750 cheque for me. I wondered about the medical practicalities of donation, the long-term consequences, and costs. Most of all I wondered: have any donors came to regret this huge and irreversible decision? Is the 750 - which is by no means a huge sum - anywhere near worth it, or was it never about the money in the first place?
Three years ago, Izzie, 29 who works in admin, was also stopped in her tracks when she heard a friend of a friend discuss her experience of donating. Shed had a really positive experience and were very similar so I thought, maybe I could do this?
After reading blogs written by donors online, she quickly discovered that, as a mixed-race woman, her eggs would be in particular demand, due to a shortage of non-white donors. It was rare to see anyone who looked like me in the promotional material and I liked the idea of being able to help a family have a baby that looks like them, she explains to me over the phone.
Izzie says she had such a positive experience at her clinic (the Bristol Centre for Reproductive Medicine) that she donated again two years later. She especially appreciated the clear communication on offer and having to undergo what she called a fertility MOT.
This MOT is thorough and time consuming. After completing an online application form to see if they meet the eligibility criteria, donors forgo rigorous health checks testing their blood, urine, and ovarian reserve and an examination of their family medical history.
Donors also have a counselling appointment discussing the emotional and legal implications of donating. A range of topics are discussed, from the donors feelings around motherhood to whats motivating them to donate. She was shown leaflets written for children who were conceived through donation about how they came into the world.
It was very 'Mummy and Daddy wanted to have a baby but needed a bit of help', Izzie explained, laughing a little.
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But according to Izzie the core point of the session was to explain that since 2005, donors have signed away their right to anonymity - meaning that once a child conceived through donation turns eighteen, they will be given access to their biological mothers name and contact details.
In her hour and a half counselling session Izzie was asked to consider challenging hypothetical questions: How would she feel if the child reached out in eighteen years time? What would she say if they wanted to be treated as a part of her family? How might she feel about this if she were to have her own children?
The crux of it was checking that Id actually thought about the implications of doing this and making sure I understood what I was signing up for and the possibility of being contacted down the line, she says.
Izzie found it interesting that the counsellor told her that at this stage, many women opt out after considering the real-life consequences of donating. That only goes to show how important this stage it, she adds.
At this point, Izzie also had the opportunity to write a message of goodwill to any potential child and a short profile of herself.
At first, I was quite stuck, but I put myself in the shoes of a child who might be curious about where they came from and that really helped. I told them how a looked, but also that I was a massive nerd at school and loved sci-fi and anime. I also made it clear that Id be very happy for them to approach me once they turn eighteen.
"I put myself in the shoes of a child who might be curious about where they came from"
The next stage of the treatment varies between clinics. Some artificially suppress the donors hormonal cycle, usually through a daily injection over a two-week period. Once the natural cycle is suppressed into an artificial menopause, donors are injected with hormones to boost the number of eggs produced, which lasts around 10 days. Then, a few days before collection, the donor will be given an injection of hCG which matures their eggs.
Other clinics work more within the donors natural cycle, skipping the two weeks of suppression injections. Then, instead of the hCG injection to mature their eggs, they use whats called a buserelin spike. This reduces the chance of ovarian hyperstimulation, a serious and potentially fatal reaction to fertility drugs, with symptoms including stomach pains, vomiting, and fainting. This method takes less time and has fewer medical risks so if you are considering donating, it is worth investigating which treatments are available
Finally, while under sedation (so, no eating that day!), the eggs are removed. The procedure takes about thirty minutes and donors feel discomfort or some pain for a few days afterwards, meaning things like sex can be difficult for a few weeks. The eggs will either be frozen, or if theyre used fresh (which increases the chance of conception) they will be mixed with a sperm sample that day usually from the intended father.
While the HFEA flags ovarian hyperstimulation as a potential risk, there is little research into the long-term health effects of donation. Although direct evidence is scant, some women have reported developing cancer or becoming infertile after donation, believing the treatment to have played a role.
A year on from her second donation, Izzie is still pleased with her decision; she knows a girl and a boy have so far been born using her eggs and although she is thrilled to have helped a family, Izzie doesnt feel any real connection to the children.
If you get very easily attached, I can see that might regret donating, she shares. You have to be not exactly cold, but detached and realistic about what it actually entails.
But what about those who didn't have as positive an experience as Izzie, or who aren't able to as easily separate themselves from the physical process?
Donating is a time consuming, invasive, and potentially dangerous process with relatively little compensation since it is illegal to sell your body parts in the UK. Here, donors are compensated up to 750 for their 'time', but the eggs themselves are given out of 'charity'. Meanwhile, in the US women can receive $50,000 per cycle. Naturally, this changes some of the factors motivating women to donate.
Liz, an American aged 43, went through three donation cycles in the mid noughties when her mother was facing eviction. I first thought of it after seeing an ad in a college magazine. I didnt respond to the flowery imagery telling me that donating my eggs would make me an 'angel'. I was purely motivated by the money as I was desperate, she tells me during a candid conversation.
Twenty years later Liz has come to regret her decision, not least since she believes it contributed to her developing an under-active thyroid. But crucially, another key difference between the UK and the States is that, according to Liz, donors are pressured to donate anonymously. Lizs donations may have resulted in birth of anything between zero and nine children, but she has no idea how many.
Ive struggled with this aspect of donating as I didnt know my father when I was growing up and Ive potentially put a group of children through the same thing, she adds.
Its an experience that Alicia, a 22-year-old opticians employee knows well. Born to an older, single mother, Alicia knew that she was donated through a sperm donation. But with her mother passing away when Alicia was seven, she was never told that she was also conceived using an egg donor. Then, last year she took a 23andme test and was connected to her biological mothers sister. After such a difficult childhood, Alicia has complicated feelings around her parentage.
I think when a lot of people donate, they consider the parents perspective, but they forget that theres going to be another human at the end of this who is going to have their own thoughts and feelings about it, she explains, adding that she now has a close relationship with both of her biological parents and even went to visit her biological father in the US.
Its bittersweet. We have a wonderful relationship but its hard that we were kept apart for so long. My biological mother and I are so similar, from the clothes we wear to the foods we hate. DNA goes so deep, and donors need to understand that, Alicia adds, remarking that on the other hand, she finds she has little in common with her aunt and uncle who raised her after her mothers death.
All UK donors are now mandatorily registered and donate in the knowledge that they may be contact by the donor conceived child in eighteen years time. However, Clare Ettinghausen of the HFEA (The Human Fertilisation and Embryology Authority) emphasises that in the days of 23andme, anonymity is far from a given and donors may be contacted sooner than they think.
Its an amazing thing to do and a truly selfless act, she told me, But you must seriously consider the lifelong implications of being a donor. And, as with all medical procedures, there is a risk and donors must do their research.
"I felt like a chicken being harvested for its eggs"
Some donors, however, have found that that their experience was not what they thought they were signing up to, even in spite of pouring time into researching the process.
Niamh was a twenty-year old veterinary student when she decided to donate her eggs at a clinic in Nottingham in 2018. However, she was disappointed with how she was treated by the clinic. During one ultrasound scan, the technician was struggling to find one of her ovaries.
They were pushing on me incredibly hard to the point that I was almost in tears. They didnt stop when I asked either. I felt like a chicken being used for its eggs, she recalls.
Despite this, after undergoing the final procedure, Niamh was overwhelmed with the desire to donate again, but this time with another clinic. She had a better experience with a London-based one but still felt that the needs of the intended parents were always put before hers.
Everything was done according to their schedule. They cancelled on me at the last minute several times and asked me to travel at short notice, so I lost money on train tickets, she shares. I also didnt realise that any travel costs would be taken out of the 750 compensation, which meant I received very little despite giving up a lot of my time.
Despite donating twice, Niamh now wouldnt recommend the experience to other women. Care really varies between clinics, and I think its up to the intended parents to demand better care for the donors we are doing for them out of charity, after all.
She and Liz have joined the online community We Are Egg Donors to spread awareness of the medical, practical, and emotional complications of egg donation.
Doctor Alexandra Price of the Bristol Centre for Reproductive Medicine clinic was saddened when I referred to some of these incidents. We really take the time to investigate if donating the right decision for them, she told me. We put our donors on a pedestal since we know its such a gift theyre giving we even give them flowers afterwards to thank them.
The joy brought by starting a family can be compared to little else and to be the person to enable that is an incredible thing. With women starting families increasingly late in life, the demand for egg donors will surely only increase over time too. However, donating your eggs is a complex and irreversible procedure. And as one donor told me: Once a baby has been born, it cant be unborn.
Ironically, my research into donation has only fed the beast and increased the influx of fertility clinic adverts into my timeline. But now, rather than picturing what I might do with 750, I see a child who looks like me. Who maybe even behaves like me but who was a total stranger. I feel unnerved and, although I admire the selflessness of all donors, I knew with absolute certainty that it's not for me.
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Egg donors in the UK: What it's actually like donating your eggs - Cosmopolitan UK