Elite education may impoverish and indebt young women and do little to get them a job, but at least it makes their eggs valuable
Reproductive Medical Associates of New York, a fertility clinic associated with Mount Sinai Hospital, maintains separate websites for egg donors and egg buyers. The home page of the donors’ site features a large stock photograph of a young woman holding schoolbooks. Behind crossed arms the pretty brunette model is clutching what looks like but is not a copy of Lauren Berlant’s Cruel Optimism, along with a white three-ring binder. She wears a zippered velor jacket in the same shade of blue as the graphic that emerges from behind her head in an oversize font: Become an Egg Donor.
Beneath is an embedded YouTube video of Dr. Georgia Witkin, a partner at Reproductive Medical Associates, who grins into the camera and delivers a poorly edited four-minute pitch to visitors interested in donating. Dr. Witkin is a woman who has undergone thorough and ambitious plastic surgery. Her stretched skin exposes the contours of her skull around glassy, saucer-size eyes, and she speaks to her audience of young women from behind sheaths of feathered blond hair. “The DNA in your eggs contains genetic material from your entire gene pool,” she says, speaking in a heavy Long Island accent. Dr. Witkin smiles, and blinks heavily at the camera.
Reproductive Medical Associates recruits women between the ages of 18 and 30 and offers each donor a flat rate of $8,000 per cycle. By market standards, this isn’t bad. Donors who are contracted directly through clinics tend to receive somewhere between $2,000 and $10,000 per donation, a process that takes, between the time that a donor is matched with a couple and the moment when she awakes from her anesthesia after the retrieval procedure, anywhere from two to six months. Donors who sign up not with clinics but via independent donor recruitment agencies—sometimes called “concierge services”—are often paid more. It is understood but never stated that this compensation is the primary motivation for many young women who sign up. It is also assumed that most of the women who donate their eggs to clinics like RMA have or are working toward a college degree. In many instances, at least some college is required of those interested in donating.
Signing up is no guarantee that a donor will be paid in full: Often, compensation is issued in installments or at the end of the process, and it is only after a match has been made, a hormone regimen completed, and the eggs harvested that an egg donor will be able to cash her check. The barriers to entry can be high. Reproductive workers—and egg donors in particular—need to prove that they are the right candidates for the job. As with other kinds of job applications, a lot of this is done online. In their personal profiles on donor websites, would-be ovum donors advertise themselves to potential buyers with all their DNA’s appealing features. There are a number of determining factors, but appearance, in particular facial resemblance to the egg buyer, tends to take precedence. But without education—high test scores, strong grade-point averages, and a completed degree—a candidate is much less likely to make the cut.
For the buyers, harvested eggs are usually a last resort. Couples struggling to conceive find that ovum donation is one of the most expensive and least desirable options available. But often, initial reproductive treatments—using sperm and eggs exclusively from the “intended parents”—don’t work. There are many reasons a hopeful heterosexual couple may be unable to conceive on their own: hereditary diseases, damage from past medical treatments, or one of the unlovely conditions that clinic websites have referred to as “intimate dysfunctions.” But most often—among the industry’s primarily white, wealthy, and educated clientele—the reason is that the woman’s eggs have aged beyond viability.
Most artificial reproductive technology clinics that offer third-party services have psychiatrists on staff. Many also employ PR experts. These professionals describe the procedures to both donors and consumers in terms that emphasize the relation of the fetus to the woman who intends to be its parent. It is her embryo. The aim with this is to stretch the particulars of biology into a useful emotional technicality—distinctions are made between “genetic” patents and “biological” parents, between “families” and “contributors.” Donors are assured, correctly, that they are not becoming mothers. But to calm donors’ fears is not really the point. Instead, the aim of this rhetoric is to assuage the consumer, the mother who will take the child home, and to grant her moral credit for the work that she has outsourced to a younger body. This anxiety of possession and kinship awkwardly marks the way that clinics advertise the services of reproductive workers across all the industry’s varying sectors. In egg donation, pregnancy is the decisive factor in granting a woman the ethical authority of motherhood. In surrogacy arrangements, the consumer’s genetic legacy is emphasized. In cases where both a surrogate womb and a third party egg are used, it is remembered, awkwardly, that it is love that makes the baby hers.
It is unclear to what extent this ambiguity bothers the ovum donors themselves. Available indicators show that it doesn’t, at least not very much. But for consumers—those couples who foot bills the size of private college tuitions for the screenings, hormone treatments, and extraction procedures that donors undergo, and who eventually gestate the embryos that donations make possible—for them, it matters a great deal. And so it is that the egg donor market becomes a site at which the always thin curtain separating psychology and consumption is torn down. In selecting a woman whose DNA they are willing to purchase, the consumer couple displays their prejudices, aspirations, and insecurities with uncommon frankness. This is not just any purchase: Wealthy women who buy eggs to conceive children are selecting, after all, the vehicle of their future familial happiness. As a commodity, the ovum comes to carry an affective significance that few others do.
The banner above the online profile of donor #60395 has pictures of eight different women, posed around the donor agency’s large-type logo. The image has four blondes and four brunettes, all white and wearing brightly colored tops. Below them are 13 photos that #60395 has provided of herself, both as a child and as an adult. The photos show that the Caucasian Brooklynite has high cheekbones, straight dark hair, a large but not Semitic nose, and pale blue eyes. Below the photos is a series of tabs labeled “General Info,” “Medical & Genetic,” “Education & Employment,” and “Traits & Characteristics.” Potential buyers of #60395’s eggs can learn that her paternal grandfather was French Canadian, and that she volunteers with a nonprofit advocating for women’s rights in rural India; they can see that she jogs, and has no history of psychiatric hospitalization. The profiles, with their abundance of finely curated personal information and prominent emphasis of standardized test scores, look almost like college applications. In the lengthy questionnaires provided by the donor agencies, young women blend half-hidden boasts of overachievement with a cheerfully ingratiating, please-pick-me eagerness. “I am a model and often am stopped in the street and asked about whether I do modeling or not,” says #60395. “I want to bring happiness to others. It’s so heart-warming to see a family completed.” Under the “Education & Employment” tab, potential buyers can see that she graduated with honors from a private liberal arts college in the northeast (annual tuition: $47,180) and has recently applied to medical school.
Even among physicians and counselors, physical traits are discussed with prominent emphasis: their professional conversations about egg donation slip from the sterile vocabulary of medicine into that of soft eugenics faster than you can say “natural blonde.” In this context, perhaps it should not be surprising that so many of the pictures that these would-be reproductive workers post of themselves are clearly meant to be sexy. The donor agency’s profile search tools are unusually specific, and using them, potential donors can search for the profiles of women with, say, postgraduate degrees, heights of over 5-foot-6, and red hair. When they hit enter they will be directed to a photograph of such a woman—donor #61688—with her arm lifted in a triangular tilt toward her pouting face and one hand running through a mass of orange curls. There are a lot of high-angle selfies, the sort that one would find on a dating site, and many full-body shots, often showing donors in athletic poses or bikinis, displaying the slender or voluptuous physiques that will be passed on to future inheritors of genetic material. On most sites, prices will vary according to demand. In one profile photograph, a donor sits cross-legged in a short black dress with a low neckline, and angles one thigh toward the camera. The expression on her heavily lined eyes says, “Purchase my ova.”
But what’s most striking about the donors’ profiles is how hard these women are trying to be liked—liked, in particular, by the educated, wealthy couples whose DNA they hope to substitute for their own. Because of the industry’s high costs—artificial reproductive technology is usually not covered by health insurance—couples in the market for a donor egg tend to be successful, credentialed, and ambitious people, positioned at the end of youth and at the top of the middle class, with the sorts of priorities and values that incline them to start a family. These are couples who, despite having the unenviable problem of being childless when they don’t want to be, are in the enviable position of being able to buy their way out of it.
For the donors, the situation looks different. There’s not a lot of candor on the donor profiles—women speak in benign dishonesties about their motivations for donating, citing altruistic impulses and their love of children—but enough information is put forth that a discerning observer can read between the lines. When a donor lists, say, that she was the first member of her family to attend college, that her mother has worked for 20 years as a letter carrier in Florida, and that she has recently been accepted to law school, it is not hard to infer that this person might be looking for a way to finance her ambitions.
In the profiles, donors list their aspirations—they want to be doctors, lawyers, and veterinarians, and very often, they want to one day have children of their own. In the questionnaires, the donors—college students and recent graduates—describe their future selves as the sort of women who would work long hours in competitive fields, women who would live in large cities, conscientiously diversify their retirement portfolios, and marry at 35. Perhaps some of these presentations are cynical, little more than workers’ performative strategies to game the industry’s biased system. Wealthy couples, after all, want to buy the eggs of someone like themselves—or, rather, of someone who resembles the better version of themselves that they would like to be. If this were not the case, Ivy League campus papers like the Yale Daily News would not regularly run ads from rich couples offering enormous sums for prize eggs, describing their ideal donors as “Asian geniuses” or women with “36-24-36 measurements and a love of Mozart.”
But some of the donor profiles’ bourgeois affectations are sincere. After all, these are young women, women who are either in college or newly out of it, and their profiles show that they decided to shell out the money to put themselves through Vanderbilt or Wellesley. Like shop girls, made to dress like their customers, potential egg donors who solicit clients online embody an aspirational ideal that some older couples—older women—are able to purchase. In the bright-faced photographs and chipper personal statements that adorn their online profiles, egg donors advertise an imaginative universe of future happiness that they, too, have been sold, but in which they have now found themselves not reaping the rewards but doing the work.
It may be useful, here, to take a moment to explain precisely what the egg donation process involves. The technology—still new, fairly complex, and faintly colored with alarmist stigma—is poorly understood by many, even the women who sign on to participate. After a donor is selected by a couple, she undergoes a series of examinations, lasting an hour or more, conducted by the supervising clinic. She is tested, among other things, for the sickle-cell trait and for any genetic predisposition to produce mentally handicapped children. She is asked about her family’s ethnic and medical histories, and whether she has multiple sex partners. She is given a blood test and a pap smear, and is dismissed if found to be unduly overweight. If everything is found to be satisfactory, the donor will be presented with a liability waiver and a set of birth control pills, in a regimen designed to sync her menstrual cycle to the buyer’s. Several weeks later, she will be told to inject herself daily, for a period of one to three weeks, with hormones that will temporarily suppress her ovarian function. Finally, she is put on a third round of drugs, follicle-stimulating hormones, which cause her ovaries to develop and release an uncommonly high number of mature eggs. During this process, she is contractually barred from drinking alcohol, having sex, or exercising, and she is monitored by clinic staff to insure her compliance. “We have an active and ‘hands-on’ approach to all matters concerning the donor,” an agency called “Elite Egg Donors” assures its clients, “and will do anything we can to make things go according to plan.”
When a doctor decides that the timing is right, the donor will take a day off to undergo the outpatient retrieval procedure. While she is under general anesthesia, a very long needle, equipped with a suctioning device, is inserted into each of her ovaries through her vaginal wall. It is only then that anyone will know for sure how successful the hormone regimens of the past months really were. Usually, a donor will produce between 10 and 15 eggs in one cycle. Rarely, women have been known to produce as many as three dozen. After harvesting, some of these eggs will likely be frozen. Others will be fertilized, cultured, and inserted, in numbers of usually no less than two and no more than five at a time, into the buyer’s uterus.
In the days following the procedure, a donor can expect to experience “pelvic soreness.” In addition, she may suffer abdominal pain, sometimes severe, along with swelling of the stomach, dehydration, diarrhea, and vomiting. These are most likely caused by an occupational hazard known as Ovarian Hyperstimulation Syndrome, which is more or less what it sounds like. In OHS, one or both ovaries become dangerously swollen. Like pregnancy, ovarian hyperstimulation syndrome is a condition that inspires medical sources to list spherical objects. Afflicted ovaries swell to the size of ping-pong balls, figs, tennis balls, grapefruits. The condition can become more complicated if an ovary bursts, and it may require surgery. Available data regarding the long-term medical impact of fertility hormones on egg donors isn’t comprehensive—most studies tend to focus on egg recipients—but other known side effects include liver failure, infertility, and an increased risk of reproductive cancers—ovarian, uterine, cervical, breast. There are donors, many of them, who experience none of these symptoms, and enough women decide to donate again that clinics generally establish a maximum limit of five cycles per donor. But the risks to reproductive workers’ health are not negligible either. Tell your gynecologist that you want to become an egg donor and she will tell you to reconsider.
Like many of the jobs that young women are recruited for, the egg retrieval process, though undeniably strenuous, is not a task that requires a college degree to perform. Following a doctor’s orders to inject themselves with hormones every night and enduring the pain and discomfort of the donation process does not draw upon the skills that donors went to school to cultivate.
That educated women are in demand for this service is one thing. That they are willing to provide it is another. But the job market, after all, is sluggish, even for those who have invested heavily in their own credentials, and the combination of climbing costs of living with stagnant wages and substantial debt liabilities means that smart young women settle for opportunities that do not call upon the full scope of their talents. It is not hard to understand that having a degree is no longer any guarantee of a livable income, and that for many it has instead provided a debt obligation that precludes much material comfort. What’s more confounding is the way that the student debt burdens that lead many women to egg donation are the result of the same elite educations that make their eggs desirable, and the way that many egg donors, in their aspirations and experiences, so closely resemble the people who are purchasing their services.
The idea that women’s reproductive functioning can be classified as work is not a new one. That carrying, birthing, and rearing children are activities that should be credited as labor has been an implicit or explicit demand in the writing of thinkers from Engles to Firestone to Federici. In the 1970s, Italian feminists sought to attack characterizations of women’s domestic activities as naturally preordained by assigning them monetary value. “Wages for housework,” went one slogan. “Every miscarriage is a work accident,” was another. At the time, this was all just theoretical; more than anything, the demand to conceive of reproduction as work was a rhetorical device aimed at destroying habitual patterns of thought. Money is transformative that way. It can change an act of love into an act of work, and it can also change an infertile woman into a mother-to-be, or a promising student into a woman injecting her abdomen with hormones. In her recruitment video, Dr. Witkin affects a staccato punctuation when she speaks of the charitable motives for egg donation. “To be an ovum donor means that you are helping somebody to have their own. Biological. Child,” she says. She pauses half a beat before adding: “Not to mention the $8,000 compensation.” Her eyes don’t wink, but her voice does.
Under the “Why I Want to Donate” tab on their profiles, young women profess altruism. In the 500-character box provided, egg donors write optimistic, loving, and imprecise declarations of “how much it means to [them] to help someone else realize their dream of having a family.” Sara Ahmed has called this sort of gesture “happiness work.” This is the job of being happy for the successes of other people, even when such successes come at one’s own expense. Donors do not say, at least not out loud, that they want to donate “because I need the money.” It would be professionally dangerous to do so.