Egg donation can be a game-changer for countless couples across the U.S., helping them realize their dreams of parenthood when their own eggs aren’t an option. Yet, behind the scenes, the egg donation industry has some unsettling realities that deserve attention.
In her insightful book, Eggonomics, medical anthropologist Diane Tober uncovers the hidden truths of egg donation.
Many donors Tober interviewed were assured by clinics and agencies that the risks were “less than 1 percent.” However, her extensive review of scientific literature revealed no support for that figure. “The actual rates of complications like ovarian hyperstimulation syndrome (OHSS) can be between 5 to 13 percent,” Tober notes. “What’s more alarming is the lack of long-term studies on the health impacts of egg donation.”
Tober engaged with over 300 donors and surveyed more than 1,000, finding that most felt inadequately informed about the risks they were taking.
While digging deeper, Tober stumbled upon troubling truths linked to compensation in the egg donation market. “In the U.S., the egg donation industry thrives on consumer demand, leading to a tiered market where donors are selected based on specific traits,” she explains. Intended parents often look for donors with attributes they hope to see in their children, including both social and physical traits.
Those searching for the ideal donor frequently prioritize physical characteristics, bringing up some unsettling eugenics implications. Tober emphasizes, “What drives donor demand often includes hair and eye color, skin tone, and ancestry.” This selection process extends to educational backgrounds—an Ivy League donor can fetch up to $250,000, while others might earn only $8,000.
Statistics from Tober’s research illustrate a stark racial disparity; top white donors earn around $100,000, while their Black counterparts may receive just $12,000.
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As one donor put it, “From me, they wanted really specific things, and I felt like, ‘Oh my god. This is eugenics.'” Despite these inequities, many women, often prompted by economic pressures like student debt, participate in multiple egg donation cycles without fully grasping the consequences.
Tober reveals concerning practices in some clinics, such as donors being encouraged to exceed the recommended donation limit of six cycles. One donor in her study reported going through the process 19 times. Additionally, some clinics push for excessive egg production—“the goal of 15 to 20 is often exceeded, with one donor producing as many as 80 eggs in a single cycle.” Such practices significantly heighten donor health risks.
During her research, Tober found women who experienced serious complications post-donation, such as life-threatening OHSS and even reproductive cancers. “While we can’t definitively pin these health issues on egg donation, they highlight the urgent need for more research on donor health over time,” she emphasizes.
While egg donation certainly brings hope to thousands of couples, Tober argues that the industry requires reform to better protect donors. “We need to consider what evidence-based policy could look like,” she suggests. “The rights of egg donors have long been overlooked.”
To promote safety and equity in egg donation, Tober advocates for several key reforms:
- Donor rights must include clear, thorough, and standardized informed consent, especially regarding pre-existing conditions like PCOS and endometriosis.
- Reduce financial incentives that encourage excessive donations.
- Ensure independent legal counsel is available to donors facing contractual violations or medical harm.
- Recognize donors as primary patients with inherent rights.
- Uphold a donor’s right to decline further cycles when they express disinterest.
- Guarantee respectful treatment for all donors and intended parents, regardless of race, identity, or orientation.
- Create a comprehensive donor registry to monitor cycles, enforce limits, and support ongoing health assessments.