If
you’re shocked by the above advertisements, chances are you
haven’t perused a college newspaper lately. If you had, you’d
know that such requests are commonplace. As student publications
scramble for cash, advertising is widely seen as a savior, the provider
of at least half the operating revenue for any given year. Call
it reproductive capitalism, a laissez faire system of buying and
selling on the open market.
Like
cosmetic, fashion, and music promoters, advocates of reproductive
capitalism specifically target college-age women—preferably
from Brandeis, Brown, Columbia, Harvard, Penn, Princeton, Stanford
or Yale—as the laborers of choice. Consumers, in this case
infertile couples, are lured by the prospect of a solution to their
problem, a way to get—or buy—what they most want: a healthy,
smart, and socially adjusted newborn baby.
Assisted
Reproductive Technology (ART) is big business and by all accounts
it is expected to get bigger in coming years. In 1996 more than
six million Americans spent approximately $2.6 billion on infertility
care. The National Infertility Association, estimates that 25 percent
of the total U.S. health care budget for that year went to treatment.
Jews,
as well as Asians, are particularly hard-hit; one in three Jewish
women reportedly has problems getting, or staying, pregnant. Abigail
Pickus, in “The Modern Dimensions of Jewish Infertility,”
attributes this to the tendency to forestall pregnancy until graduate
or professional degrees are completed.
Statistically,
the facts bear her out. Infertility among 35- to 44- year olds is
21.4 percent. Among 15- to 24-year olds it is 4.1 percent. What’s
more, women over 40 have a 30 percent higher infertility rate than
younger women. While the causes—from aging eggs to tubal and
ovulatory disorders, endometriosis, and low sperm counts—are
well documented, the ethical and moral concerns surrounding the
treatment of fertility problems are not as widely or publicly discussed.
Take
egg donation. To begin, not every fertile woman can be a donor.
Fertility Awareness Inc., a San Diego, California agency that deals
with the problem, is one of hundreds of private, for-profit programs
that run without government oversight or regulation. Marketing themselves
as specialists in “Jewish surrogacy and egg donation,”
they require “donor candidates” to be between the ages
of 19 and 31. According to their website (www.offc.com/fertility-
alternatives/news.3371) “all donors are attractive, intelligent
and healthy physically, emotionally and genetically. As well they
must be within normal height/weight ranges. Absolutely no smokers,
drug users or obese applicants will be accepted.” The group
also boasts another category of donor. Called “exceptional
women,” these donors are under 30 and “have a college
degree or are currently attending a major University, with excellent
grade point average [3.5+] and SAT/ACT scores [1400+SAT]; [28+ACT].
These donors also have proof of their academic status or are willing
to undergo an IQ test if requested.”
Once
a donor passes an arduous physical, psychological, and genetic screening
process—including tests for HIV and other sexually transmitted
diseases—she, the agency and the “intended parents”
negotiate a “compensation rate.” Although the sale of
body parts is illegal in the United States, egg donors typically
receive between $2,500 and $50,000. Dubbed a “donation,”
the payment allegedly “compensates” the donor for “inconveniences”
encountered. And what inconveniences they are.
The process begins
with a visit to an endocrinologist who prepares the woman for “egg
retrieval.” This involves daily hormone injections for between
four to six weeks. During this time the donor must be sexually abstinent.
Among the hormones used is Lupron, a drug that puts the body into
a temporary menopausal state complete with hot flashes, nausea,
and vaginal dryness. A follicle stimulant is also administered.
This causes severe bloating as the ovaries become larger and larger;
the swelling usually lasts two-to- three weeks after the eggs are
retrieved. Another drug, HCG, is administered intramuscularly exactly
40 hours before surgery. The operation is done laparascopically,
on an out-patient basis. Fifteen to twenty eggs are usually retrieved,
a number five to six times higher than the number released without
hormonal intervention.
About
48 hours after the eggs are gathered and combined with sperm in
a petri dish, the “intended mother” is inseminated with
3 to 4 embryos. Within 2 to 3 weeks she will know if she is pregnant,
a victory claimed by 25 to 35 percent of In Vitro Fertilization
(IVF) patients. Despite this relatively low rate of success, one
in five multiple births is attributed to IVF. The process will cost
the “intended mom” between $15,000 and $25,000.
Meanwhile,
the egg recipient, like the donor, has been pumped full of hormones
to increase her receptivity to implantation. Numerous side effects
are likely to ensue, including hot flashes, headaches, irritability,
joint pain, and breast swelling.
Beyond
the not insignificant physical risks of egg donation, retrieval,
and implantation lie other concerns. Among the most controversial:
the issue of “designer babies,” infants intended to bear
the physical and intellectual characteristics most revered by Americans.
Barbara
Katz Rothman, sociology professor and author of The Book of life:
A Personal and Ethical Guide to Race, Normality and the Implications
of the Human Genome Project, is horrified by what she sees as
the resurgence of eugenics and by the classism implicit in fertility
marketing. “In a system of donating gametes in which banking
is the dominant metaphor, sperm and eggs are naturally sorted by
‘worth.’ That forces us to confront the question of what
makes for worth in human beings. We don’t like to speak about
eugenics anymore, but it is hard not to think of eugenics when people
are actively seeking the very best genes money can buy,” she
says.
Tali
Amit, a 21-year-old senior at Brandeis University, likens the process
of creating a “perfect” child to wishful thinking. “You
can have Einstein’s genes but certain things in the environment
can stifle intellect or nurture it. You can be born with average
intelligence but there is a big environmental component to who you’re
going to become as a person. I don’t understand people who
make a plan for what their child will be. Will they love the baby
less if she or he doesn’t meet their expectations?”
Sara
Lieberman, a teacher and mother of six, is also leery. “I find
it repulsive,” she says. “What do you do if you don’t
get the perfect child, keep it for 30 days and put it up for adoption
or drop it off somewhere like an unwanted puppy or rabbit?”
Jamella
Jones, a scholarship student at an Ivy League college, sees the
ads in her campus newspaper as a personal affront. “Why aren’t
the people looking for egg donors asking for me, a smart, tough,
low-income woman who works incredibly hard, a biracial person with
what it takes to excel as a minority in a mostly white upper-class
school?” she asks.
Indeed,
what does it mean that eggs are sold on the open market, like any
other commodity? Rabbi Tsvi Blanchard, Director of Organizational
Development at the National Jewish Center for Learning and Leadership
(CLAL) and a psychologist in family practice, says, “We don’t
see the problem with other types of organ donation. This problem
only occurs when we turn human beings into commodities who are in
economic exchange. You want to make the case as clear as possible.
One woman needs an egg and another freely agrees to give it. It
should be consensual, just as it is when people die and leave their
bodies to medical schools.”
For
Blanchard, the goal should be the creation of a repository in which
resources are shared, not sold. “The Jewish community could
create a fund of eggs for women who need them. They’d be available
as an act of chesed, an act of love.” Health risks aside, he
argues that colleges would be better off creating this kind of program
for women experiencing problems conceiving than in publishing ads
for the sale of body parts.
“From
a rabbinic point of view,” he adds, “the narrow self involvement
that says, ‘if I can have it who cares about you,’ is
a horror. Jewish moral vision is about a covenantal relationship
between human beings. The thing that destroys the relationship between
people within a society and between God and society is the focus
on my, me, mine. In America we’re enamored of individuality.
Choice and autonomy are good values but they get strained by an
obsession with individuality and commodification of the individual.
We’re in this together but that’s not how we treat one
another. In America, if you want to have a child but can’t,
it’s not my problem unless you want to buy a solution from
me.”
Gone
unchecked is the social insistence that a woman is incomplete if
she does not bear biological offspring. Likewise, the insistence
that this is an individual problem, born out by the fact that fewer
than one-third of health insurance plans cover infertility treatments,
is both shortsighted and frustrating.
“There
are thousands of children available for adoption,” says New
York City reproductive rights activist Tracey Davidoff. “These
kids are here, in the flesh and in need, but most people who purport
to be devastated by their inability to have a child reject them.
Instead, they seem to believe that without a biological connection,
a child is not fully theirs.”
Still,
Davidoff does not completely reject technology. “Carry- ing
an embryo created by someone’s egg and your partner’s
sperm is certainly an option for those with the money to buy it,”
she says. “But the political implications of egg selling and
retrieval—especially when particular kinds of eggs are purchased—are
really very scary. Are we sure we’re ready for a Brave New
World where white skin, tall, thin bodies, high standardized test
scores and heterosexual behavior trump every other possibility?
I shudder at the thought.”
Z
Eleanor
J. Bader is co-author of Targets of Hatred: Anti-Abortion
Terrorism, published by St. Martin’s Press. She is
a frequent contributor to Library Journal, Lilith,
and the New York Law Journal.