My Egg Donor Is A Hooker? I Don't Think So...

When I read Professor Naomi Pfeffer’s article titled “Paying poor foreign women for eggs is 'a kind of prostitution’ “I blinked and then I blinked again. And then I took a deep breath and shook my head and muttered a few well chosen words under my breath and read this article once again.

Needless to say this chick really chaps my hide.

Egg donation is a form of exploitation? Oh please.

I understand in the IF community why and how it’s important to educate our patients and clients. Sometimes information is misconstrued or not clear and it’s our job as nurses, doctors, lawyers, agency owners, health educators, advocates and infertility information specialists to make sure the information that’s being shared and placed in the infertility community is correct, up-to-date, and timely.

HOWEVER, it’s really irritating to me to have to educate an infertility expert and so Ms. Pfeffer I will give it my best shot:

First I want to define the word prostitute so there is no question what the word means.
pros·ti·tute (prst-tt, -tyt)
n.
1. One who solicits and accepts payment for sex acts.
2. One who sells one's abilities, talent, or name for an unworthy purpose.

My first question would be “Do you know what egg donation is?” It’s collecting eggs from a woman, who then gives those eggs to a recipient couple or recipient parent who then has those eggs fertilized in a LABORATORY, and then the embryos that are developed and grown in that laboratory are then placed back into the waiting uterus of recipient mother.

Nowhere during this process does sex or any sort of sexual conduct enter into the picture. In fact, all egg donors are given strict orders to ABSTAIN from sex of any kind for the duration of the egg donation cycle.

I just wanted to clear the sex part up, so we are all on the same page about that.

The second part of the definition of prostitution is selling one’s abilities, talent, or name for an unworthy purpose.
Are you suggesting Ms. Pfeffer that egg donation in an unworthy purpose? Or that helping an infertile couple have the chance of becoming parents is unworthy?

Our egg donors come in all shapes, sizes, from varying backgrounds. We are grateful, damn grateful for each and every one of them.

Do they receive compensation? Absolutely. And why shouldn't they? Egg donation is not a fun process. It’s a highly regimented, choreographed exact process. Multiple medications are required to be administered through injections. The egg donor is required to agree to dietary changes (no coffee, no alcohol), as well as social changes, (no sex whatsoever from the beginning to the end of the cycle), and then the egg donor is required to undergo a surgical procedure where n ultrasound probe will be inserted into the vagina. A thin needle attached to the probe will be inserted into each follicle. Using suction, the egg and liquid inside each follicle are removed. Egg donors are given a light anesthesia during the retrieval, which lasts about 30 minutes. And then they recover which takes about a month.

Let me tell you – it’s not a picnic.

I understand that over in the UK right now there’s a huge debate in regards to egg donation because they ban compensation to egg donors and the majority of UK’s egg donors don’t want to go through the process without being compensated. And really what’s wrong with that?

Ms. Pfeffer says we recipient mothers are exploiting our egg donors. Yes, we recipient mothers who have waded through the jungle of infertility and gone through the depths of hell all in the effort to become a mother are now accused of exploiting our egg donors because we compensate them for their time, discomfort, and inconvenience.

Well gosh, thanks a lot. Thanks for shaming infertile couples all over the world who want to have children who are choosing to travel to do so. Thanks for shaming us and intimating what we are doing is bad, wrong, and that we should be embarrassed because what we are doing is morally not okay. And last but not least thank you for suggesting we be embarrassed when we talk to our children about egg donation – as we tell them we exploited the woman who helped us have them?

First of all, I am not my son’s social mother Ms. Pfeffer, I am my son’s ONLY mother but I will save that for another blog post, and secondly, I don’t know about your home, but in our home egg donation is a beautiful thing. It’s not something to be ashamed about or hidden.

When reading Ms. Pfeffer’s article I continued to shake my head. As a recipient mother via egg donation, and an infertile woman – when can I say “Enough is enough?”

Isn’t having over 300 menstrual periods in my lifetime and no baby a high enough price to pay? Isn’t nine miscarriages over the course of my reproductive life a high enough price to pay? Isn’t over 100 negative pregnancy tests, and thousands and thousands of dollars spent a high enough price to pay?

Haven’t I fairly paid my dues Ms. Pfeffer? Haven’t we been through enough and now you are accusing me of exploiting my egg donor because I compensated her?

Please.

I will say in the United States, Spain, Czech Republic, and the Ukraine egg donor are treated respectfully, carefully, and responsibly. After all, they are human beings, and are patients, just like you and I. They undergo medical testing, they are educated about what is going to happen to their bodies, and they make the final decision whether to donate eggs or not. They are not rounding up egg donors on the street and forcing them to undergo egg donation. It’s not how it’s done.
My other question is – What’s wrong with compensating an egg donor who agrees to donate her eggs? She’s a consenting adult. I notice you say nothing about sperm donors. Are they exploited as well? Why is it time and time again women who are focused on and picked on? Are you saying we are not smart enough to make the right decisions for ourselves and our bodies?

Here in the United States the ASRM (American Society for Reproductive Medicine) has strict guidelines in regards to donor compensation. Why? Because we do understand about the concern of exploitation, and that’s why these guidelines have been in place and implemented. We have an overall concern for the health and welfare of our egg donors who generously give a part of them to those of us who want nothing more than to become mothers.

I think before you make wide sweeping blanket statements Ms. Pfeffer you should really stop and think about the impact of your words to not only recipient parents but to egg donors as well.

What I think perhaps what you could have or should have said is that you have a concern about egg donors throughout the world. And your concern is that you aren’t sure (because you aren’t) if egg donors in each country throughout the world are treated with the same respect, and care as they are in the United Kingdom or the United States – and you could have listed the concerns you have and wonder about process and practices throughout the world regarding egg donation.

But you didn’t. You have lumped us all together and attempted to shame us in the process.

As I sit here thinking fond thoughts about my amazing egg donor while looking at a photo of my smiling boy who I gave birth to in 2000 through egg donation I don’t think for two seconds she felt exploited. I think she felt excited and hopeful for us. She was rooting for us the entire way as much as we were rooting for ourselves. The letters we exchanged between the two of us were filled with love and hope. They weren’t filled with angst and doubt.

And I for one felt really good about helping her put a dent in her student loan. It’s the least I could have done – as we all know there is no price on the value of our children. No amount of money could have adequately compensated her for the gift she has given me.

Infertility, Sex and a Healthier You…..

Pamela Madsen, one of the nation's most outspoken and recognized fertility educators and patient advocates, is bringing her 20-plus years of experience into the service of East Coast Fertility. As East Coast Fertility’s new Director of Public Education, Ms. Madsen is reaching out to women-- and men—to integrate infertility prevention, protection and treatment into the general health care continuum.

From sexuality to conception, Ms. Madsen is picking up the threads of the national dialog she began as the founder and first Executive Director of the American Fertility Association, a national patient education and advocacy organization. Over the last two decades, Ms. Madsen has helped shatter the myths and taboos that surrounded fertility, infertility and its treatments. She has been one of the leading voices for full reproductive rights for everyone regardless of marital status or sexual preference. She has made the biological clock, one of the most poorly understood aspects of reproductive life, a key element in her unique approach to fertility preservation education.

Ms. Madsen forcefully represented patient views before major state and federal government agencies, including the President's Council on Bioethics, to move policy toward universal access to fertility care, mandated insurance and fertility preservation information.

This is another one of Ms. Madsens outstanding commentaries.

Sometimes sexperts give really stupid and meaningless advice that someone thinks looks good on paper - but we all know it is a complete line of bullshit. Take this response to an infertility and sexuality patient question on the new and fabulous Sex & a Healthier You website brought to us by The Association of Reproductive Health Professionals.

This patient shared that after months of trying to conceive a child that there was simply no passion or spark left to their sex life. No kidding? Been there - done that, got the tee shirt and wore it out. This is not a new complaint among those trying to conceive - in fact this sorry state of sexual disconnection, body image issues compounded by infertility plus the stress and pressure of having to perform on command is the bane of existence for most of the trying to conceive population. And it is the most ignored at fertility centers. Sex can make people uncomfortable - in case you didn’t know.

Part of the advice that was offered was to “First, take a break from trying to get pregnant. Take two or three months off—that won’t make much difference in the long run, and it could do wonders for your marriage. During that time, schedule a vacation. If money is tight, the “vacation” could be to a friend’s weekend house or even just a couple of days in a local hotel—anything to get into a new environment with no reminders of fertility issues. Or, have a “staycation”—take time off, stay at home and simply enjoy the time alone with your partner”.

Hmmmm…….really? Take a vacation from your infertility? Are people with cancer able to take a vacation from their cancer? Does this sexpert really believe that people are able to turn off a life crisis? And even if we were able to - is there any reality at all that two or three months of some kind of mental and physical vacation from infertility could possibly repair the damage caused by infertility enough to turn folks back into sex kittens? I truly doubt it. It took me years and I am as resilient as they come.

Sexuality and Infertility are especially difficult because the two are intertwined. Pat answers about vacations and bubble baths don’t even begin to touch the surface for recovery.

For women turning off infertility is especially difficult since they have a direct physical tie to their sexuality and infertility all in one when they bleed on a monthly basis. There is no vacation from that. There is no vacation from the time pressure or the urgency. For many couples putting off conception for two or three months is a very big deal. And no….I don’t think that having sex in different rooms - or positions is going to help very much either.

So…what do I think? I think that the most important message of all to communicate to infertility patients is that what they are feeling is perfectly normal. That’s it. The big advice! You are not alone.

It is so important for people to know that they are not alone in their disconnect from sexual pleasure and their lack of desire for physical intimacy during this time. Simply knowing that they are not broken as sexual beings when they are feeling like failures in their ability to reproduce can be incredibly healing all by itself.

By giving this message, there is an acknowledgment of normalcy when this couple is feeling incredibly not normal and broken in the most intimate part of their marriage - reproduction.

This is a really hard time for them. Acknowledge it deeply - and let them know again and again that what they are feeling is normal.

I think that the best advice after letting couple know that they are completely not alone in their feelings is to simply encourage couples to spend time holding each other.

Offering each other physical comfort by cuddling, holding, hugging, and offering each other massage can go a long way in helping couples reconnect to each other. Encouraging individuals who are struggling with infertility to make time to get regular body work in the form of massages can also help people who are struggling with infertility. Massage not only reduces stress - but it feels good! Getting physical reminders that our bodies can give us pleasure is so important when we are going through so much physical and emotional discomfort.

Massage therapy reminds us that our bodies can give us pleasure, and can help us to reconnect to our own physical selves in a loving way. When people are going through a tremendous amount of physical discomfort they can forget that our bodies can also be a source of pleasure.

I often shudder when I read advice to couples about sexuality. Perhaps it is because the sexperts feel like they have to be politically correct or too careful in the loaded world of sexuality. We all want to talk about sex - yet it all still makes us nervous. So “vacations”, and “try sex on the kitchen table” comes up a lot in advice columns. I wish that we could get more real sometimes - and say what is so.

It’s really hard to want sex for anybody when your sexual organs are being prodded and poked. When you have to give sperm samples. When you have to face your body shifting shape every month because of fertility drugs. When you core sexuality is deeply associated with your femaleness and maleness - and it is not working! So let’s say it - it is hard and it is normal - and you may feel broken and exhausted. But you are not sexually broken - you are simply done in - and what you are feeling is normal. Forgive yourself, forgive your body and forgive your partner. Perhaps that is the best gift you can give your sexuality and your marriage.

For us “experts” - giving permission to couples not to want sex can also be really healing - and in a time when there are no easy answers - it certainly feels more real.