PHILADELPHIA — When Sandi Turner saw a television program on challenges facing infertile couples, she decided to do her part to help resolve a growing nationwide problem: She became an egg donor.
Initially, Ms. Turner (not her real name) attempted to go through an infertility agency. But, she said, "I felt like that was a cattle call, and I was just another item in a catalog." So the single woman turned to the Internet to sell her eggs directly to an infertile couple.
Her move is part of a growing trend toward selling reproductive services in cyberspace that is raising sensitive ethical and legal questions about parenting and child-rearing.
To many, the services represent an invaluable resource for helping some of the millions of couples who, for one reason or another, are unable to have children. To others, the growing number of egg donors represents a dangerous journey into the commercialization of reproduction and poses profound questions about the creation of "designer" families.
The debate is no less vociferous because it involves the selling of eggs in cyberspace. While sperm donorship has been going on for years, the practice of women offering eggs for sale is a relatively new phenomenon - especially over the Internet, the ultimate unregulated frontier. "There's no screening or even checking of who's buying the eggs," says Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia. "At least there are minimal checks with adoption."
How many women are actually acting as donors over the Internet remains uncertain. But the number of individuals and clinics providing the service is growing - as is the demand for eggs.
Indeed, one agency involved in the practice, the Center for Surrogate Parenting and Egg Donation Inc. in Beverly Hills, Calif., gets between 20 and 60 calls a day from couples interested in finding an egg donor. It gets another 100 a week from those wanting to give eggs in response to their Web site, according to Lyne Macklin-Fife, the company's egg-donor program administrator.
In most cases, a couple or individual that wants eggs contacts an agency and enters into a contract. Eggs are harvested from a donor, artificially inseminated, and then implanted in the buyer.
Often, the donors and recipients never meet. Some agencies such as the Center for Surrogate Parenting, though, specialize in what are called open donations. They encourage donors and recipients to get together prior to the egg harvesting. They believe it makes both parties feel more comfortable about the process, and can help avoid other problems that might arise later. "This has really put us out there for couples across the country and around the world whose doctors may not be in favor of the open-donation process," says Ms. Macklin-Fife.
Egg donors receive an average of $2,500 to $4,000 per harvest. The payments can go much higher, though. One middle-aged couple has advertised on the Internet, offering $10,000 - or about twice the highest agency fee offered - to a donor who is "healthy, highly intelligent, very attractive, and gifted in the arts."
It is requests like this that alarm some ethicists. For one thing, Caplan says eggs have now become a commodity. "Though there are friends and relatives who donate eggs, everybody else is a seller," he says.
Perhaps more troubling, he and others worry about the attempt by couples to create the "perfect" child. "What if you end up with something you don't want and didn't expect?" Caplan asks. "Will you somehow feel gypped if your child [isn't born healthy]?" He envisions lawsuits and attempts to return babies.
In the open forum of the Internet, ethicists worry that prospective donors won't be adequately informed of the risks they face, including side effects from fertility drugs and the consequences on donors' own ability to conceive. Nor are there any ways of enforcing contracts or screening egg recipients.
Thus some medical watchers are calling for new controls. One suggestion is to limit the age of donors and recipients. Caplan recommends, too, that there be standardized "informed consent for egg and sperm donors, so the risks are clear ... and everyone understands what their privacy and confidentiality rights are going to be."
Some agencies, like the surrogate center, carry out extensive screening of donors and recipients, but that is uncommon.
Tracie McCune advertises as a donor on the Internet but harbors concerns about medical and financial risks. Married and the mother of two, Ms. McCune has been a surrogate mother as well as an egg donor. "I tell people who answer my ad that I'm going through an agency," she says. "I will not do this independently. If you go through an agency, they have all the money up front in a trust account."
As for Turner, even though she found the donor experience more complicated than expected and had minor medical complications, she plans to leave her ad on the Internet. "You can see how much these couples want a child; that's gratifying," she says. "And this really helps me financially."