Sex Cells: The Medical Market for Eggs and Sperm (31 page)

As of 2008, this program pays first-time donors $5,500. Donors who are considered more desirable receive $6,500 for their first cycle, and for these women, recipients are charged an extra $1,500 to pay for gifts and the marketing required to recruit “this caliber of women.” All donors receive an additional $2,000 for each completed cycle.

15
. Debora Spar (2006, xvi), a professor at Harvard Business School, wrote:

It is reasonable to assume, for example, that eggs will always cost more than sperm, because egg extraction is considerably more complicated (and potentially dangerous) than sperm donation. . . . Yet this kind of predictable variation does not explain the range of prices that prevail in the baby market. Eggs, for example, cost far more than sperm—$4,500 versus $300 on average, and $50,000 versus $2,950 for the top end of the market. Why are parents willing to pay such high premiums for eggs? . . . Such variation cannot be explained by the customary laws of supply and demand. For the baby market does not operate like other markets do. There are differential prices that make little sense; scale economies that don’t bring lower costs; and customers who will literally pay whatever they possibly can.

It is important to note that the prices Spar lists are not quite referring to the same good: $4,500 is the average fee for an egg donor to complete a cycle, which can produce anywhere from a few eggs to as many as thirty or forty, and $300 is the average cost of one vial of sperm. The sperm donor’s fee is actually much less, $75 or $100 per deposit, and a single deposit can be split into as many as nine vials. Additionally, there are program fees on top of these costs for those who go through an egg agency or sperm bank.

16
. It is possible that women with posted profiles will never be chosen by recipients, just as it is possible that sperm banks may find it difficult to sell vials from particular donors. Another way to gauge supply, in sperm banks at least, would be to count the total number of vials available for purchase. However, recipients generally purchase genetic material by first choosing a donor, who may have any number of vials available, so the total number of donors is probably a more useful gauge of supply.

17
. To maintain comparability, fee information and number of donors per program are based on 2002 data, with the exception of Gametes Inc. data, which are from 2006. University Fertility Services is not included because the numbers are too small for any given year.

18
. Sperm banks do charge more for vials of “washed” sperm. This procedure is required for intrauterine insemination but is not associated with a donor’s characteristics.

19
. Rapp (2000, xiv).

20
. In reading psychological evaluations of egg donors in University Fertility Services’ files, I found a few in which the psychologist recommended that the applicant be rejected because she expressed more financial than altruistic motivations. In some cases, though, these women were still allowed to donate. Sperm donors were not subject to psychological screening, so there is no equivalent documentation of their motivations.

21
. Future technological changes will undoubtedly influence the market for sex cells. For example, the possibility of frozen egg banks will make the storage of eggs and sperm more parallel, but it is unlikely to change the need for women to take fertility medications and for men to masturbate. Also, it will not revolutionize gendered norms of parenting. So just as the emerging technologies of insemination and IVF were enacted in keeping with the gendered, raced, and classed cultural norms of the time, so too will future developments in reproductive technology.

3. PRODUCING EGGS AND SPERM

1
. Once the eggs are removed, an egg donor is finished, but an infertile woman must wait a few days to see if fertilization occurs in the laboratory. If it does, the embryos are implanted in her uterus, and she waits to see if pregnancy occurs.

2
. Franklin (1997, 130; 106; 114).

3
. Becker (2000, 55). See also Thompson (2005, Chapter 6).

4
. “Aborted cycles,” in which the donor had begun but ceased taking fertility medications before the egg retrieval, are calculated as 0.5.

5
. On average, it had been eighteen months between a woman’s
first
cycle and our interview.

6
. Two donors from two different programs, Tiffany and Kim, had not yet donated. Both could accurately describe what would happen in the cycle, and each expected to experience some cramping, “like PMS.” Both pointed out that they were not afraid of needles, so they did not think the shots would be a “big deal.”

7
. I do not use her pseudonym to protect her identity.

8
. Only one woman said she was absolutely not willing to donate again; she had donated four times several years before our interview. The other women were not sure if they would be interested in donating again but all said they would consider it.

9
. Laqueur (2004).

10
. Laumann et al. (1994, 69).

11
. Laumann et al. (1994, 81–86).

12
. Michael et al. (1994, 155) reports results from Laumann et al. (1994)’s study but is intended for a general audience.

13
. Inhorn (2007, 47). See also Thompson (2005, Chapter 4).

14
. CryoCorp put out a sign-up sheet, but none of the donors were willing to be interviewed, and University Fertility Services no longer had active sperm donors at the time of my research.

15
.
A methodological note:
In the course of doing this research, I have often been asked about what it is like to be a woman interviewing men about masturbation. I did feel some trepidation preparing for my first interview with a sperm donor, but it was not unlike the trepidation I felt before meeting with a nationally known physician or in cold-calling a donation program. My interview schedule did not include specific prompts about what happened in the donation room, but in that first interview, Ethan responded to an open-ended question about how donation fits into his daily life by offering the extremely detailed description of producing a sample that is excerpted in this section. Thus, from that very first interview, I was convinced that the reason social scientists know so little about men’s experiences of masturbation, and of reproduction more generally, is because we do not ask. I did continue to refrain from asking specific questions about masturbation, instead allowing those who wished to elaborate to do so in response to other questions. In several cases, these elaborations came at the end of the interview, when men would respond to my standard closing question, “Is there anything else you’d like to add?” by saying something along the lines of “I don’t know how much detail you want, but . . .” It is also noteworthy that men from Western Sperm Bank tended to go into more detail, which could be due to the fact that those interviews were longer and conducted outside the sperm bank.

16
. Several men mentioned the thin doors. One donor described overhearing the donor manager say to the laboratory technician that she was just “waiting for one more” before going to lunch, so he tried to hurry up and finish.

17
. There is no significant difference between the average weekly visits of donors at Gametes Inc. and Western Sperm Bank.

18
. The four youngest egg donors (all under twenty-two years of age) were the only ones to mention abstinence, and they did so briefly. Heather noted, “I told my boyfriend that I was thinking about doing [egg donation]. He was supportive. I told him you have to go for a period of abstinence. You can’t even really be anywhere remotely close to each other, or I’m popping out eight kids at once [
laughs
].”

19
. Michael et al. (1994, 155).

20
. Thompson (2005, Chapter 2) summarizes the history of feminist scholarship on IVF.

21
. Konrad (2005, 61–66). Emphasis added.

22
. On the social construction of the body, see Turner (1984), Butler (1993), and Fausto-Sterling (2000).

23
. See, for example, Scheper-Hughes and Lock (1987), Williams (1998), Wilkinson (1996), and Fausto-Sterling (2005).

4. BEING A PAID DONOR

1
. Classic works include Snow et al. (1986), Swidler (1986), Swidler (2001), and Lamont (1992).

2
. Healy (2006, 17). Healy provides several examples of how gift rhetoric results in particular organizational configurations, including a comparison of how voluntary blood banks and for-profit plasma companies responded to the emerging risk of HIV in the 1980s. Healy construes this episode as a natural experiment of Titmuss’ argument that relying on altruism produces safer blood and is morally preferable to for-profit systems. Blood bank staffers, who characterized blood as a gift, resisted new screening measures for fear of alienating loyal donors, thereby endangering the blood supply. Plasma companies, who perceived plasma as a commodity, had little compunction about jettisoning paid providers but responded to financial incentives to keep older (and contaminated) batches of plasma on the market. In decoupling the type of exchange from its effects, Healy successfully undermines normative assumptions about the evils of the marketplace and the benefits of gift exchange by showing the failures of both to protect the blood supply.

3
. Beyond the donors interviewed for this study, additional evidence that egg and sperm donors are motivated by money comes from the psychological literature (Schover et al. 1991 and Schover, Rothmann, and Collins 1992) and the fact that there is a shortage of people willing to donate in countries where compensation is either minimal or not allowed, including Australia, Canada, and the United Kingdom (Mundy 2007, 186–7). There have also been news reports in the United States of a sharp increase in the number of applicants to egg agencies following the economic crisis of 2008 (Nichols and Moore 2009).

4
. I did not ask donors about religion or spirituality, but there are linguistic hints of this being important in a few interviews, as when Ben, who is Jewish, uses the term “blessed” or when Ryan refers to the “miracle” of having a child.

5
. Since women donated at different times and in different programs, the fees of individual egg donors are not directly comparable to one another.

6
. It is interesting to note that Gretchen did not tell the friends to whom she had donated that she signed on with an egg agency. “Part of me thinks that Barbara and Phil would think it would lessen our bond. It is kind of a special bond. I’m going to be in their life the rest of their life, and even if they try to forget about me, every time they look at their kid, that kid would not be there, or at least partially, except for me. So, I wonder if Barbara might think I was cheapening it, if that makes sense.”

7
. Egg donors’ reluctance to ask for higher fees reflects a broader trend of gender differences in negotiating strategies, which have been studied extensively in the context of salary negotiations (Babcock and Laschever 2003 and Stuhlmacher and Walters 1999).

8
. See Zelizer (1997) on earmarking money.

9
. I interviewed each donor once (with the exception of Ethan, who I interviewed a second time), so this model is not based on temporal data. However, I structured the interviews chronologically, first asking how they originally heard about donation, what led them to contact the donation program, and about their initial meetings with staff before asking where donation fits into daily life, how they spend the money, and how gamete donation compares to blood and organ donation, paid employment, and parenthood. In this way, I can compare what originally sparked their interest in donation with how they talk about what kind of activity it is. Also, I conducted interviews with women and men at various stages in the process of donation, and there were differences in how those who were relatively new talked about it compared to those who had been donating longer, which provides additional support for the finding that donors’ conceptualizations of donation shifts over time.

10
. Three men and seven women did not use the specific terms “gift” and “job,” so I rely on other indicators of how they conceptualize donation. The three men were all students who cataloged sperm donation alongside their other forms of low-wage employment, suggesting that they do consider it a job. Two women’s descriptions echoed those of egg donors who did call donation a gift, but five women were more outspoken about their interest in the money. Nevertheless, these five still did not call donation a job. Of the donors who were primarily interested in helping recipients, none called donation a job, and all three women in that category called donation a gift.

11
. Three-quarters of the women, compared to just 10% of the men, referenced the money that recipients are spending on donation. Half the women and 15% of the men talked about the recipients’ emotional investment.