The Business of Fertility

Until reading Outsourcing the Womb by France Winndance Twine I thought surrogacy was a generally accepted way to have a child; I never even considered how corrupt it could be. This got me thinking about all the options people with fertility problems have to get pregnant. I do not know much about fertility treatments but Outsourcing the Womb has made me develop an interest in the world of fertility. The book gave some background on the process of surrogacy and in this discussed briefly the role of sperm donors and egg donors. I discovered that about 7.3 million Americans are infertile, which makes up around 12 percent of the population. The role of different social classes gives a lot of background to what fertility treatments certain people can get. Although everyone is looking for the most effective fertility treatment, only some can truly afford them. I am interested in examining how affordable and effective different treatments are.

Surrogacy: The role of a surrogate is to carry a baby for an intended parent. In vitro fertilization, which is when fertilization happens outside of the womb, is most common in our modern culture. The egg and sperm often belong to the intended parents if possible, but sperm and egg donors can be involved too. Surrogacy is typically a very costly process and therefore is more common among the upper-middle class. The problem with this is that the option of surrogacy is not available to everyone, leading to the outsourcing of surrogacy. Many countries, and some states in America, have banned surrogacy, but some that have not present opportunities for cheaper surrogates. Many people will travel to countries such as India, where women are willing to be surrogate mothers for a much lower price and where the medical care is respectable.

Fertility Drugs: I have heard of fertility drugs before but did not know what they were specifically for or how well they worked. These drugs can come in pill form or can be injected and they help to induce ovulation. They are typically pretty low cost and are sometimes effective, making them a good first choice for people with fertility problems. The problem I see with fertility drugs are the possible side effects. The shot produced some of the worst side effects including premature deliveries and formations of ovarian cysts. Although the shots are a bit more effective than the pills, the side effects, in my opinion, seem to outweigh benefits.

Egg and Sperm Donors: Donor sperm and eggs are used in a few different fertility treatments. For treatments requiring donor sperm, the price is typically low, whereas treatments using donor eggs can cost anywhere from $15,000 to $30,000. It is also a more invasive process to donate eggs than to donate sperm. Egg and sperm donations can be used in surrogacy, in vitro fertilization, and artificial insemination. Artificial insemination is when donor sperm is injected directly into the woman’s uterus. It is fairly inexpensive but usually requires multiple tries to actually work. Not just anyone can be a sperm or egg donor, there are certain guidelines and requirements to donate. I found a website that gave me a lot of good information on sperm and egg donation and all its uses, which can be found here.

All of these treatment options come at a cost whether it is a monetary cost or a lasting physical effect. We also see that many of these fertilization treatments increase the chances of having multiple births, such as having twins, or triplets. The controversy over fertility treatments is immense. In terms of surrogacy, there was a huge lawsuit over Baby M. This was a case that happened in New Jersey in 1986. In this instance the surrogate was the biological mother of the baby, and she had signed a contract agreeing to give up the baby to its biological father and intended mother. The problem came when the child was born and the surrogate decided she wanted to keep the baby. The trial was over who would get custody of the baby, the biological mother, or the biological father. A different case involving in vitro fertilization had to do with issues of age discrimination. A couple was seeking in vitro fertilization after failing to get pregnant for three years. The woman was 37 years old, and national guidelines state that women up to the age of 39 should be funded for this treatment. However when she tried to get funding, her local primacy care trust (PCT) refused to pay saying they do not fund women over the age of 34. Issues like this are not uncommon because despite national guidelines, local PCT are in fact allowed to set their own restrictions.

Another major issue we see with fertility treatments is involving money. People can be paid good money for being a surrogate or for donating eggs or sperm. If someone is really struggling for money and they are offered double their salary to be a surrogate it is difficult for many women to refuse. There are surrogates out there who claim to do it just because they love being pregnant and think everyone should be able to have their own child, but some are in the business because they ran out of options and need the money. The monetary incentive for donating eggs and sperm is just as enticing, and although it pays less than surrogacy, it is an easier process, especially for sperm donation. 

The problem I am seeing is that the fertility revolves around money. If you have enough money you have better chances of getting the fertility treatments that would best suit you. But what if you desperately want a child of your own and just can't afford the treatment options? People will go to desperate measures for something as important as having a child that is your own, even if it means someone else is getting ripped off along the way. Other people are going to extreme lengths just to make money and they may turn to doing something that they are not fully comfortable with doing, such as being a surrogate or donating eggs/sperm. The option of fertility treatments is very necessary, and we should be doing more to help people afford the proper treatment for them.