11 Sep

Surrogacy and Egg Donors

Surrogacy is a not spoken about a lot in South Africa, relatively speaking, when compared with social and political developments.  However, there are thousands of people who suffer the heartache of not being able to have children and who have been turning to surrogacy as a solution.

In an article published in the Sunday Times on 24 August 2014, entitled “A Gift – Egg donors are realising the dream of parenthood for thousands of SA couples.” Shanthini Naidoo spoke about surrogacy and pointed out various perspectives worth reading about, particularly for women who are egg donors.  The information below which highlights the different roles played by men and women, as well as some cost overviews, has been extracted from that article.

An interesting fact – sperm donors get a few hundred rand for their donation, while egg donors receive R6 000.

“For the male donor, it is really ejaculation in a cup and it is over,” says Lindsay Broome who works with an egg donor agency, Nurture. “At sperm banks, a recipient will get a spread sheet of characteristics to choose from, but not much detail. Often students, sperm donors fill in a few lines about their race, hair colour, make a deposit and leave.”

“On the other hand, an egg donor is altruistic” says Broome, “sure, some people do it for the money. But the procedure is really not worth it; it entails invasive tests, fertility drugs, an in-hospital retrieval procedure and recovery. It is physically taxing in a way that the money doesn’t match up.”

However, not everyone can donate. Broome adds “It may sound shallow, but impoverished people won’t likely make it onto a donor list, so it is not a way of earning a living. People choose donors who are educated, firstly.” In fact, some agencies ask for school reports.

“Logistically, they must have an e-mail address and internet access, because there are many doctors’ appointments and procedures to schedule and reminders to take the fertility injections. Recipients will also choose a person who has a good family history. They also have to be a healthy weight, aged 20 to 34, and drug free.” A donor can contribute up to six successful births.

“Then there are the donors who may tick all the boxes, but are never chosen on physical characteristics,” says Broome.

After the psychological and medical screening, donors are placed on a course of medication that stimulates follicle growth.

The daily injections can put off a lot of women.  The donor has to undergo scans with the doctor before being given two shots to ripen the eggs, 36 and 24 hours before donating her eggs. The process takes about 14 days. The 20 minute non- surgical procedure is mildly painful. Under anaesthetic, a needle is inserted into the ovary via the vagina to retrieve the egg.

It is cosy in Dawn Blank’s offices: white with a tinge of pink, warm lighting and soft carpets. It’s fittingly womb-like for the place where couples come to choose their child’s genetics. Her agency, Gift Ov Life, pairs egg donors with prospective parents.

“It is easy to choose a profile off the website, but we always meet with the couple to talk them through the process, explain the options and work out the long term questions,” she says.

“There is a recent study in epigenetics*, which found that the carrier contributes 50% of the genetic profile to the baby. We didn’t realise that before, but it comes from the hormones, shared blood etc in utero.

“The study was conducted with surrogacy in mind, but it is obviously a positive for those who go the egg donation route. Usually the partner’s sperm is used, so it is a genetic addition from the father.”

The prospective parents consider donors who match their own physical characteristics as closely as possible. “But I have a 50 year old Indian client who chose a white donor and it didn’t matter to her,” she says.

Not every couple can make the choice. Donor-conception is expensive. With medical costs around R 65 000, donor fees and the agency’s finding fee, it could add up to as much as R 90 000.

“The costs mean there are far more donors than recipients at the moment. We have about 70 donors around the country, but it is not affordable for many couples. Medical aid does not cover egg donation. Some say they will save up for five years and come back.”

Gift Ov Life do “fertilisation tourism” for overseas clients. “About a third of our couples come from Australia, a few from Britain and Europe. They have the implantation procedure, then go on holiday to the Kruger while they relax and wait for the process to happen,” says Blank.

“We use young donors. The younger the DNA is, the easier it is to replicate all the way to full-term. The reality for middle for middle-aged women is that DNA which is 40 years old will battle to replicate itself. Half of those pregnancies result in miscarriage, if there is conception at all,” says Blank.

Couples also appreciate the anonymity of the process. “In other countries, the donor is not always anonymous, so at 18, the child can choose to find their donor. As a result, there aren’t many donors. In this instances, not even the gynaecologist needs to know that the couple has used a donor egg.”

Blank says that once couples understand the science, they consider the opportunity as a blessing. “People save lives donating blood with bone marrow. When a woman donates an egg, she is giving someone an opportunity to create a life.”

* Epigenetics is the study of changes in gene expression caused by certain base pairs in DNA, or RNA, being “turned off” or “turned on” again, through chemical reactions.