This is the “in thing” at universities. A quick way to make money. Egg donation among humans is a biological way to help women who cannot conceive naturally to have children.
However, for many young women in Kenya, the process has been turned into a quick way to earn money from clinics in Nairobi, which are themselves making a killing by selling them to the women who cannot conceive naturally.
Responding to adverts by these clinics on social media, hundreds of young women are giving away their eggs for just Sh50,000 to Sh70,000, oblivious of the risks they are exposing themselves to, and without knowledge of what these eggs fetch for the clinics.
Egg donation involves taking eggs from one woman, fertilising the viable ones, and then transferring them into the uterus of either the aspiring mother or a surrogate, in the hope of achieving pregnancy. This procedure is known as in-vitro fertilisation (IVF).
Last week, the La Femme Healthcare clinic, a fertility clinic along Ngong Road, Nairobi, placed an advert on its Facebook and Instagram pages seeking to recruit “voluntary donors” who would later be paid Sh50,000 should they turn out to be potential donors.
The voluntary donors were expected to be fit and healthy, 25 years old or younger.
At the end of the ad, the clinic placed Sh50,000 as monetary compensation to the donors. “Visit us at the Green House Mall, Ngong Road,” the advert states.
Dr Martha Kuruga, a fertility specialist at the facility, says several volunteers are required to match them to the women seeking eggs for IVF.
Interestingly, she says women seeking IVF using donor eggs have to part with Sh500,000. The amount includes the cost of the procedure and the treatment for the donor before the egg harvesting and afterwards should complications arise.
The Nation established that the cost could go as high as Sh1 million in other health facilities.
At the clinic, a donor is required to produce the National Identification card, school certificates and a photograph, for a start.
The information is then shared with women seeking donated eggs, who select a potential donor, based on physical appearance and academic qualifications.
Tests, including to check the blood group, are then conducted to match the donor to the recipient.
Once selected, the young woman is put on hormonal treatment to speed up the production of eggs in preparation for harvesting. Egg production depends on the individual’s response to the hormonal treatment, and some women can produce as many as 40 eggs while some manage only five.
At the age of 23, Maria Nyokabi (not her real name) decided to sell her eggs without a second thought just because she needed the money.
Like many of her peers, she had on several occasions found herself broke. Being an orphan with no one to go to whenever she needed the money, she started a small business of packing and selling groundnuts at her campus room.
She would use the proceeds to pay rent and buy food but, with all these, she was still struggling.
So what do you do to realise your dream? How do you pay rent and how do you eat? Yet you have dangling cash at your disposal just to donate an egg?
“The possible answer then was to sell my egg at Sh70,000. I was editing my college newspaper and would constantly see ads titled “Donate Your Eggs … At Sh70,000 and everyone was welcome if you met the criteria. I went for it,” says Ms Nyokabi.
At first, she could not imagine that selling her eggs would be an option she would pursue. Fast forward, two years later she developed an interest.
A friend at the university directed her to a clinic where she had done it and was selected.
After tough scrutiny and answering a number of questions, she was chosen as a donor.
Weeks before the procedure, she wanted to give up but the Sh70,000 outweighed all her fears.
On her appointment day, she sat in the waiting room listening to music and reading a book.
“After a few minutes, I received three taps on my shoulder asking me to proceed to the doctor’s office. We sat and looked over paperwork, blood was drawn, and then I went for an ultrasound to make sure everything looked fine. The doctor warned me that I might become overwhelmed with emotion during the process,” she says.
“No drinking, no sex, and no exercise until the end of the process,” the nurse told me. She showed me how to administer the hormone shots myself, and off I went.
After four days, she had to return to the clinic to check her vitals and get an ultrasound check on how the eggs were multiplying. At the second day, she had a few noticeable symptoms of withdrawal other than boredom, her life revolved around the process.
Each day she went back to the clinic, she had three or four more follicle pouches filled with eggs popping up. Every day something new was happening in her body.
Two days before she was scheduled for the egg retrieval, she had more than 10 follicles in the ovaries, the nurse waved the cold metal rod up, down and around searching for more follicle pouches. The more follicles that appeared, the more uncomfortable she became.
Though painless and quick, the 45-minute procedure was life threatening, she says. She was weak and could not stand on her own. She was given antibiotics.
Third day after the surgery, she felt her body was rejecting everything she tried to put into it.
She had developed ovarian hyperstimulation syndrome and needed to have a procedure to drain all the excess fluid from her abdominal cavity.
She went back to the hospital and the fluid was drained; a suction cup was inserted into her vagina that sucked the liquid out.
“I felt better and, from then, I swore never to do it again. I think my body can only survive one egg donation and I would never do it again because of money. That was physically painful,” she says.
The same case applied to Monica Nyasukuta (not her real name). Last year, she had no one to turn to when she needed a bailout, fortunately, or unfortunately, when she sought help from her gynaecologist friend, she was advised to go and donate eggs.
Since she was clutching at straws, she had no option but to sign up to donate eggs. It was such a risky and top-secret experience that she only confided in her closest friend.
“She doesn’t like to talk about it,” her friend recounts.
She had a series of tests to confirm her viability to donate eggs. She made the cut and the process began. It earned her Sh80,000 that temporarily put a smile on her face.
“She signed a few legal documents that bound her never to go back to the clinic asking for her egg, and she left.”
The hospital only keeps tabs when complications related to the procedure arise. If not, it lets go of the girl with “it was nice doing business with you” written on their faces.
“Egg donors still take on medical risks: Women can suffer subsequent health problems, most commonly ovarian hyperstimulation syndrome (OHSS), in which the ovaries swell too much, causing fluid to leak into the abdomen and chest. This can be fatal,” says Dr Paul Mitei, a gynaecologist and obstetrician.
Other symptoms include bloating, weight gain, nausea and, in rare severe cases, blood clots and kidney failure.
He says that before retrieval is done, a donor is first given an oral birth control pill for 21 days to stabilise the egg donor’s (ED) hormones and make it possible to time other medications. This causes breast tenderness, temporary weight gain, mood changes, missed periods and decreased libido.
She is then placed on steroids to suppress some hormones in donors with polycystic ovaries (PCO) for a week. Then they are later placed on follicle-stimulating hormones to stimulate and mature the eggs that will be donated. “The hormones have serious side-effects to the young girls including headache, temporary weight gain, ovarian hyperstimulation syndrome (rare), multiple gestations (rare), ectopic (tubal) pregnancy (rare), ovarian twisting and injection site skin reactions. If done continuously, it might interfere with their fertility,” he said
The donors are then given injections of gonadotrophin-releasing hormone antagonist to prevent premature release of hormones during the cycle; prevents ovarian hyperstimulation syndrome and human chorionic gonadotrophin, a trigger shot to (36-40 hours before retrieval) fully mature the eggs before they are retrieved
Finally, before retrieval, they are given two small injections of gonadotrophin-releasing hormone agonists to stop the production of some fertility hormones — this allows the donor to donate a good number of high-quality eggs.
This is followed by antibiotics to decrease the risk of infection during egg retrieval.
“Egg retrieval is always performed under ultrasound guidance. However, there is always a risk that a needle may puncture surrounding tissue or organs causing injury, bleeding and/or infection. Some of the hormones given to the young women are too strong for them and might [not] be necessary at their age,” he said.
“No one can say exactly what will happen if you donate your eggs because there’s not much research into the long-term health risks egg donors may face,” says Dr Diane Tober, who studied egg donors.
There have been reported cases of OHSS (which can be life-threatening), ovarian torsion, blood clots, development of long-term health problems, infertility and, according to some researchers, even cancer.
In October, arguing that egg donation “carries the same risks as other surgical procedures involving anaesthesia,” the San Francisco civil-rights lawyer MonaLisa Wallace petitioned the US Justice Department to crack down on “the illegal egg-trafficking industry.”
In a website of support and advocacy groups known as We Are Egg Donors, donors have found the donation process to be physically painful, emotionally jarring or both.
Some donors find the experience, which involves hormone injections for 10 days or more until a doctor pierces the vaginal wall with thick needles to suck out the extra eggs, produced differs greatly from the marketing.
“There's a huge lack of data there to help women to make informed decisions. This is a big problem, simply because, people are making decisions that could affect their future health, well-being, and their ability to have children,” Dr Tober said.