Kaylene Breeding was always driven by a desire to help other women. In her twenties, she spent years volunteering at women’s charities. That’s when an idea she had considered since high school—donating her eggs—seemed like the “next step” in her volunteering. She would be helping a family in the “utmost way possible,” she recalls thinking.
Breeding, now 36, first heard about egg donation when she was a teenager and her local radio station in Oregon constantly aired commercials inviting young women to become donors. Breeding told me that when she reached her late twenties and wasn’t ready to have children, she decided to do something good with her eggs in the meantime.
Breeding donated her eggs six times. Twice these were “altruistic egg donations,” meaning she was paid by the recipient only for her medical and travel expenses. Her payment for the other donations was between $7,500 and $9,000. Out of all these donations, only one resulted in children. That was a set of twins born to a gay male couple in Israel. All she knows about the children is that they were born.
Today, Breeding, who has no children of her own, is struggling with her own compromised fertility. She is facing a hysterectomy because of severe endometriosis and adenomyosis, debilitating conditions in which endometrial tissue grows where it shouldn’t. She’s in chronic pain during exercise, ovulation, and sex.
Breeding’s doctors believe this is the result of donating her eggs, which required pumping her body with sky-high levels of estrogen. Believe is the key word here, as they can’t quite confirm it. There is little research on the long-term medical consequences of egg donation.
By now Breeding, who works in the aviation industry, knows a lot about those consequences. She is a moderator and administrator of We Are Egg Donors, a private Facebook support and advocacy group that counts over 2,000 past and current members. She reads many stories similar to hers of post-donation medical conditions. “Nobody wants to do the research because, frankly, I’m assuming they’re afraid of what we would discover,” she told me.
She also said such potential side effects weren’t clear to her when she donated. “These were never presented to me as in ‘these are real risks that could impact the rest of your life,’ ” she told me. “I never saw this coming.”
Then there is the psychological distress Breeding didn’t anticipate when she was in her twenties. She wonders if the children she made possible will be curious about her—she knows she is curious about them. Or at the very least, if they will desire medical information from her. Or what they’ve been told about their origin.
Some of the Facebook stories from other women bring Breeding to tears. These include accounts of egg donors meeting their genetic children, yearly picnic reunions, or even just donors knowing their children’s identities. “They wreck me,” she said.
Knowing what she knows now, Breeding would never have donated, even for a substantial payment. “There’s no amount of money that could cover the pain I’m in.”
An Industry Is Born
Kaylene Breeding’s experience captures the many unaddressed issues affecting young women who encounter an industry that is largely unregulated in the U.S., one that critics say is often exploitative and unethical. There are the potential medical complications of donation; the inability of anonymous donors to communicate possibly crucial information to offspring; and the psychological issues that arise from making a decision at a young age that turns out to have profound and unexpected consequences.
More than 40 years ago, in 1983, the first baby from an egg donor was conceived in Australia. The technology was a breakthrough that changed the lives of millions of women struggling with infertility or concerns about passing on heritable conditions.
Egg donation started as a cottage industry, with clinics advertising in college newspapers, offering easy money and a chance to help a couple who wanted a child. Today it is a lucrative marketplace valued in the U.S. at nearly $400 million and growing as women wait longer to have children.
The main routes for making a match between a donor and recipient are egg banks and egg donor agencies. At both, donors apply by providing information such as photographs, educational background, physical characteristics, medical history, and sometimes even personal essays. Some offer sleek photo-matching technology that allows intended parents to select an egg from a donor who resembles them the most.
Both the banks and agencies generally provide medical and psychological screening of the donor, to varying degrees. (Many fertility clinics act as middlemen for both banks and agencies.)
The essential difference between a bank and a donor agency is that the bank is providing an already-donated frozen egg, ready to be chosen from the catalog, thawed, fertilized, and implanted.
Agencies, on the other hand, often make a match between a potential donor and a recipient, and allow for a “fresh” egg transfer. This means that after a selection is made, both the donor and the recipient undergo synced treatments. This results in a process in which the egg is retrieved from the donor, fertilized, and then the embryo is transferred to the intended parent within several days. It is a more time-consuming and expensive method than purchasing a frozen egg, and so commands higher compensation for the donor.
It often takes more than one cycle to conceive. One 2020 survey of fertility patients in California estimated the average cost of a single IVF cycle with donor eggs is around $38,000, with a successful outcome costing around $73,000.
Across the board, anonymous donation is common, which means the recipient doesn’t know the identity of the donor, and the donor doesn’t know who is getting her egg—this anonymity is often the preference of the intended parents. Agencies, however, tend to permit more negotiation between donor and recipient about identifying details. Arrangements can range from exchange of names only to agreements about future contact.
Anonymous donations generally mean the donor signs away all rights to the extracted eggs, including any information about the child that results. This is what Kaylene Breeding agreed to in her one successful, and anonymous, donation. An agreement she now regrets.
The Egg Hunt
The U.S. is now a leading global supplier of donor eggs—recall that an Israeli couple purchased Breeding’s—for several reasons. One is that compensation to donors has no government-mandated cap. (Some countries cap the payment donors can receive—in the UK that amount is equivalent to $1,195.) Another is that the target donors are healthy women in their twenties, many of whom are trying to pay soaring U.S. college tuition.
Diane Tober, PhD, is a medical anthropologist and associate professor at the University of Alabama who has been studying egg donors for more than a decade—a leading and rare researcher in this field. She is the author of the recent book Eggonomics: The Global Market in Human Eggs and the Donors Who Supply Them. Tober’s research shows most young women donate to pay bills and debt (37 percent), college tuition (19 percent), or student loans (16 percent).
But there’s more to it than just money: Donors are constantly told how desirable they are—how their looks, smarts, or physical build are precisely what parents are searching for. She has repeatedly heard from women who didn’t think they were pretty until selected as a donor. Tober says one donor told her, “That made me feel really good that somebody wanted my genetics, that they thought I was good enough.” Tober says the industry exploits those seeking affirmation. “It’s predatory,” she told me.
The fertility industry also presents egg donation as a selfless “gift” to help others start a family. Women are often expected to donate for altruistic reasons, a standard seemingly not demanded of clinics, investors, or even sperm donors.
Tober has also interviewed numerous physicians whose clinics have been acquired by private equity firms. The doctors said they feel stressed about “churning out” patients without enough time to relay the potential long-term risks. “It creates a model where care is no longer individualized,” Tober said, adding it’s “something that is sort of mass-produced on a conveyor line.”
Nowadays, clinics recruit the young and financially vulnerable on TikTok. YourEggs donation agency markets the benefits of donating by dangling keys to a “bigger apartment,” while Donor Nexus features a young woman flaunting hundred-dollar bills. Fairfax Egg Bank promotes its services with enticing captions like “You could make up to $48,000!” (Notably absent is the fine print explaining such a payday requires several donations. A single donation generally starts at $5,000 and averages around $10,000 if the donor goes through several rounds.)
A select “elite” few, those with impressive backgrounds or with scarce donor ethnicities (women of Asian ancestry are in high demand) can potentially earn $50,000 or more per single donation.
No wonder Gen Zers call donating eggs their next “hobby,” or that some resort to fraud to qualify for these offers. In the fertility industry, there is little verification of applicants’ backgrounds, leading to some fake Ivy League credentials, fabricate medical histories, and even misrepresent musical skills like playing the oboe.
Dr. Aimee Eyvazzadeh, a San Francisco–based fertility expert, has witnessed donors demand $75,000 with a bogus Harvard diploma while others hide that they take psychiatric medications. “You basically know more about the puppy you adopted than the egg you’ve received from an egg bank,” Dr. Eyvazzadeh told me.
“Butterflies and Unicorns”: The Known Unknowns of Medical Risks
Clinics often market egg donation as quick, easy, and profitable. In reality, it’s an exhausting, lengthy, and invasive undertaking involving four to six weeks of medical appointments, vaginal scans, hormone injections, blood tests, and a real risk of medical complications. The actual egg extraction process is generally done under anesthesia. (The same procedure is used for IVF.)
One 2014 study of 435 donor recruitment ads found that most failed to include health risk disclosures. However, a study by Tober and others of nearly 300 egg donors found that roughly 15 percent of donors had immediate and painful medical complications such as ovarian hyperstimulation syndrome (OHSS), a potentially life-threatening condition in which ovaries swell and can leak fluid into the abdomen. Another complication is a twisted ovary—which could lead to surgical removal.
Other donors deal with pelvic infections, internal hemorrhaging, and surgical mishaps, like one TikToker who reported a cut bladder during egg extraction surgery. TikTok is flush with women who had less than ideal experiences at clinics or who developed OHSS. (“This rarely happens” is a common clinic response.)
I spoke to one donor, who wishes to remain anonymous, who told me the clinic presented the egg donation process as “butterflies and unicorns,” an easy process with ultra-rare risks and an easy recovery. “I had the mindset at 21 of ‘Hey, I’m not using my eggs, so you can have ’em,’ without really having any background or insight to what that process is,” she told me. But then she nearly died from OHSS, with fluid accumulating around her lungs. She missed months of college due to chronic vomiting, decreased urine output, and severe fatigue that left her unable to walk.
Researcher Diane Tober said such complications are not so rare. Most immediate risks are largely preventable, but many donors are aggressively stimulated, Tober said, in part because the pressure is on clinics to retrieve as many eggs as possible as efficiently as possible. The ultimate goal is achieving a pregnancy for the client, and the donor is often “just a means to an end,” Tober told me.
Lauren H. was a donor in 2012 while an undergraduate student at Columbia, where she was enticed by advertisements in school buildings. She told me she felt like “an egg machine” as she went daily to receive hormone shots at Columbia University Fertility Center. She produced 28 eggs (the median number of eggs at a retrieval is about 18).
Soon thereafter she developed OHSS, and she couldn’t get access to her medical file despite asking a nurse in the examination room for it. As she recalls, the nurse responded, “Why would you want to see your file?” She finally received it last year following a formal request. (The fertility center did not respond to a request for comment.)
“The patient was somebody else,” said Lauren, meaning the woman who got her eggs rather than herself. At many clinics, donors are not also considered patients because, technically, they aren’t receiving medical care. Some egg bank contracts state that donors cannot access their medical records as these are the company’s “property.”
And according to Tober’s research, more than half of egg donors do not feel well-informed about the potential long-term health risks. But there are hardly any longitudinal studies on the health of donors, whose bodies might react differently from the infertile women undergoing in vitro fertilization, or IVF.
In interviews with hundreds of egg donors, Tober has heard repeated reports of a constellation of symptoms or chronic conditions: endometriosis so severe they became infertile, autoimmune disease, and premenopausal issues. Some of this could be due to an influx of hormones triggering an underlying condition, basically stimulating a dormant disease. “But showing cause and effect is really, really difficult,” she said.
Dr. Wendy Chavkin, a professor emerita of public health and obstetrics and gynecology at Columbia University, confirmed to me how little we know about what happens to donors down the line. “What we’re worried about is what does this do, to have this exposure to high-level hormones and to have them repeatedly.”
The American Society for Reproductive Medicine, recognizing “there is a paucity of long-term follow-up data for repeat oocyte donors,” has issued voluntary guidelines recommending a maximum of six times per donor. While other countries have a variety of laws and regulations surrounding egg donation, and some, like Germany and Switzerland, ban egg donation outright, there are no legal obligations for American clinics to follow medical advice.
“It’s a wild, wild west,” said Breeding of the U.S. egg donation industry.
Donor Remorse
As a Columbia University student, Lauren H. never anticipated that she would wonder daily if she had biological children. “I was 22, thinking about my immediate financial future. How do I live in the city for the next few months?” she said. “I hadn’t yet thought deeply about what it might mean to be a parent.”
Lauren, now 34 years old, said she didn’t fully grasp what an anonymous donation meant for her future self. “When someone asks me if I have kids, I don’t know how to answer that question because I don’t know.”
For the past few years, she has been calling the clinic to ask for confirmation, not even details, about whether her eggs resulted in a child. Lauren is simply seeking closure, but her requests were denied—it’s a violation of federal health privacy laws.
Ariel Wiggins, 32, a massage therapist in Nampa, Idaho, donated eggs 11 times in her twenties to make ends meet. She was a popular “high egg donor,” capable of producing 35–40 eggs in a cycle. Wiggins recalls being referred to as a “cheap date—the most bang for your buck” by clinic staff because of the high yield of eggs she produced.
Her prodigiousness resulted in three cases of OHSS, one of which required draining fluid from her abdomen. To date, there have been 23 confirmed live births from Wiggins’ donated eggs. She keeps track of the births with a spreadsheet. (The clinic permitted only anonymous donations, and although she wasn’t provided identifying information, she specifically requested to be informed of live births.)
At one point, she worked at the fertility clinic where she donated. On several occasions, her boss informed her that she could not work on a specific family’s case—which she believes was code for, “You’re the donor.” Seeing children who may have been her biological offspring, even if just in the waiting room, was “really rough” and “hard to process,” she told me.
On one occasion, Wiggins held a child she believes was her genetic offspring, but had to pretend she didn’t know. “I definitely went home and cried about that because I wanted nothing more than to [say to the parents] like, ‘Hey, I was your donor,’ but I couldn’t,” she said.
Today, Wiggins says, “I don’t think there should be any anonymous donations for the psychological well-being of the donor-conceived children.”
Many countries, including the UK and Australia, have banned donor anonymity. The U.S. leaves this up to each state to decide. Colorado is the only state with legislation mandating a donor-conceived individual’s right to know their genetic origins.
Some donors are trying to break the anonymity, not just to satisfy their own longings, but to pass on new health information. Angela Woodhead, 37, studying to become a financial adviser in Salt Lake City, Utah, is a four-time donor. Her main motivation was to help out a family in need: “My view was anyone who wants to have kids that badly deserves to be able to have children,” she told me. Last December, she was diagnosed with a vascular malformation in her brain, a life-threatening tangle of blood vessels. Since it’s potentially hereditary, Woodhead immediately thought of her own two children as well as her genetic ones.
Initially, the clinic Woodhead anonymously donated to ignored her calls. Later, personnel informed her that her records had been destroyed. As her brain surgery approached, Woodhead started to feel increasingly desperate, unsure if she would be well enough to continue her search. “Even though I don’t know them, I feel that I have a responsibility for their health, happiness, and safety,” Woodhead told me, “because I am responsible for them existing.”
Woodhead eventually took her mission to TikTok, publicizing her efforts to contact the families with dance videos. In one, she laments an industry she believes manipulates women into selling their genetics without warning of the long-term ramifications. Woodhead later discovered the records had not been destroyed; the staff eventually agreed to pass the information on to the families. (Woodhead’s surgery was successful.)
But as Kaylene Breeding notes, donors don’t actually know what is being relayed to potential egg recipients. She said she’s heard of clinics altering or omitting information—and even filtering photos—from donors’ profiles to make them more attractive. Donors say that using fake logins, they have looked at their profiles intended for potential parents, and seen that the info doesn’t match what they submitted.
Then there is the question of what happens with the frozen, leftover embryos. Do they go to other families, to research, or are they discarded? Many contracts lack these crucial details, or state it’s up to the intended parents to do what they please with the embryos. The donor likely forfeits control as soon as genetic material leaves her body, per standard contracts. This is one reason activists advocate for donors to have their own legal representation, separate from the intended parent, before donating.
Twelve years ago, Tonya Calilung, 52, a registered nurse from Louisville, Kentucky, donated her eggs free of charge to a friend struggling with infertility. The friend had three children, and also ended up with 16 leftover embryos.
The problem? You need to pay storage for embryos, which can run anywhere from several hundred to a thousand dollars a year. Four years in, Calilung’s friend no longer wanted to cover the costs but also didn’t want to destroy the embryos due to religious beliefs, echoing the issues currently playing out in U.S. courts.
The friend decided to donate them. Calilung protested but learned she had no legal rights in the matter. Last year, this friend casually informed Calilung there were several pregnancies from the embryos, but gave no further details. (“She gets the notifications, I don’t,” added Calilung.)
Calilung and her friend no longer speak. “I lost control,” said Calilung. “But in reality, I never even had control over my eggs.”
To deal with some of the many issues raised by egg donation, researcher Diane Tober suggests creating a national registry, much like Spain has, to keep track of the health of egg donors and impose limits on the number of extraction cycles donors can undergo, and the number of live births that result. She also emphasizes the importance of providing crucial medical information to people conceived via a donor egg. “There’s a way to ensure that everybody has access to create their families, and there’s a way to ensure that donors’ rights are protected,” said Tober.
As for Kaylene Breeding, the moderator of We Are Egg Donors, she still dreams of knowing more about her genetic twins. She sent the clinic notes and even gifts for the children—a matching pair of overalls and her favorite books—in the hope they might be passed on to the parents. She never heard back. “It hurts more now knowing I’m facing a hysterectomy,” she says through tears. “I will continue to try.”
Breeding believes women should first complete their own childbearing before even considering giving their eggs to others—at least until all the risks of donating are fully understood. And, she says, any woman who donates will need to be her own advocate in a free market industry where a donor’s best interests don’t usually come first.
“You are donating your own genetics—you absolutely have a say in what happens to them,” she said. “There are no take-backs.”
Rina Raphael is a journalist and the author of The Gospel of Wellness: Gyms, Gurus, Goop, and the False Promise of Self-Care. Her Substack Well To Do covers the wellness industry.
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