Sex Cells: The Medical Market for Eggs and Sperm
In Sex Cells, Rene Almeling describes in detail the market in what are euphemistically called donated eggs and sperm. She found gender differences not only in pay, but in the framing of the donation as a 'gift' or a 'job. In the market for gametes, eggs are more highly valued than sperm; egg donation is considered a gift of life, while sperm donors are construed as doing a job for which they are paid. To Almeling, the frame is a gendered stereotype of women as 'selfless, caring, and focused on relationships and family' (p. 131) they cannot be seen as selling babies, so their eggs are a 'gift. For sperm donors, the masculine oxymoron was in the juxtaposition of a pleasurable experience (masturbation) with a sometimes alienating job. Yet while sperm donors call themselves fathers and connect to the children born of their sperm, negating the female gestator and social parents, egg donors 'are adamant that they are not mothers' the recipients are the mothers (p. 20) Almeling's extensive, in depth ethnographic research covers the economic, cultural, and structural organization of six donor programs through interviews with 45 staff members, observations of daily practices, and analysis of more than a thousand records. She also conducted 60to 90 minute interviews with 19 egg donors and 20 sperm donors ranging in age from 19 to 46. Sperm donation went from a medical service for infertile heterosexual married couples in the 1950s using fresh sperm, to a commercial enterprise where frozen sperm is sold increasingly to single women and lesbians. The AIDs epidemic in the 1980s increased the market for sperm that could be frozen and the donors tested for several months before it was used. With new in vitro fertilization (IVF) techniques for male infertility, there are fewer heterosexual married couples seeking sperm donation, so the target buyers increasingly are single women and lesbians. The large commercial sperm banks sell donors with profiles and ID releases to meet these clients' demands. The egg donation programs that began in IVF clinics in the 1980s originally were a search for altruistic 'earth mothers. Psychological evaluations were used on the premise that altruism predicted honesty about medical information and compliance with the regimen of hormonal injections. Anonymity was discouraged; some recipients even recruited their own donors. The proliferation of IVF clinics and new techniques has increased the demand for donated eggs for women whose uteruses are intact but whose eggs are defective. There are many applications to be egg donors, but there is a high attrition rate. The ideal egg donor, according to agency staffs, is either a physically attractive college graduate or a caring mother. The ideal sperm donor is a tall college student with consistently high sperm counts. Agencies also look for ethnic, racial, and religious diversity, and may pay these donors more. The extensive testing that potential egg donors go through and the attrition rate reduce actual donors to 20 percent of the original pool. Sperm banks reject more than 90 percent of applicants, most on the basis of their sperm count. In the course of profiling, the actual sex cells (sperm, eggs) that are being sold turn into gendered people, even though few of the donors' personality characteristics are inheritable. Egg donation involves self administered injections of fertility drugs to stimulate egg production and surgical egg retrieval. In addition, the donors are monitored with blood tests and ultrasounds. They may have to travel to the recipient's city, but sometimes that is a bonus vacation. Side effects can be severe or at the least, discomforting hyperstimulation, infection, bleeding, anesthetic complications, and pain but donors prepare themselves with discussions with medical professionals and online or library research. The majority (80 percent) were willing to undergo at least one more cycle; many planned to donate several more times. The donors get paid thousands of dollars no matter how many eggs they produce, but they usually Reviews 379