Whenever the subject used to come up, I would swear up and down that with the number of children for adoption in Asia, I would never pay someone for their egg. Love is unconditional and at least within our marriage, I would hope that if our positions were reversed, I wouldn't simply get donor sperm and have the child entirely on my own, as it were. But the nature of this process is that there always comes a moment when all your options sound distressing and awful and things you would have considered unnatural or unreal before, suddenly become more attractive.
As I may have mentioned in a previous post, I met an egg donation mother (her sister donated eggs to her husband and her), who has two gorgeous daughters and their cuteness, their graciousness and warm lovingness blew me away. I looked at her family and really felt hope and inspiration for myself. Having always been quite on the fence about alternative conception or families, and I admit, always holding out hope that we would get lucky — I decided to get off the fence and do some research of my own, after reading a lot of discussions about donor eggs and embryo adoption, and how it might differ from adoption. I'm posting my findings and thoughts here, for anyone who has similar interests, as there is no comprehensive heap collation of this kind of information.
Egg donation is where a donor is solicited and provides eggs which are fertilized by the recipient couple, or donor sperm and then transferred into the recipient mother's uterus. A donated embryo is an already-fertilized embryo which is transferred into the recipient mother's uterus. These embryos typically come from couples who have leftover embryos from IVF and want to donate rather than destroy them. Adoption refers to the transfer of the rights and responsibilities for a child, typically but not always an infant, permanently to the adoptive family from the birth mother and father.
My takeaways have been the following: first, to my surprise, adoption and donated eggs are not terribly different in price. While I am sure there are more 'economical' (read: possibly illegal) ways to get both, at least from what I've read, each would cost about SGD$20,000. Adoption is not cheap and there are also costs to be paid to the adoption agency and to the child's biological mother, such as for the hospitalization and delivery fees.
Somehow, because it seems more onerous to have to produce eggs for someone else if you don't actually want them, I'd always assumed that donor eggs would be far more expensive than adoption, where in theory, no one wants the child after it's born. Turns out that maybe my calibration of this was skewed by my US experience, where it is indeed very expensive to get an egg donor. In the US, donor eggs are far more expensive than donor or adopted embryos, which can be produced in a shared cycle or from couples who have completed IVF. In Asia, I guess we have less of a premium on human effort and cost.
Second, also to my surprise, donor eggs or embryos are not always a paid-for service. Again, I thought that without monetary incentive, who would do something so tedious and invasive? However, I was pleasantly surprised at the reasons women gave that they were donating eggs and it led me to conclude that we are behind in our progressiveness of thought and action — we are just not as educated on these issues and options.
Of course, most people cited money and expenses, whether for further education or to raise the children they already had. However, a not unsubstantial number of women said that they either did not intend to have children, or did not intend to have any more children than they already had, but would like to help someone else have a child, or wanted their surplus eggs to be used, or their genes to be propagated.
A handful worked in the healthcare industry, specifically with women care or childcare and cited their experiences as the primary motivation. Many embryo donors said that they knew they had completed their family or could not afford more children, but having themselves gone through the heartache of infertility and knowing how much work went into creating their IVF embryos, they would like them to have a chance at life and to know that they would go to loving parents. I don't know if I am being naive to believe that there are a lot of non-monetary reasons, but just the idea that alternative families could be a mutually happy and untraumatic experience, was reassuring to me.
In Asia however, what I found is that there are virtually no embryo adoption sources, and almost all the egg donor programs are paid-for services. Most egg donor programs are fresh cycles, meaning the donor and yourself undergo parallel cycles, although there are the rare frozen egg banks, from which you can select an egg for fertilization and transfer at almost any time. I found this curious, because when we filled out the IVF paperwork, there were definitely many questions around what we intended to do with viable leftover embryos, whether to destroy, donate to scientific research or donate to another couple. (In case you are curious, I thought about my lesbian college roommate and her partner and checked 'donate to another couple', although this issue of leftover viable embryos has unfortunately never been an issue for us).
In Singapore, egg donorship is not legal unless the donor is a blood relative (ie. a sister) and you both do fresh parallel cycles under a doctor's supervision. We don't have an egg bank, or rather we have an egg bank in theory but it is empty. From my foggy memory about the case with sperm, I believe we have a sperm bank but it is also empty. The issue is that without monetary incentive, most egg and sperm banks would be empty, even if you had one, for show. I don't know about embryo adoption but I would assume it is equally disallowed. However, I know that many couples do have leftover frozen embryos, which probably means that we have a lot of frozen embryos in our hospitals but no embryo adoption? I guess this is because in Asia, we imbue genetic relationships with a lot of potency.
In Singapore, because of the small population and because abortion is legalized and without parental consent, there is very little in-state adoption. It would take a stroke of luck to be in-line for a baby born in Singapore. Most of the adoptions are international adoptions, which has the added logistical complication of cross-border medical checks and changing the baby's citizenship at point of legal adoption, as well as more sensitivity and less recourse, if the birth parents change their mind or are in two minds. Adoption in Singapore is primarily infant adoption (up to a month of age) and all adoptions are closed, meaning there is no contact with the birth parents and it requires court petition at legal age, to reopen the files.
Third, there were some logistical merits to donor eggs. The first, and I'm being completely candid here, is that you aren't subjected to a long-drawn wait. For adoption, there is a 6 month wait for your home study, following which it can be a two week or a year's wait for a suitable child, during which time, I presume you can't change your country of residence. Different countries have varying levels of strictness and for China, the wait is now 6 years long and allocated via a matched state-run lottery, as a revoke of the previous decades where Chinese babies were leaving China en-masse.
Alternatively, the donor egg option means you need only spend anything from two days to two weeks for a transfer. Of course, it sounds ridiculous to 'compare' this in terms of time and I don't think that's the point. It's just that I presume you might feel more in control of the process and outcome, even if it involves a 9 month pregnancy, as opposed to the shock of an insta-baby.
The second, is that you aren't subjected to tedious questioning, by child services and via a medical, phycological and home study report. I don't really mind this, but I imagine a lot of people do. And even though I don't mind it, as you know, it has taken us months to get together our questionnaire (still not finished, because I haven't read the second book on adoption) and we've just got the doctors to complete our medical report because they are long, complex and personal. They are very tedious to put together, for example in just one section of the questions, they ask for copies of the passports, identification of everyone in your home, including domestic helpers or employees, as well as letters of employment detailing your term of employment, annual income and occupation.
The third, which was probably the most attractive aspect to me, is that the process of selection and transfer in donor egg or embryo, is carried out via hospitals and doctors and not via a private agency. I have yet to do my research in visiting adoption agencies in Singapore, but I am told that I should expect something very similar to maid agencies, where there is a sorry line of 'the availables' and the agency is a money-motivated broker interested in pushing willing seller to willing buyer. Most adoptive parents have told me that while all this fades the minute you have the baby in your arms, the process of adoption is emotionally difficult and almost none of them have many nice things to say about their agents. Clearly, a bridge that we have not yet crossed.
My fourth takeaway is that unlike adoption, the concept of donor eggs and embryos is quite poorly understood. This is even though some studies say that on average 10% of children in society aren't actually fathered by the legal father identified on the birth certificate (fascinatingly, this number falls the higher the social ranking of the community)!
In a way, you could say that maternal acknowledgement is much more thorny than acknowledged paternity. Egg or embryo adoption is like the ultimate taboo of alternative conception, since in theory, you become a surrogate for someone else's genetic egg, but actually, it splits the genetic material of the egg contributor, from the process of enabling the embryo to grow and implant and of carrying the pregnancy and child.
The more I thought about it, the more it intrigued me. My experience with IVF has taught me that embryos by themselves don't have life, only the potential for life, if they are viable and healthy. When the eggs are extracted, they alone are sexless and unfertilized, with no potential for life. Then as embryos, until and unless the womb accepts and nourishes them as healthy enough to survive, they won't take or grow.
So, who is the birth mother of the child? The birth mother is the adoptive mother and the only mother, in fact, that the child will know. The egg donor is a genetic mother, although probably not even the biological mother, since arguably they didn't grow and nourish the foetus. There is no 'real' family, as is the case with an adopted child who might one day have an identity crisis. The family you are born into, is the only family you have, save for a random or sometimes, known stray egg, the donor of whom is at best a guardian or godmother whom they might feel an abstract love for, or interest in.
Some studies imply that carrying the pregnancy in fact affects not just the development of the foetus, but even some of the genetic expression, because of the blood and nutrient transfer between the mother and the child. Was this a positive or a negative? Would you see the child as biologically half yours, or would you, as the carrier, reject something as none of you?
From there, we come onto the tangible advantages of donor eggs, which is really the most dubious and sordid part of my internal debate. Inherently, both Z. and I believe that we would love a child unequivocally, even if they shared neither of our genetic material. I cannot pretend that it wouldn't be neat and reassuring to see our traits played out or combined, or not to grimace every time a well-meaning aunt says oh, they really look like you, but in general, I think both our capacities to love easily outweigh whether the child is only part his or part mine or part-none.
Some women say that they honestly think their husband would be more involved and more in love with their offspring if they are biologically represented and I really salute that honesty and fact. I don't actually think that is the case with my husband, but I can well imagine how this would be the case generally — just think about whether your in-laws would support you or the child more, or less if it were your own position. If I myself were to be perfectly honest, I suspect the integration of the child into our extended family might be a lot easier via embryo than adoption.
I also wonder if I would be more cheered by a child who looks like my husband and whether I would be more reassured by a child who has at least some certainty in genetic background. I think the best parental love actually, is the one that embraces uncertainty, as no child is certain and no outcome really, is certain. What do you do, for example, if your child happens to be autistic, or gay, or short, or fat, or wants to live across the world from you — you know what I mean?
Planning doesn't take into account uncertainty and self-expression. Love, is love. But, would I be prepared to deal with and be responsible for a child who might never have the genetic material to live life or enjoy it, to learn or go to college? Did it make a difference to me that they would be able to experience and take advantage of resources? I turned this over in my mind, and sometimes the answer was yes.
Our primary concerns have always been most significantly, the health of the child and the legality of the status, as we definitely do not want to be compounded into a messy legal situation. Many children in Asia, are put up for adoption because of health issues, many of which cannot be detected at a month old.
Both adoption and an egg donor allows you some degree of control in what your child looks like and comes from, but to be blunt, having an egg donor allows you more precise control of what your child's capacity, physically, mentally and even emotionally. Because you can better understand the genetic mother's history and health conditions, and because you can speak with them face-to-face, you may feel a bit more reassured and of course, there is more control over prenatal care, whereas with an adoption, you must assume that the prenatal care was about equal to the care with which the child was conceived.
My fifth takeaway, is that it was attractive because you deal with less hurt feelings. The birth mother's, for example. That of her family, were they all supportive of the adoption? Did the grandmother want to keep the baby? And lastly and most importantly, that of my own child.
Once the embryo is transferred and takes in your womb, the embryo belongs to you legally and the child, if one results, is yours. There is no question of anyone discounting or disclaiming this. Our child would never have to face the thought that they were not wanted or were given away by parents who simply failed to use birth control or chose to keep their siblings instead. In fact, we could conceivably tell them that they were so very wanted, that they were wanted by three people, all of whom wanted very much for them to be born and without any of which, none of this would not have been possible.
For those who want to research egg donor options in Asia, what I found were that the most viable alternatives for Singapore, are Malaysia, Thailand and India. This is because of the proximity and thus the ease and cost of transfers. I also looked at options in North Asia, because of the large proportion of ethnically Chinese — it turns out that Taiwan legislated monetary incentives for egg donors a few years ago, but the waiting list is about 2 years long. In addition, there are fairly onerous requirements, such as four blood relatives within Taiwan. I wrote to a couple of Taiwanese hospitals but only one wrote back.
I highlighted three Malaysian hospitals, from my research of patient ratings. All of these answered my email enquiries promptly although there were also some other facilities that did not answer. One replied also in their email that donors of Chinese ethnicity are rare, in the single digits, while another had more. In Thailand, I looked through a number of hospitals, but received a better impression from two. They were very prompt, pretty professional and empathetic. All their donors are Thai, although several are Thai but of Chinese descent.
In the US, donor egg services are separate to doctor's clinics, with some particularly famous ones. I was more impressed by the US-based services, for the thoroughness of their surveys and the minutia of the information provided. Although they have made a big business catering to Mainland Chinese clientele, the number of ethnically Chinese donors is very small. In Europe, the most famous donor and also IVF clinic, is IVI Valencia, which has several locations, including international locations in Asia, but again, the demographics are very specific.
In the US, the full donor profiles and details can be accessed easily online, while in Asia, they will email you the profiles in Thailand, after you complete the basic documentation and in Malaysia and Taiwan, the profiles are available upon in-person consultation. These profiles do not contain names or personal identification, but they will give statistics like height, weight, skin colour, blood group, education, hormone profiling and family medical history. It will show you pictures of the donor currently, or as a child and whether they are a proven donor (meaning that someone has conceived using their eggs). It may include a questionnaire about what they like to do and how they feel about the world.
I was surprised that you are able to view donor profiles with little trouble or registration, the guidelines around these seem looser than adoption. I was also surprised at the criteria and the level of detail in the declarations. I was expecting to find the donors to be simple, small-town women, in need of money or maybe in dodgy professions, but actually most of them were beautiful, college level graduates, or working as nurses, accountants and office receptionists. I really thought some of them were so pretty!
The US websites had donors that were older (meaning in their 30s) but the majority of the Asian donors were below 30, although it was jarring to see how close to my own age most of them were. The health declarations were across a series of tests, history and conditions and were incredibly detailed and thoughtful.
To be honest, one of the biggest concerns I have with Asian donor facilities versus say the US or Europe where medical and legal regulations are stricter and more entrenched, is that I am suspicious of the veracity of the information and that the eggs you get, are actually what is as stated, that the women adhere to the limit of 6 egg donations as claimed and that there aren't health concerns, most worryingly, HIV or AIDS.
I won't post the hospital names, nor the pricing of hospital services and financial arrangements here, but you can always contact me if you are interested. I would be so happy to hear your comments and experience too, if any.
Once I had come this far, of course, I had to get online and see the actual profiles, which was in itself a really surreal experience. For anyone who is approaching this at any point, I wish you a better experience than I. Even though I expected it to be enabling and exciting for me to know about potential egg donors, it gave me bad dreams for a week!
It was just something so far out of what I'd ever expected to be doing. I looked through the profiles without at first really understanding what I was looking for — searching through candidates for, does she have a nice smile? Is she fair? Smart-looking eyes? Does she look kind? It just seemed so weird. I felt almost like I wasn't there, like I was just drifting outside my psyche, which was at a farmer's market, sifting and picking the best cow.
The second feeling was that somehow, I expected my kid would look like this person in ten years. As I committed the faces to memory, I wasn't sure if I dreaded it, because I knew that I would love and protect this kid fiercely, or if I just expected it.
The other odd feeling was what it did Not feel like. For one, it did not feel like playing God (which I thought it might). I felt in dual part unwilling, with a heaviness that equalled the fascination. I knew that any pregnancy might not take, so it certainly couldn't be without God's sanction.
Second, I thought it might feel like your husband and this random woman would have a baby, but again, it really doesn't. I'm not sure if that's because there isn't sex involved, but it feels very scientific, and the choice somehow removes the intention.
It feels more like you are borrowing DNA from someone to create a baby, in fact, you are looking to borrow the best possible DNA you can find to create a baby that will belong to you for a short while, then later on, to themselves and to the world. And that could be DNA candidate 1, DNA candidate 2, or 3. I know that without my ability to want or carry this pregnancy, this whole thing is a no-go, no matter how many eggs there are, or how many get fertilized. The DNA might not be mine, but the child is entirely my responsibility. When you think of a child, instead of DNA, it really isn't that weird.
I also thought I would feel bad for these women, like I was subjugating them, but actually, I didn't at all. The reason I guess is simple, it is entirely voluntary and they get paid well, which is what they want. Most of them I know, from their age and hormone statistics, will have absolutely no problems going on to have heaps of children if they choose to. The reasons for why they want to be involved differ, but the unifying factor, is that all of them want to give these eggs and they want you to have a baby.
Unfortunately in Asia, I think very few of these women for reasons of uncertain future liability or lifestyle, and because the infrastructure doesn't allow for it, would want to maintain a future relationship, even though in our case we would like to or at least would like them to have an option for it, if they chose.
And so I came upon some of my last takeaways from considering donor eggs. It actually takes a while to come around to the idea of pregnancy and in this way, for me it took at least a few weeks. The first couple of nights, I would dream about going through the donor profiles again and again, seeing their faces and heights flash in my troubled sleep. (I imagine though, that when we do get around to visiting an adoption agency, this is exactly what it will also feel like, except with babies.)
During the day, I would occasionally catch myself staring at my own face in a mirror, and recognizing small things that I knew won't appear again in my child. I'd find myself staring at strangers, wondering, how fair is fair, really? Are people generally tall? Do most people draw in fake eyebrows or do they have real ones?
As much as I recognize that I'm the only me there will ever be, somehow, I was mourning the loss of my own genes. No child is going to be you, even if they may look like you. They aren't going to be the same person. Even your brother or sister as donor genes, isn't going to beget a child that looks like you both. Once mixed in with your partner, who knows what comes out of the mix?
But this process, really gets to the heart of why and how badly you want to have a child. Maybe in a scenario where you are trying so hard to identify what you do and don't care about, when you see other people's children that do resemble them, some very much so, when you are trying to ask yourself the honest questions of what you are looking for, this is the rawness of feelings that you may and do feel.
Very few sources deal with how you feel — what should you be feeling anyway? I guess so few people have been in that circumstance and even fewer are prepared to be, so there isn't any point to judging, or even glossing over, what it makes you feel, I feel. If you have an experience with donor eggs in Asia, and would be willing to share it with me, I would love to hear from you.
