It was one of those days where I had a little time to ponder about my clinical encounters. There was a 20-year-old lady who came to the clinic for STD screening. I asked her some questions to determine which are the most suitable ones for her, and her reason for wanting the test.
To my surprise, she told me it’s because she wanted to sell her eggs and the fertility centre required her to do some tests. Seeing this was a rather unusual reason, I probed further and she replied, “I’m doing this for money”.
The encounter has left me with complex feelings about how many aspects of our society is evolving, and it also brings back memories from many years ago when egg donation was a topic of interest, to the point that it even gained coverage in one of the mainstream newspapers.
The fertility rate in Malaysia has been on a steady decline since the 1960s, from around 6.3 births per woman to 1.94 births per woman this year (2022). The same can be seen throughout most of the world, which can be attributed to rising costs of living, changes in values and attitudes towards families, and advancements in contraceptive methods.
Late marriages and delayed motherhood, coupled with a lot of other factors, have increased demand for fertility treatment such as in-vitro fertilisation (IVF). While new technologies in fertility medicine have offered new hopes to prospective families, there is also a flip side to it.
To understand what I want to discuss later, let me give you a very simplified process of IVF. Normally, the IVF process begins with ovarian stimulation at the beginning of the menstrual cycle, in which follicle stimulating hormone (FSH) is injected to obtain a good quality of oocytes (eggs).
The development of the ovarian follicle is monitored by regular ultrasound scans. When the end of the maturation nears, human chorionic gonadotrophin (HCG) injection is given, and the eggs are collected about 36 hours later at an outpatient setting.
The eggs aspirated will be studied, and will then be fertilised using the sperms. Now, only about 60 per cent of the retrieved eggs are viable, and only about 60 per cent to 70 per cent of fertilised eggs develop normally.
Hence, the development of the embryo (fertilised egg) is monitored, and out of all the collected eggs, only one or two of those which have the best chance of success are selected for transfer into the womb. The rest of the pregnancy will then be followed up closely by the gynaecologist.
Women with reduced ovarian reserves can opt for egg donation. Egg donation is where a woman (donor) gives her eggs to another woman (recipient) to allow her to have a baby.
In a perfect world, there may be patients who request for egg donations, and there are donors who give their eggs to them out of purely altruistic reasons. I mean, who doesn’t want to be a major part of making other people’s lives complete?
However, the basics of economics state that a business is driven by supply and demand. With the increase in infertility, the demand for these services is increasing. What happens when many patients fail IVF and seek egg donors?
It opens up opportunities for profit-seeking agencies to assist physicians by advertising lucrative incentives (compensation) for egg donors. Besides the poaching, donors are often ranked according to their traits (so donors with in-demand traits are paid more than donors with less desirable traits). See where we are heading?
Currently, there are no specific laws governing IVF in Malaysia, and the closest thing you can get is an outdated Malaysian Medical Council guideline on assisted reproduction, published in 2006, and another guideline on stem cell research and stem cell therapy, published in 2009.
IVF treatment is also considerably cheaper in Malaysia compared to neighbouring countries. Hence, there will be people from other countries coming to seek for egg donors in Malaysia. This factor, together with a weakened ringgit, is fertile ground for unscrupulous marketing practices.
Now, imagine if you are a fresh graduate earning about RM2,000 to 4,000 monthly in a big city, and along came an opportunity to earn a quick RM5,000 to 8,000 (that was the price back in around 2017) with relatively less effort. Many will find this quite tempting.
I am not saying egg donation is a bad, I am merely disputing the way potential donors are recruited (and some are not even given detailed risks about the procedure that they may go through).
Ultimately, the trend of people (while I used women as example in this article, I’m referring to both males and females) trading their genes for money is gaining popularity. Perhaps we should also look at this problem from a financial perspective.
Are Malaysians paid less compared to citizens of other countries? Are Malaysian employers paying their workers fairly? With the upcoming global recession, are young people nowadays earning enough to keep a roof over their heads?
Will all these factors lead them to find an easy money such as selling eggs? This is an important topic with a lot of socio-economical ramifications for the country’s development. I hope I can do more about this, but for now, sharing my thoughts is all that I can do.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.