22-year-old Cui Yumu (alias) is a college student living in Guangzhou. She said her life was forever changed when one day she saw an advertisement recruiting women who can donate their eggs for requite on WeChat, a social media platform in China.

Financially troubled at that time, Cui contacted the agency and donated her eggs. The process was not done at one time, several punctures were conducted to retrieve all the eggs. The non-narcotic process was even more painful than usual as the organizer wanted to save costs.

Now, after 2 years of that donation, she said that she regretted her decision.

What is egg donation?

Advertisements for egg donation can be seen in restrooms, on telephone poles, walls, or doors. They often carry the banner of "public welfare volunteering" and promise a certain amount of remuneration. There are also plenty of relevant news and stories on the Internet. However, the information is at best fragmentary. Many people are uninformed.

As part of an assisted reproduction treatment, egg donation is a process by which a woman donates eggs to enable another woman to conceive. Sometimes, unfertilized eggs may be frozen and stored for later use, which is called egg freezing.

At present, China prohibits commercial egg donation in medical practice and adopts the model of egg sharing. It stipulates that the eggs from donors can only be donated but not sold to people. Buying eggs is also prohibited.

A survey conducted by our group shows that 51.35% of respondents have mixed attitudes toward egg donation. When it comes to the understanding of domestic egg donation policies, 70% answered that they were not clear.

The demand for eggs from infertile couples is high but the supply is low.

The main reason for egg donation is in-vitro fertilization (IVF). According to the "Survey Report on the Current Situation of Infertility in China," the infertility rate in China stood at a range of 12.5% to 15% (~50 million citizens). That is, one in every 8 couples might have infertility problems.

Currently, only couples who have undergone IVF are entitled to the right to donate the wife’s surplus eggs to other infertile couples. Medical institutions don’t accept egg donations from any women who don’t fit the above criteria.

However, because egg donors are mothers seeking "children," it is challenging for them to donate eggs. Even if they agree to donate, there are not sufficient eggs for market needs.

8-20 eggs can be retrieved in one procedure with the help of ovulation induction drugs for IVF. On the contrary, about 60,000,000 healthy sperm can be retrieved in one procedure for IVF. According to The Beijing News, in China, there are 27 legal sperm storerooms, but 0 legal ovum storerooms. These make egg supply more scarce.

As a result, illegal egg markets become ubiquitous. Some unqualified clinics will even coax young girls to donate eggs by giving them money.

The misuse of ovulation induction drugs and improper procedures may cause ovarian swelling and even lead to ovarian hyperstimulation syndrome (OHSS), which causes abdominal pain, nausea, vomiting, blood clots, and even death.

Egg donors have reported other post-donation issues including aggressive breast cancer, loss of fertility, and fatal colon cancer. These symptoms sometimes occur just a few years after donation.

Nevertheless, high financial incentives lead many women to donate their eggs despite the risks. It’s dangerous and illegal, but also lucrative.

Our team reporter disguised herself as a college student who wanted to donate eggs and visited the principal in charge of an underground egg donation agency. The principal introduced that generally, the egg donation cycle is around 7-12 days, from which donors can receive 15,000-60,000 RMB remuneration. Yet the specific amount depends on their egg quality, appearance, education, and other factors.

“Needs, ethics, morals, laws...We have to consider and balance them all”

In 2022, the National Health Regulatory Commission issued a "Proposal on Prohibiting Underground Commercial Trade of Eggs" to establish and improve legal channels for egg donation and egg storage.

Chinese singer Xu Jinglei said that many women including her chose to freeze eggs in Hongkong or the United States because they were not sure whether they might want to have children in the future. Xu’s experience led to widespread discussions online as people debated on whether egg donation should be legalized, or even commercialized.

On the one hand, the expansion of the legal egg donation channels and the scope of the egg donor population to improve the supply of eggs will make it easier for infertility patients to obtain suitable eggs.

Lin Wei (alias) and his wife, who are infertile, said if donating eggs becomes legal, patients like them will no longer have to seek help from the illegal market. Hence the series of problems, such as gynecological diseases, caused by the illegal market may be greatly reduced.

As a specialist in reproductive medicine, Dr. Liu Jiaen mentioned the increasing trend of late marriage and late childbearing, and infertility are highly overlapping, and having a child becomes more challenging as people age. The egg donation technology has promising potential. He said with more advanced scientific development, perhaps more infertile couples in the future can have their children through IVF.

There are also ethical concerns. One is about consent regarding whether or not the IVF children should be informed about their third-party, biological mother. In general, the child is the combination of parental genes. But through egg donation, the body contains the genes of a third person other than the parents.

“What kind of psychological changes will occur after the child knows? Whether the parental relationship will be more likely to be abused or abandoned after the relationship is broken?” asked Long Xinxin, a lawyer. She added that it is necessary to consider having laws addressing egg donation and cracking down on illegal institutions.

Another concern is centered around human rights. Professor Xia Ming (alias) is a manager of a fertility center of an IVF-qualified hospital in Guangzhou. He said that the possibility of completely liberalizing voluntary egg donation is non-existent because its risk is tantamount to human trafficking.

He added that too many uncontrollable links and factors might affect citizens' basic rights and it is difficult to judge whether a peer-to-peer donation can be achieved.

A coin has both sides, and the same is true for an event. It is precise because of the particularity of egg donation that people should establish a more inclusive environment to openly discuss the advantages and disadvantages. Rational dialectical thinking and not blindly taking sides may also have a positive impact to a certain extent.

As Professor Xia said, “every life is so essential and unique. Needs, ethics, morals, laws...We have to consider and balance them all.”