The safety and legality of certain fertility procedures

by Joanna Perlman

First published in ‘O’ (Oprah) Magazine February, 2004.
Published on this website with kind permission of Joanna Perlman.

"$20,000 for eggs." The ad in my Barnard College newspaper definitely caught my attention. It was posted by an infertile couple looking for a Jewish Ivy League student
with good SAT scores. Although I was tempted, I decided not to respond.

Six years later, this past spring, I read about Calla Papademas, a 22-year-old Stanford graduate who did answer such an ad. A few days after starting Lupron, a drug used to control the timing of ovulation so it's easier to collect the eggs, a benign mass was found growing rapidly on her pituitary gland. The tumor ruptured, sending Papademas into a coma from which she awoke eight weeks later with brain damage.

Hoping to find out how something like this could happen, I recently called 17 fertility clinics posing as a prospective donor. Typically, the drill for egg donors is similar to that of women undergoing in vitro fertilization treatment - injecting oneself with hormones once or twice daily, and several times a week going to a clinic for blood tests and internal ultrasounds. At the end of about three weeks, the woman is sedated and a doctor passes a needle through her vaginal walls to collect anywhere from 5 to 35 eggs.

When I contacted the clinics to inquire about the safety of these procedures, only 3 of the 17 people I reached had medical backgrounds; the rest were secretaries and office administrators. In each conversation, I distinctly asked if Lupron was approved by the Food and Drug Administration (FDA) for fertility use. Responses ranged from "I would assume so. I can't imagine hundreds of doctors and thousands of women; I just can't believe that it's not approved" to "The drug has to be FDA approved for these uses because you're bringing a human life into this world." Only one clinic gave the correct answer, which is no. In a few cases, I was referred to the American Society for Reproductive Medicine (ASRM) for further information. In ASRM's pamphlets, there is no mention of the fact that Lupron is not approved for fertility treatments. A spokesperson suggested that members of the society "think the matter should be left to the discretion of the physician." And that may be true, but the majority of physicians I spoke with as a potential patient never mentioned it, and I collected eight informed consent forms before finding one that clearly stated anything about the nonapproved status.

When pressed, the doctors cited numerous studies on Lupron and said that women have used it for years without problems. Both are points that David Redwine, MD, a gynecologist at the St. Charles Medical Center in Bend, Oregon, takes issue with. He has treated hundreds of women who have gone on Lupron for endometriosis and suffered adverse reactions, including arthritis-like symptoms and headaches. As for the studies, he says, "Some have followed women while they're on it, some have followed them for a few months after they stop it. But these studies aren't going to pick up long-term effects." I'm 27 now and still find the money being offered for a woman's eggs - I've seen sums up to $50,000 - enticing. But without knowing the real cost to your body, it may not be a great deal.
*Joanna Perlman