Are Ugandan egg/sperm donors being exploited?

SUNDAY VISION

Egg and sperm donation is becoming a booming business in Kampala. It is as rigorous as it is tedious yet, as our undercover reporter writes, there is neither a law nor financial benefit for Uganda donors, unlike in the Western world.

The receptionist at Endoscopy Fertility Clinic leads me to Dr. Patel Prakash’s office. It is a Tuesday lunch time but I am still attended to.

“What can I do for you?” he asks. For some reason, my mouth runs dry, for I do not know how to start.

“Don’t worry, everything is confidential,” he assures me.

I decide not to beat around the bush. Patients might be flooding in soon.

“I want to donate my eggs,” I say hastily. He smiles broadly, but wonders out loud why I am keen to give out my eggs when I could make use of them. I tell him it is out of courtesy.

I narrate a story of a friend who is trying to have children in vain. “I want to help anyone in that state,” I say. Prakash looks sympathetic.

“I hope you are aware that what you are doing has no monetary gain. Donating is free of charge, just like someone donates blood to save people’s lives,” Prakash says, emphasising that there will be no room whatsoever to meet the recipient of my eggs.

“When you donate, we do not give you chance to know who you have donated to and the recipient also doesn’t know who the egg giver is. We are going to ask you to sign a contract so you do not come back with various claims,” he says.

“Will I have the chance to see the child from my eggs eventually?” I ask.

His answer is an absolute no, but explains that if, at 18 years, the child decides that he wants to see me, legally, he would be allowed to. But that is if the parents reveal to him about how he was conceived.

Prakash adds that the recipient would also receive my egg free of charge. But that the costs of operation involved and checking her reproductive system would be at a certain cost, which he declines to reveal.

“As a donor, you do not have to pay any money for donation or the process of extracting your eggs. Everything is free of charge,” he repeats.

Having answered all my questions, he creates a file for me. He takes down my basic information, from my age to my date and place of birth, my tribe, place of residence, contact details and Facebook account, level of education, my workplace and profession.

For all these details, I give him fictitious names for the purpose of this story. He also wants to know about my children, my menstruation cycle, blood group and if I have any ailments.

He goes on to record as many details as possible; my skin colour, the texture and colour of my hair, my height, weight, interests and hobbies, among others.

“The recipient wants as many details as possible. In fact, I know someone who wants a light skinned person who is a degree holder. When you entered my office, I could see a perfect match,” Prakash says, before asking me to blow my trumpet.

“Talk about yourself and your good attributes,” he says. He is noting everything down as I speak.

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Sometimes, egg recepients make specific claims about the sex of the baby they want - girl or boy.
 

He repeatedly asks me if I am really ready psychologically to give out my eggs. And I tell him I have nothing to lose.

“Do you have a passport?” he asks. “I am processing one,” I lie.

“Please do that as fast as possible, because I do a lot of my work in India. Everything is free of charge — the visa and the air ticket and accommodation and operation costs.”

Prakash says he has a long list of potential egg donors and recipients and that a group would be leaving sometime in May this year.

“We compile lists and keep matching them depending on the attributes recipients come asking for. So, endeavour to have your passport by the end of April,” he says.

He reveals that there are plans to open a centre in South Africa where he can take his clients for operations. “But for sperm donation, we do it here at this centre, because it is not as complicated as egg donation,” he says.

He asks me to bring three photographs on my next visit (these are to be attached to my file). He adds that I can email him soft copies. “We can assure you that this is confidential and not even your recipient will know about them. I need one passport photograph, another with a side view and another full picture,” he says.

All these requirements are needed before I can sign a contract and we get down to business.

In the meantime, he asks me to pay sh150,000. He needs an additional sh50,000 for a scan of my fallopian tubes and my ovaries. But I do not have any money left. I promise to return soon.

Giving out sperm

Since Prakash had earlier talked about sperm donation, I ask if I could buy sperm from this centre if I get desperate to conceive.

“It is not buying. Sperm is free of charge, but it is the procedures that cost much. For instance, we need to do scans to see if your uterus and ovaries are okay. We also need to check your hormones and stimulate them to release three eggs in a month to increase your chances of getting pregnant. In a normal cycle, you release only one egg in a month,” he explains.

In between, we chat about broken relationships in society and he explains that some women are too hurt that they decide enough is enough with men.

“Some women want to get pregnant, but without a man. Others genuinely have problems and cannot conceive, yet they want children,” he says.

The procedure of inserting sperm in my uterus could take me only 10 minutes, Prakash assures me. “So when you are ready, you can walk out of office at lunch time and come and it is done,” he says.

Just like egg donation, Prakash says he receives so many inquiries every week of many young men seeking to donate sperm. “We take the same precaution. We also first test their sperm, because we want our recipients to have good quality sperm or eggs. If you have an infection, we disqualify the sperms.”

I insist on knowing the cost of the procedure, but he tells me it is not constant. He, however, mentions only initial costs. Checking hormones would be sh240,000, scans would be 60,000 and an X-ray would be sh80,000.

As I prepare to leave, he reminds me to come with sh50,000 for my scan, so we begin to process to egg donation on my next visit. true

Legal and financial implications

Dr. Prakash told this undercover reporter that he follows the international law on egg donation.

The decision to create a family via egg donation is an immensely personal and emotional one for most aspiring parents. And in most countries, families are protected by qualified, experienced legal counsel, every step of the way.

At present, donor-assisted offspring can ask if they are related to someone they wish to marry once they are 18, according to the international laws.

Unlike in Uganda, in other countries, egg/sperm donors are entitled to a good payment. In the UK for instance, the Human Fertilisation and Embryology Authority is pushing for significant increase in payments made to those donating their eggs or sperm for infertility treatment.

Under the planned scheme, egg donors would be paid up to £750 (about sh3m) for each cycle of donation, compared with the current maximum of £250 (about sh1m).

Similarly, it suggests that men should be compensated to the tune of £35 (about sh140,000) for each visit to the clinic to provide sperm.

The £750 figure for egg donors is the same as that used in Spain, while the £35 for sperm donations matches that of Denmark.

Notoriously, in America, some female students reportedly pay their way through college by donating their eggs, as there are no statutory limits on how many donations one should give.

Are Ugandan egg/sperm donors being exploited?

The world over, the egg/sperm donation is booming business for most fertility centres. But in Uganda, it is still being done behind drawn curtains as it is stigmatised. In fact, there are no available researches, or even statistics on the issue.

Sunday Vision has established that there are a number of fertility centres sprawling across the city. Yet, surprisingly, the Ministry of Health has not formulated a policy on egg/sperm donation, surrogate motherhood and generally invitro fertilisation.

“Right now, there is no policy. We shall consider looking into the issue. But I understand there are contracts. So if there is a problem, one could sue using the contract act,” says Sarah Opendi, the state minister for primary health care.

Huge moral questions arise. While so much emphasis seems to be given to the demands of individuals and couples who want to conceive, critics also worry about the egg or sperm donors, the children born out of such processes, and the wider effect on families.

Besides, there are also questions on the children’s genetic heritage.

“Genetics sometimes have a huge influence over one’s illnesses and diseases. A child has a right to know its family’s medical history, so what happens when the donors remain anonymous?” asks Dr. Nathan Oryem, a gynaecologist in private practice.

All you need to know about egg donation and how it is done

For many clinics, one must be under 35 years of age, as the risk of birth defects is lower. Most clinics have anonymous donation, where the donor does not know who receives her eggs and the recipient does not know who has donated them.

Sometimes, couples choose an open donation, where the egg donor meets the potential “birth mother”/parents.

The egg donation process can last up to three months, depending on a particular clinic’s programme.

The process begins with a comprehensive questionnaire, asking the donor about her medical history, physical attributes, and personal characteristics. This helps identify and match prospective candidates with the egg recipient(s). Donors then have a complete physical exam, including blood, genetic, and psychological testing.

After a donor is approved, documents, including a medical release form to state that the donor gives up rights to the donated eggs once they are harvested, are given to the donor to sign.

No matter how factually informed and emotionally prepared potential egg donors are, the process itself is complicated and can be frightening, uncomfortable and even painful, according to a doctor who prefers anonymity.

Unlike sperm donation, which is relatively quick and easy, egg donation requires medications and a disturbing procedure to retrieve the eggs. Once a woman has been selected as a donor, she is taught how to give herself daily injections of medications and fertility drugs for three to five weeks.

The fertility drugs stimulate multiple eggs to develop and their maturation is monitored by ultrasound examinations. A drug that temporarily prevents the ovaries from releasing a single egg each month (which is a typical menstrual cycle) is also administered by daily injection.

Women resume menstrual activity shortly after stopping these injections.

Once the eggs are ready to be harvested, a fertility specialist identifies the eggs to be retrieved and a minor operation is done to remove the eggs from the ovaries.

This procedure usually takes 30 to 60 minutes. After about 20 minutes of recovery, the donor can go home. If the donor egg procedure is done correctly, it does not interfere with a donor’s fertility.

Once retrieved, the eggs may undergo testing; if they are okay, they are fertilised (with sperm) and grown in the lab for two to three days in a Petri dish before being inserted into the recipient’s uterus.

Sperm donation

The man deposits a semen sample into a sterile container. The sample is mixed with a preservative solution, sealed in vials and frozen with liquid nitrogen. The frozen semen is stored at -321oF. When needed, the semen sample is thawed and used in artificial insemination.true

Before this, however, applicants go through a rigorous screening process before they are cleared to donate sperm.

Donor screening consists of questionnaires, blood screening, semen specimen screening, genetic analysis and a physical evaluation. Sperm count and family history are also analysed. The candidate is also tested for infectious diseases like HIV, Hepatitis B, and Hepatitis C, among others.

This screening process takes between eight weeks and six months, depending on the sperm bank to which the man is applying.

If the man is one of the lucky applicants who are accepted to donate, he will be paid between $40 and $100 (about sh100,000 and sh260,000) for each semen sample.