“There's a huge lack of data there to really [allow women] to make informed decisions,” says Dr. Diane Tober, an assistant professor at the UC San Francisco, who studies egg donors. “And that's really problematic, obviously, when you have people making decisions that could affect their future health, well-being, and their ability to have children.”

Ads or marketing materials targeting potential donors rarely mention the risks or common complaints. Liz Scheier donated eggs three times between 2005 and 2007, and says she was told there were no known risks associated with egg donation. Today, Scheier is a media liaison for We Are Egg Donors, a women’s health organization that works with more than 1,500 donors to promote transparency and advocate for their concerns. She says that donors nowadays hear the same line she did, delivered almost verbatim. But it’s missing one key detail. “There are no known risks because no one has looked,” she adds.

“There's a huge lack of data there to really [allow women] to make informed decisions.” Dr. Diane Tober, UC San Francisco

Tober aims to change that. She has spent the past five years interviewing hundreds of egg donors and studying the short- and long-term impacts of the procedure. Her findings suggest that donating eggs is riskier than some agencies say, and that many egg donors don’t understand how the industry operates.

Some women suffer a reaction to the fertility injections known as ovarian hyperstimulation syndrome, which in extreme cases can be fatal. Tober says clinics often downplay the risks by citing statistics that apply only to the most severe cases, and glossing over other potential side effects of egg donation. She also says her research has found that mild to moderate cases of ovarian hyperstimulation—including symptoms like abdominal pain, nausea, vomiting, diarrhea, and sudden weight gain—are “quite common” among egg donors, sometimes requiring hospitalization. Other donors suffer complications including ovarian torsion or surgical mishaps.

Looking back on her first donation, Griffin marvels at how little she knew about what she signed up for. “I had no idea what was going on,” she says.

That’s understandable. The process is complicated, involving screening, multiple tests, drug regimens, and finally, harvesting eggs.

Screenings and tests

The screening alone can be arduous. Here are some of the requirements for donors working with A Perfect Match, an agency in La Mesa, California: Potential donors must be between the ages of 19 and 29; have no criminal record; not be overweight; not taking antidepressant drugs; fill out a medical and genetic questionnaire about themselves and their extended family; and submit academic transcripts and SAT/ACT scores. Potential donors must also submit to genetic testing; a psychological screening, the results of which they can’t see; a medical screening; and to an ultrasound, vaginal culture, and STD screening. A drug, nicotine, and alcohol screening is required as well.

After they are chosen by an aspiring parent, donors take medication to synchronize their menstrual cycles with the recipient’s. Then come the injections.

Normally, women produce one egg each cycle. To increase the chance of success, donors are given drugs to promote the production of additional eggs. Typically, donors are given dozens of lengthy syringes and tiny glass vials, and instructed to inject themselves with up to four drugs multiple times a day to coerce their ovaries into producing dozens of eggs, according to interviews with donors. Women are urged to stick the syringe in a fatty place on the body, like the stomach or thigh, to minimize bruising and pain from the needles, some of which are longer than an inch.

During this process, donors are instructed to abstain from sex, alcohol, drugs, tobacco, staying up late (or waking up too early), jumping, walking up stairs too aggressively, or any other activities that might jostle their swollen ovaries. Every one to three days they must visit a doctor—chosen by the intended parents or agency—for blood work and ultrasounds.

Griffin’s first donation was through the Pacific Fertility Center in San Francisco. She recalls meeting with a doctor to discuss potential risks, many of which she now thinks were downplayed. The clinic allowed her to choose when she wanted to donate and how many cycles she’d like to complete. She was in college at the time and needed cash, so she opted for two cycles, for which she was paid $8,000 each—in June and August 2014.