NEW YORK — The global human egg business is still in its infancy and there is one lesson the egg entrepreneurs should learn before it's too late: we need a global registry.
We never did it with sperm and now the sperm bank industry is too entrenched to change anything. But the egg industry is poised to take off and we should get it right this time around.
A global registry would track fresh egg trades and collect data on egg freezing techniques, as well as the health of the offspring. In essence, it would allow everyone to know what’s going on. Something that seems rather obvious.
Sperm has been traded fresh and frozen for years. The first reported case of a baby born from donor insemination goes back to 1909, but some say it was done secretly before that. The first baby from frozen sperm was born in 1953.
Sperm bankers do not have a registry. Instead each one has relied on customers calling them with results — the quantity of babies born, gender and health. Most clientele have so many other things on their mind by the time the baby is born, they forget to check in with the sperm salesman. The upshot is that we really do not know how many babies are born from each donor and where in the world these kids are.
The fresh egg business has been around for a few decades with younger women “donating” their eggs for a hefty price to women who do not have fertile ones. The donor takes hormone drugs and undergoes an invasive procedure. Needless to say, it is a much more cumbersome and pricey process than sperm donation, which only requires a bit of privacy and a few porn magazines.
Egg freezing is a much newer technique — still considered experimental by most major medical societies in the U.S. and Europe. For the most part, egg freezing is used by women who want to put their own eggs on ice for use later. Some women haven’t met the right man, or sperm donor. Others are undergoing chemotherapy and worry the drugs will damage their reproductive tract, so they want to get their healthy eggs out of their body for the time being.
No surprise, there is a for-profit company, Cryo Eggs International based in Indianapolis, that trades in frozen eggs.
Eggs are trickier to defrost than sperm and embryos because they are huge, fluid-filled and have lots of complicated machinery inside. One tiny ice crystal sneaking inside during the process damages the whole thing.
Ever since the first babies were born from frozen eggs — Australian researchers reported a set of twins in 1986 — defrosting techniques have improved tremendously. Italians were pushed to perfect egg freezing because of strict limits on frozen embryos there. Americans were prodded by Lindsay Nohr Beck, a young woman with tongue cancer who insisted on having her eggs frozen because she worried the chemotherapy would destroy her ovaries. Since then, she has launched a foundation that raises money and awareness about egg freezing.
Not surprisingly, what started as a huge boon for cancer survivors has evolved into a global enterprise aimed at single women. Some ethicists worry that marketers are hyping success rates.
As of last count, the number of babies born from frozen eggs is anywhere from 475 to 1,000. The success rates range from 2 percent to 10 percent, depending on who is giving you the numbers. The huge variation means only one thing: the statistics are not reliable. That’s not a good thing for the scientists in the field or potential clients.
“An egg registry, at least on a national level if not international, is an idea whose time has come and will become a reality,” said Susan Crockin, an expert in reproductive technology law and co-author with Howard Jones of "Legal Conceptions: The Evolving Law and Policy of Assisted Reproductive Technology."
"The need however is primarily to track genetic information for the benefit of the multiple offspring. This is a health care issue, not a commercial issue. Professional guidelines in the U.S. require permanent records of gamete donation but no mechanism currently exists to capture and collate data," she said.
Last year, EMD Serono Inc, an affiliate of Merck KGaA, of Darmstadt, Germany, launched a frozen egg registry limited to the U.S. to monitor the safety of the process and figure out which freezing technique work best. There are two ways to freeze human eggs — one is slow-freezing and the other vitrification, which really isn’t freezing so much as encasing the egg.
A bigger registry, that includes fresh and frozen, and spans the globe would keep track of the entire business as well as evaluate the science. Ideally, this registry would be run by an international fertility society (some already exist) that has representatives from various countries. It's something we do for cancer — we have registries in each country and then they combine data — why not the egg industry?
We need to do precisely what we didn’t do for sperm. For instance, there have been babies born from sperm donors who end up with medical problems and there is no way to alert the other families who used the same sperm. The Merck Serono registry called HOPE (short for Human Oocyte Preservation Experience) is a start. Let’s aim to expand the data and broaden our knowledge base. The ethics, as always, will come as lawsuits arise.
Randi Hutter Epstein, M.D., is the author of "Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank."
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