INDEPENDENT
Many call it egg harvesting, experts call it egg donation, but for the young women who throng fertility clinics in Nigeria day and night to sell their eggs, it is just another hustle, a means to make ends meet by earning ‘legal’ money.
In today’s Nigeria, fertility medicine is gradually evolving to meet up with global standards, and many families now invest in assisted reproductive technology like In Vitro Fertilisation (IVF), Surrogacy options, all in a bid to get a baby.
But with the demand created by Nigeria’s under-reproductive population, the market for the legal and illegal sale of viable eggs has created a market for young women to put up their eggs for sale.
Is the practice safe and how many ovarian eggs does a woman have?
According to our research, during fetal development, a woman usually has about 6 million eggs. However, at birth, there are approximately 1 million eggs left. By the time she reaches puberty, only about 300,000 remain. In essence, the number of eggs a woman has continues to decline as she ages and as she menstruates each cycle.
22-year-old Favour has gone through the process five times and is set to start the process a sixth time. She confided in Saturday INDEPENDENT during a visit to a clinic in Abeokuta, Ogun State.
Weighing over 70 kg, Favour revealed that before she started selling her eggs, she barely weighed 50kg and was a size eight. “I think the hormone injections and drugs also made me add weight,” she confides to our reporter during a visit to a fertility clinic in Abeokuta.
According to Favour, she discovered that egg selling was a viable business after the COVID-19 lockdown.
“I am a student at The Polytechnic, Ibadan (Ibadan Poly), and my father sends me N10,000 every other month. Even though I manage the money, it is never enough.
“When the lockdown started, I didn’t go home because some of my friends were in school. But it was very hard for us. By the time the lockdown period was over, I was owing the woman that sold me foodstuff almost N28,000. Even if they send me money, I know they won’t send more than N10,000. I was very desperate.
“One of my friends who was also owing about N15,000 saw the advert on Facebook that an agent posted, so we called the number. After all the discussions, I went with two of my friends to the clinic the man asked us to go to in Abeokuta. He even sent us money when we said we didn’t have money to leave school. When we got there, they gave us forms to fill out and registered us for medicals. One of my friends was AS, so they said she was not qualified. My other friend and I were okay, so they did a lot of tests for us.
“By the time they explained everything we would do, my friend was scared, so she pulled out. But I was desperate, and I was ready to do anything. So I signed all the agreements and they gave me an injection. Another nurse there taught me how to take the injections every day since we travelled down. She also gave me a lot of rules before I left the place and went back to school.
“I couldn’t give myself the injections, but my friend was there to help me every day since school had not resumed. I felt it in my body, and it was more painful than even period pain for me, but I knew that if I did not do it, I won’t get the money. I did it for 11 days before I went back there and they took out the eggs. They gave me something to sleep so I don’t know exactly how they removed it, but I felt different when I woke up.
“By the time I got back to school, there was N70,000 in my account and I was able to pay my debt. I also gave my friend who helped with the injections some money. I even still had enough money to last me the entire month without calling my father. I later found out that the clinic paid N90,000, and the agent took his share.”
When asked what was the worst part of her story, she revealed that it is the shame she feels after each procedure.
“I know what I am doing is not as bad as prostitution, but I feel ashamed every time I do it. This is my sixth time doing it and it may be my last time because I don’t like feeling ashamed. I know I am helping people, and the money is also helping my life, but I still feel ashamed so much that I can’t tell anyone except people that have already known I do it.”
In the case of Mrs. Blessing Idowu, her absentee husband led her to it. A 27-year-old resident of Lagos, Idowu reveals that she does it once or twice a year, and she has donated her eggs four times already.
In an Instagram call made in pidgin and Yoruba, she revealed that she found her way to egg donation by accident.
“I got married in 2018, when I was 22 and I was supposed to travel with my husband to the U.S. to become a hairdresser. He didn’t impregnate me before going back because we thought I would soon join him, but he ran into a lot of problems, and he could not do my papers, so I started selling goods on social media.
“My business is not doing badly, but by 2021 when my husband had still not sorted his issues out, I decided to make enquiries about fertility and things like that.
“I found a fertility clinic in Lagos Mainland, and I went to make enquiries. They gave me the option of freezing my eggs pending the time I would be ready, but the price was so high. While I was in the waiting room reading their pamphlets. I noticed that there were a lot of young girls there and they were being taken in one after the other.
“I knew it was not possible all of those girls had the money to freeze eggs, so I went to ask the nurse that I saw leading them in. When I got to her, she said, ‘Have you finished filling out your donation form?’ I said no that I wanted to make enquiries. It was then she sat with me and explained it all.
“One of the things she said that helped me make up my mind was that donating eggs will not affect my choice to have children later and that what they do is to give injections that would stimulate hormones that will increase the number of eggs I produce that month (hyperovulation). She also assured me that whether I donate eggs or not, my body only releases one egg each month normally, while the other eggs that have been prepared are discarded at the end of the cycle.
“This was what made me realise that instead of wasting eggs every month, once in a while, I can donate eggs for other women and still make money in the process.”
Responding to a question on whether her husband is aware of her newfound money-spinner, she said no, “Since it won’t affect him, why would I tell him, it is my body and we are not using the eggs now?”
Saturday INDEPENDENT further tracked down an agent who recruits young women for the clinics, and she revealed that 80 to 90 percent of the women do it for the money, not out of a genuine need to help others conceive.
“The money they make is not that much because it depends on the hospital. Some hospitals pay N200,000, some pay N150,000, some pay N120,000. The least paying that I work with is N100,000.
“Most ladies can do it without anyone knowing because it is a two-week process. Some are not even up to two weeks; some are 12 days, while others are up to 14 days.”
Speaking on how long she has been on the job and what the procedure is like, she revealed, “Most donors go through agents. I am an agent, and I have been doing this for the past six or seven years now.
“We put out a notification post on social media. Sometimes, I post on Facebook, and sometimes I post on WhatsApp. The girls will chat you up themselves.
“The average age for donation is 18. Also, we don’t use virgins. The reason we insist on girls from 18 is because we know that by that time they are disvirgined, so it is just from 18, 20 years to 26 years for our donors.
“We also allow multiple egg donations, it can be done every three months, so in a year, you can do it up to three times depending on what you want.
“Before the hospital uses anyone, they go through medical checks. They do scans to check your eggs. Sometimes, after they have done some tests and scans, we let them know that their eggs are not even enough, or that they are weak.
“Basically, the ladies are like incubators, we just need their womb to build up what we want because the injections they take are what forms the eggs that we need.
“The collection day is the day we remove the eggs and give them to the surrogate mother or the woman that will carry the pregnancy. But during the process, most of the donors are allowed to go home. Some hospitals will ask them to come to the hospital every day to take the injection at the same hour, others will give you to take home after they teach you how to administer it. You will only come back maybe after five days to do a scan and to do a check-up and see if the person is doing well.”
Also weighing in on the inherent dangers of the collection process, she revealed that it is not a surgical procedure. “It is just like ‘Dilatation and Curettage’, D&C. They go in through the vagina and remove the eggs. The girls are not aware though because they would be put to sleep. The entire collection process is not up to an hour, but during the two weeks preceding the time, they must not have sex, they also can’t drink alcohol or smoke. The reason for abstinence during that period is that once they have unprotected sex and pregnancy occurs; the pregnancy is very dangerous because it will usually result in multiple babies. That is why most people that do IVF give birth to triplets or quadruplets.”
Advising donors, she stated that “My usual advice is that they do it not more than three to four. I have seen someone do it four and five times. I had a lady then who told me she had donated at Lagos State University Teaching Hospital ((LASUTH) twice, and at another hospital in Lekki, Lagos before coming to me. I think she did it up to five times.
“It is not advisable to do it too many times. Too much of everything is not good. That way, you won’t also start looking for people that will do for you in the future.”
Her position was corroborated by a fertility nurse practising in the United States of America, Mrs. Chinny Reuben. She said, “Unfortunately, while egg donation is not my exact area of expertise, there is a limit to how many times eggs can be donated by a woman. Eggs can be donated six times in a person’s lifetime. That’s the guidelines set by the American Society of Reproductive Society.
“While it may be something new in Nigeria, egg donation is encouraged and has been practised outside of Nigeria for years, and based on what I know about the process, once the egg collection is done at a reputable clinic there are no inherent dangers.
“But I must say that people should not refer to the process as ‘harvesting’ because it adds negative connotation to an otherwise positive action.”
Dr. Oyinlola Ahmed, a medical practitioner in a government-owned hospital in South West Nigeria, however, holds a different opinion.
While speaking to Saturday INDEPENDENT, he said, “Egg donation is not entirely safe. As we grow, eggs deplete. A one-time donation is fine, multiple donations are dangerous. This is because they usually have to use egg-stimulating drugs for them, and this could lead to so many issues like ovarian failure, Polycystic Ovary Syndrome (PCOS), ovarian insufficiency and problems like that.
“Some disreputable clinics do it illegally, and it is in places like that you find women who have done it up to seven times. I don’t know if the medical council is doing anything about it. But my advice to any young woman thinking of donating just for money is to not do it at all because that one time may be the start of problems that money won’t solve.”
Again, despite Nigeria’s huge population and high fertility rate, why are fertility clinics booming?
The fertility rate in Nigeria is estimated at 5.4, implying that an average Nigerian woman can have at least about 5 children during her lifetime. However, many Nigerian couples are experiencing infertility, which is creating a huge market for reproductive health practitioners to latch on.
While some believe that it is a level of insanity to donate eggs for the paltry sum being paid by fertility clinics in Nigeria, Dr Enifeni Abimbola, a psychiatrist states that the mental state and the mental capacity of a person are two different things.
“If someone is prone to guilt, or a lot of rumination, later on in life, if for example that person decides to have a child and for any reason, they find it difficult, it is possible for the person to look back and feel guilty about what has happened, and that can make them feel bad. So, there is the possibility of being prone to trauma or anxiety. It may not always lead to depression though because there will be other things.
“It is not a single thing that leads to depression, usually, it is a confluence of events but it could be significant, especially in the context of someone who used to donate a lot and then eventually cannot have a child. It is possible that such a person will feel guilty about it and they can feel depressed.
“You also have to look at it from the perspective of those who are donating, and whether they have a history of mental health concerns before donation. Do these fertility clinics screen for that? And if they do screen for that, are they donating in the context of an episode or them not feeling particularly well and have they been supported?
“I know there is a small percentage of women who afterward have menstrual irregularities or issues in that area. Lots of women talk of mood changes and swings, now think of adding a lot of these drugs that hyperstimulate and do other things to somebody who is prone to having maybe mood swings. Doing all of these things could compound it. So, have the fertility clinics that collect the eggs put structures in place to support ladies like this? These are the questions.
“I believe there should also be some form of guidance that sets out the minimum standard for egg donors, looking at their physical and mental state, and giving them the appropriate support. Most importantly though, donors must be allowed to have informed consent. These things need to be regulated so that you’re not just taking things from people with the impression that you have paid for them.
“Finally, in all of this, is the person donating already pre-disposed to having a mental health concern? We all are, really, but some people are more pre-disposed than others. By donating, one must be sure that if things go wrong, it won’t precipitate or tip this person over.
“One of the reasons this is important in this clime is because of how we are in Africa. We are still a bit primal and very communal, we don’t look at it in a logical sense of things. There might still be a lot of sentiment in it because for the donors it can feel like they are giving a part of themselves away. That is why giving donors the right kind of information to let them know the consequences of their actions and every single thing that may happen is important to help them make better, informed decisions. As a professional, you must have a duty of care, and this is why regulation needs to be in place to protect donors.”
A retired police officer resident in Port Harcourt, Rivers State revealed that one of the dangers posed by the fertility clinics is the issue of organ harvesting and child trafficking.
Pleading anonymity, he said, “As a security person, I am not particularly worried about the legality as much as the consequences of flooding fertility clinics with eggs. This opens the market to child traffickers and organ harvesters who are in the business for the long term.
“Unlike with adoption where the parents undergo scrutiny and all kinds of checks to protect the children, those who donate eggs do so to the highest bidder, whether their intentions are good or bad.
“Child traffickers and organ harvesters can pose as needy parents and get these eggs implanted in their agents. The children are then raised solely for their organs. It is a long con, but it can happen. Our laws are not sophisticated enough for the problems egg donations can create.”
For Litigation lawyer, Adetunji Adegboyega, the position is the same. “From the Nigerian perspective, I do not think that Nigeria presently has enough laws to regulate that industry.
“For me, the thing that I would want to bring out is that in law there’s a maxim that says ‘Volenti non fit injuria’ (to a willing person, injury is not done). This means that when you voluntarily consent to something, there cannot be an injury, and you cannot go to claim injury.
“What I think will regulate a situation like this is the agreement between the parties because obviously, they would have entered into a contract, which would list out the terms and conditions. As long as both of them agree to the contract, the agreement will be valid and legal.
“But we also need to understand that as much as there are no specific laws that are regulating egg donation, the position of the law remains that you cannot agree to do something that is illegal. So if there are no specific laws regulating this or criminalising this, the parties can come to an agreement that this is what we want to do and then each person states their own liabilities and their responsibilities.
“It is it’s an act of survival, and people will go to any length to survive. I believe that as our country develops, our laws also need to develop alongside to be able to match it, make provisions for it and regulate it properly because you’ll find out that anything you do not regulate properly will subject people to criminal practices and unhealthy medical situations. Even though it is not criminalised, I believe that it’s something that we really need to regulate.”
Further research reveals that the only legal framework that comes close to governing egg donation in Nigeria is the 2014 National Health Act. Section 53 of the Act criminalises the exchange of human tissue and blood products for money, even allowing for a fine and/or up to a year’s imprisonment for those convicted. However, that law is not public knowledge, hence the laxity in its enforcement.
During a visit to a fertility clinic, Saturday INDEPENDENT discovered that while poverty is the main bane of these young women, the clinics take all steps to protect themselves from litigation by a thorough form-filling process that ensures that donors sign away their complete rights to the clinics who may sometimes even violate the rules of practice by not giving donors adequate information to enable them to make informed decisions in the case of multiple donations. They further ensure that the egg collection process is termed donation as against selling.
With these issues, many postulate that the Nigerian fertility rate of the future may be in serious jeopardy.
