MINNEAPOLIS — Caitlin Karolczak sees it as a classic case of supply and demand. After all, one of her eggs goes to waste every month, so she might as well share it with a woman who can use it.
She thinks the $8,000 she can get is a reasonable price for helping someone create a life. "If you give something away, they won't cherish it," she said.
Much has changed since the first test-tube baby was conceived in a petri dish in 1978. Today, Karolczak, a 24-year-old Minneapolis artist and antique dealer, is a bit player in a $3 billion business that is thriving on the Internet. It is also being transformed by advances in medical technology and new competition among clinics promising miracles to couples often desperate to have a child.
But as it flourishes, some are warning that the freewheeling marketplace is turning the creation of human life into a commercial enterprise that cries out for consumer protection. Nowhere is this more evident than in the exploding market for human eggs, where there are few laws protecting the rights and health of donors and parents.
Though women like Karolczak are called egg donors, most are well-paid. Couples in parts of the country offer fees of $20,000 or more for the eggs of educated, attractive young women.
"The first donations were sister-to-sister," said Linda Hammer Burns, a psychologist at the University of Minnesota and an expert in infertility. "Now it's an industry."
She worries that clinics and egg-donor agencies are increasingly motivated by money rather than the best interests of patients, donors and the children they create. "Doctors are putting money first," she said. "If you turn someone down, it's a patient walking out the door."
Web sites are making finding a donor egg as easy as shopping for a car. Egg brokers are assembling detailed databases of young women — their hobbies, religion, education — willing to hand over their eggs. They are marketing package deals to their customers that include medical and psychological screening of egg donors.
Some fertility clinics are even offering money-back guarantees if the couple fails to conceive.
And now, scientists are working on freezing eggs — a technique that, once perfected, promises to propel the industry into even more rapid change.
Karolczak was donor 8447 on the Web site created by Egg Donation Inc., one of the largest egg-donor agencies in California. The site says it's the place "where dreams come true." It's also a place where the supply and demand for human eggs come together.
This year, Karolczak's picture was one of nearly 1,200 photos that pop up on the site like electronic baseball cards: Sarah, 24, blue eyes, blond hair; Ashley, 21, brown hair, green eyes; Caitlin, 23, blue eyes, brown hair.
The increasing demand for eggs is fueled by the growing numbers of older women who want children but who find, too late, that their ovaries have quietly failed them. "It's a social phenomenon we are seeing worldwide," Burns said. "Women are postponing childbearing."
Ten percent of couples are unable to conceive on their own, and many are turning to donor eggs. Minnesota has five clinics specializing in fertilization, all clustered in the Twin Cities and Rochester and attracting patients from across the Upper Midwest. Donor-egg prices are lower there than in Boston and Los Angeles, where eggs can go for $20,000 or more.
Lyne Macklin-Fife, program administrator for Egg Donation Inc., said that when she got into the business a dozen years ago, donors primarily wanted to help other women. They were happy getting paid $2,500 or less. But as the prices increased, the motivation changed.
"Donors are becoming savvy," she said. "In the big scope, girls are doing it because it helps with their finances."
Today, the fees are driven primarily by couples on the coasts who are willing to pay high prices for "our crème de la crème kind of lady," Macklin-Fife said. That's a woman who has successfully donated — or "cycled" — three or four times, "has a phenomenal health history, Ivy League academics and is very attractive."
Health plans, which routinely control quality and pricing and set treatment standards in other areas of health care, seldom pay for in-vitro fertilization, commonly known as IVF. That process, in which an egg and sperm meet outside the body in a petri dish, is the only way to get pregnant with a donor egg.
So would-be parents pay the fee to the egg donor themselves, in addition to the $15,000 or more that goes to the agency for insurance, and the donor's medical and legal costs.
Karolczak said she found the Egg Donation Inc. Web site a few years ago when she was a student at the University of Minnesota. She sent in her profile and waited a year before the agency contacted her, saying a Los Angeles couple had chosen her to be the biological mother of their baby. Karolczak flew to Los Angeles for medical, genetic and psychological screening.
The couple paid her $6,000, an average fee for first-time donors in the Egg Donation Inc. database, and the woman is now pregnant, Karolczak said.
The second couple paid her more — $8,000 — because she was a proven donor. After injecting herself with fertility drugs every day for six weeks, Karolczak flew to a Los Angeles IVF clinic, where she produced 16 eggs at once.
The husband's sperm and her eggs were combined in a petri dish and during the next few days grew into embryos. Karolczak said some were frozen and some were implanted in a surrogate carrier the couple also hired because the woman was unable to carry a child.
She has heard since that the surrogate miscarried and the couple plans to try again with the frozen embryos. Given the chance, she would donate again, Karolczak said.
"I think it's great," she said. "Men have always been able to spread their genes. Now I can spread my genes."
THE LOCAL ANGLE
In 2006, Gov. Janet Napolitano vetoed the Legislature's attempt to make it a crime for women to sell their eggs for cloning research.
She said the proposed law was "an unwarranted intrusion into the medical decisions of women — and only women."
The legislators had refused to try imposing similar restrictions on men selling their sperm.