The Egg

The human egg is a precious resource, exchanged in markets open, gray or black. To tell its story, we follow a teenage girl in India, lured into selling her eggs; a model in Argentina whose genetic makeup is prized; a mother in Greece, told by police that her eggs were stolen; and two “egg girls” from Taiwan who have put themselves at risk to earn money in the US. By Natalie Obiko Pearson, Jessica Brice, Susan Berfield, Vernon Silver, Kanoko Matsuyama, Cindy Wang, Sinduja Rangarajan and Fani Nikiforaki

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:01):
The egg a single cell, a global business worth billions,
a trade that can bring rewards or human costs that
cannot be measured. The human egg is a precious resource,
exchanged in markets open, gray or black. To tell its story,
we follow a teenage girl in India lured into selling

(00:22):
her eggs, a model in Argentina whose genetic makeup is prized,
a mother in Greece told by police that her eggs
were stolen. And two egg girls from Taiwan who have
put themselves at risk to earn money in the US.
By Natalie Obiko Pearson, Jessica Bryce, Susan Burfield, Vernon Silver,

(00:43):
Kanoku Matsuyama, Cindy Wang, Sinduja Ragarajan, and Fani Nikiferaki Read
aloud by Mark Leedorf. Chapter one, The teen don't tell
your mother. She wakes early, then waits quietly for her
mother to leave for work. The nurse in the gleaming

(01:03):
glass building in Baranasi, India, had told her to arrive
by seven a m. So she doesn't have much time.
Her fingers working quickly, she drapes asari across her adolescent frame,
making her look older and curvier than the salwar Camille's tunics.

Speaker 2 (01:19):
She usually prefers.

Speaker 1 (01:21):
She's tired of these trips, but this one on October eighth,
twenty twenty three, will be her last. For ten days,
she's been sneaking to an upscale fertility clinic to receive
injections that trigger her ovaries into mimicking the monthly reproductive
cycle that typically readies a single egg for fertilization. In
her case, the powerful synthetic hormones were meant to deliver

(01:43):
not just one egg, but a cash to be sold
in the lucrative global market for humanova. That stash is
more valuable than anything among her family's modest possessions. Today,
the cash is.

Speaker 2 (01:55):
Ready for retrieval.

Speaker 1 (01:57):
Her ovaries are teeming with follicles, each swet to more
than half an inch and ready to release a mature egg.
By law, egg donors in India must be at least
twenty three, but her only piece of identification, a school
record from the state government, shows her as thirteen. The
truth is she doesn't know her age, and neither does

(02:18):
her mother. This isn't particularly unusual at the lower rungs
of Indian society, where millions of births go unregistered. The
girl is in seventh grade. To get around the law,
she must present as a woman. For this, she has
help her grandmother's neighbor, a woman named Sema, is a
fixer of sorts, an agent. According to police records, it

(02:41):
was Seema, the girl will say who put all this
in motion. Seema persuaded her to sell her eggs. Seema
had her pose for a photo for a fake id.
Sema drilled her on the story she had to tell.
Wedded with two children, on the raft of forms for
the clinic, Sema had her own husband sign off as
the girls spouse. The girl trusted Sema, who told her

(03:03):
she could earn as much as fifteen thousand rupees about
one hundred and eighty dollars for a gift of life.
It's a paltry sum, but for the girl it would
be enough to buy what she longed for, a smartphone,
so she heeded SEMA's advice, don't tell anyone, not even
your mother. The girl comes from a family of sweepers
in Varanasi, relegated by cast to cleaning up the detritus

(03:26):
of Hinduism's holiest city. Her mother is the family's pillar,
working long hours at a doctor's office to raise her
three daughters. The teen is the middle daughter, the light
of the family. Chatty with a sharp wit. She likes
to put on make up and borrow her sister's phone
to post videos to Instagram and Snapchat, imagining a future

(03:47):
beyond her home in a cramped settlement perched precariously along
a railway track. The clinic belongs to another world, one
with money and the hope it can buy. We will
make your dream of building a family come true. A
billboard on the building says, inside for a shot at
getting pregnant, dozens of couple sit ready to part with

(04:08):
ten twenty times what donors get paid for their eggs.
As the girl arrives on this morning, Sema waits with
another woman named Anita, who hands her a fake government
ID showing her as twenty four according to police records.
The women press of vermilion bindi onto the teen's forehead,
clasp a Mango sutra wedding necklace around her neck, and

(04:30):
adjust her sorry. As a finishing touch, they put a
toddler in her arms. Sema ushers the girl into the clinic.
The girl is scared, and no matter what the paperwork says,
there are signs that something's amiss. There's the adolescent plump
to her cheeks. She holds one child and claims to
have another at home, but the ultrasounds she's undergone could

(04:52):
raise the question of whether she has any at all.
Then there's Sema, who keeps talking over her, prompting the
doctor to order the older one out of the counseling room.
The doctor wants to talk to the girl alone. Her
heartbeat races. The doctor asks why is she selling her eggs?
How long has she been married? How many children does

(05:12):
she have? The toddler squirms in her lap, fighting waves
of panic. She clings to the story she needn't have worried. Soon,
she's whisked into an operating room and put under anesthesia.
When she comes to, only a nurse is there. The
girl asks if it's okay to leave.

Speaker 2 (05:30):
The nurse says yes.

Speaker 1 (05:32):
Outside, Sema and Anita are waiting. Anita withdraws fifteen thousand
rupees from a nearby atm. Sema takes a cut, and
then the girl goes shopping, buying a cheap Oppo smartphone
with the remaining eleven thousand, six hundred rupees. Her case
could have ended there passing unnoticed, like tens of thousands.

Speaker 2 (05:51):
Of egg extractions in India every year.

Speaker 1 (05:54):
But in Varanasi's less fortunate neighborhoods, where there's little space
between one small concrete hut and the neck, and conversations
drift through window openings with no glass, secrets don't stay
secret for long. Competition is fierce among agents in Varanasi,
and days after the retrieval, an argument erupts in the
street between Sima and Arrival. They bicker loudly over who

(06:17):
had first rights to the girl and who was entitled
to the thirty four hundred rupee commission. A crowd gathers,
and in this crowd, among those listening is a member
of the girl's family. Chapter two, The Model an explosion
of stars. On a chilly Thursday in June, Karen Pets

(06:38):
takes a black uber to a fertility clinic along a
busy street in Buenos Aires. She wears an olive green
granny knit sweater cropped short on her long torso. Her
belly is swollen. It's getting uncomfortable to walk. She says,
my ovaries are pushing on my organs. She presses four
fingers into her lower abdomen and pushes back. Karen is

(07:00):
tall in the US. I think you would say six feet,
she says, one hundred and eighty three centimeters. Her eyes
are a watery green, her hair long and blonde, like
many tall women. She hated this trait right up to
the point it turned into an asset. Years back, when
she was modeling clothes in Chile, her agency told clients
her look was aspirational, as in, she is what other

(07:23):
women aspire to. The sun isn't fully up. When Karen
walks into the wee Feve clinic at thirty one, she'd
retired as an egg donor, but a couple in Mexico
had said they were desperate for a donor just like her,
and so Karen agreed to provide her eggs one more time.
When her US based agency asked her to make an exception.
In an industry void of broad regulation, one thing doctors

(07:47):
generally agree on is that no one should donate more
than six times. To day will be Karen's seventh. She
checks in and is escorted into an elevator up three
floors to a private patient suite. She changes into a
white waffle robe and waits for a nurse to come
claim her with a wheelchair. Then it's up another floor
to answer a checklist of questions. Have you eaten anything

(08:09):
this morning? Have you ever had a bad reaction to anesthesia?
Are you wearing contact lenses? It's a routine that five
to six women take part in daily, always in the morning,
six days a week. Most are having their own eggs
harvested for future in vitro fertilization treatments, but a growing
number are here to help fill the clinic's egg bank.

(08:30):
With its large European population, weak currency, and liberal laws
around reproductive issues, Argentina has become an important producer of
eggs for both the domestic market and export. Fees for
donors like Karen, college educated, good looking, athletic, charismatic range
from two thousand dollars to well, the sky's the limit, really,

(08:52):
says Natalia Bazile, wee Thieve's co owner and chief embryologist.
The most we ever had a donor ask for was
seventy five thousand, forty five. Minutes after arriving, Karen is
rolled into Weefeve's surgical suite. An operating table with stirrups
sits off center. A thirty five centimeter needle waits atop
a steel cart on the ceiling. An explosion of stars

(09:16):
is projected from a light machine tucked in a corner.
It's the last thing she sees before the anesthesia kicks in.
It's bustling but quiet, as two doctors and three nurses
play parts performed so often its now second nature. On
the wall, a screen displays the transvaginal ultrasound of Karen's
right ovary after a two week regiment of hormones. It's

(09:38):
swollen four times in size. Beneath the projection of stars,
the grainy image could be a moonscape poked with a
dozen dark craters. Each crater is a follicle. Wee Thieve's
chief physician guides the needle through the recesses of Karen's body,
piercing the vaginal wall to reach the ovary. One by one,
the follicles are drained.

Speaker 2 (09:59):
Of the liquid.

Speaker 1 (10:01):
Karen snores, the craters disappear from the screen. Karen squirms,
and a nurse adjusts her back into position. The fluid
is deposited into vials. There's a nurse whose only job
during the procedure is to spirit those vials away to
a lab connected to the operating room. At either end
of the lab, an embryologist peers through a microscope and

(10:23):
sorts eggs from liquid that's the color of watered down blood.
The courier nurse delivers a vial to the first station,
returns to the operating room to retrieve another, then drops
it off at the second station. It goes on like
this for twenty five minutes. In and out one and two.
Karen's procedure ends. The final egg count is still being

(10:43):
tallied when another woman takes her place on the operating table.
It's a lot, Bazili says.

Speaker 2 (10:49):
In the lab. We knew it was going to be.

Speaker 1 (10:51):
You can tell on the ultrasound, but we also knew
based on the patient's history what to expect. Karen is
a super producer, someone whose body reacts so strongly to
the hormones that it turns out far more than the
typical fifteen to twenty eggs. The first station's numbers are
in twenty six eggs. How many you got over there,

(11:12):
Santi Buzzy Lay shouts across the lab. Embryologist Santiago Giordana
at the second station checks a Petrie dish with a
cluster of just visible gray specks in the center seventeen.
He yells back, and that's why Karen is so popular.

Speaker 2 (11:28):
Buzzi Lay says.

Speaker 1 (11:29):
For the next hour or two, these forty three eggs
will rest in a culture medium, then get a quick
rent in an enzyme solution that will eat away their
protective cellular covering. Sixteen won't be mature enough and will
be discarded. The remainder will be frozen in a process
known as vitrification, and stored for several more weeks until
they're ready for an intercontinental trip spanning almost eight thousand miles.

(11:54):
A Bloomberg Business Week reporter will follow them from operating
room to journey's end. By the time the twenty seven
eggs reached their destination, they will have generated revenue for doctors, agents, airlines, lawyers, counselors, couriers, insurers,
and drug companies. Karen is paid thirty five thousand dollars.

(12:17):
Chapter three, The mother tracking codes.

Speaker 2 (12:22):
For Maria.

Speaker 1 (12:22):
It's already a bad sign that two police officers have
summoned her to their station. When they say the woman
with them is a psychologist, she braces for the worst
as the four take seats in February. All Maria knows
is that the matter relates to the birth of her
three year old child, the happy result of in vitro fertilization.
Maria is a pseudonym. She shared her story but asked

(12:45):
that we withhold her name. Four years earlier, Maria had
gone to a fertility clinic near her home on the
Greek island of Crete to have eggs retrieved. She wasn't
donating her eggs. As a smoker in her late thirties,
she'd have been a poor candidate if that had been
her intention. She just wanted to have a child. But
now these police officers, members of a national organized crime unit,

(13:10):
are saying she'd been lied to. The clinic staff had
told her they'd harvested a half dozen eggs, but the
real number was twice that.

Speaker 2 (13:18):
The police tell her.

Speaker 1 (13:20):
The other eggs had been used to create embryos for
another woman. This news devastates Maria. To her it means
she might be the mother of another child. The psychologist
is here to help her process the news. For Maria,
questions swirl how many other children might have been born
of her eggs?

Speaker 2 (13:38):
One, three, none?

Speaker 1 (13:42):
And how is this allowed to happen? The police are
also summoning other women delivering similar news. Most like Maria,
live in and around Hanya, a seaside tourist town that
had become an unlikely hub of the global fertility industry.
The Mediterranean Fertility Institute or MFI, was a magnet for

(14:02):
aspiring parents from nations with restrictive assisted reproduction laws. To
make babies, the clinic needed eggs.

Speaker 2 (14:10):
The police in these.

Speaker 1 (14:11):
Visits want to nail down a key detail from women
whose names have shown up and seized records.

Speaker 2 (14:17):
Did they ever give.

Speaker 1 (14:18):
Permission to surrender some of their eggs? The officers ask
Maria what happened at the clinic in early twenty twenty.
Maria reconstructs the day her eggs were retrieved, then asks
questions of her own. Yes, the police tell her clinic
records show it actually had been her eggs and her
husband's sperm that produced her child. That part had gone normally. Unfortunately,

(14:41):
the police tell her records indicate her remaining eggs became
a donation to another woman, and no, they don't know
if the other woman had any babies using Maria's eggs.
Who is this other woman? Maria is led to believe
the police no, but can't say, partly because of a
Greek privacy law surrounding eg egg and sperm donation. But

(15:02):
while the police don't give a name, they do offer
something else. The clinic had assigned tracking codes to the
women passing through. Egg donors received six digit codes IVF
patients four digit codes. Maria already had her own code.
Before she leaves the station, police give her another, the

(15:22):
code for the woman who got her eggs. Chapter four,
The egg Girls Eggs three point thirty earnings one hundred
and sixty thousand dollars. She was a young woman in
Taiwan it would have been twenty eighteen, a graduate student
on her own, an extroverted intuitive type on the Meyers

(15:44):
Briggs personality test, a feminist. She liked being independent, but
she felt poor. She wanted a job with a high
CP value or cost performance, which is what young women
in Taiwan sometimes say when they consider taking a calculated
chance to become happier, better off. She searched online for
a quick way to make money. The first possibility nightclub escort.

(16:09):
The second egg donor ten thousand dollars for one cycle
in the US. Oh, she thought it's quite big.

Speaker 2 (16:17):
Money.

Speaker 1 (16:18):
Amber, the name she's chosen for this story, is now
thirty years old. She's a translator and a competitive Vogue dancer,
and an egg girl, the term Taiwanese used to describe
the hundreds, maybe thousands of women who sell their eggs.

Speaker 2 (16:33):
In the US.

Speaker 1 (16:34):
The buyers usually come from China because it's illegal to
make these kinds of arrangements. There in the middle are
recruiters and agents, doctors and nurses. Amber is fine with
calling it a market place. She's gone through eleven cycles
in the US, sold about three hundred and thirty eggs,
earned one hundred and sixty thousand dollars, worked with four agents,

(16:57):
four clinics, two egg banks, and at least nine Chinese families.
She's in a cafe in Diamond Bar, California, in May,
five days after her latest retrieval, eating noodles and wearing
black pants, a crop top, frayed jean jacket, orange lipstick.
That is, she looks comfortable. She says, she feels good.

(17:18):
The daily shots and clinic visits, the enlarged ovaries, swollen feet, sleepiness,
and anxiety. Their memories. Thirty three eggs of hers are
in the lab sixteen thousand dollars deposited in her bank account.
Tonight she's clubbing with friends. Egg donation is legal in Taiwan,
but women are allowed to do so only once if

(17:40):
a baby is born as a result, and they can
be paid only about three thousand dollars. Easy decision for
Amber in twenty eighteen. If I'm going to do the
same thing, why don't I choose the place where the
price is higher?

Speaker 2 (17:53):
But everything else.

Speaker 1 (17:54):
That first time made her nervous. She didn't know any
other egg girls, she hadn't ever traveled to the US,
and now she'd have to lie to pass through customs.
She had to trust her agent, a Chinese American woman
she'd never met in person whose last name she didn't
know would be parents tend to want the eggs of
someone who's relatively tall and slim and well educated, someone

(18:18):
who might resemble the mother, maybe plays the violin or tennis.
The specifications can be exacting. Amber submitted photos that made
her look friendly, videos that made her look cute. She
took genetic tests and blood and urine tests, had physical
and gynecological exams, a psychological evaluation. She did all this

(18:40):
without telling her parents. They wouldn't have approved. When Amber
had to take a car alone from the Los Angeles airport,
when she had to pinch a fold of skin over
her left ovary, take a deep breath and inject the
stimulation medication herself, when she felt bloated and ugly. When
she thought of giving up, she told herself, I'm here

(19:00):
for the money. I can do this thing. And when
the doctor said he'd extracted thirty four eggs, Amber knew
she'd do this thing again. A successful retrieval meant she
could ask for more money next time. My eggs are
like a treasure. Over the next six years, Amber learned
about the trade and the trade offs. Once someone said

(19:21):
to her, the thing you do is not about donation,
it's a business. Don't say it so pretty. Amber replied, yes,
I'm doing a business. And so what right? Because I
think about the injection, the egg retrieval, so many inconveniences,
so much is uncomfortable, and also the pain right, Amber
has learned anyone can be an agent. There's no exam

(19:44):
to pass, no medical experience or legal training required. Many
agents are former donors in the US. They can operate
in the open, even if some Chinese American agents prefer
not to. In Taiwan, agents exist in a liminal space,
phibited from brokering the sale of eggs, but seemingly able
to match a young woman with would be parents, collect

(20:06):
a fee, and never be named in the contract between them. Also,
the US industry guideline limiting donors to six cycles is
rarely enforced. There's no way for a clinic to track
retrievals elsewhere. If a nurse asks how many times Amber
has donated, she always says four. Then the nurse might
remind her of the recommendation. After that, Because the clinic

(20:28):
also wants to make money, they won't purposely raise this question.
She says, she's learned she has power. That's why she's
worked with different agents. If one can't find her a
match when she's available at the fee she desires, she
turns to another. Where the money is. That's where I am,
Amber says, laughing. Her highest fee twenty five thousand dollars,

(20:51):
the most eggs extracted fifty two. Her best investment Crypto,
especially ether. Her worst experience donate Nation number five forty
four eggs fifteen thousand dollars. She was in so much
pain after the retrieval that she had trouble lying down
to sleep. The danger of that kind of pain or

(21:11):
worse goes up with the number of eggs harvested. More
than fifteen eggs and the risk of getting what's called
ovarian hyperstimulation syndrome increases more than thirty and the risk
increases even more. AMBER doesn't worry about that. Every egg
girl coming to the US must contend with another potential obstacle,

(21:32):
Customs and Border Protection. AMBER has learned how to deal
with that too. The young women arrive on travel documents
that don't allow them to work or earn money. Immigration
officers can turn anyone away if anything seems suspicious. The
women's agents coach them on how to answer likely questions.
They tell the women to book the airplane tickets themselves,

(21:53):
delete sensitive emails, remove the whee chat app altogether, where
plane clothes skip makes. They should have a vacation itinerary,
sometimes even a hotel reservation. When asked for a local contact,
they shouldn't write the clinic's address, as did one donor
who was turned back, but still they might be taken
to the room for questioning. Customs may say, don't lie

(22:17):
to me.

Speaker 2 (22:17):
Anymore.

Speaker 1 (22:18):
I know you are here to work to make money.
And then Amber says, some donors just tell them everything.

Speaker 2 (22:25):
Not Amber.

Speaker 1 (22:26):
She's been taken to the room twice. The second time,
an immigration officer scrolled through her phone for half an hour,
reviewing two years worth of bank statements. She told him
she was there to visit friends she danced and competed with.
She showed him videos of her voguing.

Speaker 2 (22:42):
He let her go.

Speaker 1 (22:45):
Chapter five thirty five billion dollars in growing. Every fifteen
seconds or so, a batch of eggs is extracted from
a woman somewhere on the planet. Most IVF treatments involve
women using their own eggs. In at least six percent
of cases, the eggs come from donors, the fertility industry's term,
who agree to have their eggs removed, often in exchange

(23:08):
for money. The donors are recruited into a thirty five
billion dollars and growing global market for assisted reproduction. This
market comprises would be parents, agents, doctors, and clinics, many
of the latter backed by Wall Street and private equity. Globally,
more than one hundred and twenty thousand embryos were created

(23:28):
with donated eggs in twenty nineteen, almost double the number
in twenty eleven. According to the International Committee from Monitoring
Assisted Reproductive Technologies, the real number is certainly much higher.
Not all countries reliably monitor this, and the numbers don't
include India. An analysis of data from Barat Serums and Vaccines,

(23:50):
one of India's largest fertility drug makers, shows an estimated
ninety five thousand rounds of IVF using donor eggs occurred
in the country just in twenty twenty three. The demand
for eggs extracted from younger women is likely to increase
as more older women try to have children. As women age,
the number and quality of their eggs decline. The egg trade,

(24:12):
which operates with minimal regulation across borders, thrives in open markets,
gray markets, and black markets. When the rules or circumstances
change in one country, foreigners are banned from using surrogates
in India, war shuts down fertility tourism. In Ukraine, Chinese
couples are permitted more than one child, but forbidden to

(24:32):
buy other women's eggs. The contours of the business changed too.
Those who want children seek help in Greece instead of India,
Argentina instead of Ukraine. Egg donors have few advocates and
few laws to protect their health or prevent their exploitation.
In the US, the Food and Drug Administration requires that

(24:53):
donors undergo a physical exam, including tests for infectious diseases,
and provide their medical history. On that clinics are expected
to comply with guidelines set by a fertility industry trade group,
the American Society for Reproductive Medicine. The guidelines recommend, among
other things, that donors receive mental health counseling and get

(25:13):
their own legal review of all contracts. The ASRM also
suggests that donors undergo only six retrievals. That's meant to
reduce the chance of complications. The short term risks of
hormonal stimulation range from discomfort to in rare cases, death,
The long term risks of repeated egg donation are unknown.

(25:34):
That's not an accident, says Robert Klitzman, a professor and
director of the Master of Science and Bioethics program at
Columbia University. They are making millions off women who are
making thousands, He says, if they did the research, they
might find out there are long term harms that may
decrease the business and the amount of money they can earn.

(25:56):
Chapter six, The model You should do It. An old
friend of Karen's, also a model, sold her on the idea.
Karen was living in Santiago and working as a research translator.
Kenya Iost, who'd recently moved to Mexico, was in town
for a wedding when they ran into each other. I

(26:16):
just got back from Los Angeles, Kenya told Karen, explaining
how she'd been paid six thousand dollars for her eggs.

Speaker 2 (26:23):
You should do it.

Speaker 1 (26:25):
Social media is full of ads offering compensation for eggs.
Influencers dance in front of clinics on TikTok or hype
egg donation on Instagram between posts about lip filler and
breast implants. But for donors who command the highest prices,
word of mouth is everything. Kenya herself had been scouted

(26:45):
by a fitness influencer who'd undergone the procedure and got
a referral fee for every recruit. In January twenty nineteen,
when Karen was twenty six, she flew to la to
donate her eggs for the first time. She'd be paid
the same as Kenya. She went to one of the
eleven clinics run by Huntington Reproductive Center or h r C,

(27:05):
among the biggest fertility chains in the US. A nurse
turned scout had arranged everything, but on the ride from
the airport, Karen got a text saying the intended parent
had backed out. She had no idea what that meant.
Would she get paid, would her hotel reservation be canceled?
Hours later, another text arrived the retrieval was back on.

(27:27):
A couple in China would buy the eggs instead. It
all felt very sloppy, Karen re calls. Everything about that
situation was wrong. I know that now, but at the
time I had no idea about anything. HRC didn't respond
to requests for comment for this story. When the retrieval
at h r C yielded forty five eggs, word somehow

(27:48):
got out. Within a week, a surrogacy and egg donation
agency named Growing Generations reached out, offering at least ten
thousand dollars per donation if Karen signed with it. Growing Generations,
based in LA asked Karen for childhood photos and her
family medical history. The agency wanted to know her professional aspirations,

(28:10):
her philosophy on life, how she liked to spend her day,
Karen wrote almost a dozen pages about everything from her
work as a model, to her business studies, to her
German heritage, to the marathon she'd recently run. I really
poured my heart into the questionnaire, she says. The idea
that people choose me not only because of my looks,

(28:30):
but because of my personality, it really validates me. Karen's
profile went live in February twenty nineteen. Within a couple
of days, Growing Generations got a call. Someone was interested.
Chapter seven, The Teen a suspicious situation. The family member

(28:52):
who overheard the agent's argument tells another relative, who in
turn tells another relative. Word reaches the teenage girl's mind.
She discovers the phone her daughter has been hiding and
confronts her. The girl comes clean, the truth spilling out.
On October seventeenth, twenty twenty three, the girl's mother reports

(29:12):
what's happened to the police, triggering an investigation. Police soon
identify the clinic in question a branch of Nova ivf Fertility,
one of India's largest fertility chains, which has been backed
by some of America's most powerful financiers. Nova is owned
by Asia health Care Holdings, which in turn is controlled

(29:32):
by the American private equity giant TPG. Nova's rise was
powered by Goldman Sax Group and venture capitol Giant New
Enterprise Associates. NEA part of a flood of investment into
India as it emerged as one of the world's largest,
fastest growing, and least regulated markets for IVF and egg donations.

(29:53):
Three days after the girl's mother notifies authorities, police and
inspectors working for the state's chief medical lawf officer arrive
at the NOVA clinic. Reading the clinic's file.

Speaker 2 (30:03):
For the girl.

Speaker 1 (30:04):
They're disturbed by what they see. The girl's insurance documents
carried the details of a different patient. She'd been screened
at a lab not registered with the state. One form
said she had one child, another said she had two.
She'd signed an affidavit written in English, but she spoke
only Hindi. This is also a suspicious situation. The confidential

(30:28):
inspection report reviewed by BusinessWeek noted the inspectors also question
how two doctors at the clinic were unable to determine
whether she'd ever given birth. Caesarean sections leave scars, and
vaginal deliveries typically leave signs.

Speaker 2 (30:42):
Such as scar tissue.

Speaker 1 (30:44):
This situation raises doubts on the quality of the entire process.
The report said the retrieval of eggs from a miner
wouldn't have been possible without the active role of employees
and doctors at NOVA. According to the report, the following month,
police arrest five people, Seema and Anita and three male accomplices.

(31:05):
A press release trumpets the bust of a gang that
lured poor women and girls into selling their eggs. It
causes barely a blip of interest. The country's biggest English
language daily publishes a brief on page twelve before disappearing
from the news cycle. Police refused to identify the clinic
that took a child's eggs when making the arrests. Police

(31:26):
confiscate phones from three of the suspects At the all
women police station heading the investigation, a sub inspector opens
their WhatsApp messages and begins scrolling Chapter eight The Mother,
an assembly line of women. It was early twenty twenty,
the first days of COVID nineteen, when Maria made the

(31:49):
quick drive across Kanya to have her eggs retrieved. This
was her third IVF attempt. The first two had failed,
but Maria and her husband felt lucky that writing in
their own ties, they had a clinic operating since nineteen
ninety two that attracted prospective parents from all over the Mediterranean.
Fertility Institute's founder, a Greek gynecologist, had fashioned himself into

(32:12):
a fertility personality, presenting at conferences and cultivating a following
of families who posted baby pictures on Facebook. In more
recent years, he'd been joined by a Greek embryologist, who,
a scientific director, helped expand the operation. They were taking
on a lot of cases a ton, says Sam Everingham,

(32:33):
global director of an organization in Australia that advises clients
on surrogacy and egg donation. Everingham had seen personally and
professionally a shift in the global fertility industry. His family's
own quest for kids had led him to India, where
his two daughters were born in twenty eleven with the
help of two surrogates and a single egg donor, or

(32:53):
so he was told. At the time, India was experiencing
a gold rush, he says, as clinics sprouted up providing
inexpensive fertility services. But in twenty fifteen India banned surrogacy
for foreigners, so did Thailand. Cambodia soon followed suit. The
year before India closed its market, Greece opened its up,

(33:16):
allowing non residents to arrange pregnancies using local surrogates. Positioning
itself as a reproductive tourism destination, Greece promoted its beaches
and relatively inexpensive IVF treatments. By twenty seventeen, more would
be parents from other countries began using Greek clinics. MFI
was by far the most popular Everingham says clients came

(33:39):
to Hanya not just from Australia, but from India, Italy
and the US too. When Maria arrived that day for
her retrieval, COVID restrictions limited who could be in the
waiting room. A drawing of a woman cradling a baby
hung on a wall at the staff's instruction. Maria had
already undergone weeks of tests and appointments, some of which

(34:00):
puzzled her, including a genetic screening for cystic fibrosis. She
was going to use her eggs to attempt a pregnancy,
no matter what the lab results were, so why bother. Nevertheless,
she was ready for what was now a familiar retrieval procedure.
First came the consent form, which she says she recalls vividly,
and included a box to tick if she wanted to

(34:21):
share any excess embryos, which she didn't mark. The form
had nothing on it about eggs, she says. A woman
employed at the clinic at the time as a junior
embryologist corroborated Maria's description of mfi's release forms. Maria awoke
to be told the retrieval was a success. Her eggs
would be fertilized and the embryos frozen to be implanted

(34:43):
in a few weeks. On a spring day, she returned
to the clinic and joined an assembly line of women.
If she ever unknowingly crossed paths with the woman who
got her eggs, there's a chance this was the moment.
The IVF patient cycled through in groups of about a
half dozen each. They were in planted one after another
in a private surgery room, then sent to rest for

(35:04):
fifteen to twenty minutes in an adjacent room lined with beds.
It was so crowded that when Maria emerged from her procedure,
there was no bed to spare, so she sat in
a chair next to a row of other women. Hoping
the embryo would take hold as soon as her group
was done. Another came in chapter nine, The egg Girls

(35:28):
trigger shot. On May twenty first, four days before Amberzegg retrieval,
about seventy miles to the west, Brandy gives herself the
first of at least twenty injections. Two medications stimulate her
ovaries to allow dozens of eggs to grow. A third
prevents her ovaries from releasing the eggs until they're mature

(35:48):
enough to be extracted. Brandy, who's a nurse in Taiwan,
has been through this five times before. She's thirty years old. Confident,
almost nonchalant, she asks to use Brandy as her pseudonym.
When we ask if she might record a few thoughts
before the shots are after, she says why, there's nothing
to tell. She's staying in a room in a home

(36:10):
owned by a Chinese American family in a Chinese American
neighborhood in Thousand Oaks, California. She shares the refrigerator where
she keeps her medication, next to her bockchoy and milk.
The family doesn't ask any questions. Brandy gives herself the shots,
sitting in front of a glass desk covered with her makeup,
hair conditioner, and vitamins, or she gives herself the shots

(36:33):
while standing no big deal. The first evening and each
evening for about a week she gives herself two shots,
then for several days she adds a third. She mixes
one cc of salt solution with seventy five units of minopur,
a medication derived from the urine of postman apausal women,
finds a spot above the right ovary, pinches the skin.

(36:55):
She takes a pen needle with three hundred and seventy
five units of falestem and injects same with a point
five milliliter dose of ganyrelics. Three minutes she's done. She's
made a video of it for her agent, As most
Taiwanese egg girls must proof that they've completed the day's task.

Speaker 2 (37:13):
Then dinner.

Speaker 1 (37:15):
Brandy loves to eat, but when she's working her word,
she's careful lots of protein and fruit and vegetables, milk,
and water. Starting a month before the injections, she takes calcium,
vitamin D and co Q ten, which she says helps
reduce inflammation in her ovaries and maybe prevents the problems
that can come from hyperstimulation. Five cycles and she's never

(37:38):
had any lingering concerns. Every time more than thirty eggs,
she says, the docters and nurses are very happy. It
makes me popular. This is her third cycle at the
HRC clinic in Pasadena. HRC opened in southern California in
nineteen eighty eight, seven years after the first baby was
born in the US using in vitro fertilization. Its doctors

(38:01):
have long been early adopters, quick to seize opportunities. They
helped women over fifty become pregnant when few others would.
They've treated more than one Bravo reality TV star.

Speaker 2 (38:13):
Now.

Speaker 1 (38:13):
HRC Fertility Management, which oversees the clinics, is owned by
one of the biggest Chinese fertility companies, Genshen Fertility Group,
which trades on the Hong Kong Sock Exchange. About one
third of the cycles HRC performs are for Chinese clients.
Brandy ubers to the clinic several mornings so a nurse
can adjust the doses of her medications if her eggs

(38:36):
are growing too slowly or her body is reacting badly.
The instructions arrive afterward by email. In Mandarin. The discomfort
usually begins during the second week of injections. By then,
Brandy is bruised, bloated, tired. She's relieved when she's told
to give herself a trigger shot of the hormone hCG
or human choreonic gonadotropin on Thursday, May thirtieth at ten

(38:59):
pm exactly, and come in the next morning for a
last checkup. Her cycle is almost complete. Her retrieval will
be thirty six hours later. The clinic is on the
ninth floor of an office building. It's waiting area lit
by chandeliers. We're supposed to meet Brandy that Friday morning,
but she doesn't show. When we reach her later, she

(39:19):
tells us she's cranky and just wants to sleep, but
she'll meet us after her retrieval, which is scheduled for
nine am the following day.

Speaker 2 (39:28):
On Saturday.

Speaker 1 (39:28):
At around ten thirty am, she emerges from the elevator
in a wheelchair, pushed by a nurse. She's wearing a
light white mini dress and smiling. She just made eighteen
thousand dollars. That's almost as much as her annual salary
in Taiwan. She produced twenty nine eggs. She says she's
already feeling better. She's hungry for dim sum at the

(39:50):
restaurant over a platter of barbecued meat. She says she
doesn't think much about the people who are buying her
eggs or the kids they might one day have. I
could be like Confucius with his seventy two students, she says.
But everyone wants to make sure that the donors won't
love their eggs too much. That we understand the eggs
belong to the parents now. Later Brandy will report back

(40:13):
to her agents. One in Taipei is a former model
and nightclub promoter who used to recruit young women to
work in Singapore in bars. Since twenty fifteen, he's been
recruiting them to be egg girls instead and sending them
to his partner outside Los Angeles. She runs an agency
that was among the first to connect aspiring parents in
China with American clinics. In China, fertility treatments are available

(40:37):
only for married heterosexual couples, and surrogacy and paid egg
donation are forbidden. The only way a woman can use
someone else's eggs is if that someone has gone through
IVF herself and shares her unused eggs that's rare for
Brandy's eggs that would be parents will pay her agents
ten thousand dollars. Brandy is already considering another retreat, evil

(41:00):
with a different agency. She thinks putting herself on the
market again might allow her to earn more the next time.
She's hoping for twenty thousand dollars. We'll be right back
with the egg. Welcome back to the egg Chapter ten.

(41:20):
Three hundred buckets of urine. Every morning, starting around six,
older women ride their electric tricycles around the village of
huh in Hubbe Province in northeast China. They stop briefly
at the homes of other older women, where waiting at
front doors are small buckets of fresh urine. Not just
any urine. It must be urine from women who've gone

(41:42):
through menopause because they can produce elevated levels of two
important hormones. The collectors check the quality of the urine
with a paper test strip. If the strip remains yellow,
they'll pour the urine into jugs. Someone then takes it
to be processed by Wychin Biological Products, a privately owned
co company about an hour's drive away. Wachen says it

(42:03):
extracts hormones from tons of urine.

Speaker 2 (42:05):
Every day for drug makers.

Speaker 1 (42:07):
Eventually, those hormones will be the most essential ingredient in
some of the most common fertility drugs used to stimulate ovulation.
The hormones can be synthesized. Demand for the drugs made
that a necessity years ago, but the drugs development depended
on the urine of postman aposal women, and in some
places their manufacture still does. Five hours, three hundred buckets

(42:30):
of urine a good morning for the collectors. Most don't
seem to do this for the money. The collectors who
also give their own urine get paid minimally, but they
aren't complaining. It's something that would otherwise be wasted, so
if it's useful, why not collect it and use it.
One of the women says they don't know the names
of the drugs created from it, fertility medicine of some kind.

(42:53):
The contributors receive a token of appreciation, some salt, a
bag of laundry detergent, turn trash into treasure, goes a
line on the packaging, and let a mom Help a
future mom Chapter eleven. The model like scrolling on tender
Alice Kempton was thirty two and newly married when she

(43:14):
and her husband Paul, asked a cousin for a favor.
Alice had been born without ovaries. If she wanted kids,
and she did, she'd.

Speaker 2 (43:23):
Need an egg donor.

Speaker 1 (43:24):
But in her native Australia, donors must be someone you
have an established relationship with and must be motivated only
by altruism. I'm ready to help. The cousin said she
wasn't the ideal candidate. Donors over thirty five are considered geriatric,
and the cousin was thirty six. A woman has up
to two million eggs at birth, but by her mid

(43:46):
to late thirties, fewer than three percent remain. In twenty seventeen,
a fertility specialist in Melbourne retrieved twenty eggs from the cousin.
Fewer than half were turned into embryos using Paul's sperm.
Over eighteen months, Alice went through seven IVF cycles. Two
didn't take, but five did. They all ended in miscarriage.

Speaker 2 (44:08):
It was full on for a while there.

Speaker 1 (44:10):
Bang Bang Bang, Alice recalls her longest pregnancy made it
to fourteen weeks. When they asked the cousin to donate
a second time. She declined, I can't go through that again,
she told them. For many Australians, the journey would have
ended there. Paul and Alice Kempton instead tapped into a
growing global industry that caters to struggling couples from parts

(44:33):
of the world where egg donation is heavily restricted or
cost prohibitive. They turned to the US, valuing, in Paul's words,
the country's transparent capitalism. Paul is a commercial real estate advisor.
Alice a veterinarian, whimsical and gregarious. Alice was on Big
Brother in her twenties and has long been an avid runner.

(44:54):
With blonde hair and blue eyes, she wanted an egg
donor who looked like her and had a similar lifestyle.
In the US and elsewhere, donor agencies serve as match makers,
posting exhaustive online profiles that would be parents can search
the deep dives into donors lives can be innocuous, what's
your favorite color, favorite food, or at times intrusive. Do

(45:17):
you have a lot of body hair, a history of
sexually transmitted diseases. Some agencies hire photographers to portray their
egg donors in a soft maternal way. Others feature photos
of women in racy attire. Alice signed up for as
many catalogs as she could, paying annual subscriptions of as
much as a couple hundred dollars apiece. Paul would find

(45:39):
me up at three a m. Just scrolling and scrolling.
Alice says, we're talking thousands of girls. It was like
scrolling on tender. In February twenty nineteen, during one of
her late night hunts, Alice spotted a just uploaded profile
in Growing Generations catalog. It was the candidate they'd been
looking for. Chapter twelve in glass in vitro is Latin

(46:05):
for in glass. In nineteen seventy eight, in England, Louise
Joy Brown became the world's first IVF baby after being
conceived in a petri dish using the egg and sperm
of her biological parents. Her birth touched off a reimagining
of how babies could be made. Next, Australian researchers advanced
a solution for women whose eggs weren't viable. Using hormones,

(46:28):
They prepared the uterus of a twenty five year old
woman in premature menopause for pregnancy, then implanted an embryo
created from her husband's sperm and another woman's donated egg.
In December nineteen eighty three, the woman gave birth to
the world's first child conceived with the help of an
egg donor. Around that time, researchers began experimenting with freezing eggs.

Speaker 2 (46:51):
Success rates were low.

Speaker 1 (46:53):
The human egg is ninety percent water, and when it freezes,
ice crystals can damage the delicate spindle of chromosomes. In
Even as IVF became mainstream, only a few berths using
frozen eggs occurred over the next two decades. By the
early two thousands, a new technology known as vitrification allowed

(47:13):
eggs to be frozen so quickly that the fluid has
no time to form crystals and instead turns into a
glass like solid. In twenty twelve, two of the world's
largest organizations representing fertility practitioners back to the technique. Vitrification boomed.
In the US alone, the number of fertility procedures using

(47:33):
frozen donor eggs or embryos tripled from twenty twelve to
twenty twenty one to twenty six thousand, seven hundred, according
to the Centers for Disease Control and Prevention. Now, eggs
can be frozen on one continent, fertilized and implanted.

Speaker 2 (47:48):
On another.

Speaker 1 (47:51):
Chapter thirteen, the teen one hundred rupees for a fake ID.
As the police officer scrolled through the Whatsze messages, fake
ID after fake ID pops up on the screen. The
teenage girl wasn't an isolated case, and Nova wasn't the
only company using donors with forged documents. In the world's

(48:13):
most populous nation, demand for eggs is insatiable. About fifteen
hundred fertility clinics are registered, with possibly thousands more in operation.
India's biggest chain, in Dera, IVF, conducts about forty five
thousand cycles a year, more than half the number for
the entire UK, the birthplace of IVF, and while donated

(48:35):
eggs are used in a small percentage of embryo transfers worldwide,
more than a dozen doctors in India told us that
at their clinics it can range from thirty percent to
fifty percent. Cultural demands fuel the business. Indian women face
intense pressure to procreate. At a Hindu wedding, a priest
blesses a bride by wishing upon her eight sons. Once married,

(48:57):
the relentless needling begins. Arbeta good news cob de rajijo
or child, When will you bring good news? Everyone feels
entitled to weigh in on an intimately private issue aunties, cousins, neighbors, shopkeepers,
taxi drivers, the watchmen. Over time, the questions turn into recriminations.

(49:19):
In conservative, rural areas, where a woman's standing is already precarious,
infertility is the height of shame. Fertility clinics may offer
an antidote. In two thousand and nine, a New York
based private equity firm GTI Group started Nova as a
hospital chain in EA invested the next year. The year

(49:40):
after that, Nova entered the fertility sector, opening three clinics.
In twenty twelve, Nova formed a partnership with a well
known Spanish fertility chain now called EVRMA. That same year,
Goldman Sachs invested. It would eventually become one of the
biggest shareholders. The investors pushed for expansion. In a few years,

(50:02):
five clinics grew to twenty one. Garcia of Alasko, evrma's
global chief scientific officer, who traveled regularly to India evaluating
clinical standards, tried to push back, warning that embryologists couldn't
be trained fast enough. The pressure to grow was tremendous.
Garcia of Alasko recalls we were thinking about the damage

(50:23):
to the brand if anything went wrong. By twenty eleven,
Nova was losing money, and its partnership with EVRMA fell apart.
Goldman and other investors sold out to the current owner,
the TPG unit. A new chief executive officer cut costs
and returned Nova to profitability. The number of Nova clinics
tripled in five years, growing to more than seventy. Among

(50:47):
them was a clinic built in a five story commercial
building at a bustling intersection in Varanasi. With the increase
in clinics came a web of agents, who, in many
cases wedged themselves between a rich person's desks inspiration for
a child, and a poor woman's desperation for money. Anita
told police she'd worked as a cleaner at a fertility

(51:07):
clinic and saw that women made good money selling their eggs,
so she sold hers. Then she became an agent, persuading
other women to sell theirs and taking a cut. Sema
likewise went from donor to agent. When Sema recruited the
teen and discovered she needed ID, Anita told her not
to worry to just send a photo of the girl.

(51:30):
Anita had a go to person for fake IDs, a
young man who worked in a cyber cafe. She told
police he'd won Anita's business by underbidding her prior forger.
When police interrogated him, he was as forthcoming as Anita.
According to police records, he said Anita paid him one
hundred rupees about a dollar and twenty cents for a

(51:51):
fake ID and two hundred and fifty rupees for a
fake affidavit. He also said she'd initially asked him to
falsify one or two cards every few days, but that
quickly turned into a torrent as many as one hundred
a month. In December twenty twenty three, a month after
the arrests, NOVA sent a letter to the National Ministry

(52:11):
of Health saying it was deeply concerned about the rise
of fake IDs in the sale of human eggs. The
exploitation of ocyte donation through fraudulent identification poses a significant
ethical and legal challenge, NOVA warned, describing the risk as systemic.
The statements from those arrested in the girl's case indicated

(52:32):
that at least a half dozen agents were part of
the same informal network funneling donors to fertility clinics across Varanasi.
Those clinics, according to their statements, also included Burla Fertility
and IVF, part of the three billion dollar Indian manufacturing
conglomerate c K Burla Group, and Indira IVF, which is

(52:52):
controlled by one of Europe's largest private equity firms, EQT.
Burla Fertility and IVF didn't respond to requests for comment.
Indira IVF, in an emailed response, said it has no
involvement in the alleged activities mentioned, nor any connection to
the individuals who were arrested. The company said it has
strict protocols to prevent such fraud. Goldman, Sachs, NEA and

(53:17):
EQT declined to comment. Nova told BusinessWeek it had cooperated
with local authorities and cut ties with an egg bank
whose employee was among those arrested. It disputed an assertion
in the Chief Medical Officer's report that doctors should have
been able to determine the girl was under age, calling
that an impossible task. TPG deferred comment to Nova. Identification

(53:41):
of fake official documents is something beyond our expertise and
we are unfortunately impacted by this deceitful operation, Nova said,
in effect, we are a wronged party here. The company
sent a follow up letter to the Health Ministry in August,
urging it to introduce more robust oversight measures. It didn't
hear back, it said. The Ministry didn't respond to multiple

(54:04):
requests from Business Week seeking comment. Chapter fourteen, The model
Sperm on the Barbecue.

Speaker 2 (54:13):
Dear Karen.

Speaker 1 (54:14):
The letter began, this is Alice and Paul Kempton from Melbourne, Australia.
We are very honored that this journey has led us
to you. Alice had found the perfect donor. Still, she
thought it was weird not to know the woman who'd
contribute half the genetic make up of the children she
longed to have, and so in her letter in May
twenty nineteen, she proposed they meet something donors and recipients

(54:38):
rarely do. They were both going to be in Portland,
Oregon at o RM Fertility, Alice for her IVF treatment,
Karen for her egg retrieval. Karen's boyfriend was traveling with her,
but she didn't ask him to join their meeting. She
considered what she did with her eggs to be her
decision alone. It's an egg, not an embryo. In August,

(55:00):
Intended parents number twenty five twenty five and egg donor
number thirty three fourteen twenty seven met at a local restaurant.
Karen and Alice chatted for hours, bonding over their shared
interests marathon running, farm living, and the reason for the
restaurant choice pizza. The Kimptens had to borrow the money

(55:20):
to pay for everything. They'd paid growing generations seventeen thousand,
five hundred dollars to find them a donor. Karen's fee
was an additional twenty five thousand dollars plus fifteen thousand
dollars in travel costs. The clinic charged forty thousand dollars
add in expenses for their own plane tickets, hormones for
both Karen and Alice, which ran about one thousand dollars

(55:42):
a month, plus several weeks of lodging, food, and a car,
and their debt exceeded one hundred and seventy thousand dollars.
Alice was worried Paul was still recovering from a flu
that had hospitalized him the previous month, with a fever
topping one hundred and five degrees fahrenheit. She asked the clinic,
should we freeze the eggs and wait for him to
get healthy before the sperm collection. They asked Paul to

(56:05):
start taking a male fertility supplement and then following a
sperm analysis, assured the Kemptons everything would be fine. Alice
says the retrieval went incredibly well. Fifty one eggs nineteen
were successfully turned into embryos. Once created, an embryo is
incubated for about five days until it turns into what's
called a blastocyst with an inner cell mass that could

(56:28):
become a baby and an outer layer that could become
the placenta. Then it's either implanted fresh or, as in
the Kempton's case, frozen so genetic testing can be performed.
For five days, the Kemptens explored Portland. Then the doctor's
assistant called and delivered devastating news. Not a single one
of the embryos was viable. To Alice, the loss felt

(56:51):
like a death. She shouted and cried. She spent the
next twenty hours on her laptop reading every medical paper
she could find. She came away with one conclin illusion.
Of course, it was never going to work. Alice says,
Paul had fried those sperm on the barbecue for way
too long. John Hesla, medical director of O r M,
told us in an interview. We work with compromised sperm

(57:13):
all the time. We thought it was a reasonable plan
to move forward. The clinic agreed to do the entire
procedure over again for free.

Speaker 2 (57:21):
All of us, especially me, are.

Speaker 1 (57:23):
Extremely disappointed and saddened with the result. Hesla wrote to
the Kemptons in an email seen by BusinessWeek, I have
directed the business office to authorize a second IVF cycle
with Karen's eggs to create more embryos without charge to you.
Karen also offered to donate again for free. Unlike Amber
and Brandy, the women from Taiwan, Karen says she doesn't

(57:46):
see this as a marketplace or what she's doing as
a sale. I don't sell my eggs. I've never sold
my eggs.

Speaker 2 (57:53):
She says.

Speaker 1 (57:53):
It's an opportunity to help, but Growing Generations wouldn't allow it.
The Kemptens and Karen say the agency also declined to
waive its fee, and instead it offered a twenty percent
discount for this story. Growing Generations didn't respond to written
requests for comment. The reason for the additional agency fee
and contract is because you are cycling Karen for an

(58:14):
additional donation, and every donor is limited to five or
six donations. Jessica Junyent, then Growing Generations vice president for
International Development and Karen's point person at the agency, said
in an October twenty nineteen email to Alice. As a business,
we rely on being able to cycle most donors multiple
times in order to make financial sense of everything we do.

(58:37):
Junyent continued, it doesn't seem right or fair to say
we should do this for free or hand our donor
over torm to bypass Growing Generations, the Kemptens had to
come up with even more money now their debt was
approaching a quarter of a million dollars. In December twenty nineteen,
Karen underwent a second egg harvest for the Kemptens. In

(59:00):
any IVF cycle, the math is rarely kind. Thirty six
eggs were retrieved, nineteen embryos were created four past genetic
testing after five miscarriages. Alice prayed that just one of
the embryos would make it. Chapter fifteen, The mother Egg theft.

(59:22):
Imagine you bring a rock embedded with diamonds to a
jeweler scans show an unclear number of gems inside. The
jeweler disappears to his workshop and emerges later with good news.

Speaker 2 (59:33):
Ten diamonds.

Speaker 1 (59:35):
You'd have to trust that, but maybe the actual.

Speaker 2 (59:38):
Count was higher.

Speaker 1 (59:40):
The same is true with an ovary when a patient
is under anesthesia when the doctor extracts the eggs. It's
only him, says a Greek law enforcement official. A woman
coming too is in no position to question the count,
and clinics have sometimes taken advantage. For three decades, the
egg trade has contended with egg theft, and for three decades,

(01:00:01):
different jurisdictions have found their laws and regulatory practices ill
equipped to handle the threat. In nineteen ninety five, an
investigation by the Orange County Register revealed that at a
fertility clinic at the University of California at Irvine, eggs
were being taken from patients without their consent and used
to make other women pregnant. The UC system paid more

(01:00:23):
than twenty four million dollars to settle lawsuits filed in
the aftermath, but at the time, no criminal statute in
California covered the clinics alleged egg theft. One reason there
was no saying definitively what the eggs were worth. Afterward,
the state passed a law making it illegal to steal
human eggs. In Israel, a doctor admitted taking hundreds of

(01:00:46):
eggs from IVF patients without their consent from nineteen ninety
six to nineteen ninety nine.

Speaker 2 (01:00:52):
The doctor took two.

Speaker 1 (01:00:53):
Hundred and thirty two eggs from one patient alone and
diverted them to thirty three other women. No law law
specifically prohibited his actions, but in a disciplinary proceeding his
license was suspended for two and a half years. Today,
he's the founder of an annual conference, the World Congress
on Controversies in Obstetrics, Gynecology and Infertility. In Italy, a

(01:01:16):
doctor was arrested in twenty sixteen after a woman told
police he'd removed her eggs without consent during a procedure.
He was convicted and received a six and a half
year sentence, which, for health reasons, he was allowed to
serve under house arrest. In Crete, regulatory authorities were aware
of possible problems at the Mediterranean Fertility Institute a year

(01:01:38):
before Maria's eggs were collected. In twenty nineteen, the Hellenic
National Authority for Medically assisted reproduction. Acting upon a complaint,
dispatched two doctors and a lawyer to conduct an inspection
of mfi's clinic. The inspector's checked files involving the clinic's
surrogacy program. According to Immanuel Lascarides, the lawyer, in the end,

(01:01:59):
he said, we were sure that these were not all
the files of the clients they had. The team voted
two to one to suspend mfi's license for improper recordkeeping,
but the suspension went unenforced, and in the fall of
twenty twenty, the Greek parliament abolished the authority. In twenty
twenty one, the government named a new president to lead

(01:02:19):
a reconstituted version of the agency, Prominent Athens fertility expert
Nicolaus Rachnice, the lone inspector who'd voted against suspending mfi's license.
MFI stayed open, with more women passing through Chapter sixteen.
The egg girls. The price of an egg. Brandy can

(01:02:42):
ask for twenty thousand dollars for a retrieval, Amber can
make as much as twenty five thousand dollars. It's been
possible for young women to sell their eggs in the
US for decades, but it hasn't always been this profitable.
For that, the egg Girls and thousands of others owe
a woman named Lindsay Kamakahi in nineteen eighty four, when

(01:03:03):
few practices in the country offered to help patients use
someone else's eggs. The price compensation is the industry's preferred
term for a batch of eggs, was about two hundred
and fifty dollars. By nineteen eighty seven, it was five
hundred dollars by nineteen ninety three, about fifteen hundred dollars.

Speaker 2 (01:03:20):
For the buyers. It was still a bargain. Then.

Speaker 1 (01:03:23):
In nineteen ninety nine, an ad appeared in the newspapers
of top universities for a five foot ten athletic woman
who'd scored at least fourteen hundred on her SAT she'd
be paid fifty thousand.

Speaker 2 (01:03:35):
Dollars for her eggs.

Speaker 1 (01:03:37):
By then, ASRM, the fertility industry trade group, had begun
to reckon with this growing market, saying the amount paid
to donors should not be so excessive as to constitute
coercion or exploitation. In two thousand, it advised members that
compensation shouldn't be so high as to suggest people are
paying for a donor's ethnicity or personality or achievements. To

(01:03:59):
determine fair payment, the trade group did some strange math.
It started with what sperm donors earn in an hour,
multiplied that by the number of hours required of egg donors,
then added an arbitrary amount to account for the additional
physical and emotional burden. The result sums of five thousand
dollars or more required justification, and sums above ten thousand

(01:04:21):
dollars go beyond what is appropriate. In two thousand and seven,
Kamikahi sold some eggs after college. She'd moved to California,
where she donated blood and plasma regularly. She realized people
needed eggs too. That's what I have, and that's what
you need. She was matched with a couple who were
Asian American academics. She shared the same background. Before she

(01:04:45):
went in for the retrieval, they gave her a gift,
a blue cashmir scarf with a card. She says she
also received sixty five hundred dollars, which she thought was fair.
At the time, she already had two jobs, one to
support herself, the other to fund travel. The extra money
would make a trip to the Netherlands possible. Kama Kahi

(01:05:05):
had male friends who'd sold their sperm and so for fun.
They compared their earnings over the years. It was about
the same. Given the ease of donating sperm versus the
hardship of donating eggs, that didn't seem fair. By chance,
one of those friends was dating a woman who worked
at a law firm that wanted to challenge asrm's donor

(01:05:25):
compensation limits as price fixing. Kamakahi looked at how clinics
treated sperm donations and bristled, the guys can do it
for the money, and there's no cap on how much
they can make. The girls must be nurturing. It's a donation.
Just say it's a transaction. She agreed to be the
lead plaintiff in a twenty eleven antitrust case alleging that

(01:05:47):
ASRM was keeping prices artificially low and that clinics were
benefiting a buyer side conspiracy. According to legal documents, ASRM
declined to comment. I wasn't financially motivated to file this lawsuit,
Kamikahi told us in her first time speaking publicly about
the case. It was just that girls were getting the

(01:06:07):
short end of the stick. How come, it's the women's
job to care. In twenty sixteen, the case was settled,
and by the end of the year, ASRM had removed
its guidelines on compensation, egg donors would be able to
earn as much as an aspiring parent was willing to pay,
and aspiring parents in China were willing to pay quite
a lot. The government had just ended its one child policy.

(01:06:31):
Older parents who wanted a second child, and many others
traveled to the US, especially to California, where they could
take advantage of legal protections and services not permitted at home.
Soon Amber and Brandy and other egg girls were traveling
to the US too. Brandy received eleven thousand dollars her
first time in twenty seventeen. Two years later, Amber earned

(01:06:54):
seventeen thousand dollars for a cycle market mechanism. She says,
chapter seventeen, the teen She's just resting. Years before the
teen in Varanasi was persuaded to sell her eggs. A
woman named Yuma Sherpa moved from Darjeeling to Delhi. Sherpa

(01:07:15):
worked in a garment shop making little money. In late
twenty thirteen, a woman approached her with an offer she
could sell her eggs for twenty five thousand rupees, the
kind of money it would take months to save, and
enough to allow her to visit her three year old daughter,
who lived with relatives in the Himalayan foothills. With Sherpa's
silky hair, fair skin and almond shaped eyes, her eggs

(01:07:37):
would quickly find a buyer. Without telling her husband, Sanjur Rana,
Sherpa said yes. On January twenty ninth, twenty fourteen, around
four p m. Sherpa arrived at an IVF clinic. Some
days before, she'd told daughters that the hormone injections had
caused her discomfort and she wanted to back out. The
clinic told her it was too late. She had to

(01:07:59):
move ahead. Her eggs were harvested in less than ten minutes.
From the recovery room, she phoned Rana, sounding distressed, Come quickly,
she told him. When Rana arrived at about seven fifteen pm,
Sherpa was unresponsive. She's just resting, staff told him. According
to court records, an hour passed, a doctor finally examined her,

(01:08:22):
and then an ambulance was called.

Speaker 2 (01:08:24):
It was now ten pm.

Speaker 1 (01:08:26):
She was transported to a hospital, arriving there without a pulse.
Shortly after midnight, she was declared dead. An autopsy determined
Sherpa had died from ovarian hyperstimulation syndrome OHSS. Her ovaries
had tripled in size, blood and fluids leaked into her
abdomen and pooled around her heart and lungs. Such fatalities

(01:08:48):
are avoidable through judicious use of hormones and careful monitoring
of patients. A case report later concluded. Since the early
two thousands, when India became a popular destination for fertility treatments,
a pattern had taken hold, a scandal followed by calls
to regulate, followed by nothing. Sherpa's death made headlines, but

(01:09:09):
interest soon waned.

Speaker 2 (01:09:11):
The following year.

Speaker 1 (01:09:12):
In twenty fifteen, the Delhi Medical Council determined that the
doctor who oversaw Sherpa's retrieval didn't appear to be negligent.
The council settled the matter as a rare complication. Its
sole rebuke was that the clinic, owned by New Life
Global Network had used an agent to find an egg donor.
New Life, which offers fertility services on four continents, didn't

(01:09:34):
respond to requests seeking comment. Two years later, in twenty seventeen,
the Delhi Medical Council heard another matter. A whistleblower complaint
alleged that doctors at the country's premier public research hospital,
the All India Institute of Medical Sciences, New Delhi, had
extracted thirty eggs from an IVF patient and without her consent,

(01:09:55):
given fourteen to two other fertility patients. According to Council
documents obtained by BusinessWeek, it was another case of alleged
egg theft. This is completely unethical. The complaint alleged. The
doctor who'd implanted the eggs in the other patients, Nita Singh,
said in a phone interview that she was told by
staff that the patient had given consent. She called it

(01:10:17):
a small procedural lapse for which she'd been unfairly blamed.
The Delhi Medical Council, citing the gravity of the lapse,
ordered that Singh be suspended.

Speaker 2 (01:10:26):
For a month.

Speaker 1 (01:10:27):
The National Medical Commission overturned the decision and instead led
her off with a warning. In December twenty twenty one,
India passed a law to regulate assisted reproductive technology. A
key step was establishing a national board to advise the
government on policy and create a code of conduct. Sitting
on that board is SINGH Chapter eighteen. OHSS. Ovarian hyperstimulation

(01:10:54):
syndrome or OHSS is a nyatrogenic disorder that is an
illness caused by medical treatment itself. The treatment in this
case is the hormones egg donors and IVF patients take
to induce superovulation. A mild case can mean abdominal pain, nausea,
and diarrhea. A severe case can lead to blood clots,

(01:11:15):
fluid filled lungs, a twisted ovary that could cut off
its own blood supply. Death from OHSS appears to be rare.
OHSS still isn't fully understood, and it often goes unreported.
The European Society of Human Reproduction and Embryology says mild
OHSS affects as many as thirty three percent of IVF patients.

(01:11:37):
The American Society for Reproductive Medicine says moderate to severe
OHSS occurs in one percent to five percent of IVF cycles.
In the Australian state of Victoria, a strictly monitored market,
auditors found that clinics had been reporting only a third
of OHSS cases that required overnight hospitalization from twenty eighteen

(01:11:58):
to twenty twenty one. Follow up care for egg donors
is inconsistent, so we don't know how often they experience OHSS. Overall,
younger women and those who produce more than fifteen eggs
a cycle are particularly vulnerable. That describes many donors, Amber, Brandy,
and Karen among them. Some clinics try to get as

(01:12:19):
many eggs as possible, especially for their egg banks, by
providing higher doses of medication, says Diane Tober, a medical
anthropologist at the University of Alabama and author of economics
the global market in human eggs and the donors who
supply them. In the US, the Centers for Disease Control
and Prevention collects a wealth of data from fertility clinics

(01:12:40):
and makes public their rates of success, that is, live births,
but it refuses to disclose how frequently IVF patients and
donors at each clinic experienced medical complications. Bloomberg has filed
a Freedom of Information Act lawsuit seeking to compel the
public Health agency to do so. The CDC says it
doesn't comment on pending litigation. Chapter nineteen the model twenty

(01:13:06):
four hours in custody. Karen sat in a windowless room
of the Miami International Airport. Feeling scared and exhausted. She'd
been escorted there following a nine hour flight from Buenos Aires.
Her phone and Argentine passport were confiscated. A federal immigration
agent bombarded her with questions about her trip and tourist visa.

(01:13:28):
Why are you in the US just visiting? Who were
you visiting?

Speaker 2 (01:13:32):
My boyfriend? What's his address?

Speaker 1 (01:13:35):
Karen didn't know exactly Somewhere in Atlanta. Why is your
connecting flight to LA again? She had no easy answer.
It was October twenty twenty, and Karen was making her
fifth trip to the US to have her eggs retrieved.
She'd last donated seven months earlier at an HRC in
southern California, when sixty eggs were retrieved, the most of

(01:13:56):
any of her procedures. Now in the middle of the
pan pandemic, flights into the US had been slashed and
immigration officials had stepped up screening. Officially, they were looking
for signs of sickness, but unofficially, the extra scrutiny made
it easier to pick apart stories that didn't add up,
and Karen's wasn't adding up. On previous trips, Karen says

(01:14:18):
she'd been coached by her agency, Growing Generations to keep
the details vague when passing through immigration and to tell
anyone who asked that she was on vacation. Growing Generations
didn't respond when asked about this. Official searching, Karen's phone
found WhatsApp exchanges referencing her contract. When confronted, she confessed,
I finally admitted, Okay, yes, I know I said I

(01:14:41):
was on vacation, but that contract is why I'm really here.

Speaker 2 (01:14:45):
She says.

Speaker 1 (01:14:46):
She spent twenty four hours in custody. What am I doing?
She recalls thinking is this really so bad that they
are going to treat me like a terrorist? Karen's entry
into the US was denied. I had to fly back
to Argentina. Karen would eventually complete the donation in Buenos
Aires and the eggs were shipped to HRC. She developed

(01:15:08):
a mild case of OHSS and had to rest for
several days until the fluid in her ovaries cleared up.
Karen didn't get her phone back until she boarded her
flight home. When the plane touched down, she powered it up.
Her WhatsApp flooded with messages from the Growing Generation's rep
wondering why she hadn't made her connecting flight from her boyfriend.
From her friend Kenya. There was also a message from

(01:15:31):
Alice Kempton. Paul and I are parents, she said, sharing
a photo of a healthy baby boy. They'd named him Rupert.
We love you, Alice said so much. Karen started crying.
That for me was a sign. Karen says, it was
telling me what you are doing is not bad. It
allowed for this baby to be born. Chapter twenty, The

(01:15:56):
Mother Wire taps Russiassi of Ukraine disrupted the global egg trade,
imperiling a key supplier. In February twenty twenty two, staff
at Ukrainian Cryobanks stuffed canisters of frozen genetic material into
cars and sped them across the Polish and Slovakian borders.
One destination was the MFI clinic in Honya, which announced

(01:16:19):
it would provide safe keeping, despite the Greek regulator's earlier
findings that the clinic should shudder. Mfi's profile was only growing,
with donors and surrogates coming in, prospective parents coming in,
frozen eggs coming in. The Assisted Reproduction Authority, in response
to a request for comment, didn't directly address why its
suspension order hadn't been enforced. That same year, the Greek

(01:16:43):
National Police's organized crime unit began looking at a property
in Knia where the clinic housed pregnant surrogates. The police
launched an investigation in December twenty twenty two, with court
permission to tap phones of clinic staff. On February twentieth,
twenty twenty THREEFI staff put a Bulgarian woman under anesthesia
to retrieve her eggs. She suffered severe convulsions and her

(01:17:06):
oxygen dropped. According to police wire taps, the woman lived,
though the extraction was unsuccessful. Police mapped what they said
was a criminal network with the clinic at its center.
In August twenty twenty three, they arrested eight MFI staff members,
including the clinic's founding doctor and its scientific director. Both
remained in jail awaiting possible trial. The doctor's lawyer didn't

(01:17:30):
respond to a request for comment. The scientific director's lawyer
said in an email that a list of questions from
BusinessWeek about the police case contained inaccuracies, but didn't specify
what they were. The clinic recruited vulnerable women from Albania, Georgia, Moldova,
Romania and Ukraine to be egg donors and surrogates and
put them up in more than a dozen houses. The

(01:17:52):
police said in a press release clinic staff falsified medical
and court records and aided in illegal adoptions. The police
VIE also said that in hundreds of instances, the clinic
charged patients for IVF services they never performed, including sham
embryo transfers. Police took control of the clinic, which ceased operating,

(01:18:12):
and genetic material in frozen storage at MFI was transferred
to Kanya General Hospital. The same month, the Greek press
reported that police were investigating the possibility that Raknie, the
man who'd voted against suspending mfi's license and later became
head of the Greek Assisted Reproduction Authority, had taken a bribe.
The police didn't arrest or name Vrachnice, but the government

(01:18:36):
dismissed him within the week. Vrachnice didn't respond to emailed
requests for comment for this story. The police, now with
access to the clinic's files, continued investigating. As they sifted
through handwritten records, they spotted a pattern involving IVF patients
like Maria. Eggs would be retrieved from the patient, some

(01:18:56):
but not all, would be used to make embryos for
her on that day. The same day, a different woman
would receive a donation of eggs equivalent to the number
not used for the IVF patient. The details of this
ongoing probe haven't yet been made public, but in June,
a Crete based prosecutor prepared remarks for a closed door
presentation at the European Union Agency for Criminal Justice Cooperation

(01:19:20):
at the HOGUE. Her remarks, seen by BusinessWeek, revealed that
police had identified as many as seventy five cases of
egg theft at MFI. The final count could be much higher.
A Greek judicial source says, we'll be right back.

Speaker 2 (01:19:36):
With the egg.

Speaker 1 (01:19:40):
Welcome back to the Egg. Chapter twenty one. The model
Hi Lovely. Karen's sixth donation took place in late twenty
twenty one in Cancun, Mexico, where she moved to wait.

Speaker 2 (01:19:55):
Out the pandemic.

Speaker 1 (01:19:57):
Fifty eight eggs were retrieved and the batch was again
shipped to the US. She'd planned for that donation to
be her last. In keeping with health guidelines. In recent years,
Karen had been transitioning from donor to scout. She joined
Kenya and Kenya's husband to found a recruiting firm that
she says is focused on donor well being. They'll stroll

(01:20:18):
beaches eyeing runners and volleyball players while walking right past
anyone who's smoking or drinking. We tell the girls they
should talk to their own doctors, and we really want
to make sure they are represented and understand everything involved.
Karen says, I don't want anyone we work with to
have a bad experience. I worry about feeling responsible for

(01:20:39):
each completed donation. The firm takes a twenty percent fee.
Karen estimates they've recruited about fifty women so far. Almost
two years after her sixth donation, Karen got a voice
message from Junient to tot Growing Generations. Karen was back
in Buenos Aires. She was a few months shy of
her thirty first birthday, past the age agency's internal age

(01:21:01):
limit of twenty nine. Her history of hyper egg production
and past experience with OHSS put her at greater risk
for another bout. She'd already donated almost three hundred eggs
in her lifetime. In the message, Junient asked if Karen
would consider donating once again. She later explained to Karen
that Growing Generations was working on behalf of a same

(01:21:23):
sex couple in Mexico. One partner had a dark complexion
and black hair. The other was Australian, tall, blonde, blue eyes.
That's whose phenotype they wanted reflect it in the egg donor,
but they'd rejected every candidate in the Growing Generations catalog.
We asked Junent about this in October. Why did Growing
Generations ask Karen to donate for a seventh time, counter

(01:21:46):
to the policies outlined on the agency's website. It didn't,
Junient said. If she did a donation, that is on her.
But I did not participate in any donation, said Junient,
who's now a senior associate at the Losties Angela's law firm, International.

Speaker 2 (01:22:01):
Reproductive Law Group.

Speaker 1 (01:22:03):
I can assure you that Growing Generations did not do
a donation with Karen this year. But BusinessWeek saw a
contract dated twenty twenty four and drafted by Junion's law firm,
in which the donor is identified with Karen's six digit number.
The agency handling the transaction is identified as Growing Generations.
We feeve the fertility clinic confirmed that it worked with

(01:22:26):
Growing Generations on the donation, and we also listened to
the voice message Karen received from junent on August sixteenth,
twenty twenty three, about eight months before Junion left the agency. Hi, Lovely,
Junient says, Look, I wanted to let you know that
I just shared your profile with an intended parent. She
wraps up the message with there is a possibility that

(01:22:47):
we could have a seventh donation in Argentina when we
let Junian know all that. She acknowledged Growing Generation's role
in the donation, but said she'd left the agency by
the time of Karen's retrieval and hadn't remembered the initial conversations.
While industry guidelines typically recommend limiting donors to six cycles,
it is common for exceptions to be made, Junyan said

(01:23:10):
in an email, citing the use of exceptionally healthy donors
as an example. Chapter twenty two, The Egg Girls a
van with darkened windows as Amber completed her eleventh retrieval
in the US. In May, another young woman from Taiwan
was completing her first Thirty two eggs were harvested, and

(01:23:33):
two days afterward, the woman developed ovarian hyperstimulation syndrome. Her
doctor in Taichung told us fluid had collected in her
abdomen and lungs, and she had trouble breathing. She had
to be admitted to an intensive care unit in Los Angeles.
Two weeks later, she was able to return home. Her
experience was one reason the health Ministry in Taiwan issued

(01:23:55):
a warning in late July about donating eggs in the US.
The warning the risks, they don't disturb Amber. She's gained
a few pounds from all the hormones, she thinks, but
that doesn't bother her either. With the money she's made,
she traveled this summer to Hong Kong and Tokyo for
Vogue dance competitions. By early August, she was back home

(01:24:16):
in central Taiwan training to swim in a three thousand
meter race across sun Moon Lake. She's expecting to travel
somewhere afterward for one, possibly two retrievals. Sitting in a cafe,
Amber share some surprising information. In addition to completing eleven
cycles in the US, she sold her eggs four times
in China clandestinely on the black market. She went in

(01:24:40):
twenty twenty one on her own. During the pandemic. She
stayed in a big city, which she declines to identify,
until she was ready for her retrieval. Then she moved
into a hotel outside the city that the agent had booked.
She didn't know the name of any doctor or nurse,
or the name of the clinic, or even where it
was located. Apparently she was supposed to. Around half past

(01:25:02):
five in the morning, a van with darkened windows pulled up.
She and five other donors were told to turn over
their phones and keep quiet. Twenty minutes later they arrived
at a four story residence, living room on the first floor,
surgery on the second. Amber says it was well equipped
and the doctor seemed well trained. She produced thirty eggs

(01:25:23):
and was paid thirteen thousand dollars. She stayed in China
for eight months, completing two more rounds. She returned in
twenty twenty three, same routine. She says, it's easier to
get to China, but scarier once she's there. But I
think this is what you have to overcome. She says,
you can choose not to make this money. After fifteen

(01:25:45):
cycles in the US and China, Amber had made about
two hundred and thirteen thousand dollars. Chapter twenty three, the
mother unclaimed eggs. The arrest at the m I clinic
created chaos that rippled across borders. Sam Evingham, the Australian
consultant with clients who went to MFI, now helped them

(01:26:08):
navigate the aftermath. Some prospective parents abandoned their embryos because
they'd either given up on IVF or found the bureaucracy daunting,
he says. Tracing where eggs came from proved impossible. Clients
weren't told who the donors were. Some clients had paid
MFI in cash, meaning they lacked paperwork. They came away

(01:26:30):
without receipts. The tumult reminded Evingham of the fertility industry
he'd left behind in India. He and his partner had
been told the same donor provided the eggs for their
two daughters, but over time they began to have doubts.
I got sick of wondering, Everingham says, so in twenty
twenty three they had their daughter's DNA tested. It wasn't

(01:26:52):
a match. That's happened to a number of US couples
that went to India at the time, he says, and
now he was seeing similar to hermoil at MFI. It
sent goosebumps up my spine. It was terrifying to see
that twelve years later, the same things are happening, giving
vulnerable parents whatever they have on ice. In June, at

(01:27:13):
Hanya General Hospital, an embriologist entered a keypad protected chamber
with a climate controlled unit displaying a steady sixteen degrees
celsius or sixty one degrees fahrenheit. Along the walls were
six metal containers that resembled R two D two from
Star Wars. Temperature monitors, fitted with wires poked from their
tops connecting to online alarms. Each contained genetic material seized

(01:27:38):
from MFI in all eggs, embryos, and sperm from about
nine hundred people. An embryologist, Margherita Levanillu was now their caretaker.
She'd worked at MFI for a decade but hadn't been
implicated in the criminal case. When this frozen collection was transferred,
she came along. When Levanillu unscrewed the top of one

(01:28:00):
droid mist rolled out, she reached in and retrieved a
rod known as a straw. Attached were vials, each labeled
with a code that we were admonished not to photograph.
Were there eggs on this rod? I don't know, maybe
Levannillu said she took a closer look than added yes,
the collection's documentation frustratingly incomplete, made a precise census impossible.

(01:28:26):
Levanniu said about one hundred and twenty five foreigners had
frozen eggs and embryos at MFI. She'd determined about forty
couples from Italy, twenty two from Australia, some from India, Germany, France.
Most of the eggs and embryos remained unclaimed, including many
shipped from Ukraine. Chapter twenty four, The teen small Players.

(01:28:52):
Gopal Krishna sits with the police report that details the
Varanazi girl's case. The pages spread out on his.

Speaker 2 (01:28:59):
Wood veneer desk. It's July.

Speaker 1 (01:29:02):
To the untrained eye, the investigation looks like its pressing ahead,
but Krishna, a lawyer who's representing the family for free,
is skeptical. For two decades, Krishna has worked at Guria India,
a local nonprofit that's helped rescue sex trafficking victims. He
taps at a document in the teenage girl's file, the
report sent by the chief medical officer to police. It

(01:29:25):
had been explicit, saying the incident couldn't have happened without
the knowledge of NOVA employees and doctors. Yet when police
filed their initial report a week afterward, they didn't name
the clinic or a single employee among the accused. He
ticks off questions that could have been answered by now
CCTV footage from the clinic had shown other women entering

(01:29:45):
that day. Had police sought to identify whether any others
were miners?

Speaker 2 (01:29:50):
Where were the girl's eggs?

Speaker 1 (01:29:52):
By law, clinics are required to maintain such records. The
accused told police they'd also sent donors to other clinics.
Had police followed up One chain of clinics in Dira
IVF said it was never contacted by police and learned
of the case from BusinessWeek's inquiries. The judge overseeing Anita's
bail hearing questioned why the case appeared to gloss over

(01:30:13):
the role of the clinic. The owner of the hospital
has never been brought into the picture, just as Sarab
tri Vistava of the Alahabad High Court noted, asking if
the prosecution had deliberately refrained from implicating certain highly influential
personalities to focus on petty employees reached by BusinessWeek. Anita's
lawyer declined to comment. Sima's lawyer, Sanjiv Kumar Chobei, told

(01:30:38):
us there was a big egg donation racket going on
in Varanasi. His client, he said, comes from a poor
background and made little for her role. The main culprit
is the hospital. A year on, Krishna wonders if the
arrest of small players, as he calls them, was all
for show. In twenty twenty two, a year before the

(01:30:58):
Varanasi teen sold her eggs, another girl sixteen years old,
told police she'd been forced to sell her eggs eight
times over the past three years at private hospitals across
southern India. The police investigation languished and the accused were
freed on bail in May. Following questions from BusinessWeek, the
public prosecutor realized that almost two years on, she still

(01:31:22):
hadn't received a copy of the charge sheet from police
to take the case forward. She now says she's planning
to take the case to trial. Chapter twenty five signed
with thumb prints. A thousand miles south of the teen's
home in Varanasi, is the city of Chennai, India's.

Speaker 2 (01:31:41):
Health care capital.

Speaker 1 (01:31:42):
On its outskirts, there's a neighborhood where dozens of women
have donated eggs. We interview four who asked that we
meet outside their homes, away from their husbands. All sold
eggs while in their twenties or thirties, recruited by agents
who supplied donors for fertility clinics across the city. The
women say that an agent, an older woman named Lakshmi,

(01:32:04):
would hover by the communal water tanks where women go
daily to fill plastic bats if she heard a woman
speak of financial struggle, she'd say, I'll tell you an
idea to make money. Will you listen to it. When
we ask why they sold their eggs, one woman says,
if I get money to day, we will eat today.

Speaker 2 (01:32:23):
That's all.

Speaker 1 (01:32:24):
Another says she was too weak to donate blood, so
she donated eggs instead. They speak of debts of husbands
who are alcoholic and abusive, of wanting to set aside
money for daughter's dowries even though such payments have been
illegal since nineteen sixty one. They speak of wanting to
secure a better future for their children, and of wanting

(01:32:44):
to help other women. Because the stigma of infertility spans
India's class divides, they have jobs such as cleaning homes
or sewage drains, or silver plates that pay three dollars
maybe five dollars a day for their eggs, their pay
three hundred dollars or three hundred and fifty dollars. Unable
to read or write, they signed consent forms with their

(01:33:07):
thumb prints. They counted the number of bus stops to
know where to get off for their injections. One woman
says that after donating, my entire body was in pain.
My stomach was cramping. It felt like pens and needles
in the injected area. Would they do it again? What
other option do we have? One woman asks, chapter twenty six,

(01:33:31):
the model eight thousand miles. At the Weefe Fertility Clinic
in Buenos Aires, a small truck pulls into the underground
garage carrying two twenty four pound canisters. One is white
and looks like a vintage steel milk can the other
a light gray could be some sort of heavy artillery shell.

(01:33:52):
The tanks, known as dry shippers, have crisscrossed the globe
many times over This morning, a Monday in July, they'll
begin another journey. The white canister carrying the eggs from
Karen's seventh donation, the other carrying eggs from a donor
Karen recruited, Damian Gustavo. Terrera hauls the canisters up the
stairs to the clinic's lobby, where he hands them to

(01:34:14):
a lab tech in blue scrubs and a floral surgical cap.
Twenty minutes, the tech tells him.

Speaker 2 (01:34:20):
I'll be here, Terrera says.

Speaker 1 (01:34:22):
The tech heads to the clinic's fifth floor, where Karen's
twenty seven eggs have been suspended for thirty two days
in storage tank number forty seven eighty The other donors
are next to it in Tank forty seven eighty two.
With two techs working together, it takes only seconds to
move straws holding Karen's eggs into the dry shipper. The
rest of the twenty minutes is needed to double and

(01:34:44):
triple check that the right eggs are going to the
right place. Terrera gets the canister's back, along with a
plastic folder of paperwork, and drives to a warehouse leased
by Space Courier, a logistics company he co owns. Terrera,
a former bar tender, is squat and bald, with a
passing resemblance to Joe Rogan. A few years back, he

(01:35:06):
bought a stake in Space Courier, joining a sprawling logistics
network that makes the growing global egg trade possible. Space
Courier charges three thousand dollars per export, and lately business
has been good. The egg is the largest cell in
the human body, but it's far more fragile than sperm
or embryos, and extremely vulnerable during transport. If the dry

(01:35:28):
shipper tips over, the eggs might be destroyed. If the
tank goes through an X ray machine, the eggs will
be destroyed. Too much jostling, too much heat, too much
time waiting in customs. The list of threats is long.
At the warehouse, in a third floor walk up, the
documentation for the two egg shipments is laid out on
an old woodworker's bench. The paperwork is thin, single page

(01:35:53):
declarations from Argentina's Health Ministry that nothing can be x rayed,
from Weefeve that nothing is infectious, and from Space Courier
that nothing is explosive. A final page, the shipping waybill,
values Karen's eggs at one hundred and thirty five dollars
or five dollars apiece. These are the same eggs for
which he was paid thirty five thousand dollars. The two

(01:36:15):
canisters get put in boxes. The one for Karen's Eggs
is cardboard about two and a half feet tall, with
arrows saying which end is up. Then it's off to
the airport, where the boxes are put on a dolly
and wheeled through the restricted cargo zone. They sit for
hours among huge bags of lithium carbonate. They're swiped for explosives,

(01:36:36):
sent down a conveyor, packed into a scuffed silver container,
and loaded into the hold of American Airlines Flight nine
fifty four. The flight is an overnight Buenos Aires to
New York. The next morning, the plane touches down at
John F. Kennedy International Airport in Queens in the middle
of a heat wave. Inside the tanks, the subarctic cold

(01:36:56):
hasn't changed To make sure space currier checks censor that
monitors the temperature every second of the trip. US Customs
and Border Protection releases both boxes without a physical inspection,
according to shipping records. An eight hour layover. Then the
two batches of eggs go their separate ways. One heads
to San Francisco. Karen's Eggs will go to Los Angeles

(01:37:19):
on American Airlines Flight three hundred. The box goes up
a conveyor belt into the cargo hold with everyone's luggage.
Six hours later, at Los Angeles International Airport, the box
comes down another conveyor belt. It's lying at an angle.
A burly baggage handler yanks it off the belt and
chucks it into a cargo cart. For an instant it's airborne.

(01:37:42):
With a thud, it lands on its side. The holes
that serve as handles are torn as the box heads
to American Airlines warehouse on the edge of the airport.
It spends the night there among a sea of pallets
and cardboard boxes behind a chain link fence. The heat
is oppressive the following day, when a US Department of
Agriculture agent arrives to investigate a palette of Carolina reaper

(01:38:04):
peppers shipped from the Netherlands. A couple hours later, an
agent from the US Fish and Wildlife Service arrives to
check out a shipment of thirty six styrofoam coolers holding
tropical saltwater fish from Australia. He looks over the paperwork
and randomly chooses a handful of coolers to open and inspect.
At twelve oh five pm, a yellow moving truck.

Speaker 2 (01:38:26):
Rolls up to collect the eggs.

Speaker 1 (01:38:28):
A cargo handler uses a forklift to transfer the box.
Now dented and worn. A delivery driver in a newsboy
cap signs for the package. No government inspection needed, no
visit from the FDA. The agency doesn't review imports of
eggs or sperm at the time of entry, and prioritizes
acting promptly to let them reach women who may be

(01:38:49):
undergoing hormonal treatments, according to a twenty seventeen compliance manual.
HI A BusinessWeek reporter says to the driver, this is
going to sound wild, but I've been and following this
package all the way from Buenos Aires. Do you know
what's inside inside?

Speaker 2 (01:39:05):
He asks? No one ever tells us.

Speaker 1 (01:39:07):
What's inside human eggs. The reporter says, no kidding. He
stops to consider the box alone in the vast emptiness
of the trucks hold. Maybe I should put it in
the front seat, he says, you know, with the seat
belt around it. He ends up fitting it snug in
a corner of the truck's bed, then secures it with

(01:39:28):
a canvas belt. The truck leaves Lax and joins the
crush of cars streaming up Interstate four h five. It's
a forty five minute drive. Low rise apartment buildings and
unkempt brush give way to manicured yards and palm trees.
The truck pulls up to a fertility clinic in Beverly Hills.
A sign sitting on the front desk inside advertises five

(01:39:50):
hundred dollars egg rejuvenation packages. Around the corner is Rodeo Drive.
Fifty seven hours and thirty two minutes after leaving the
clinic in Buenos Aires, Karen's eggs reach their destination. From here,
they may mark a beginning for the couple in Mexico.
Karen doesn't know the couple's names, and neither do we,

(01:40:10):
so this is where our journey ends. Chapter twenty seven.
Nearly impossible to trace. In much of the world, the
cross border egg trade operates with minimal government oversight. BusinessWeek
sought data on egg imports and exports in fifteen countries
through records requests, private vendors, and research reports. It was

(01:40:32):
difficult to draw conclusions beyond this, it's nearly impossible to
trace the flow of frozen eggs or of the donors themselves.
We found that Japan and Spain don't reliably track the
movement of eggs in or out. Canada keeps a list
of companies registered to import eggs, but not how many shipments.

Speaker 2 (01:40:50):
They bring in.

Speaker 1 (01:40:52):
In some countries that track shipments, the numbers show growth
is booming. In Italy, imports of eggs nearly tripled over
five years, reaching seventeen, eight hundred and seventy three shipments
in twenty twenty one. In Brazil, imports increased from only
four in twenty sixteen to two thousand, six hundred and
sixty eight shipments in twenty twenty three. In the US,

(01:41:14):
the FDA maintains a database where clinics and egg banks
are required to register imports. Only sixty four shipments are
listed from twenty eighteen to twenty twenty four. Of the
two shipments we followed from Buenos Aires to California in July,
only Karen's eggs were registered. The eggs from the donor
she recruited were not. When we asked about the discrepancy,

(01:41:36):
an FDA spokesperson confirmed the entry wasn't listed in the
database and said the agency would look into it. Chapter
twenty eight. The mother I just want to know. On
a recent sunny weekday, in Honya, Maria greets a reporter
at the store where she works in the town's bustling center.
An icon of the Virgin Mary holding the baby Jesus

(01:41:59):
hangs on the wall. Asked how she's doing, Maria turns
to her computer screen, opens a web page with Google Translate,
and types a word in Greek on the left hand side.
On the right the result emerges psychologist. She's getting professional help,
but her therapist says there simply isn't an entry in
the psychology manuals for the trauma of having your eggs stolen.

(01:42:22):
Maria compares it to kidnapping, like old stories of women
being told their baby hadn't survived birth when actually they'd
been given away for adoption. They don't even have to
do that anymore, she says, They just take your eggs.
Scenarios rattle around in her imagination. One is her child
grows up and falls in love with someone roughly the

(01:42:43):
same age. Maria will wonder could they be siblings? Will
Maria be on constant lookout for a family resemblance And
if another child was born from Maria's egg, what about
that child's family? The child's mine, but it's not mine,
She says, it's their child. Maria has been thinking about

(01:43:03):
those tracking codes, the one for her and the one
for the woman who received her eggs. She's been pondering
what to do with them. She hopes police will provide
a way of her families to connect with each other
if they want, But if there's no official route, the
women in possession of those codes could act on their own,
perhaps using social media. It could be as simple as

(01:43:24):
a Facebook group where mother's post code one two three
four seeking code six seven eight nine. I don't want
to take their child away from them, Maria says of
the family, which she imagines is as far away as
North America or Australia, or as near as her neighborhood
in Crete.

Speaker 2 (01:43:41):
I just want to know.

Speaker 1 (01:43:45):
Chapter twenty nine, The Egg Girls Retrievals sixteen and counting.
When we talk with Amber again in September, she tells
us about her side business as an agent. For every
match she makes the aspiring parents, it's usually pay her
from two thousand to five thousand dollars. She represents about
thirty donors. She sent many of them to China. If

(01:44:08):
they worry about what might happen there, she promises that
they won't feel any pain under the anesthesia, that their
organs won't be cut out, But now she says they're
cracking down on the business. Local news reports confirm this.
Her main contact in China was arrested, held for four months,
and released in August. He's already been in touch. He

(01:44:30):
said he'd be taking precautions. Better that donors administer the
first week's hormone shots in Taiwan and traveled to China
after less time on the ground may be less risk.
Amber has other plans for her egg girls. Chinese investors, doctors,
and patients have already been shifting to non pen Cambodia.
Travel is easier, costs are lower. Surrogacy is prohibited, and

(01:44:54):
clinics must get permission to operate, but few other laws
govern the Industry's the gray area, she says, but she
can work with that for herself, though she's willing to
go back to China if the timing and the money
are right. In October, she's there for retrieval number sixteen.
She'd rather we not mention exactly where. She says she

(01:45:15):
had no trouble, though she doesn't know how many eggs
she produced. The clinic wouldn't tell her, and she wasn't
going to ask any questions. While in China, she left
with about eleven thousand dollars. Amber has earned about two
hundred and twenty four thousand dollars in all.

Speaker 2 (01:45:31):
Some of that has.

Speaker 1 (01:45:32):
Gone toward her mortgage, tuition to become an English as
a second Language teacher in the US, travel to dance competitions.
After the retrieval, she visited Tokyo and Bangkok. In November,
she told us she had arranged two more, perhaps her
last this spring. Amber will turn thirty one, maybe when
she's thirty four, definitely before she's thirty six. Amber hopes

(01:45:56):
to have a child of her own. A year ago,
she made a deal with an egg in New York.
In return for giving the bank half the eggs retrieved,
she was allowed to freeze the rest for herself for
a decade without charge.

Speaker 2 (01:46:08):
It's a hedge.

Speaker 1 (01:46:10):
When the time comes, Amber hopes she can find a tall,
ivy league educated man Caucasian or Hispanic to provide sperm.

Speaker 2 (01:46:18):
She's prepared to pay.

Speaker 1 (01:46:21):
Chapter thirty the teen a life in ruins in the
year since the girl's eggs were harvested, The phone sheet
coveted has turned out to be a curse. It seems
everyone in Varanasi knows she did something illicit for money.
Few understand what it means to sell eggs or how
it's done. Her own mother initially conflated it with sex.

(01:46:42):
My daughter is a virgin, the mother said in her
police complaint. My daughter has been sold off for some wrongdoing.
The girl dropped out of school after seventh grade, unable
to face the taunts. Neighbours confront her mother in the streets,
blaming her for giving her daughter too much freedom. Whispers
spread the kind of doubts dreaded by Indian women. Can

(01:47:04):
she still have babies? The teen sits in a metal chair,
wearing a white kurta that accentuates hips that have just
begun to widen with puberty. She was good in school,
a quick learner. Her mother is a wonderful cook. But
the girl is content making instant Maggie noodles in a cup.
She has other ambitions. She wants more than the path

(01:47:24):
of wife and childbearer. She used to dream of becoming
a beautician. I want to do something in life, she says.
Now shame gnaws at her. I feel that no one
would even want to get married to me.

Speaker 2 (01:47:37):
She says.

Speaker 1 (01:47:38):
Her voice falters and she presses her fingers into the
corners of her eyes, trying to stop the tears. All
she'd wanted was a phone. I am a kid, I
have the mind of a child. I didn't know that
it was a huge deal. The five arrested have since
been freed on bail. Meanwhile, she sits at home, barely
going out toying, with the phone as her window to

(01:48:01):
the world. She asks why big doctors, held in such
high esteem in Indian society, couldn't discern a child from
an adult. She wonders why she's the one being blamed.
Even her own grandfather blames her for bringing shame on
the family. I was wronged too, she says, her bare
feet kicking the rail of the chair. I want people

(01:48:22):
to understand someone's helplessness, to not take advantage of that helplessness.
Her mother says, whatever happened to my daughter should not
happen with anyone else. Some two thousand years ago, India
gave the world one of its earliest codes of medical
ethics in a body of iervateic texts, including the Charaka
Samhita they laid down for healers, a core principle to

(01:48:46):
help all patients of all means. No one told the
teen that she was never the patient, that she was
only a tool in the service of the real patient.
She barely grasps that by now her eggs may have
been used to create children. She'll never know. One side
walked away with the gift of life. The other got
a one time payment. The fertility industry sells this as

(01:49:09):
a win win. Rarely is it an arrangement between two equals.
Too late, the girl realizes she gave away far more
than she received. Chapter thirty one, The Model Rupert and Matilda.
About an hour southwest of central Melbourne, in a ranch

(01:49:29):
house on two and a half acres of land with
a chicken coop and playground out back, a new kind
of extended family catches up over video conference on a
Tuesday in September. All around are the chaotic markers of
a two toddler home, bibbs hanging to dry, toys strewn about,
a half eaten slice of apple on the couch. Alice

(01:49:50):
Kempton sits on the white leather sofa with a laptop
on her knees orbited by Rupert and Matilda. Rupert is
four Matilda one. Alice, who recently turned forty one, gave
birth to Matilda in twenty twenty three, using another one
of the four embryos created from Karen's eggs. She's already
contemplating baby number three. Paul's not convinced. Karen smiles on

(01:50:15):
screen from seventy two hundred miles away. You're both getting
so big. Do you remember who this is?

Speaker 2 (01:50:21):
Matilda?

Speaker 1 (01:50:22):
Alice asks, do you remember what she gave us? Daddy too?
Matilda responds and her toddler speak. That's right, Alice says,
she and Daddy made the embryo that went into mummy's tummy.
It's not uncommon in Australia for donor conceived people to
know who gave their biological material so they could be born.

(01:50:43):
Several of the country's states have passed legislation giving children
the right to know their heritage. It's a culture that
Alice and Paul embrace. There's a world map in a
corner where Rupert and Matilda can pinpoint where Karen lives
and where the Portland Clinic is. On a low shelf
of books, they can pick one of a half dozen
stories explaining what it means to be a donor conceived person.

(01:51:07):
It's the sort of relationship that many children born from
the technology will never experience. That's especially true as the
industry ships more frozen eggs across borders, many sourced from
nations without strong right to know laws or reliable record keeping.
Karen has donated three hundred and thirty six eggs in
seven retrievals over five years in three countries. At least

(01:51:30):
five pregnancies have resulted. Rupert and Matilda are the only
children born of her eggs, she knows. About ten minutes
into the video chat, both children start to lose interest.
Rupert runs outside and digs for imaginary treasure. Matilda picks daisies.
Alice and Karen are left alone to talk. Alice says

(01:51:51):
she started running again. Karen is training for a trek
and asks for tips. The conversation circles back to Matilda.
Alice says she's starting to see more of Karen in
her We should send new photos to your mum, Alice says.
Karen's phone is filled with such photos, which she eagerly
shows off. Sometimes she seems like a proud aunt. Other

(01:52:13):
times she's an agent trying to persuade other young women
to become egg doners too, With reporting by Rachel Adams Hurd,
Nyla Khan, Lucille lu Kendall, Taggart, smith, A t. Quay,
ad Vait Palapou, Vicki Kai Fung, Philip Glehman, Sabah mettings
Angus Whitley, and Karumi moriy