Should young women sell their eggs?

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Justine Griffin was 25 when she submitted an application to donate her eggs to a fertility clinic in Florida, detailing everything about herself from her appearance to her SAT scores. An infertile couple liked what they saw on paper and Ms. Griffin was notified that they wanted to buy her eggs.

That was the easy part. For three weeks in 2013, Ms. Griffin underwent physical and psychological tests, injected herself with hormones to stimulate her egg production and then had five eggs harvested through a surgical procedure. She was paid $5,000 for her eggs. Ms. Griffin, then a reporter for The Sarasota Herald Tribune, chronicled the experience for the newspaper in a series called “The Cost of Life.”

While both men and women in their 20s may be tempted to sell or donate their genetic material to make money or simply for altruistic reasons, the decision is not merely a financial transaction. For both sexes there are ethical factors. But for a woman the stakes are higher because a decision to sell her eggs may pose both short- and long-term health risks.

(Related: The misleading promise of I.V.F. for women over 40)

Ms. Griffin knew the short-term risks of egg donation when she underwent the procedure: The hormone treatments could cause hot flashes, vaginal dryness, fatigue, sleep problems, body aches, mood swings, breast tenderness, headaches or vision problems, according to the New York State Department of Health, which addresses at length questions about being an egg donor on its website.

Raquel Cool, co-founder of We Are Egg Donors, a space for past and current egg donors to connect, recently started the site Is Egg Donation For Me to help potential egg donors through the procedure. She said she wanted to provide resources to egg donors that she did not get when she donated her eggs in 2011 at the age of 26.

She was paid $7,000 for her eggs, but she developed ovarian hyperstimulation syndrome, a consequence of the hormone treatments, which causes fluid retention and the swelling of the ovaries. Mrs. Cool said she had nine pounds of fluid which was extremely painful. According to the American Society of Reproductive Medicine, ovarian hyperstimulation syndrome is “relatively common.”

The invasive procedure to extract the eggs is called transvaginal ovarian aspiration and there are risks, such as bleeding and although rare, damage or puncture of the bowel, bladder and nearby blood vessels from the needle attached to the ultrasound probe that is inserted into a woman’s vagina. There are no good statistics on how long it takes a woman to recover from the egg donation procedure but in most cases, donors are scheduled for a post-op checkup a week after the process. Ms. Griffin said a few weeks after her eggs were harvested a cyst burst on one of her ovaries, sending her to an emergency room. Her gynecologist told her the cyst most likely formed during the time she was taking the hormone treatments.

What was less certain were the potential long-term consequences of egg donation. By putting egg maturation into overdrive, was she putting her long-term fertility at risk? But few studies have been done on the long-term impact donating eggs has on a woman’s fertility and overall health.

Ms. Griffin, now a business reporter with The Tampa Bay Times, wonders if being an egg donor jeopardized her health in the long run.

“I don’t know if one day, if I want to have a family, my egg donation will have an effect on that,” she said.

Women are born with one million to two million eggs, but by puberty girls are down to about 300,000 eggs, said Nancy Kenney, an associate professor of gender, women and sexuality studies and of psychology at the University of Washington in Seattle.

“A typical woman uses about 400 eggs throughout her life span for ovulation, so having several eggs harvested for egg donation will not deplete your supply,” Dr. Kenney said. “But I don’t think the question is whether there are enough eggs. I think the question is whether the effects of the hormone treatments is contributing to the dying off of the eggs. We don’t know whether the treatments mean eggs are dying off more rapidly than if you weren’t on hormones.”

“It is so frustrating that there is such little research on the long-term effects of egg donation and if my granddaughter came and told me she wanted to donate eggs, I would talk her out of it,” Dr. Kenney said. “We don’t know the risks, and to risk my granddaughter’s life or her fertility is not worth it.”

Dr. Kenney was a co-author of a 2010 study published in Fertility and Sterility that surveyed 80 egg donors on their experiences following their donations.

“In our study some of the former donors were struggling with infertility, which they blamed on the procedure, but they really had no way of knowing the cause of their problems,” Dr. Kenney said.

The study also found that the women were evenly split on their physical reactions upon donating their eggs, with 40 women saying it was positive and 37 saying it was negative (three did not answer).

This is a growing issue: a 2013 report by Emory University, using data representing 93 percent of all United States fertility centers, found that the number of eggs used for in vitro fertilization procedures increased from 10,801 in 2000 to 18,306 in 2010.

Being an egg donor was never about the money for Ms. Griffin, who declined to donate a second time, despite an offer of $7,500. She had wanted to be an egg donor after seeing the mother of a deceased childhood friend struggle to get pregnant after her daughter’s death.

Ms. Griffin said her mother was concerned enough to offer her $10,000 to walk away and said several times that she would never know her first grandchild.

“That still kind of bothers my mother and I think it always will, but she was very supportive of my decision and I was grateful for that,” Ms. Griffin said.

In the case of Mrs. Cool, a writer from Santa Cruz, Calif., who has a 1-year-old son, her parents reacted differently to her decision to donate her eggs, with her father supportive but her mother against it. She said she wanted to help a couple conceive a child but the financial aspect was also an incentive.

Elizabeth Yuko, a bioethicist at Fordham University, said women should not be criticized for being paid to donate their eggs.

“There are a lot of things people are allowed to do with their bodies for money that are risky: pro sports for example, being a firefighter,” Dr. Yuko said. “We’re fine with people using their bodies in those ways to make money. Why shouldn’t women have the option to donate their eggs?”

Dr. Andrea Braverman, a clinical psychologist at Thomas Jefferson University Hospital in Philadelphia who focuses on infertility and reproductive issues, said she has no issue with encouraging women to become egg donors, as long as they’ve done all their homework on the procedure.

“I’ve talked to friends’ daughters, and my own daughters about this,” Dr. Braverman said. “I said, ‘Feel free to be a donor but do it for the right reasons’” — altruistic ones, she said — “‘just don’t do it for the money.’ That’s a quick decision that may work in the short term, but you do have to think about the long-term effects of your choice.”

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