Infertile couples who think they have exhausted every option in their quest to have a baby will soon have another alternative: eggs from anonymous donors.
The University of Maryland Medical Center is offering $1,200 to women who are willing to undergo a few weeks of hormone injections, four or five days of ultrasound tests and a semi-surgical "egg retrieval" -- only to give up their eggs to someone else.
Advertisements soliciting donors between the ages of 18 and 35 began appearing in community newspapers last week. Already, the medical center has mailed information to about 30 women who saw the ads and were curious enough to phone in.
But Michelle I. McCullom, the nurse coordinating the program, said mere interest won't be enough to qualify women as donors. Applicants will go through rigorous interviews and psychological tests. The aim is to select donors who have a charitable streak and appear emotionally prepared to swear off any claim to their genetic offspring.
"I'm not saying I'm strictly going to weed out somebody doing it for the money," Ms. McCullom said. "I'd just like to see them have motives other than that. If there aren't really some altruistic motives, when the money is gone they may begin to regret that they did it. There could be the chance that the person may have such strong regrets they may want to find out if there is a child and where that child is. It's a scary thing if you're trying to run an anonymous program."
In many ways, anonymous egg donations are the next logical step beyond sperm banking. But unlike sperm, eggs are less viable when they are frozen. As a result, most centers prefer to fertilize them the day they are collected, making the matching of donor and recipient a more complicated matter that relies on intricate timing.
And because donating eggs requires drugs and a 30-minute hospital procedure, colleagues at the University of Maryland do not foresee amassing enough donors to compile catalogs with intricate details about the donors' hobbies, IQ levels and physical attributes.
Dr. Howard D. McClamrock, medical director of the University of Maryland program, said he will stick to basics when describing donors to couples.
"Most people just say they want their child to be healthy and for the donor to be reasonably intelligent," he said. "That's the major concern. We pick a compatible blood type, pick eye and hair color that seems compatible." Race and religion will also be supplied. Musical and athletic prowess will not.
Donor eggs are for women who cannot conceive but are perfectly capable of carrying a pregnancy. They have stopped producing eggs, produce eggs that don't fertilize or have lost their ovaries because of disease.
The University of Maryland's program will use the same in-vitro fertilization process that has resulted in 15,000 births worldwide since Louise Brown was born to an English couple in 1979. Eggs extracted from a woman's follicles are fertilized with a man's sperm in a petri dish, then implanted into the woman's womb, enabling her to have a normal pregnancy.
So far, in-vitro fertilization has been used mainly to help couples who couldn't conceive because of a woman's blocked fallopian tubes or tubal ligation, a sterilization procedure. In such cases, the woman uses her own healthy eggs.
The idea of using donor eggs isn't entirely new. Many hospitals, including the University of Maryland, have asked women who produce more eggs than they need for their own in-vitro conception to donate excess eggs to someone else. Many clinics have also allowed friends or relatives to donate eggs to women who can't produce their own.
In 1987, the Cleveland Clinic became the first center to solicit anonymous donors -- women who wouldn't otherwise be walking into an in-vitro clinic. The University of Maryland is the first center in metropolitan Baltimore to solicit anonymous donors, although Johns Hopkins Hospital is gearing up to do the same.
Under normal circumstances, in-vitro fertilization is an expensive process that may have only a 25 percent chance of success. Maryland charges about $11,000 when the woman uses her own eggs, but plans to add another $4,000 when donor eggs are used. The extra charge covers the cost of recruitment, counseling and medical procedures.
Don't expect insurance coverage. Ms. McCullom said she knows of no insurers in Maryland that cover in-vitro fertilization for couples using someone else's eggs.
Despite this, anonymous donor programs don't attract only the rich. Desperation has driven many middle-class couples to stretch their resources to the limit.
"People save their money, will take out loans, will take out a second mortgage on their homes," said Susan Richards, a nurse who runs the Cleveland Clinic's program. "Most thought they were never going to have a baby. They have tried adoption and were put on lists that were 10 or 12 years long. This has opened up new hope."