For three years Lily Mwabea has financed her education at a private university mainly from the sale of her eggs.
“Next month, I will be going for the ninth cycle and not the last by a long shot,” says the 23-year-old college beauty.
In her ova marketing resume, she describes herself as highly talented, athletic, all brains woman pursuing a degree in medicine, a roaring beauty to die for and carrying an ideal body mass index (BMI) of 19.
This profile is important in her business. She has all the attributes demanded by some local and cross-border agencies in the growing human egg donor market.
Lily gets between Sh30,000 and Sh45,000 for each cycle of donation. The one time she dealt abroad, she secured a Sh400,000 windfall.
“US market pays best, but are very competitive making it difficult for Africans to get through,” she says.
On average the US market pays about $8,000 (Sh800,000) per cycle and sometimes more with the higher prices largely reserved for Caucasians.
But with nine donations, gynaecologists say Lily has gone way beyond the limit of six cycles.
“I am not aware of a limit, I have never been told and in any case I am in great health,” she told My Health in a WhatsApp chat.
Kenya does not have a law regulating the donation or selling of human gametes. The Assisted Reproductive Technology Bill, 2016 is still in the parliamentary legislative process but proposes that no money or other benefits shall be given in exchange for eggs or sperms.
However, this has not deterred the mushrooming of egg, sperm and surrogacy clinics and agencies in Kenya. Already, many of these are doing heavy advertising through the internet and social media.
“Our process is 100 per cent event free, comfortable and safe,” advertises one agency located along Ngong Road in Nairobi.
This glossing over health safety information, says Diane Tober, a reproductive expert at the University of California in the US, is a major cause of concern with donors not being fully informed of possible health risks from the process.
In August, 2020 Prof Tober published the world’s largest study on cross-border egg donor trade and whether women are being fully informed of possible risks.
Short-term risks
The study, appearing in the Reproductive Biomedicine & Society Online, involved 375 current and past donors from Kenya and 19 other countries. Eighty six per cent of the women, aged 18 to 57, had exchanged their eggs for pay.
“While many participants, felt well informed about potential short-term risks, 55.2 per cent did not feel well informed about potential long-term risks,” Tober writes in the study.
Worried over possible long-term negative health impact from repeat ovarian stimulation, the American Society for Reproductive Medicine in 2014 recommended no more than six donations in a woman’s lifetime.
The recommendation, which has since become the global yardstick, also suggests donors should wait for at least two months in between donations.
However, in her study, Tober says many women like Lily are going well over the six recommended cycles.
This is mainly because they are either not being informed of the limit by the engaging agencies or they are deliberately visiting different clinics to maximise the financial gains.
In the current study a total of 17 donors had completed seven cycles or more. The highest was a paid US donor who had completed 17 donation cycles over three and a half years, at an average of 4.2 cycles per year, or one cycle every three months.
This, Tober says, is a cause for concern: “Either some donors are not reporting their cycles to clinics and therefore continuing to donate at different sites when they should not; or some clinics or agencies are encouraging donors to continue, or at least not advising them to stop; or a combination of these.”
But even more worrying, he warns, is that about 77 per cent of donors felt uninformed about possible long term risks, including endometriosis and reproductive cancers.
Endometriosis is a disorder in which tissue that normally lines the uterus grows outside the uterus and in rare cases can lead to infertility.
A significant number of women felt they had not been adequately informed on possible complications from stimulation medicines, surgical procedures or even the emotional and psychological ramifications.
Common complications
A third of the women reported either not being informed at all or just somehow about ovarian hyperstimulation syndrome (OHSS) – the most common complication triggered by the egg stimulation medications.
The condition happens when the ovaries swell with fluid that eventually leaks into the body. The condition can be mild, moderate or severe and in rare cases life threatening, with many of the women in the study saying this distinction was rarely explained to them.
Most troubling, warns Tober, in the survey text boxes, many donors reported feeling that their clinic intentionally excluded important information.
“Several donors who experienced moderate to severe OHSS felt that they were under informed about this possible complication.”
The study says lack of adequate research on the health impact of ovarian stimulation on donors should not be used to indicate there are no unknown dangers hence need for caution.
