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Posted by avnerhershlag on November 17, 2010

  • A recent report by Cohn and Livingston from the Pew Research Center concludes that:
  • Nearly one-in-five American women end their childbearing years without having borne a child, compared with one-in-ten in the 1970s.
  • While childlessness has risen for all racial and ethnic groups, and most education levels, it has fallen over the past decade for women with advanced degrees.
  • The most educated women still are among the most likely never to have had a child. But in a notable exception to the overall rising trend, in 2008, 24% of women ages 40-44 with a master’s, doctoral or professional degree had not had children, a decline from 31% in 1994.
  • Among older women, ages 40-44, there are equal numbers of women who are childless by choice and those who would like children but cannot have them, according to an analysis of data from the National Survey of Family Growth. In 2002, among women ages 40-44, 6% were deemed voluntarily childless, 6% involuntarily childless and 2% childless but hoping to have children in the future.


  • Clearly, there are women and couples who remain childless by choice.
  • However, it’s practically impossible to estimate how many of these childless women, from early to mid-forties, would have rather had children, had they be given the choice.
  • While some women truly prefer not to have children, others might be secretly wishing for a child while not openly admitting their inability to conceive late in the reproductive lifespan.

So if you do want to become a mom – what action should you take?

  1. If you are in your early thirties and not planning to have a child anytime soon because of your career or because you haven’t found a partner yet, you may freeze your eggs. Recent technology allows long-term survival and good chances for a pregnancy in the future.
  2. If you are over 35 years of age and have experienced multiple failures to conceive and/or several miscarriages, you may choose to have genetic screening (PGS – Preimplantation Genetic Screening) of your embryos, which should help identify embryos with normal chromosomes and increase your chances to have a live, normal baby.
  3. If you’re unable to conceive from your own eggs, using Donor Eggs you should have an excellent chance of conceiving.  In fact, you could have several children through egg donation, even if you are in your mid-forties.

  • So – yes!  Childlessless in your forties may represent empowerment of women who choose not to have a child.  However, for those of you who do not wish to remain childless, the true empowerment is through reproductive technologies.
  • If you are younger, plan for the future!  Be proactive!
  • And if you are older, you can still be a very happy mother if you’re ready to open up your mind to new reproductive options.

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Posted by avnerhershlag on July 15, 2010

In this comedy, which opened in theaters last weekend, a lesbian couple, Nic and Jules (Annette Benning and Julianne Moore), live with their teenage children, Joni and Laser (Mia Wasikowska and Josh Hutcherson), in LA. As Joni prepares for college, her younger brother pesters her for a big favor—help him find their biological father. Against her better judgment, she makes a call to the sperm bank; the bank, in turn, calls Paul (Mark Ruffalo) and asks him if he’s willing to meet his daughter. He agrees, and a complicated new chapter begins for the family.

The movie’s message is that these teenage kids, raised by two mothers, are going to be all right.  Is that true?

A recent study by Catrell & Bos, published in Pediatrics, looked at 78 offspring born to 154 lesbian mothers who conceived through donor inseminations.

They found that 17-yesr-old children of lesbian mothers:

  • Were rated significantly higher in social, academic, and total competence than typical American children, as compared with Achenbach’s normative sample of American youth.
  • Had significantly fewer social problems, and less rule-breaking, aggressive, and externalizing problem behavior than age-matched children.
  • There were no differences among adolescent offspring conceived by known, as-yet-unknown, and permanently unknown donors, or between offspring whose mothers were still together and offspring whose mothers had separated.


  • The mothers’ “commitment even before their offspring were born to be fully engaged in the process of parenting.” During pregnancy, the mothers took classes and formed support groups to learn about raising a child.
  • “They were actively involved in the education of their children and aspired to remain close to them, however unique their interests, orientations, and preferences may be.”
  • The mothers were keenly aware of the prospect of discrimination, so they “took a lot of time educating people who came into contact with their families — obstetricians, pediatricians, teachers, administrators. They were always working on diversity programs and anti-bullying programs.”
  • The lower levels of externalizing problems may be explained by disciplinary styles. The mothers used verbal limit setting, and studies have shown they use less corporal punishment and less power assertion than heterosexual fathers.
  • “Growing up in households with less power assertion and more parental involvement has been shown to be associated with healthier psychological adjustment.”

In an accompanying editorial, Joseph Hagan MD, of the U of Vermont, writes:

“Our experience tells of the resilience of children who are loved and know that love. Our learning tells us of the boundless ability of children to respond to that love despite the absence of a traditional parenting relationship.

So, the kids are all right?

You bet they are!

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Posted by avnerhershlag on July 4, 2010

In a new study published in Science, Genetic Signatures of Exceptional Longevity in Humans, ( Sebastiani & Perls ,BU), the genome of over 1000 people who lived to be 100 or more was studied.  The authors constructed a genetic model that included 150 genetic markers (called SNP, pronounced “snips” – similar to the technique used by the FBI for genetic fingerprinting):  They identified 19 patterns that predicted with 77% accuracy who would live to be 100 and beyond. Currently, 1 in 6000 people may live to be 100 and 1 in 7 million makes it to 110!


  • Here we go again: nature or nurture: which is more important?
  • Dr. Sebastiani commented that Seventh Day Adventists have an average life expectancy of 88, eight years more than average US contemporaries, which has been attributed to their vegetarianism, exercise, no smoking, no alcohol, less stress because they rely on religion… question is, do they have fun living this long?
  • Now – I’m sure you’re asking – so if I have the centenarian genetics  – can I go ahead and not worry about “healthy living” – eat what I want and as much as I want… drink, smoke.. not stress about stress – and live happily ever after?
  • And If I don’t have the long life doom – should I be preparing for a short life and if that’s my genetic destiny anyway – shouldn’t I just live it up since it’s all in the genes?
  • Genetic Hedonism?
  • Life Insurance premium may soon be based on your genome: if there is a genetic test to predict that one person will get sick early in life and die young, and another will live to a hundred, disease free, insurance companies may prefer to check your longevity markers rather than your cholesterol or blood pressure!
  • From my perspective, perhaps we’ll be able to check embryos for potential longevity.   Through embryo biopsy (PGD), we may in the near future, be able to check for multiple “predictive” genes, and help patients choose to get pregnant with embryos that have the potential to live to be 100 years old and older!

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Donor Sperm Children Turn Young Adults

Posted by avnerhershlag on June 5, 2010


A New Study of Young Adults Conceived through Sperm Donation

A study published by the Institute for American Values (Elizabeth Marquardt, Norval D. Glenn and Karen Clark) Analyzes the results of web interviews of 1,687 adults ages 18-45. The young adults were divided into three groups:

Sperm Donor Conceived Offspring: n=562

Adopted Offspring: n=562

Raised by Biological Parents Offspring: n=563

The authors came up with the following findings:

1. Young adults conceived through sperm donation (or “donor offspring”) experience profound struggles with their origins and identities.

2. Family relationships for donor offspring are more often characterized by confusion, tension, and loss.

3. Donor offspring often worry about the implications of interacting with – and possibly forming intimate relationships with – unknown, blood-related family members.

4. Donor offspring are more likely to have experienced divorce or multiple family transitions in their families of origin.

5. Donor offspring are significantly more likely than those raised by their biological parents to struggle with serious, negative outcomes such as delinquency, substance abuse, and depression, even when controlling for socio-economic and other factors.

6. Donor offspring born to heterosexual married couples, single mothers, or lesbian couples share many similarities.

7. At the same time, there appear to be notable differences between donor offspring born to heterosexual married couples, single mothers, and lesbian couples.

8. Donor offspring broadly affirm a right to know the truth about their origins.

9. About half of donor offspring have concerns about or serious objections to donor conception itself, even when parents tell the children the truth about their origins.

10. Openness alone does not appear to resolve the complex risks that are associated with being conceived through sperm donation.

11. While a majority of donor offspring support a right to know the truth about their origins, significant majorities also support, at least in the abstract, a strikingly libertarian approach to reproductive technologies in general.

12. Adults conceived through sperm donation are far more likely than others to become sperm or egg donors or surrogates themselves.

13. Those donor offspring who do not support the practice of donor conception are more than three times as likely to say they do not feel they can express their views in public.

14. Donor conception is not “just like” adoption.

15. Today’s grown donor offspring present a striking portrait of racial, ethnic, and religious diversity.


This is, as far as I know, the largest, most comprehensive study ever done on young donor sperm offspring.
Finally, some of the mystery begins to unravel: what happens to people conceived through sperm donation: do they grow up unscathed by the process that brought them to this world?
How much does genetics play a role in who we are? Are donor offspring a good model to study nature versus nurture?
As the study points out, there are different sperm donation situations: a single mother; a mother married to a man with no sperm; and the ever-growing community of lesbian parents.
Obviously, 3 dramatically different households for donor offspring to grow up in. Issues of role modeling: is there a male role model? And what about the female role model, if instead of a heterosexual, married mom, your mother is single or, you have two (lesbian) mothers? What’s more confusing: to grow up with no male as a parent, or growing up with a father figure who’s not your biological father?
What does it feel like to grow up with the constant shadow of secrecy following you wherever you go: How did you get here? What is your DNA lineage?
What does it mean if it’s taken all these years for her (them) to tell me my father was a sperm donor? Is it something I should be ashamed of? Donor offspring who grow up with 2 heterosexual parents are camouflaged. No one at school will ask: who’s your dad? Where’s your dad? It’s a different story when there’s only a mother, or 2 mothers, and no father.
So how does this study change things?
Should donor inseminations be stopped? Better regulated?
As is commonly asked in reproductive ethical debates: are these children better off not being born at all, rather than having to deal with this emotional baggage for the rest of their lives? This is a very difficult question to answer. Impossible. My guess is that most, if not all the donor offspring who’ve now reached adulthood would rather be her, than not exist at all!
Right now, women can purchase sperm directly from a sperm bank, try to conceive by themselves (“the turkey baster technique”), and never see a doctor.
We, fertility doctors, feel that this practice is wrong, potentially dangerous (could introduce infections, for example), and that donor inseminations should be confined to a meticulously run program specializing in reproductive technology.
The law (at a state level) should prohibit direct sales of donor sperm to consumers.
Is there anything we should change in the way we practice sperm donation? Yes. This study is an eye opener. Every reproductive endocrinologist should read it. She or he should tell their patients about it. Counseling by a psychologist experienced in gamete donation should be offered, if not mandated.
We, fertility doctors, cannot escape the responsibility we’ve been charged with. We are NOT reproductive technicians. We are physicians with social responsibilities. While we cannot assume the role of a moral compass, we can’t sit by the wayside and watch the children we have created suffer. As the babies we have created come into adulthood, we should keep a close watch on their psychosocial integration into society. This study should make us take a critical look into our current practices and constantly assess what we do, how we do it, and aim to do better.

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Posted by avnerhershlag on May 4, 2010

Is menstruating once a month good for you?

Pincus, who developed the first contraceptive pill, wrote in 1958: ‘a cycle of any desired length could presumably be produced.”

However, the belief that having a period every month is normal.

What’s good about having a period?

  • Hippocrates wrote: “menstruation was designed to cleanse women of bad humors.”
  • Many cultures believe that a woman is impure during the period and even several days afterwords.
  • Orthodox Jewish religion prohibits sex and other physical contact for 7 days post menses,.  Sex can only be resumed after the woman purifies herself in a water bath, the “Mikveh.”
  • Menstruating women in Islam are exempt from prayers, fasting and pilgrimage to Mecca.  They are not allowed to have sex, but may have other contact with their husband.
  • When a woman gets her scheduled period, she knows that she is not pregnant.  A relief for some.  For others, a period signifies fertility, and that soon, in a couple of weeks, she will ovulate and have another chance to get pregnant.
  • So the traditional pill was designed in keeping with the natural schedule; 21 days of active pills and 7 days of placebo will give you, by design, regular ‘period” every 28 days.

In recent years, new contraceptives have become available that reduce the number of bleeding episodes annually.

How do women view these new options?

Benagiano et al (Patient Prefer Adherence.,2009) reviewed so the attitudes towards the new pills:


  • Black women conservative – prefer monthly period.
  • 2/3 of  white women don’t like monthly bleeds and would prefer bleeding-free intervals ranging from 90 days to no periods at all.
  • 40% of these women – ready to consider using a hormonal contraceptive that stops menstruation altogether. (Kaunitz, Contraception. 2000)


  • How many women would like to have no periods?
  • Netherlands: 25%
  • France: 57%
  • Italy: 29%
  • Germany – 37-46%
  • Spain: 5% only, but 50% of women < 25 years old.

Continuous birth control pills are safe.  In a multicenter European study (Teichmann et al, Contraception 2009), continuous pills (90 mcg levonorgerstrel/20 mcg ethinyl estradiol) resulted in 535 amenorrhea after a year and 79% no bleeding (with or without spotting) After 1 year.

Return to fertility following discontinuation of oral contraceptives

A recent survey (Barnhardt & Schreiber, Fert Steril 2009 Mar 91:659-63), reported that the return of fertility in former OC users (both cyclical and extended/continuous regimens) in women who stop to conceive is comparable to that observed with other contraceptive methods.

The reported 12-months conception rates were;

  • Cyclic OC – 72-94%
  • IUD – 70-95%
  • Condoms – 91%
  • Natural family planning – 92%


Over the years, Oral Contraceptives (OCs) has been blamed for practically everything, from heart attack and stroke to cancer.

However, the WHI – the Women’s health Initiative, found that OCs do not increase the risk of breast cancer, thus diffusing a major fear from previous studies.

The WHI also reported a LOWER risk of heart attacks and strokes.

This in addition to well known benefits:

If you take OC’s over 4 years, the risk of Ovarian Cancer drops by 42% and of uterine cancer by 31%.

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Posted by avnerhershlag on May 2, 2010


How many women with breast cancer would like to have a baby?

In 2009, 192,370 women were be diagnosed with breast cancer.

It is estimated that about 15% are in the reproductive age.

I was just diagnosed with breast cancer.  And I’ve never had a child.  Will I be fertile when I’m done with my treatment?

About 15% of women diagnosed with breast cancer (192,370 new cases in the US in 2009) are in the reproductive age.

When the diagnosis is made, women not only have to worry about their cancer.  They also worry about losing their fertility as a result of chemotherapy.

Good News: A recent study from Egypt by Badawy et al (Fert Ster 2009) reported that the GnRHa (a drug to suppress ovarian function) during chemotherapy helps the return of menstruation and ovulation.

89.6% resumed menses and 69.2% resumed spontaneous ovulation within 3-8 months of termination of the GnRHa/chemotherapy co-treatment.

How can I improve my chances of having children in the future?

  • You should see a fertility doctor as soon as possible.
  • When you call the office, ask if the center has a Fertility Preservation Program for Cancer patients.
  • The doctor will evaluate you and discuss your options.

What options do I have, doctor?

  • There is a “window of opportunity” of about 6 weeks between surgery and chemotherapy.
  • During that time you can be given fertility drugs for an average of 10 days.
  • Following this treatment, eggs can be harvested from your ovaries.
  • This is a short procedure, less than half an hour, done under anesthesia.
  • If you have a partner, your eggs will be fertilized with his sperm to create embryos.
  • All embryos will be frozen.
  • If you don’t have a partner yet, your eggs will be frozen.
  • Less frequently, a piece of an ovary may be frozen.

How long will I have to wait to have children?

  • It is currently recommended to wait 2 years.
  • However, the doctors taking care of your breast cancer have to clear you based on your specific situation.

What treatment will I have once I’m allowed to conceive?

  • Your fertility potential will be evaluated (physical exam, ultrasound of your ovaries and blood tests).
  • If the tests show that your ovaries are producing eggs, you may want to try to conceive on your own.
  • If your ovaries are functioning but you’re worried that time is running out, you can get treatment to enhance your chances 9fertility drugs and inseminations or IVF).
  • If your ovaries don’t produce eggs and you have frozen embryos, they can be thawed out and transferred to your uterus.
  • If you have frozen eggs and now have a partner, your eggs can be thawed out, injected with your partner’s sperm and the embryos thus created transferred into your uterus.

What if I have frozen eggs and l haven’t yet met “Mr. Right?”

  • Then you have 2 options:
  • One option is to wait until you have a partner.  Your eggs will continue to be frozen until you have a partner.
  • Or, if you don’t want to wait, you may choose to use donor sperm.  In that case, your eggs will be thawed out, injected with the donor’s sperm and the embryos transferred into your uterus.

What do I do if I never had eggs or embryos frozen before I started chemo?

In that case you can use eggs from a donor of your choice.  We can create embryos for you (with your partner’s sperm or if no partner – with donor sperm).  Pregnancy rates from donor eggs are very high.

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Russian Adoption Debacle – the Alternative

Posted by avnerhershlag on April 16, 2010

  • International adoption is happening in large numbers.  The 3 leading sources of adopted children in the United States in 2009 (according to State Department figures quoted by the NY Times), were:
  • China – 3001 children
  • Ethiopia – 2,277 children
  • Russia – 1,586 children

United States citizens have adopted more than 50,000 Russian children since 1991!

Professor David Smolin, (Cumberland Law School, Ala.) writes on the NYT blog :

“Inter-country adoption, particularly of older children, and most especially of children from abusive families or neglectful institutions, is inherently a high risk process. Children coming from traumatic backgrounds commonly suffer from serious psychological, behavioral, cognitive and educational issues. The language and cultural transitions of inter-country adoption compound and complicate both the child’s trauma and therapeutic interventions.

The child welfare and adoption systems that have created countless cases far more tragic than this latest one are the real criminals.

Unfortunately, the adoption myth in the United States sends the message that the love and care found in any normal American home is enough to heal any child. This myth leads to numerous inadequacies:

  • Inadequate evaluation of children prior to adoption
  • Inadequate preparation, training and selection of prospective adoptive families;
  • Inadequate post-placement services.”


  • This tragic incident brings to light serious problems associated with adoption.
  • These problems, some delineated above by Prof. Smolin, are not limited to international adoptions.  Frequently, mothers who give up babies for adoption have had no prenatal care, and the American adoption agency pushes the couple to sign adoption papers before the mother is checked by a designated Ob/Gyn and the child – by a pediatrician.
  • a less discussed angle of the current debate is: Fertility Treatment as an alternative to adoption.
  • Most adoptions are due to infertility.
  • Some of the adoptive couples are not too old to have a baby.  They just choose adoption, because, “this way we’re sure we get the baby.  Fertility treatment is expensive, and you’re not guaranteed that you’d walk out with a baby.”
  • For those couples: please reconsider; fertility treatment is highly successful.  There are many new options available.  Yes, adoption may be successful.  But in many cases, psycho-social issues may complicate things, becoming a huge burden for a lifetime.
  • Other couples feel that they are too old to have a baby.
  • Men, by design, are almost never too old to reproduce.
  • Women, on the other hand, do experience “reproductive aging” in the middle of their life.
  • I call on women with reduced ovarian reserve: please consider Donor Eggs.
  • With Donor eggs, you get to choose your donor.  Your donor gets screened carefully: for infectious disease; genetics; and psychologically – by a standardized test and an interview with a psychologist.
  • “But this child will not be from my egg, doctor…”  True, but you will have optimal control over the physical, genetic and mental health of the egg donor.
  • The child will inherit half of the genetics of the couple, since your partner’s sperm will be used.
  • And you get to have the maternal experience by carrying the pregnancy and delivering the child.

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Posted by avnerhershlag on April 4, 2010

In a study by Walsh et al (Cancer, 2010), 22,562 men who were evaluated for infertility from 1967 to 1998 were indentified from 15 California infertility centers and linked to the California Cancer Registry.

A total of 168 cases of prostate cancer that developed after infertility were identified.

Men evaluated for infertility but not necessarily with male factors were not found to have an increased risk of cancer compared with the general population

Male infertility increased the chances aggressive prostate cancer by 2.6 times. The risk of slow-growing prostate cancer was increased by 1.6 times.


  • A message to men experiencing infertility: don’t panic!  Likelihood is that you will be healthy and never develop prostate cancer!  Why?
  • Because only 1.2 percent of infertile men developed prostate cancer in this study, compared to 0.4 of fertile men.
  • This means that your chance of NOT developing prostate cancer, even if you have a fertility problem and abnormal sperm, is 98.8%!
  • Also, what the media forgot to mention, is that men who were evaluated for infertility had normal sperm DID NOT have an increased chance to develop prostate cancer.
  • And yes, it is true that previous research by the same authors reported a 2.8-fold increase chance to develop testicular cancer,

But they had only 34 cases in over 22,000 men studied.

  • Both observations are interesting, demanding close attention and hopefully studies that will shed light on this association.
  • We are still in the dark regarding the genetics of male infertility.  There are also ongoing studies on the genetics of both prostate and testicular cancer.
  • Hopefully, in the not to far future, the genes responsible will be discovered.  It may be that they are, in some cases, evil neighbors on the same chromosome.
  • If we know the genes, we can check if patients carry them, and aim to eliminate them in your children (through IVF and genetic diagnosis of your embryos — PGD).
  • One of the researchers mentioned God and Darwin in this context… as if male infertility was a signal to stop certain men from reproducing.  I’d rather stay away from sacrilegious statements.  As far as Darwin goes — I’m sure that he’s modify his evolution theories had he lived today and saw all the wonderful new human being that we bring to life, bypassing infertility obstacles.
  • EVERY MAN WITH INFERTILITY SHOULD HAVE A CHANCE TO BECOME A FATHER!  It is the basic right of every human being.
  • So here is the message to you: a man with infertility, who’s lost sleep since this report came out:  Take charge of your health.  This is what you should do:
  • 1. If you and your wife have fertility problems, and you have normal sperm, you DO NOT have an increased chance to develop prostate and testicular cancer and you DO NOT have to see a male fertility specialist.
  • 2. If you have abnormal sperm test (semen analysis), SEE A UROLOGIST WHO SPECIALIZES IN MALE INFERTILITY.  He or she will examine you and in most cases will reassure you that you are healthy and that you can proceed with fertility treatment.
  • 3. Like all men, you should have regular, annual exams, including a prostate check.
  • And most importantly, we are now very successful in helping infertile men have a baby.
  • So the bottom-line: even if you have abnormal sperm, likelihood is the YOU WILL BE CANCER FREE AND THAT YOU WILL BECOME A FATHER!

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Posted by avnerhershlag on April 4, 2010

In her new movie Back-up Plan, a single woman (Lopez) turns to artificial insemination to answer her ticking biological clock only to meet the man of her dreams on the same day as her positive pregnancy test results.

In an upcoming film, The Switch, based on a New Yorker story by Jeffrey Eugenides (author of Middlesex, one of my favorite books), a neurotic and insecure man finds out his best friend (Jennifer Aniston) wants to have a child through artificial insemination. He surreptitiously replaces her donor’s semen with his own and is then forced to live with the secret that he is the child’s real father.

Now what’s happening in the REAL WORLD?  If you are a single woman out there, is artificial insemination by a sperm donor an option for you?

Here are some talking points:

  • Women increasingly take control over their reproductive future.
  • This is part and parcel of the EMANCIPATION OF WOMEN
  • As women climb up in the social ladder, spending as much time on higher education and career advancement as men, they come to realize that biology has not dealt them a fair share:  as years go by, HER biologic clock is not only ticking; the alarm keeps sounding off! And the man — HE doesn’t even own a biologic clock.  His fertility is always at a high.  He doesn’t have to juggle fertility and career.  And wait:  he doesn’t have to juggle motherhood and career either!  His bread is buttered on both sides.
  • So now you may realize why so many men who may finally seem to be “Mr. Right,” turn out to be “Mr. Not Right Now.”
  • So as you go up in age, the number of possible contenders dwindles, should you consider the alternative:  taking control over your reproductive future, before it is too late?
  • How much of a choice do you have when it comes to donors?
  • Anonymous.  Does it scare you?  How much will you know about your donor (you’ll be surprised)
  • How safe is it?
  • What do you tell my child?  When?
  • What if your child wants to meet his father?
  • Are you ready for single motherhood?

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Posted by avnerhershlag on April 4, 2010

Yes, top students reap rich rewards, even as egg donors

would-be parents want high scorers

Stephanie Ebert, Boston Globe (March 26, 2010)

The Harvard Crimson was one of three college newspapers that ran an identical classified ad seeking a woman who fit a narrow profile: younger than 29 with a GPA over 3.5 and an SAT score over 1,400. The lucky candidate stood to collect $35,000 if she donated her eggs for harvesting.

From a sample of over 300 college newspapers, findings revealed that almost one-quarter of advertisements offered payment in excess of $10,000, a violation of guidelines issued by the American Society for Reproductive Medicine (ASRM).


* Whether you’re trying to improve your offspring by genetic technology or by selecting a smart and/or good looking sperm or egg donor, the ethical question remain: is this right?

* The issue of PAYMENT for eggs or sperm, above and beyond the compensation given to the donor for their effort, is considered flawed and rides down the slippery slope of paying for body parts.

*But the question still remains: what’s wrong with prospective parents to try to “upgrade their child?” and how is the GAMETE DATING GAME different from the PEOPLE DATING GAME?

If you want to read more on this topic, please click on DESIGNER BABIES

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