Up First from NPR
Up First from NPR

The Human Egg Sellers

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For years, India was thought of as the Wild West of the fertility industry. But in 2021, a new law in India made it illegal for women to sell their eggs or serve as paid surrogates. That law clashed w...

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Support for NPR and the following message come from the William and Flora Hew...

investing in creative thinkers and problem solvers who help people, communities and the planet

β€œflourish. More information is available at Hewlett.org. I'm Ayy Sharasko and this is the Sunday”

story from up first where we go beyond the news of the day to bring you one big story. Couples began flacking to India around 2002 because it was one of the easiest countries where people wanting to have a child could procure eggs and surrogates at about a third of

the price it would be in the United States. A multi-million dollar fertility industry boomed and

thousands of babies were born of surrogate mothers to the point where one publication called India quote a global baby factory. That was until 2021. When much of this industry went underground in part because of a new law that made it illegal for Indian women to sell their eggs or to be

β€œcompensated as a surrogate. So this international women's day we go to India to investigate the”

underground market for human eggs that's taken hold in the past several years. NPR correspondent Dia Hadid and producer Schweta Desai tracked the story for over nine months,

tracing how eggs from impoverished women make their way through a chain of agents and clinics

to reach couples who seek them to have a baby. They crisscrossed India from the southern city of Chennai to the holy Hindu city of Aranasi connecting fertility doctors and high end clinics to women living in slums. And just ahead's up this story contains descriptions of physical abuse and invasive medical procedures.

β€œDia Hadid takes the story after the break, stay with us.”

Support for NPR and the following message come from the William and Flora Hewlett Foundation, investing in creative thinkers and problem solvers who help people, communities and the planet flourish. More information is available at Hewlett.org. We're back with a Sunday story. Here's NPR's Dia Hadid. It took us months to find the woman we are calling H. She asks that we don't use her name because

she fears for her safety. She works in an industry that is so underground, so secretive, that to find her, my co-reporter Schweta Desai has to go through a chain of people, each suspicious of who we are and what we're doing. And then H. Well, Schweta is on the phone with her for weeks before she agrees to meet us in person at a cafe in a community town near Mumbai. That's India's sprawling port city. She walks in late wearing a long black robe and a black head scarf, which

throws us off. H is Muslim, but we didn't expect her to be religious or conservative. She lasts when we comment on it. She lightly touches her Hishab and says, she's only wearing it because we're in a Muslim majority area and she doesn't feel comfortable in jeans and a t-shirt around here. H is one of the countless Indian women who sells her eggs to survive. Couples are in the market for a human egg to have a baby, like how she looks, pale skin,

thick hair and our glass figure, a pretty smile. She says, "I have good eggs. They make good babies." H is 35. She tells us that she started selling her eggs about five years ago after she left her husband. It was a miserable, arranged marriage. H says her conservative Muslim family didn't let her come home. She'd shave them for seeking a divorce. Without a home, she couldn't care for her two children, so her ex-husband got custody. She says she moved in with a man who offered

her shelter, but when he lost his job, he passed it her for rent. H had no money and no skills and a girlfriend told her, "You're young and you're pretty. Sell your eggs. Lots of girls do it. I've done it. Do it and say." H was confused. It sounded like sex work.

Like most Indian women we meet for the story, she'd never been taught about the human bodies

we productive plumbing. Her friend told her, "We're a body-shapad, Pune-kalkar de re."

Producer Shwara decides, "The friend said this is just about providing a part...

to another person and ones that will have the babies."

β€œDespite India's latest law banning the sale of eggs, the demand continues to be enormous.”

Photility clinics and academics tell us it's because women are marrying later, but they still want to have children, so they're turning to the fertility industry for help. At a time, when taboo's about fertility are shifting, Indian celebrities are openly talking about seeking help to have babies, and there are screwball-ballied with movies like this one, called "Good news."

The ticket eggs of Aapka Sula school might allow me to fertilize them. In this process is called "In vitro fertilization, IVF." Perfect. Let's do it. About two couples who accidentally have each other's babies.

β€œAre you also Madras? Yeah. Wow, we also!”

And in India, the ultra-rich can buy special VIP services to have a baby. I've worked with a lot of people from Bollywood, and I'm currently a lot of them. In fact, I was with someone yesterday, one of the richest families in Bollywood yesterday. In a noisy cafe, Shwedda Desai and I meet a man who runs a beauty for reproductive agency with offices flung around the world. Here requests we don't use his name, because the work he does, he describes it

as operating in a Grey Zone. Depending on your economic status, your budgets, sexual preferences, single-married, unmarried, etc., etc., whether you want a nation-domar, Caucasian donor, Indian donor,

African donor, I can place them anywhere in the world, Hispanic as well. He says, basically,

it's like having, what's the bumble or Tinder? I'm the bumble or Tinder, but a more, what's our guess it? On his folding phone that opens like a tablet, he shows that some of the Indian models

β€œand actresses whose eggs he purchases for clients. So, so this is like what we call a premium donor?”

Premium donors. So, I'll show you the database of, yeah, this is like I have a, like a batch in March in April, so I'll tell you, these are the girls that have approached us. He pulls out the profile of one of these women. Let me just pick up this girl, okay? This is just a good-looking girl from Mumbai. Just see the profile, this is just any, any and a girl you'll find. Yeah. She's gorgeous. Yeah. On the screen, the young woman has long glossy brown hair, clear olive skin and smiling brown eyes.

I'm really curious about the egg donation aspect. What makes someone premium? Like, it's a skin-file beauty. Is it education? Is it age? It's a combination of all these things, gut feeling and also medical thing as well. He says, these premium donors are paid between $3,000 to $7,000 for their highly sought after eggs and to extract those premium eggs. He says he has two options. He can arrange a procedure for the woman in India. The pens, you know, if the clinic in

India is willing to do this under the table, behind the scenes without registering them, we can do it in India. Under the table, otherwise we fly them out to Bangkok or to Georgia, or to Kenya. He paints it as a glamorous side hustle for the women involved and talks about a premium donor who's sent to Kenya. He was supposed to go for a safari today. I kept a one. No, no, no. She's coming back in a few hours. She should be about to land now.

India.

Like, other women we interview in this long, she asked to only use her first name because she doesn't

want to risk getting in trouble. The women belong to a group at the bottom of South Asia's cast hierarchy. They're known as per A.R. From where the English gets the word "paraya." I'll be Rahmi and her girlfriends walk us through their homes. Each a tiny room in a row of tiny rooms, down a tight alleyway. They're painted bright blues and purples. The mats are rolled in one corner, a gas burner for cooking in the other.

I'll be Rahmi's husband, Polish his spoons in a steel mill for about $1 a day.

away his wages. They have two daughters, but they live with Abirame's sister-in-law.

β€œThat's because Abirame has no time to care for them. She works in a toy workshop,”

assembling plastic guns for about $3 a day. Twice she says she sold her eggs to put food on the table.

For rent. I'll be Rahmi first heard about selling eggs from her neighbor while standing in line

for her turn at the water pump. She pleaded with her neighbor. Tell me where I can go and do it. I'll be Rahmi says when she told her husband about her plans, he thought it was sex work. She's this. He doesn't understand the difference between thick and thick. I'll be Rahmi says her neighbor told her, forget about your damn husband. He's not paying the rent.

β€œYou'll get $25,000. About $300 more than what should make in three months at the plastic gun factory.”

Her neighbor knew about selling eggs because she had been in and out of hospitals herself. To make ends meet, she used to sell her blood. She once sold her eggs when she was younger. She was once paid to carry a baby and she sold a kidney. She shows us the scars. She took Abirami to a fertility clinic. Abirami says she can't read. She only finished school

to the second grade, but her neighbor told her it was seven stops away on the bus so she counted them.

Abirami says in the fertility clinic she was hustled into a room where patients couldn't see her. A nurse filled out a form on her behalf and told her to sign it with her thumbprint.

β€œAbirami says a nurse put gel on her stomach and scanned her. She says she was taught to come back after she got her period.”

And when she returned, she was injected. She's not sure with what, but it was most likely hormones to stimulate her ovaries to produce more eggs.

Every day for about 10 days Abirami went back to the clinic. She counted seven bus stops

to know where she had to get off and the nurse ushered into a room to be injected. She says she thought she'd die from the nausea she was experiencing. She began swelling around her stomach. Based on what we've heard from doctors, her response to the injections sounds like she'd been overstimulated, which isn't uncommon. She focused on the money she'd make, but when her husband noticed her swelling,

she says he beat her up. Abirami remembers shouting at him, "You drink away your money. I don't have enough for rice." She says she hid at her neighbor's house until it was time for her to have her eggs extracted. For that, a doctor put her under anesthesia. She's unsure how the eggs came out, but typically they're removed with a long thin needle

that goes through the wall of a woman's vagina and they're extracted from follicles on a woman's ovaries. The nice thing Abirami says was that she got to sleep overnight in the hospital for the procedure. Even so, she says, her pain didn't end after her eggs were extracted. Two years later, she sold her eggs to the same amount. For years, India's full-profit fertility industry was under-regulated and highly commercial,

but after a series of scandals, Lomek is reacted with a dramatic restructuring. In 2021, the assisted reproductive technology act or ART law, as it's called, restricted access to fertility treatments to married heterosexual couples. And demanded that women provide their biological material for free.

So, this is what the underground market looks like now.

Marginalized women often desperate for money sell their eggs for a fraction of the cost that it would be in the

U.S. and despite the great toll it takes on them and the cash being exchanged, fertility clinics and egg banks call this a donation. Academics who've researched this industry say as it exists, it's a disaster for vulnerable women. You've told yourself you've done something, but actually you only made it worse. That's Linda Marva. She's an assistant professor at the University of South Florida, and she studied the fertility industry. You've created a black market,

you've pushed it underground, which means that people participating in it have more protections. They have more bargaining power. If something goes wrong, they're already doing something

β€œcriminals, something illegal. So, who are they going to turn to for help?”

We spoke to three members of the regulatory board that oversees implementation of India's

assisted reproductive technology laws. They spoke on condition of anonymity because they're not authorized to speak to the media. They said the laws were designed to offer legal clarity for the industry, safety for couples trying to have a baby, and guaranteed medical insurance and care for the women whose eggs were being harvested, or who were acting as surrogates. The law was meant to halt the exploitation of those women. The board members we spoke to said they

were not aware of the vast underground market that has emerged since these new laws were passed. A senior member of the board was also not aware that in one case, in the northern city of Varunasi,

β€œa 13-year-old girl was lowered into selling her eggs to one of India's largest fertility clinic”

franchises. We met her to charity that defends women who've been trafficked. Her parents' request, we keep her identity anonymous. They say their daughter's been socially stigmatized, and she dropped out of school after her classmates found out that she sold her eggs. She's now 15. And she says about two years ago, an able told her she'd get $180 for her eggs. She didn't understand eggs, like a chicken.

But she says she really wanted a smartphone. The teenagers lawyer, Krishnogapal, believes this is happening to other miners, but there's no incentive for families to come forward. The teenagers' neighbor was arrested,

β€œbut he says the police have not followed up with the clinic that extracted her eggs.”

Police said that she's taken care of, so it's a lot of people who are involved. The clinic in question is part of the neuvel IVF fertility franchise. In a statement, neuvel IVF fertility said that the teenager was screened by separate company that signed off on having her eggs harvested.

Industry professionals who were critical of the new laws say there's just not enough oversight

of this massive industry. Consider this, according to the Indian Health Ministry, there's nearly 8,600 fertility clinics and egg banks operating in India. Just over 3,200 are actually registered. That's less than half. H says in her experience, the industry does what the industry wants. She says clinics and egg banks don't look very hard at her IDs.

She has two, and they fake to maximize her exals. The fake IDs list her as being under 30, because young women get more business. She's also lied about her height, she's on the short say, and she's lied about her faith. H is Muslim, but sometimes she pretends she's converted to Hinduism if that's needed. Clinic directors say some couples only want eggs from a woman who matches their faith.

Coming up after the break, the middleman, mostly women who operate in this underground market and how they shield the industry from accountability. We're back. This is a Sunday story with more from MPR's Dia Hadid. Pacing together how the industry functions was not easy. Doctors and clinic directors don't want to go on the record about their clients or their dealings.

Here's what one prominent fertility doctor told us about the process.

On the condition that we don't use her name or voice, because she doesn't want to come into

β€œthe government's crosshairs. We confirm to her account in dozens of other conversations”

with researchers, fertility clinic directors and women who sell their eggs. The doctor said when a couple comes to her and the woman can't produce her in eggs, she tells them that her hospital will help them, but it's going to cost a little extra. And one way she procures those eggs is through an agent. An agent is the person who will often end up finding women. They move them through the process of extracting their eggs and they

pay them. This go between person allows the fertility clinic to plausibly say,

"We are paying women for their eggs. We're paying an agent to recruit women for us."

It was even harder to get an agent to speak to us, but we found one woman. Her name is Ruby. We connected over a crackly Zoom call. "Hello!" "Hello!" "The earth, this is Ruby." "Oh!"

β€œ"Key asks me only use her first name. Of course, her work isn't legal."”

Ruby says she had a dead end draw, but a new Delhi call center and wanted to make more money. Her friend talked to her into selling her eggs and then Ruby realized she can make more as an agent. We hear it's common for women who age out of selling their eggs to turn to this hustle.

Each month, Ruby gets about a dozen requests for egg donors, mostly over what's out.

Ruby says clinics mostly want women who are educated, light-skinned and pretty. Some high-profile women. She finds them through her networks and social media. Ruby will find a donor, agree on a price, get their details. Sometimes she directs women to their scans, arranges their daily hormone jabs, lines up their agriculture. Clinics pay Ruby. She takes a cart between $50 to $100 and then passes the rest on.

She says her recruits are mostly poor. They've got alcoholic husbands, their single mothers. That's got money problems. There's an entire industry that's living off these women's biomaterials, right? But then you don't want to pay the women themselves. This is Prabha Karaswaran, a professor of law at King's College London. She's filed what's called an intervention in India's Supreme Court to demand women get

legally compensated for the work of producing their eggs. We live in a capitalist society. This is a sector that's generating so much profit for everyone concerned. Everyone else is getting paid without any restrictions.

β€œSo she says, why not the women who enable the industry to exist?”

Kataswaran acknowledges a lively debate in feminist circles. Some argue all commercial egg donation and surrogacy should be banned because of how it commodifies women, how it commercializes the creation of a baby. If that's the case, you really have a problem with commercialization. Why don't you regulate the private IDF sector? Nobody does that, right? But they want to tell the women they

shouldn't do it. It's a very paternalistic approach to say you're being exploited. You're a victim. We don't want it to be exploited or your body to be commercialized. So why don't you give up everything for free? And then everyone else will use it up for their own purposes and get what they want. Be huge amounts to form their families, but you won't get anything. H estimates she's harvested her eggs at least 30 times since she began.

If each round of eggs produced one baby, should have some 30 biological children. H is sure, though, she's made more babies than that. She says, "If each time they've harvested 20 eggs from my body, you can assume at least 10 kids have popped out." Schweter Desai, who was reporting the story with me, tells her,

"There's little research on the impacts for women who retrieve their eggs repeatedly. Critics say that reflects how little value is given to women who provide their biomaterial once their eggs have been removed. But one known impact is ovarian hyperstimulation syndrome,

Mild cases can cause bloating.

And according to reports published in two medical journals,

β€œtwo women died after these latest laws were passed, after they were stimulated to produce eggs.”

Is there more? There's no data, no reporting. And who would these women report to?"

There's one incident that H tells us that has never made it into a police complaint or into data.

Two years ago, she says, "She went to Chennai to harvest her eggs at a fertility clinic there. The agent, unusually, was a man. She'd never worked with him before, and she didn't like his vibe." She says, "When she came out of anesthesia, she realized her eye was swollen. Her lip was cut. She had Wiltson her back, and she was wearing a diaper."

She said, "She fled the hospital as soon as she was able."

β€œAnd she told us, "If that man did something to me,”

"may God punish him." Ever since then, H tells us, she experiences a sense of terror before she goes under anesthesia.

Weeks after our first meeting, we see H again. This time, we meet at a cafe in downtown Mumbai.

She's dressed the way she likes. Jeans, t-shirt, a short hair is found out. She's distracted, impatient, and constantly checking her phone. She talks to us while complaining that she's feeling bloated, nauseous, breathless, weak. She's nursing a bruise under her right eye. She says, "Her boyfriend is stressed. He lost another job to say he didn't lean to hit her heart." Besides, her face is at the bruises.

β€œShweta asks her about her short hair and tells me what H tells her.”

"I had very long hair earlier, but then I just dropped it because of our fight."

And she says, "What happened?" And she says, "Her boyfriend dragged her by her hair on a side wall." So she cut it off, despite him, maybe also to protect herself. But this is what she says, "He hater her and then what she did was she dropped her hair." And she's like, "Now who it is?" And Shweta says, "She's just been treated by a new agent." Shweta, she got half the money. She was promised for harvesting her eggs at a well-known hospital.

H says, "She only got $160 because the agent told her she didn't produce enough eggs." H was counted on that money because she's behind on rent. So she says, "She's taking drugs to try to speed up her next period. So she can be stimulated sooner to produce more eggs." H says, "I don't have a choice. I know this will kill me, but we'll all die someday, right?"

What comforts her is thinking about her kids? "I don't know what you're saying, so you don't know what you're saying." Her 11-year-old daughter, her 13-year-old son. "The ones she birthed herself, they're being raised by her ex-husband." She says, "I love them so much. Whenever I can, I give them money. They say I don't have to, but my heart

doesn't listen. After all, I'm a mother." "She pushes back her chair to leave. She's got word that should be able to see them. If she can leg it across town in half an hour, she's got to run." That was NPR's India Correspondent, Dia Hadid, and co-reporter Shweta Desai. This episode of the Sunday Story was produced by Justin Jan,

it was edited by Janishmit and Vincent Ni. It was engineered by Robert Rodriguez. Special thanks to Giselle Grayson and Anupama Chandra Sekaron. The Sunday Story team includes Andrew Mambo, and our senior supervising producer Leanna Semstrom.

Irene Negucci is our executive producer.

all the news you need to start your week. Until then, have a great rest of your weekend.

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