The Donor Egg Choice
In a Lexington, Kentucky, fertility clinic, in a lab not much bigger than a walk-in closet, 300 eggs sit in liquid nitrogen, waiting to be chosen for fertilization. They belong to, among others, 19-year-old Victoria, a brown-eyed college student whose special talents include lacrosse and tennis; Kymberly, a 24-year-old Korean-American with a passion for hunting; and Priyanka, a 27-year-old Indian who speaks fluent Hindi. Plucked from the ovaries of healthy women under age 30, the eggs will almost certainly find their way into the uterus of a woman over 40.
And Diana Thomas’s company may well be making the match. In the next two years, her agency hopes to corner 10 percent of the egg donor market in the United States. Thomas, 52, started X and Y Consulting in 1996 to provide her clients — 99 percent of whom are over 40 — with viable eggs; eight years later, she launched a division, Cryo Eggs International (CEI), to offer women the option of using the latest frozen-egg technology. For Thomas’s clients, having the choice — and the chance — to become pregnant with a donor egg is the ultimate gift. But it comes with a price tag: The company’s clients typically pay from $25,000 to $40,000 for each pregnancy attempt that uses fresh eggs. The fee covers donor recruiting, compensation, and insurance; screening tests (donors have to take genetic and psychological exams); and transportation. The services of CEI, whose technology eliminates the donor’s need to travel, cost less: from $15,000 to $18,000 per attempt.
By age 40, the probability of getting pregnant with your own eggs is about 10 percent. By that time the eggs that remain often have abnormal chromosomes, and the embryos that do form end in miscarriage more than half the time. Although birthrates for women ages 40 to 44 increased by 62 percent from 1990 to 2004, the rise is linked mostly to advances in technology and the advent of many fertility-enhancing therapies. "Beyond 45, it’s rare to get pregnant. We’re talking almost lottery odds," says Jamie Akin, MD, medical director of the Bluegrass Fertility Center and of CEI. "The Hollywood actresses who become pregnant in their mid-forties have almost certainly done it with donor eggs."
The struggle to get pregnant is one that Thomas knows personally. She first attempted to conceive at 25, when she was newly married to her college sweetheart. They had settled in Edmonton, Alberta, where Thomas worked as head of architectural history and preservation for the province. Unable to get pregnant after trying for a year, Thomas and her husband were tested. He checked out fine. Doctors performed laparoscopies on Thomas, in search of fibroids or endometriosis or anything that might inhibit implantation of an egg, and when they found nothing, they began a series of fertility treatments. "I questioned myself all the time," Thomas says now. "I would wonder, should I stand on my head after sex? Did I contract a disease while traveling?" None of the treatments worked, and after three years, her marriage failed. Thomas moved to Phoenix and took a job preserving historic structures for the state.
But the desire to become pregnant never faded. She married her second husband, Andre Best, an environmental compliance officer for the city, when she was 33. Within a year she was back in the babymaking game.
This time around, Thomas was better prepared for the doctor visits — and their inevitable emotional toll. Sitting in waiting rooms, she could easily pick out the angry, the grieving, and the women like her, many of whom were eager to share their stories. Thomas signed up for intrauterine insemination (commonly known as artificial insemination), and when that failed, in vitro fertilization (IVF), in which eggs are fertilized by sperm outside of the womb. She and Best drained their savings and relied on their combined salaries — under $100,000 — to help fund treatments, which eventually totaled $60,000. When a sick neighbor that Thomas had cared for in Canada left her $7,000 in his will, she used the money for her third and final chance at an IVF pregnancy with her own eggs.
The day after the procedure, the phone rang in her kitchen. It was the embryologist, breaking the news that the eggs had not proved viable. "I was home alone, and I remember not being able to breathe," Thomas says. "It’s so overwhelming to hear that all of the money you spent and the effort you put into it and the hopes you had have just vanished." She was 39; it was time to move on.
Seeds of a Business
Thomas flirted with the idea of adoption, but soon realized it wasn’t for her. "I had a strong biological drive to carry a child," she says. "Anybody who is infertile has this image in their mind; they think it is their God-given right." For that reason, and because she wanted her husband to have the opportunity to pass his genes on to the next generation, she began to consider using donor eggs. "I had to let go of the idea that my child would have a nose like my mother’s or that he would be three-quarters Irish," she says. "I decided to use another woman’s eggs because I felt very strongly that I would love the child no matter what."
That was 1995, when there was little choice with donor eggs. "You had to face that you were replacing yourself, and the clinics were handing you two profiles to choose from," Thomas says. "The process didn’t acknowledge the emotional side of using an egg donor." That’s when she got the go-ahead from her doctors to search for a donor herself. She placed an ad in Arizona State University’s student newspaper that read: "Would you like to help a couple have a child? I’m looking for an egg donor. Can we meet?" Six young women responded. Armed with literature from the American Society for Reproductive Medicine, Thomas met each of the potential donors at an espresso bar on ASU’s main drag.
Thomas instantly connected with Nicole Leach, a 20-year-old student who shared Thomas’s coloring and also asked smart, serious questions. Thomas agreed to pay Leach $500. Leach spent a month wearing estrogen and progesterone patches, and then took the Pill to synchronize her cycle with Thomas’s. When Leach’s eggs matured, they were removed by needle from her ovaries. Thomas drove Leach to the specialist’s office and sat in on the procedure so she could hold her hand. "I felt like her mother," Thomas says. "I was very protective of her."
The eggs were mixed with Best’s sperm that same day. Three days later, Thomas stared at the eight-cell embryos under a microscope moments before they were transferred to her uterus, a privilege not available in today’s era of malpractice concerns and strict privacy laws. "Imagine knowing the moment of conception," she says. "I felt like I was in a sci-fi movie." Thomas waited nervously for an embryo to attach to her uterine wall. The stakes were high: The donor cycle cost $40,000, which she and Best had financed by taking out a second mortgage. To their profound relief, it worked. Their son August was born in 1996, the same year Thomas turned 40.
The Technology Connection
A few months later, Thomas got a call from her fertility specialist. For once the doctor didn’t want to discuss hormone levels or follicle growth. Instead, the physician had another couple desperate to choose their own egg donor, and they hoped Thomas would help them find someone. "It began to resonate with me that there was something in this," says Thomas, who had transitioned to a job share at the historical registry so she could spend more time with her son. "I realized I could control my own hours and do something that was immensely gratifying." She named her company X and Y Consulting and invested $10,000 in ads, computers, and attorney fees for drafting contracts.
In the next four years the business grew, and so did Thomas’s family. In 2000, she managed the construction of a home office from her hospital bed, where she was in preterm labor with her twin sons, Emerson and Nolan, a "gift" from Tiffany Bates, a donor whom Thomas had recruited to X and Y the year before. By this time, she was experienced at brokering relationships between donors and clients, and well understood the pitfalls. "Everyone in this business faces legal situations," Thomas says. "Your clients may have spent thousands of dollars vetting a donor, and then the donor says, ‘Gee, my boyfriend doesn’t like this.’ I have had to learn how to negotiate those situations over the years."
Also in 2000, Thomas decided to go national. She took her business to the Web (eggdonorsnow.com), where she posts photos of donors alongside lists of their talents and interests — a sort of match.com for the childless. "I’d get the fallout from these fly-by-night operations that were started by donors who thought, this looks like an easy way to make money," Thomas says. "My resolve was to be as good and ethical and knowledgeable about my business as anyone can be." She says her biggest challenge was charging for her services: "It probably sounds odd, but I knew from a recipient’s perspective how unbearably expensive the whole process was. My goal wasn’t to create another barrier for anyone."
Then, in 2002, she attended a conference on reproductive technology and heard for the first time about a theoretical method called cryopreservation. Embryos had been successfully frozen since 1986; this would extend the technology to freezing donor eggs, which would make the need to synchronize cycles obsolete. Instead of flying donors around the country to meet a recipient for egg retrieval, Thomas would only need to ship the eggs, dramatically reducing costs. "I knew it would be the future of the industry," she says.
Helping Other Women
The following year, Jeffrey Boldt, PhD, scientific director for assisted fertility services at the Community Health Network in Indianapolis, published a research paper in which he demonstrated a 46 percent pregnancy success rate using cryopreservation. Thomas and Akin, from the Bluegrass Fertility Center, met with Boldt to discuss starting a commercial egg bank, and the trio formed CEI. They enlisted six physicians to invest; Thomas, who owns 60 percent of the business, contributed $60,000.Akin would act as medical director, and Boldt would supervise the lab as scientific director.
For the first frozen-egg retrieval, Thomas boarded a plane with 15 recruits and met Akin at the lab in Lexington. "I felt like a den mother," says Thomas, who regularly traveled with her young donors (now chaperones go in her place). "They were all in their twenties and on hormones. They acted like 16-year-olds, I’m afraid, but it was a lot of fun." The experience convinced her that frozen-egg banks would soon become as ubiquitous as their sperm counterparts. Now she is aiming to become a leader in the global egg bank market; already 85 percent of CEI’s inventory is sent to Europe.
But as CEI came together, Thomas’s marriage fell apart. She and Best legally separated in 2005, and their divorce became official in 2007. Thomas attributes the split, in large part, to their protracted experience with infertility. "Having children became both a mutual goal and a consuming focus in our lives," she says of the 10-year stretch. "Once we completed our family, we realized that without a joint goal to focus on, we had little in common." Best declined to comment for this story.
Today, with the boys ensconced in their routines (August is now 12 and the twins are 8), Thomas says she couldn’t be happier. "I love being an older mother," she says. "And it’s rewarding to know that I have cut the learning curve in half for others like me who have had to figure out how to have a baby when our biology says it’s too late."
Originally published in MORE magazine, December 2008/January 2009.