India’s black market for human eggs

0:00Today on State of the World, India's black market for human eggs.

0:09You're listening to State of the World from NPR. We bring you the day's most vital international stories, up close where they're happening. I'm Greg Dixon. In India, like a lot of places, couples are waiting longer to try to have children. That's given rise to a fertility industry and a demand for egg donors. But Indian laws constraining the supply of donated eggs means there is now a thriving black market in which women are paid for their eggs. But with this unregulated sector comes risks. NPR's Dia Hadid, with reporting help from Shweta Desai, has been investigating India's black market for human eggs.

0:48We meet Haech in a Mumbai cafe. Couples who need a human egg to have a baby like how she looks, pale skin, a pretty smile. H asks we don't use her full name because her survival depends on work that is illegal in India. She doesn't want to get caught. H estimates that over the past five years, she's harvested her eggs for money at least 30 times. If each time produced one baby, she'd have some 30 biological children. H is sure she's made more babies than that.

1:22H says you can assume they've made at least 10 kids from me each time I've had my eggs harvested. She says, I'm that fertile. Producing those eggs isn't easy. When H has a commission, she'll inject herself with hormones for days. She says it stimulates her ovaries to produce about two dozen eggs. Under anaesthesia, a doctor will insert a long thin needle through the wall of H's vagina to retrieve her eggs from follicles on her ovaries. Depending on the client, H makes anywhere from$280 to$800. Even the lowest amount is more than the monthly wage for most jobs in India. Women selling their eggs is an open secret in the Indian fertility industry, but it's unclear how many women do it.

2:08Off tape, H tells this to producer Shweta Desai, who interprets. There are so many of them who are doing this, who are literally running their houses on egg donation. This is often called egg donation. But selling her eggs is how H has survived since she left her husband. He took their two children. H was homeless. And a girlfriend told her, you're young and pretty, sell your eggs.

2:36Her girlfriend said, lots of girls do it. I've done it. Critics say this illegal market exists because India radically constrained the supply of human eggs after the government passed laws to regulate its fertility industry in 2021. The laws say a woman can only donate her eggs, she can only do it once. Supply was constrained as demand surges because women here are waiting longer to have children. Meanwhile, women don't have enough jobs and there's a lot of need. Prabha Kodaswaran studies the fertility industry's impacts on women. She's a professor of law and social justice at King's College London.

3:14In that context, if you bring about a law that essentially shuts down a certain sector, it may be well-intentioned, but it is bound to have unintended consequences. Unintended consequences. Kodaswaran says soon after the law was implemented, she found... There was a vibrant market in paid egg donations. That market can exist because there's no central registration in India. So there's no way of knowing how many times a woman has donated her eggs. When clinics need eggs for their patients, they often work through intermediaries who rely on people called agents, like Ruby. She asks we only use her first name.

3:52Her work isn't legal. In a month, Ruby gets about a dozen requests for egg donors, mostly over WhatsApp. Ruby says her demand is for women who are pale and pretty, like H. She finds them through her networks and social media ads. She gets paid for finding the women. We found this is how clinics and their intermediaries can claim that they aren't paying women for eggs. They're paying agents for recruitment. Ruby takes a cut between$50 to$100 and passes the rest on to the women whose eggs have been harvested. Vrinda Marava is an associate professor at the University of South Florida. She's researched this industry and says the new laws are harming people who are already vulnerable.

4:36If something goes wrong, they're already doing something criminal. So who are they going to turn to for help? H, who sells her eggs to survive, says she couldn't ask anyone for help when two years ago, a male agent sent her to a hospital to have her eggs extracted. H says she emerged from anaesthesia with swollen eyes, cuts on her lip, welts on her back and was wearing a diaper.

5:02H fled the hospital as soon as she could.

5:07H says, if that agent, that man, did something to me, God will punish him. Amid the demand for eggs in the northern city of Varanasi, a 13-year-old girl was lured into selling her eggs to one of India's largest fertility clinic franchises. Her parents request we keep her identity anonymous. The teenager says about two years ago, A neighbour who happened to be an agent told her she'd get$180 for her eggs. The teenager says she didn't understand. Eggs? Like a chicken?

5:42But she really wanted a phone. The teenager's lawyer, Krishna Gopal, believes this is happening to other minors, but there's no incentive for families to come forward.

5:56He says the clinic that extracted the teenager's eggs, Nova IVF Fertility, hasn't suffered any consequences. Nova IVF Fertility said in an emailed statement that the teenager was screened by a separate company that signed off on having her eggs harvested and they had no way of knowing the teenager's real age. We spoke to three members of the board that advises the health minister on the implementation of India's fertility laws. They requested anonymity. They aren't allowed to speak to media. None were aware that clinics were buying eggs from women through intermediaries. Kodaswaran, the law professor, says the best way to curb the black market for human eggs is to legally compensate the women who provide them.

6:37We think there should be contracts that are drawn up in favour of the women. She says without the women supplying their eggs, couples trying to have a baby in India wouldn't have options. There is an entire industry that's living off these women's biomaterial. But then you don't want to pay the women themselves. Weeks after we first met H, who sells her eggs to survive, we reunite in a Mumbai cafe. She's bloated, nauseous, breathless. They're all signs H was overstimulated to produce eggs. In rare cases, that can be fatal. H says, I know this will kill me, but someday we'll all die, right? Dear Adid, NPR News, with Shweta Desai in Moombra, Chennai, Varanasi and Mumbai.

7:35That's the State of the World from NPR. Thanks for listening.