India's Underground Egg Market: Poverty, Loopholes, and Exploitation

Despite India's Assisted Reproductive Technology (Regulation) Act of 2021 outlawing the for-profit sale of human eggs, a thriving black market persists. Women, often driven by dire financial necessity, are illegally selling their eggs for In Vitro Fertilization (IVF), exposing themselves to significant health risks and exploitation in an unregulated environment.

Egg Sellers' Harsh Realities

One woman, identified as "H", 34, embodies the precarious reality of these sellers. Over five years, she estimates undergoing approximately 30 egg retrievals, producing 20-30 eggs per cycle. For each cycle, she receives between $280 and $800, a sum often exceeding average monthly wages in India. The procedure involves hormone injections to stimulate ovaries, followed by surgical retrieval under anesthesia.

H employs fake identification to bypass age restrictions and religious preferences sought by some couples. Her experiences include overstimulation symptoms, non-payment, and even alleged assault. She did not report these incidents due to the illegal nature of her activities, highlighting the extreme vulnerability of those involved.

"She has experienced overstimulation symptoms, non-payment, and alleged assault, which she did not report due to the illegality of her activity."

Legal Landscape and Unintended Consequences

The 2021 ART Act aimed to regulate an industry previously characterized by commercial surrogacy, which had earned India the moniker "global baby factory." The law strictly limits egg donation to a single instance for one couple. Donors must be 23-35 years old, previously married, and have at least one child aged three or older.

However, these stringent restrictions have inadvertently fueled the black market. Professor Prabha Kotiswaran, a vocal critic, argues that demand for eggs remains high due to Indian women delaying childbirth and pervasive economic inequality.

"Critics, including Professor Prabha Kotiswaran, suggest these stringent restrictions have inadvertently created a black market."

How the Black Market Operates

The black market thrives on the absence of a central registry for egg donors, allowing women to operate across different regions with relative anonymity. Clinics often face challenges in verifying donor identities; Dr. Duru Shah, a Mumbai clinic director, noted the difficulty in confirming a donor's prior history. There are also commercial incentives for clinics to encourage women to produce more eggs than the legally recommended seven per cycle.

Intermediaries play a crucial role in facilitating these illicit transactions. ART banks and agents connect prospective donors with clinics and couples. An agent named Ruby reported receiving around a dozen requests monthly and recruiting women via social media, taking a commission for her services. This indirect payment system allows clinics to claim compliance by paying ART banks rather than individual donors directly.

Vulnerability and Lack of Protection

The women involved in selling their eggs are typically poor, driven by urgent financial needs such as rent, school fees, medical expenses, or funeral costs. Social stigma is also a factor, with some associating egg retrieval with sex work.

Sellers like Abirami, who is illiterate, have described being rushed through paperwork and enduring painful side effects, including nausea and abdominal swelling, consistent with ovarian overstimulation.

Sociologist Vrinda Marwah asserts that the new laws have exacerbated the vulnerability of these women. By pushing the practice into an unregulated black market, they are stripped of legal protections and recourse for any issues or abuses they may face.

"Sociologist Vrinda Marwah asserts that the new laws have exacerbated the vulnerability of these women by pushing the practice into an unregulated black market, where they lack legal protections and recourse for issues."

A Minor's Case: Allegations and Inaction

A particularly disturbing incident involved a 13-year-old girl allegedly coerced into selling her eggs to a branch of Nova IVF Fertility in Varanasi. The teenager used a fake ID, presenting herself as an older, married woman.

Despite a police complaint filed by her family, her lawyer, Krishna Gopal, stated that no action has been taken against the clinic or the doctor involved. Nova IVF Fertility commented that the teenager was screened by a separate company and they were unaware of her actual age.

Call for Reform and Oversight

An anonymous senior member of India's regulatory board acknowledged that the laws aimed to protect women from exploitation. However, this official was reportedly unaware of the ongoing black market activity and confirmed there are currently no plans for an egg donor registry.

Professor Kotiswaran proposes a critical solution: legal compensation for women's labor in generating and retrieving eggs, rather than for the eggs themselves. She argues this approach could mitigate the black market and offer essential protections. This proposal highlights the disparity of an industry that profits significantly from women's biological contributions without providing direct, legal compensation to the women themselves.

"Professor Kotiswaran proposes that legal compensation for women's labor in generating and retrieving eggs, rather than for the eggs themselves, could mitigate the black market and provide protection."