By Helen Grange
South Africa has a well-priced and desirable commodity to offer the world - human eggs.
Infertile couples from all over the world are increasingly choosing local fertility clinics to realise their dream of having a baby, and like the phenomenon of plastic surgery safaris, they are linking their reproductive mission to an affordable holiday.
The most popular clinic among couples from America, the UK, Australia, Europe and countries in Africa is the Cape Fertility Clinic, run by Dr Paul le Roux and partner Dr Klaus Wiswedel.
"We are getting between 30 and 40 foreign visitors a month seeking egg donations, and it's because the medical care here is very good, and highly personalised," says Dr Wiswedel.
The Cape Fertility Clinic is among four fertility clinics - two are in Johannesburg - listed on the international website www.renewfertility.com, an American-based site founded by Californian Robin Newman.
She herself came to SA looking to redress her childless status, found the facilities here world-class, and now helps others find their way here through her website.
Her site features a comprehensive list of tariffs for hotels and lodges, as well as for an egg donation programme - which Dr Wiswedel tags at between R35 000 and R45 000 over a 10- to 12-day period.
"The Internet has enabled fertility clinics to compete globally," says Dr Wiswedel.
"Our competitors are not in South Africa - they are in Cyprus, Moscow, Spain.
"We help with finding these couples accommodation, and they are also spending millions on the tourist attractions in and around Cape Town.
"Most importantly, we are giving these people a gift they desire most in their lives, which is very gratifying."
Typically, the egg recipient is a woman in her late 30's or 40's who, due to putting career first, has left child-bearing too late, he says.
At the Sandton Fertility Clinic, also on Newman's site, director Dr Goolam Mohamed puts about three or four foreign couples a month into egg donation programmes, and says they have usually spent many heart-breaking years trying fertility treatments, at enormous cost, before opting for egg donation.
The first egg donation programme in SA took place in 1986. It carries a 45-70 percent success rate, depending on the age of the donor, as fertility is defined by the age of the eggs.
Waiting periods for an egg donor in the past were long - up to two years, but egg donor agencies have helped to shorten this time.
"The donor agencies we use are very professional," says Dr Wiswedel.
"The egg donors are carefully screened. They are provided with support through the whole process, so they know exactly what they are in for."
One of these agencies, which seeks donors mainly via its website, is baby2mom, founded by Jenny Currie. It has been running for just less than a year, and has so far achieved 15 pregnancies from 39 egg donor programmes.
Although egg donation is the most successful of fertility treatments, it is not without risk.
Donors are given, for two weeks, powerful hormones to stimulate their ovaries to produce a batch of eggs (usually between 10 and 20 ).
These drugs can cause bloating and irritability, but in isolated cases lead to a rare, life-threatening condition called "ovarian hyperstimulation".
There have also been a few reports of donors been left sterile by the egg retrieval process.
But Dr Johan van Rensburg, of the Medfem Clinic in Joburg, says the risks are negligible if the procedure in done by a reputable fertility clinic with skilled and responsible medical staff.
"If the donor is stimulated in a controlled and careful manner, and well-monitored throughout, it should not compromise her health or fertility in any way," he says.
Dr Mohamed confirms this, adding a South African donor won't be used more than two or three times.
"At my clinic I won't allow more than two donor pregnancies."
Under the Human Tissue Act, donors are not permitted to be paid for their eggs. They are, however, entitled to compensation or a gratuity for time spent on the donor programme, and for transport.
This will vary from clinic to clinic, but up to R6 000 is an acceptable fee for having to take the hormones, and having three scans to confirm that the drugs are working effectively.
Jenny says many of the donors are housewives with the time to go through this taxing process, and are "genuinely altruistic people".
They are ideally between the age of 18 and 34, must be medically and psychologically healthy, and have an acceptable body mass index (not too underweight or overweight).
Donors with a history of genetic or other familial illness will be excluded.
Ultimately, a team approach is used to screen donors, involving doctors, social workers and professional nurses.
The donor is involved only up to the point that her egg is harvested, with no further commitment after that.
The only information she is entitled to is whether the recipient achieved a pregnancy. She remains completely anonymous, as do recipients.
The eggs are retrieved via the vagina on the day the donor ovulates. It is a minor, 20-minute procedure, under sedation, in a safe and secure environment, says Jenny.
In the meantime, the recipient has been prepared, with medication, to receive the egg, which is fertilised with her partner's donated sperm and grown in a special medium before being implanted in her womb five days later.
After a two-week wait, a pregnancy test is performed.
The egg contains the genetic material and make-up of the donor, so the child conceived will carry these genetics.
"We try to match up the donors as closely as possible to the recipients, physically and racially, so the children look like their parents," says Jenny.
"Although the recipient isn't the genetic mother, these children tend to assume other familial characteristics from being in the presence of their parents, such as laughing, talking and walking mannerisms."
Jenny says egg donation is a way to deal with infertility in a confidential manner, and many recipients opt to keep the details of their child's conception a secret, even from their families and their children.
But while all these people are different, the opportunity to have children that carry at least half the family's genetics is "often the most dreamt-about and greatest wish for many people, and a way to complete and balance their lives", says Jenny
"The gift these donors bestow on an infertile couple is extremely special and precious," she adds. "Egg donation changes 'Sorry, you can't have children' to 'Through the generous donation of an angel, you can be pregnant'."
Anne (not her real name) was just 29 when she was diagnosed with early menopause.
Her ovaries had diminished to the size of peanuts, a condition that affects about one percent of the population, and in her case had no known cause.
"It was devastating," she says. "I was married, had never had any major illness, and so desperately wanted my own children.
"When I found I could not get pregnant, I tried everything - faith healing, reflexology, hypnotherapy, acupuncture and herbal treatments. The fertility specialist eventually pinpointed the problem."
Realising there was no "cure" for her infertility, Anne found herself on the verge of serious depression.
"I also felt terribly inadequate and empty, and robbed of my femininity," she says.
Then fate stepped in and heralded new hope. Anne received a call from the fertility clinic saying it had found her an egg donor, a woman prepared to have eggs retrieved from her ovaries, to be fertilised in vitro by Anne's husband. The embryos would then be implanted in Anne's womb.
After three failed egg donor programmes, Anne finally achieved a pregnancy. Of two implanted embryos, one had attached itself to her womb lining, which had been carefully prepared with medication to receive a fertilised egg, and continued to grow.
Today Anne has a three-year-old daughter, who she says has completely changed her life. "I resigned from my job when my daughter was born. "I didn't want to miss a moment of this miracle!"
Anne is now trying for a sibling, though it seems she was fortunate to have one child.
She has tried four times to become pregnant with donor eggs since, at a cost of between R20 000 and R40 000 per attempt, but none of the eggs has attached so far.