Every life starts with an egg. [Alarm rings] — Oh, my god! I am late again. I got up with a sudden jerk. Got ready, got dressed, and went to wake up my daughter. “Eli, wake up! It’s 8:00 AM, the sun is above your head.” I almost screeched, scurrying to the kitchen. Eli rushed to the bathroom without saying anything. She has her important presentation today. Eli is nineteen and is working as an intern in a software company for her summer project. By the way, I am Marissa, and I am fifty years old, working in a biotechnology company. Life is busy for me, always has been. I took four eggs out from the refrigerator and started whipping them to make a big omelet for the two of us for breakfast. How one egg is so quintessential for life! All it takes is one egg to begin life. As I am thinking and whipping eggs, I drift to the memories several years back. ***** I was a nineteen years old biotech student in college. An aspiring student, but financially challenged. I was also teaching swimming classes as a part-time job. Life was good back then. I had no worries about anything. I had these two boys in my swimming class that were just fantastic. I got to know their parents very well. One day after swimming lessons, the boys’ mother and I were having a little chit-chat, which changed my life completely. “Marissa, do you know, my boys are adopted? My husband and I went through several fertility treatments, but I never could get pregnant.” She said wistfully. That day we spent a lot of time talking about how she made her family. It was just fascinating to me that there were people who desperately wanted to have kids, and for some reason they couldn’t get there on their own. “Marissa do you know, these clinics are always looking for really intelligent women with a good background who would be interested in helping other people by donating their eggs.” She looked in my eyes with eagerness and empathy. “I am too busy with college work and part-time jobs. I can’t even think of this sort of thing right now. Financially, I have to make two ends meet.” I had laughed it out. “You know you’ll get compensated for egg donation.” She had almost coerced me. Neither of us brought up this topic after that day. But the thought was there — in the back of my head.  Well, that’s a way I can help people, and I’m not using my eggs right now anyways, they are just getting wasted every month. I only had a smattering of egg donation processes back then. So I went to the same clinic the boys’ mom had gone through and met Dr. Carrie, and the endocrinologist, Dr. Susan.  “Look, this is a really long and involved process.” Doctor Susan disclosed honestly. “And I know you are a student. So we will compensate you; we’ll pay you for this moral ordeal. I hope that amount will help you unburden some of your financial loads. We call it a donation, but we pay you for this, because of what you are going to go through in the donation process.” Dr. Carrie made it sound very appealing. I had nodded in agreement. Although I hadn't completely decided yet, there definitely was a sense of altruism. “I want to learn a little more about my own body and the reservoir of eggs I have before I make a decision.” I didn’t hesitate to put forth myself first. “Sure! Look, there’s no pressure, but when you are in your 20’s, you are most fertile, that’s when you have lots of mature eggs in your uterus, ready to go; BOOM! The older you get, the harder it will be to get pregnant.” Doctor Carrie enunciated. “For the same reason, if you are a career woman, I would suggest that while you are donating eggs, why not freeze some eggs for yourself to use later, when you are actually ready to have a family. You don’t want to be under that ‘biological clock’ pressure — do you?” Dr. Susan suggested. That really hit the nail on my head. Still undecided, I had got up, turned, and walked to the window. I certainly have plans for my career; also one day, I would definitely want to have a family and have kids. “What do you mean by ‘biological clock’?” I turned back to doctors with a concerned look. “This term was coined by Richard Cohen in 1978 for women in a workplace, and he framed reproduction solely as a woman’s problem. He described the biological clock as a handicap, really as a disadvantage.” Dr. Susan added.   “Oh, wow! Looks like ‘biological clock’ is a real thing.” I interjected. “He didn’t mean it as a put down though, it’s a reality.” Dr. Susan said insightfully. “Well, how much truth is there to it? Now that medical science has developed more than before.” I had asked inquisitively. “The whole question is how much are you willing to give up in your career to have a child? Do you have to give up anything?” Dr. Susan challenged formidably. “Now women can freeze their eggs, donate their eggs, and I think that’s wonderful.” Dr. Carrie sounded optimistic. I had never felt I was defined by my biological clock, and while I had more opportunities and choices than women before me, I still did not know how my body worked. “Could you elaborate a little, about how our body works? What ‘biological clock’ really is?” I was in my quest to know everything before I endeavored with my egg freezing and donating. “Your biological clock is the point in time at which you no longer have viable eggs that can be fertilized and make a baby. Women are born with all the eggs we’re ever going to have, and so lots of people think of egg freezing as a way to extend the biological clock.” Dr. Carrie said with conviction. “But I’m nineteen and I really feel young!!” I was firm. “In egg years, that’s not true! It varies from woman to woman, but broadly speaking, women are born with more than millions of eggs. Thousands of eggs die every month until puberty, and we’re left with about three hundred thousand to five hundred thousand eggs. We’ll continue to lose about a thousand eggs a month after puberty until menopause, when our ovaries stop releasing eggs.” Doctor Susan enlightened me. “In that case, donating eggs doesn’t look like a good idea to me.” I had almost made up my mind not to donate at this point, just freeze eggs to use them later.  “But until you decide to have a family, you are losing so many eggs in vain, why not let someone who is desperate, use it!?” Dr. Susan stepped closer to me. “As we get older, our eggs lose freshness, just like eggs you’d buy at the grocery store. But for women this means that the eggs can develop chromosomal abnormalities.” Dr. Susan tried to convince me. Why waste my eggs if someone else can use them! I’ll do it. Before the day dawned I had made my decision. The process started right away. I was given a manual of twenty pages, a few forms to fill up about my life, my family’s medical history — to check if there are no health issues, no genetic diseases, and no cancer history anywhere.  The process of going through the egg donation was very much like, “Oh well, we get a lot of donors and it would be very special if you were chosen.” You kind of develop this train of thought, where you really want to be chosen. It would be something special to be one of the chosen ones that could help people. So I signed the disclosure-agreement papers. The disclosure was of one page, and the only mention of any type of cancer was a two-sentence short paragraph that said — “ In the 1970’s it was thought that exposure to this type of hormones for a lengthy period of time could cause ovarian cancer, and that has since been proven false.”   When I had read the word cancer, it stood out to me; it really made me stop and say, I’m gonna read that again, because I don’t want to put myself in a situation where I could potentially be harming myself or my ability to have children later on. Finally I signed the document, because I felt that this form was presented to me by doctors, written by doctors that I could trust. I was chosen within a couple of weeks of having submitted my information. I was very much made to feel, “wow! You’ve been chosen; this is so exciting; we can’t wait for you etc-etc.” On donation day, the doctors did my ultrasound, measured the number of eggs, how quickly they were growing, and the time of retrieval. They gave me an HCG injection. That’s a shot that triggers your body for egg retrieval. They knocked me out and went in with a needle and extracted my eggs. When I woke up after the retrieval, the nurse had come in and said, “I can’t wait to use you again. You lit up like a Christmas tree in the Time Square.” “What do you mean?” I had asked. “I’ve never gotten so many eggs from a donor before.” The nurse’s eyes had widened.  Oh, that’s kind of cool. That’s good for the recipient, because now she won’t have to go through this painful process again; now that there are so many eggs for her to use. So now lots of my eggs were sent to freeze, and the rest went for donation. I was happy that I could help someone. It also gave me peace of mind that I am not under pressure of ‘biological clock’ anymore, but I felt very sore and exhausted for several weeks afterwards. It was relatively a minimal amount that I was compensated with — sixteen hundred dollars, and that went for the fee, books, and classes for that semester. For the amount of pain I had gone through, I wanted to ask for more, but to me that felt like less of a donor relationship, and more of a sales relationship.  A few months later, I got a call from Dr. Susan. “Hey Marissa, it’s really exciting that another family has chosen you. Would you like to donate again, since it worked so well the last time?” Dr. Susan had sounded exhilarated. I was definitely not forced, but I do think that I was a little naive, and it didn’t occur to me that I could say “NO”, because in my mind, I would have been saying, no I don't want to help people anymore, because I felt very sick for the next couple of weeks after donation.  Instead, I had said “YES.” After I donated for the second time, I was approaching the time in my academic career where I needed to have a culminating project. I chose to do my project on infertility and the role an egg donor might play in that process. My project demanded a lot of work and time, but my health was not allowing that. I was feeling unwell; more mentally than physically. Why did I think that? Because I could feel a palpable lump in my breast, tiredness, and mood swings. I had a mammogram and ultrasound and they told me, “it’s just a cyst and that is because of your age.” It was scary to go for a mammogram at twenty-four, but I thought, okay they know what they are doing. Throughout that year I had watched that lump grow, and I just kept convincing myself that it was a figment of my imagination. By the time two months passed, I decided to see a different PCP.   “Is there a family history of breast cancer?” The PCP asked me casually. “No.” I had said firmly. “Good. So you are healthy and young. The only risk factor you have is that you are a female.” And we just laughed. “To be on the safe side let’s do a mammogram and biopsy; nothing to worry about.” The PCP had smiled to put me at ease. I went for the tests. The results were sent to my PCP and the oncologist, but I knew right away that there was something wrong. Just by the demeanor of the person who was doing the scan, had somewhat revealed it to me. I had to see the oncologist in two days. “I am really sorry to say that the lump turned out to be cancer in stage four. It’s invasive ductal carcinoma and it has spread to your bones and your liver that have metastasized.” The oncologist had said. “Are you sure?” “It’s very odd to see someone your age, with this type of cancer. It’s present in women that have been through menopause, women that are receiving hormone treatments, or women who have multiple pregnancies.” Oncologist said. The oncologist had felt that it was very strange that I was there at the age of twenty-five.“Have you ever been on hormones or pills or that sort of thing?”  I told her my history of egg freezing and donation, and I remember seeing the look on her face. “Did this cause my cancer??” I had asked. “I am a firm believer that a positive attitude is just going to do as much for you as the medication that I’m going to give you.” She didn’t answer my question. Later on she went on so far as to say, “yes we do have information that shows that exposure to these hormones can result in certain types of cancer or at least increase the chances.” “Is this something that you know, because you are an oncologist or this is something that all doctors know?” I had asked her point blank. “This information is available to any doctor that wants to find it.” The oncologist had alluded. For me, that was crushing to hear, because that was the first confirmation, that Dr. Carrie and Dr. Susan were probably using me.  What were these doctors thinking, if they knew that the drugs and the hormone injections that I was given as a donor, had a connection to women that develop certain types of cancer? Was it appropriate to give me the hormones, and take that risk without ever notifying me that it was a risk?  Well, you know, it is a painful and private story and there has been some shame that came along with it in admitting that I willingly chose to do something that I thought I was informed about. However I would always wonder if there was more, that I could have done to truly understand what I was getting myself into? My treatment began right away and I started to see the rays of light. Since I was young and strong, my body responded well and chemotherapy was tolerable. I had support from my parents. I got involved in the cancer society relay. That day I couldn’t be in the sun because I had chemotherapy the day before. That night I was walking laps with my dad in the dark and it was the first time that we talked about me being an egg donor. “You and I both know that if you had not gotten the hormone injection, there’s no reason that you would have gotten cancer that would have shown up at twenty-four. If all you were exposed to was just your natural estrogen, this wouldn’t have happened.” Both of us nodded in agreement. At thirty-three, I got married and settled down, I tried to get pregnant naturally, but it never happened. After trying for two years I finally gave up. You might be wondering, what happened to my eggs that I froze to use later? My husband and I decided to use my frozen eggs, and go through the IVF process. We had 4-5 failed attempts, which lead to miscarriages every time. I couldn’t take it anymore. I was not ready to torture myself mentally and physically anymore.  We decided to adopt a beautiful girl, Eli. Even though I had regrets from the past, and fear of the future, I was very optimistic for my life ahead. **** Eli rushed out of her room, breaking the silence, dressed up and ready to leave. “Mom can I have a quick breakfast please? Oh, no, not again! Mom, look, your omelet is burning again.” Eli quickly turned off the heat, took the spatula from my hand, and tried to flip the omelet which was already half burnt. Smoke started wafting from the kitchen as well. “Mom, are you lost in your thoughts again? You need to let it go mom! You can't keep beating yourself up for something you weren’t aware of.” Eli locked me in her embrace. “It’s just that, every time I see eggs, I start thinking about getting the word out and saving as many girls as I can. Most young women conjecture egg donation to be harmless; which is not true. It’s a brutal process; injecting hormones and being forced to ovulate multiple times has significant health risks. I don't want a single young woman stripped ruthlessly of her eggs by means of fraud, coercion, or deception to be used selfishly for another’s gain, with a total lack of regard for the well-being of the donor.” I said, choking back my tears. For me, I hold grief in one hand, and gratitude in the other hand but for someone else it can be disastrous. At age forty-two, I was scheduled to have a follow up scan and since then my cancer has been inactive till this time.  __________________________ Glossary: PCP — Primary Care Physician HCG — Human chorionic gonadotropin IVF — In Vitro Fertilization Author Note: This is my interpretation of the prompt image: Human face:- A woman being over stimulated by injections,hormones which lead to  spewing eggs everywhere. Broken ladders :- genetic abnormalities/ DNA molecule double helix chromosomes Broken clock :- woman’s disrupted biological clock. Melting world map :- Egg donors suffering problems world wide.

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