Traders of gametes, brokers of values: Mediating commercial gamete donations in Delhi

Abstract

Scholarly analyses of transactions of biological material are often focused on either the moral economy of exchange or the political economy of production. In this paper, I highlight the ambiguities that characterize commercial gamete donations in daily clinical life in In Vitro Fertilization (IVF) hospitals in Delhi through agents’ practices of valuation. In Delhi’s IVF economy, agents occupy a pivotal role in mediating gamete transactions: not only as traders of biological substances but also as brokers of values. Aligning various regimes of value, they let transactions appear as morally meaningful as well as economically profitable to donors. Agents also make use of polyvalences and frame transactions in distinct lights in negotiations with different participants. It is their mediations and practices of valuation, I argue, that make commercial gamete donations viable and sustain Delhi’s intimate IVF economy.

Keywords:

• agents
• gametes
• practices of valuation
• intimate economies
• reproductive technologies
• India

Acknowledgements

I am deeply indebted to my interlocutors in Delhi for generously sharing their experiences. Thanks also to Samina Khan, Vivek Kumar Shukla and Nidhi Mittal for their advice and friendship over the course of this research. Sneha Banerjee, Supurna Banerjee, Jacob Copeman, Christian Strümpell and my colleagues at the Department of Social Anthropology and Cultural Studies at the University of Zurich provided helpful comments on earlier drafts of this paper. This part of my research was funded by the ‘Asia and Europe in a Global Context’ Research Cluster at the University of Heidelberg, Germany.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Sandra Bärnreuther is an Assistant Professor in social anthropology at the University of Lucerne, Switzerland. She is also an Ambizione Research Fellow with the Swiss National Science Foundation and an associate member of the ‘History of Knowledge’ Center in Zurich.

Notes

1 I use the terms ‘agents’, ‘brokers’ and ‘middlemen’ interchangeably in this paper.

2 Gametes are germ cells. I refer to female gametes as egg cells or oocytes and to male gametes as semen or sperm. While the focus of this paper lies on egg cells, I discuss semen donation at the end of the paper. Furthermore, although the terms ‘donation’, ‘donor’, and ‘donate’ are contested, I continue to use them in this paper, as they reflect my interlocutors’ language (see Deomampo, 2016, p. 14).

3 In Vitro Fertilization (IVF) literally means fertilization inside a glass, implying that fertilization takes place outside the body, in a petri dish in a laboratory. In most cases, the medical procedure involves hormonal ovarian stimulation to grow several egg cells, then extracting these cells from a female body, fertilizing them with sperm in a laboratory, and inserting the developing embryos inside the uterus.

4 Consent was granted orally, and conversations were recorded on tape or in writing. Some of the direct quotations are not verbatim because they derive from notes typed out after the interview. All names used in the paper are pseudonyms.

5 Deviating in important aspects from Mauss' (2002 [1925]) famous description of the gift in Polynesia, dān – the ‘pure’ gift (J. Parry, 1986) – has been an object of scholarly scrutiny in India for many years (e.g. Heim, 2004; Laidlaw, 2000; J. Parry, 1986; Raheja, 1988). One of the most distinctive features of dān is that it remains un-reciprocated in the here-and-now. The fruits of religious merit (puṇya) are yielded only later on. Furthermore, dān ‘is alienated in an absolute way’ (J. Parry, 1986, p. 461). Hence, in contrast to the Maori gift, dān does not work as a ‘mechanism of social solidarity through mutual exchange’ (Heim, 2004, p. 34; see Laidlaw, 2000). This is also connected to the fact that dān is not motivated by altruism or compassion (Heim, 2004, p. 54), but – in a contemporary Hindu context – it works in a purificatory way (Raheja, 1988; cf. Copeman, 2011, p. 1060; J. Parry, 1986, p. 459).

6 One British pound amounts to roughly 90 Indian rupees (Rs), one euro to 70 Rs, and one US dollar to 55 Rs.

7 While their ‘bioavailability’ unites these workers, the gamete market is highly stratified as the scale of payment varies drastically between donors and is based on existing fault lines of inequality, such as religion, education and caste.

8 Clinical labour power in India’s IVF world has also been discussed with regard to surrogacy. Pande (2014), for example discusses surrogacy as ‘wombs in labour’, and Rudrappa (2015) describes a surrogate agency as a ‘model neoliberal firm’ that integrates women ‘to the reproductive assembly lines’.

9 Latour (2005, p. 39) defines an intermediary as something that ‘transports meaning or force without transformation: defining its inputs is enough to define its outputs’. He states that mediators, in contrast, ‘transform, translate, distort, and modify the meaning or the elements they are supposed to carry’.

10 The practice of IVF in India is partly moderated by the National Guidelines for Accreditation, Supervision and Regulation of ART Clinics that were issued by the Indian Council of Medical Research (ICMR) in 2005. However, these are not legally binding. Furthermore, the Assisted Reproductive Technologies (Regulation) Bill, a document that aims to turn some of the regulations posited by the Guidelines into law, has been awaiting debate in parliament for several years. Yet, although they are toothless so far, both documents are effective, as they inspire a ‘regime of self-regulation’ (Spar, 2006, p. 34) and govern clinical practice through the logic of anticipation.

11 I have addressed recipients’ demands regarding donors elsewhere (Bärnreuther, 2018). Suffice it to say that these expectations influence recruitment practices as well as the amount of compensation paid to donors. Yet, clinicians, agents and donors also negotiate recipients’ demands in creative ways (e.g., Muslim donors introducing themselves with a Hindu name).

12 It is important to note the differences between biological substances such as sperm and eggs within IVF hospitals. Sperm is located on the lower echelons of the clinical hierarchy because of its easy availability, plenitude and storability and the low amount of specialist work required to handle it. This is reflected in the way semen is priced: donors are usually only given low compensation (250–500 Rs), and samples are quite affordable for recipients (700–1,000 Rs). However, this meagre exchange value stands in stark contrast to the valuation of semen as a refined and vigorous substance in popular understandings in South Asia (e.g. Copeman, 2013, pp. 205–206; Simpson, 2004) – a relationship that is reversed in the case of egg cells. Eggs appear much more valuable than semen in hospitals due to the elaborate and costly process of production that requires a high input of pharmaceutical resources and medical expertise, their scarcity, and short shelf-life (see Bergmann, 2014, p. 132). Hence, in contrast to predominant understandings of unused egg cells (which are often equated with menstrual blood) as useless and even polluting substances, they are highly priced in a biomedical logic: compensation varies between 25,000 and 300,000 Rs.

13 The ‘big’ agencies in Delhi stated that they recruit around 20–30 donors every month.

14 Dr Monisha’s statement makes it clear that agents hardly ever address the medical risks for donors in detail.

15 Similar to replacement blood donation, where one sample is secretly split into many saleable components (J. Copeman, personal communication), semen samples are also divided and sold.

16 Apart from increasing the price of the end product, Mr Singh also feared that paying for semen samples would make the highly private and often covert transaction more visible: ‘when you [agents] buy [i.e. pay for a sample], it is more open. You have to have a percentage of tax, and it is not hidden anymore’ – circumstances that might deter possible donors from providing sperm and, ultimately, diminish supply.