In this week’s issue of the New York Times Magazine Melanie Thernstrom has written a long account of her journey with egg donation and surrogacy (read it here). At 41 she has already gone through six unsuccessful attempts at IVF treatments before she explores the possibility of adoption and rejects it. when she looks into egg donation, but learns that she has a medical condition that would prevent her from carrying a child to term. Finally she opts for a pair of surrogates and egg donors to carry two children at the same time for her so that she can start a new family.  Sort of twins, sort of siblings, she calls the children “twiblings”.

Over the years I’ve written on the complex politics, economics and social consequences of surrogacy, egg donation and international adoption. In that time I have generally avoided following the stories of customers of the baby-making industry. Instead, as you will read in my forthcoming book The Red Market (obligatory plug) looks primarily at the supply side. I’ve been particularly concerned with the way that donations of human materials (whether they is blood, kidneys, human eggs or adopted children) are sourced with a presumption of altruism, while simultaneously cloaking the identities of the donors behing a wall of privacy and anonymity. I’ve found many cases where those two things together provide cover for criminals and unethical doctors to cut corners and exploit their patients.

Some of my readers assume that because I have explored the unseemly elements of the red market that I am explicitly against all forms of tissue donation, adoption, and all other technologies that move human materials through the marketplace.  This is not true. In her quest to have children Thernstrom navigated the complex and murky waters of the fertility industry with a level of grace and forethought which is missing in most transactions on the red market. She wasn’t content to take different doctor’s word that her surrogate and egg donors were enlisting for the right reasons. In fact, she fired one donation agency when she didn’t like the way that they did business and ended up arranging for the donations in person.  She could be sure that no one was exploited because she took an active role in the supply chain from beginning to end.

It is easy to look at surrogacy or egg donation as simply an anonymous commercial transaction but Thernstrom managed to transcend the limitations of the marketplace and know what happened every step of the way. She negotiated contracts directly with the surrogate she hired and went over all of the potential issues that could arise point by point. She didn’t let a profit-taking middle man to take control of the transaction. Her article is a must-read for people looking for models when contemplating  their own fertility treatments.

Read Meet the Twiblings.