Janine* was raised by a single mother in the San Francisco Bay Area. With limited resources, she and her sister had to find a way to put themselves through college. Her sister started donating her eggs for cash once she turned 20, working two jobs and struggling to stay in school. When Janine turned 19, she also started donating eggs. “I was a desperate college student, living paycheck to paycheck,” she told me. “So when my sister told me I could make $7,000 by donating eggs, I jumped at the chance. For that desperation, most women wouldn’t.”

The cost of tuition in the United States across all sectors has more than tripled in the last twenty years— far beyond the cost of inflation — making education out of reach for many. The rapidly rising cost of education has led to a increased student loan debt as parents and students borrow to fulfill their dreams of future success.

I’ve learned in my interviews and surveys with over 600 egg donors that the burden of student debt drives some Americans to make medical decisions they might not otherwise have made.

Egg donation can help people create the families they desperately want, and many egg donors have no complications and find egg donation rewarding. However, it is not a medical procedure to be undertaken lightly or under financial duress. More than 60% of US donors I surveyed agreed that “financial need strongly influenced my decision to donate.” Forty-five percent had between $10,000 and $100,000 in student loan debt, some with more than that, and spent their egg donation money to pay off that debt and other education costs. .

While making major medical decisions under the weight of crushing debt, at least 30% of egg donors said they felt underinformed about the potential short-term and long-term risks and benefits.

Meghan* attended Northwestern University outside Chicago and had racked up over $100,000 in student debt. She was 23 and working full time when her friend first told her about egg donation and the money she could earn.

“But I struggled a lot afterwards. I was in so much pain and bloating that I couldn’t walk for a week, and I was nauseous and sick. I was miserable. I almost lost my new job because I couldn’t go to So I decided I was done after that.

Anna* underwent seven cycles of egg donation starting when she was 20 years old. Her situation was complicated when the IRS sued her for taxes and penalties on the more than $60,000 she had earned and put a lien on her accounts. Her clinic never said her egg donation income was taxable or that she issued her a 1099.

Anna underwent two more egg donations after she intended to quit just so she could cover some IRS and student loan repayments. Immediately after her seventh and final donation, Anna was rushed to the emergency room in extreme pain. After three days in hospital losing blood, a doctor finally did an ultrasound to find that her ovary had twisted inside her body and needed to be removed. Medical bills were piling up on top of her tax bills and student loan repayments, leaving her with very little to live on. “It’s been a nightmare,” she told me. “I ended up in a deep depression because of it.”

Some donors in my study have gone through as many as 19 egg donation cycles – well beyond The Recommendation from the American Society for Reproductive Medicine of no more than six in a lifetime. There are guidelines, but no set policy that prevents cash-strapped people from continuing to donate.

But while American egg donors often donate out of desperation, those outside the United States cite very different justifications. Indeed, I have spoken with over 100 egg donors living in other countries including Spain, Canada, UK, Australia, South Africa and Brazil. Not a single egg donor from any of these places cites student loan debt or the high cost of education as a motivator for becoming an egg donor. Not one.

The United States emerges in my study as the only country where women in their twenties feel compelled to make medical decisions with lifelong implications to reduce or eliminate the affliction of student debt. Without this burden, people may still decide to donate eggs for financial assistance – even in countries like Spain where donor compensation is much lower than in the United States – but they are not pushed by the even financial desperation resulting from the cost of education.

Student debt is taking over the lives of many Americans in a relentless strangulation, derail decisions to have children, buy homes, invest in retirement, and live undisturbed. Canceling student loans would provide more resources to invest in life and build a better future.

The Biden administration must heed calls to reduce that burden. A just and humane society depends on it. Millions of Americans, including women, students of color and first-generation college graduates, are disproportionately affected by student debt, many for life. For students like Janine, Meghan and Anna, we need student debt relief coupled with containing the high cost of education.

*Names have been changed to protect privacy.