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eggs under a microscope

In the summer of 2017, Julie Johnson saw a Facebook ad about egg donation. Somebody out there — an older mother, maybe, or a gay couple — needed eggs to have a child, and hers could be removed and given to them. In return, she could make a few thousand dollars. After giving it some thought, Johnson decided egg donation was something she might like to try. She filled out online forms about her family’s health history and about herself. Not long after, someone from a network of clinics called the Fertility Institutes got in touch about an appointment.

The Fertility Institutes was founded in Los Angeles, but it has offices and affiliates across the country and around the world. During Johnson’s first meeting with the group, at an office in Draper, Utah, near her home, she went through a basic health screening and learned more about the process.

Egg donation isn’t easy. Typically, it requires a woman to synchronize her ovulation cycle with that of the recipient woman, using birth control pills. Then the donor injects herself with hormones...