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An Indian woman gazes into the distance and appears to be thinking.

In March, Mumbai resident Shaheeda Khan*, 26, spent 20 days at a fertility clinic in Kerala, where doctors gave her hormone injections every day. The shots were aimed at stimulating her ovaries to make them produce multiple eggs, not just the one or two they would generate naturally in a month. At the end of the 20 days, several of Khan’s eggs were surgically extracted and fertilised in a laboratory – a procedure known as in-vitro fertilisation or IVF. Khan did not know where the sperms for the fertilisation process came from, nor what happened to the embryos. Some of these would be implanted in the wombs of women willing to bear children.

Though the clinic listed Khan as an “egg donor”, this was a euphemism. Khan was paid Rs 45,000 for undergoing the procedure.

Women like Khan are small parts of a global IVF machine that was valued at $15 billion in 2017, according to one estimate. Said a doctor who treats infertility in Chennai, requesting anonymity, “Eggs are the raw materials for IVF procedures and these donors... see more