So you’ve seen the ads, you’ve thought about it and now you’re seriously looking into egg donation. Take a look at Navigating the Decision to Become an Egg Donor for a good overview of what you might want to consider when deciding to donate your eggs. The next steps include deciding what kind of egg donation arrangement you prefer. There are multiple options to choose from if you are interested in providing eggs for someone else to have a child. Some of the main options include:
- An egg donation agency
- A clinic with an internal egg donation program
- An egg bank
- Using an online forum for people looking for “known” donors
Which is the ideal arrangement for you? Each of these options involves different circumstances and requirements that may affect your experiences as an egg donor, legally, medically and emotionally. Let’s take a deeper look at the different options available for providing eggs and what you'll want to consider.
Egg Donation Agencies
Egg donation agencies are businesses that act as go-betweens between donors, intended parents (or recipients) and medical clinics where egg donation is performed. Each business may operate differently and have different standards when it comes to looking out for their donors. Your agency coordinator is supposed to be your advocate throughout the process and help look out for your interests and medical care. But this does not always happen. It is important to ask around before signing up with any particular agency to find out about other women’s experiences donating through them. In some online forums, such as We Are Egg Donors, current and former donors may share their experiences—good and bad—with specific agencies and help you decide on a practice that is right for you. You can also see if the agency will connect you with other donors in their program.
Once you sign up with an agency most will have you go through an initial screening process. In the screening process, they will want to know your family’s genetic history, such as any heritable diseases in close or distant relatives. You will probably also have to be within a particular weight and height ratios with a Body Mass Index between 18-29. They will want to know your hobbies, educational background, and other information as well. The process of gathering all of this information, and for them to sort through it, may take several weeks. The majority of women who apply to become donors—almost two-thirds—are rejected at this point.
Once you are accepted into a program, they will ask you to create an online profile. This is similar to building a Facebook profile, and may include:
- Baby photos
- Current photos
- Your bio—or description of who you are and why you want to donate eggs
- Health information
You should know upfront how much the agency pays per donation. You should also know in advance if they require donor anonymity. Some donors want to have their identity open, so any child can reach them at some point in the future. Some want to be known from the outset and exchange emails or phone calls with recipients. And some want anonymity. With genetic test kits, however, anonymity can never be guaranteed.
It is also important to only agree to one cycle at a time. Some businesses try to get donors to agree to multiple cycles before they have ever done one. Since you may not yet know how your body responds to the hormones used to stimulate egg production, or if you will want to commit to more than one cycle, it is important to only agree to one egg donation cycle at a time, with plenty of time off between cycles so that your body can recuperate. Do not feel pressured to commit to more than what you are ready for.
Egg donation agencies work with a number of different clinics. If you sign up with an agency, you may have different standards of care depending upon which clinic the agency and recipients decide to use. For example, some clinics or physicians use more aggressive hormone protocols than others and have higher rates of complications such as ovarian hyperstimulation syndrome (OHSS). Some physicians or their staff may make you feel more comfortable and well cared for than others. It is not uncommon for a repeat donor to have a good egg donation experience at one clinic and then go on to have a horrible experience at another.
Not only do you have to do your background research on the agency, but also the different clinics they may send you to. They may not tell you, but most in the industry know which medical practices or individual physicians have higher OHSS rates. Some insurers now refuse to provide coverage for physicians with donors who have high rates of complications like OHSS.
Private Fertility Clinics with Egg Donor Programs
Some egg donors choose to go to a private fertility clinic with an internal egg donation program. Using a private clinic, rather than an agency, will improve your chances of having the same standard of care throughout each egg donation cycle, assuming you see the same physician every time and build a relationship with the clinic staff. Private clinics, or clinics in university hospitals, often offer lower compensation than some agencies, but not always. But if you are a donor at a clinic that has doctors you are comfortable with, and who closely monitor how many eggs you produce and adjust your hormone dosages accordingly, you should have a more consistent standard of care throughout repeat egg donation cycles. At the same time, if you are not happy with the clinic or physician at a particular practice, you should avoid them.
Some clinics match a single donor to a single set of recipients—what is called a “one-to-one cycle.” Other clinics have different kinds of programs and fees for different kinds of cycles, including “shared cycles.”
One type of shared cycle may include saving and freezing some eggs for yourself—at a reduced or no egg donation payment to you—and sharing half of your eggs with a recipient. If you negotiate to freeze some of your eggs for yourself, you will have to be prepared to pay cryopreservation storage fees and you probably will not be compensated to be a donor.
Another type of “shared cycle” is when a clinic matches a donor with more than one recipient at a time, at a reduced cost for the intended parents. For example, a single donor may be matched with three or more sets of intended parents, each of whom are guaranteed five eggs for, say, $18,000. The donor will still be paid the same flat rate—between $5000 and $10,000—regardless of how many recipients are receiving her eggs. If you produce a lot of eggs, more than 15, the clinic may freeze and bank the remainder and sell batches of five to more recipients, without increasing donor compensation. While this model does allow more recipients with more modest financial circumstances to afford IVF with donor eggs, it is not necessarily the best medical practice for women who provide eggs. For these kinds of cycles, women who naturally produce high quantities of eggs—or who have high resting antral follicle counts—are chosen and stimulated to retrieve as many as possible. Producing higher quantities of mature eggs increases a donor’s risk for complications like OHSS and ovarian torsion when the ovary twists in the body and may have to be removed.
You should not have to be made exceptionally uncomfortable in order to produce more eggs.
Ask ahead of time how many eggs a physician plans to get and what the doctor plans to do if your ovaries start producing too many maturing follicles. If you start an egg donation cycle and are producing high quantities of eggs (for example, over 20 to 25), ask the doctor to reduce your medication dosages. You should not have to be made exceptionally uncomfortable in order to produce more eggs.
Egg Banks
Egg freezing has revolutionized the fertility industry. Not only for women who want to freeze their own eggs—or transgender men before transitioning—but also for the egg donation business. Advances in egg freezing technologies, known as vitrification, have increased the survival rate of frozen and thawed eggs. With the advances in egg freezing, we have seen the rise in egg banks, using a similar model to sperm banks. This means a woman to donate directly to an egg bank, and the egg bank will freeze and store her eggs, and thaw them whenever an intended parent chooses a particular donor from an online catalog.
One of the reasons some women choose to donate directly to egg banks, rather than at agencies or clinics, is because they do not have to wait to be matched with intended parents. This means that as soon as a prospective donor goes through the screening process—the same screening process that an agency or clinic donor goes through—she can start the hormone stimulation protocols right away, have her eggs retrieved as soon as the physician deems they are mature enough and receive her compensation.
Providing eggs to egg banks reduces wait times to go through the process, but there are some other things to consider as well:
- While at some agencies and clinics donors may be able to have contact with recipients or know something about them, at an egg bank you will not receive any information about the recipients
- Your eggs belong to the bank and you will have no say as to how many people receive them, whether they are donated/sold to science or any other consideration
- Many egg banks require donor anonymity. Though some do offer an open identity option, where the children created from your eggs can contact you when they reach 18 years of age
Again, when donating through an egg bank—or any other situation—you want to have a good idea of how many eggs per cycle they plan on taking. If you start producing more than what they tell you upfront, you will want to know what steps the doctor will take to reduce the number of mature eggs that develop. You will also want to ask about what steps the physician will take to prevent ovarian hyperstimulation syndrome. It is advisable to not agree to commit to more than a single cycle. If you are pressured to commit to doing two or more cycles right from the start or feel pressured to do back-to-back cycles without time for recovery, you should seriously question whether this practice has your best medical care in mind.
Private Egg Donation Arrangements
For some women considering egg donation, it is important to know who will be receiving their eggs and have some contact with recipients and any children who may be born as a result. For women who know they want a “known donation”—and want as much information about the recipients as the recipients have about them—one option is to advertise to be an egg donor in an online forum where people are seeking egg donors.
Doing a private arrangement can be challenging on many levels. You will need to advocate for yourself, know that you are dealing with an actual and honest person rather than someone who is out to scam you, and know how to get your own attorney to draw up any legal contracts. Even if you do have an attorney, contracts stating you have a right to have ongoing contact with recipients and to receive information about (or have contact with) the child you helped create, may not be enforceable. Once someone has your eggs, they may change their minds regarding terms and there is not much you can do about it.
Choosing a private arrangement can be risky. But for some people, these arrangements have worked out well. In those cases, donor-conceived children benefit because they have fewer questions about their genetic history and the person who helped create them.
Becoming an egg donor is not a quick and easy process.
Other Important Considerations: Connection with Recipients and Donor-Conceived Children
Becoming an egg donor is not a quick and easy process. Some women think that as soon as they sign up with an agency, clinic or egg bank, they will receive a check in as little as a few weeks. In fact, however, while some donors are chosen quickly, others may wait years before being selected, or not ever be selected at all.
Becoming an egg donor requires a series of steps, from signing up with an agency or clinic, going through the screening process (psychological, genetic, medical, fertility screening that can be a months-long process), being selected by intended parents and signing legal and medical consent forms and other steps. In addition to the logistics surrounding becoming an egg donor, there is also the medical side of hormonally stimulating your ovaries to produce more eggs than usual and surgery under anesthesia to retrieve them.
Before deciding to become an egg donor it’s important to think about what kind of circumstances you feel comfortable with:
- Do you want to be in contact with the intended parents receiving your eggs or have information about them?
- Do you want to be known to the children born from your eggs?
- Do you want to have future contact with any children born from your eggs once they reach adulthood?
- Do you want to forever remain anonymous?
How you feel about the type of connection you want—or don’t want—with recipients and/or future children may affect the type of practice you choose to become an egg donor. Some clinics, agencies and egg banks require donors to remain anonymous, while others are more flexible.
Any children born from your eggs may also eventually want contact with you once they find out they’re donor-conceived. So it is also important to think about the needs of any children that may result from your donations as well, and how they may reach out to you in the future. If you are not comfortable with the idea that a future child may find you, it is important to know with direct consumer DNA tests, ancestry websites and social media, anonymity cannot be guaranteed.