You made it through at least one egg donation cycle and now you’re thinking about doing another—but you likely still have questions. How much time does my body need to recover? Can I increase my fee or negotiate new contract terms? Will I run out of eggs? Can I freeze some eggs for myself? Does doing multiple cycles increase the risk to my health? These are all important questions, and things you will likely want to investigate before undergoing multiple egg donation cycles.

If your last donation cycle was successful—for example, if you produced a lot of high-quality eggs that became embryos and the intended parents (IPs) reported a positive pregnancy—it is likely your egg donor coordinator will contact you again soon to schedule your next cycle. They may even provide you with birth control pills as you leave the clinic, so you are ready to go for another cycle, or they may ask if you’re interested during a follow-up exam (and yes, it is in your best interests to have a follow-up). You may feel elated if and when you find out your IPs are pregnant—or need the money to pay bills—but whatever the case, it is likely best to step back; it might be beneficial to see how your body recovers and take stock of your experience rather than immediately agreeing to do another cycle.

Deciding to donate eggs again is entirely up to you—but it is typically in your best interest to not agree to do more than one cycle at a time.

Here are some things to think about when considering another egg donation cycle.

How did my body respond to fertility drugs?

The first thing to consider before deciding to do another cycle is how your body responded the first time. If you experienced extreme discomfort or bloating—an indication of ovarian hyperstimulation syndrome (OHSS)—you are highly likely to have the same or worse experience on the next cycle. This is especially true if the doctor uses the same medication protocol he or she used during your last cycle. Some medications are more likely to cause OHSS, and others have different effects on the body. Some people are more sensitive than others.

If you had no negative side effects throughout the process, and it went smoothly for you, hopefully, that will still be the case for your next cycle. But every cycle is different and there are no guarantees.

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How much time does my body need to recover?

Many donors report feeling pressured to do another cycle right away. Sometimes there are recipients anxiously waiting for a donor to be available, and this time that donor is you. Yes, it may feel good to know people want you, but this is your body and your first commitment is to your own health and well-being—and taking time for a full recovery is important.

The length of time it takes to recover is different for everyone. Some women feel back to normal within a few days, and others may still be sore, bloated, and uncomfortable for months. A good rule of thumb is to wait for at least two or three menstrual cycles before undergoing another donation cycle and surgical procedure. Your ovaries were most likely quite large and need time to settle down to normal size. You will also want to make sure you have normal periods before proceeding with another cycle. Give yourself time to observe your body and make sure you’re not having any lingering pains in your abdomen or ovaries.

Will I be able to negotiate my contract? Or ask for a higher fee?

Every egg donation cycle will require a new contract. If there was something you didn’t like about your last contract, this is the time to make sure you negotiate better terms for yourself. You can also ask for a higher fee—especially if your eggs produced a pregnancy.

Read: What Egg Donors Should Know About Egg Donation Contracts

If you are working through an agency it is likely that you will be sent to different clinics and different doctors on subsequent donations. This also means you may be given different medication protocols than you had on your last cycle. If you had a protocol that worked well for you, ask the new doctor if you can use that one again. If your other protocol did not work well for you, ask to have it adjusted.

This is a whole new cycle, and since you’ve donated before you have a pretty good idea of how everything works. Use the knowledge you’ve gained to advocate for yourself.

Will I run out of eggs? Can I keep some of my eggs for myself?

Every female is born with about two million eggs and they do not make any new eggs during their lifetime. Every month some eggs die off. By the time a girl reaches puberty she has about 400,000 left and by the time she reaches thirty, that number is about 100,000. Of course, every woman is different, and some suffer from premature ovarian failure (POF)—meaning they entered menopause before they were supposed to.

During an egg donation cycle, the fertility drugs increase the number of eggs that come to maturity in that cycle, but this does not necessarily mean that you are losing eggs faster by being an egg donor. However, that said, some egg donors do go on to face their own infertility. With the lack of research, no one really knows if being an egg donor increases a woman’s chance of becoming infertile.

With recent advances in egg freezing a lot of donors are asking: Can I save some eggs for myself? At many fertility clinics, the answer to this is “no.” However, there are some fertility practices that are now offering donors the ability to “freeze and share.” This means that during an egg donation cycle you will give half of your eggs to an intended parent, and keep the other half for yourself. With freeze and share programs, though, you may not be paid to donate eggs, but you will receive the freezing process free of charge, including some months of storage. If being compensated is a factor in deciding to become an egg donor this might not be an option for you. But if you were thinking about freezing your own eggs and cannot afford it, this might be one solution. Whether donating or freezing, the medical process is the same.

Will multiple cycles increase risks to my health?

With the lack of long-term studies, this is a difficult question to answer. Currently, the American Society for Reproductive Medicine (ASRM) recommends that donors undergo no more than six cycles in their lifetime. The reasons for this guideline are, essentially, two-fold:

  1. To reduce possible exposure to risks from fertility drugs, surgical procedures, and anesthesia, including infections, bleeding, and inflammation, among other things, and
  2. To reduce the possibility that children conceived from the same donor meet and reproduce with one another.

Clinics that are members of the ASRM are supposed to adhere to that guideline. Not all clinics do, however.

It is important to know that every egg donation cycle carries some risk—how much and how often, no one knows. Every time you donate your eggs you increase your exposure to possible complications related to the drugs and procedures, including both immediate and possibly long-term risks. Further research is needed to understand how egg donation affects egg donors’ health and well-being over time.

Read: Egg Donation Risk and Recovery: What We Know and What We Don’t

Other things to consider

Regardless of how many times you donate eggs, you should always get and keep copies of your medical records. Some clinics are reluctant to provide these, but having access to your own records is your right as a patient.

You should also let your own physicians know that you’ve been an egg donor, especially if you have a health problem that is of concern to you. Health issues later in life may or may not be related to your egg donations, but this information could be important—including how many cycles you underwent, the medications you took and any reactions you experienced.

While you do not have any control over what happens to your eggs once they’ve left your body, you still have rights and responsibilities.

  • Clinics and agencies will ask that you provide updates of any changes in your health in the future.
  • While you are free to talk about your egg donations, you will probably be required to maintain the confidentiality of the recipients of your eggs (if you know their name, for example).
  • At some point in the future children conceived from your eggs may find you, your own children or other genetic relatives through DNA testing or other methods. You will need to be prepared for how to respond and what kind of contact you feel comfortable with.

Answering these questions for yourself can help inform if and when an additional donation cycle is right for you.

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