What is the process involved in donating eggs?
Not all women can donate eggs. Programs vary in the qualities they prefer, but some criteria are fairly standard. Certain rules are set for legal reasons. Other policies are designed to increase the chance that a pregnancy will result and that the process will be safe for both donor and recipient. At IVF1, we are very strict about who we will accept to be an egg donor for one of our patients.
At IVF1, a woman must be at least 18 years old in order to become an egg donor. This is to ensure that you can legally enter into a contract. We don’t accept donors who are over 27 years old except in certain circumstances such as when the donor is a sister of the recipient. This is done to increase the chances for a pregnancy to occur in the recipient and to reduce the risk for miscarriage and birth defects.
At IVF1, we encourage our patients to place their own ads to recruit egg donors instead of using a broker or agency. The patients are instructed to use a code name so that they can maintain their anonymity. If you respond to an ad, you will be asked to give us the code name so that we know which recipient couple is responsible for recruiting you. We will perform all the screening, testing and medical procedures required of an egg donor.
In some cases, ads are placed by egg brokers or agencies. These individuals or organizations recruit egg donors but do not provide medical services. If you are referred to us from an egg donor agency, you will be asked to fill out our egg donor application. This is necessary since many of the questions asked fulfill certain requirements from the FDA. The FDA regulates the process of screening and testing donors. It is impossible for us to determine whether an outside agency has included all of the questions necessary to meet these requirements, thus we ask you to fill out our application.
Occasionally, advertisements – supposedly on behalf of a specific couple – will offer a large amount of money to the right egg donor. These ads seek donors with special qualities, such as above-average height, athletic or musical ability, or advanced education. Be aware that, in some cases, there is actually no couple willing to pay the enticing fees. Instead, a broker is trying to attract a large number of applicants. Details about these applicants will be used in the broker’s advertising or on its web site to attract recipients. Some brokers will use the information you give in these ways unless you specifically refuse permission.
For this reason as well as others, we strongly encourage our recipients as well as egg donors to avoid the use of agencies or brokers.
Remember, the purpose of an ad is to entice you to become an egg donor. Do not rely on an advertisement for details about the process. You will need to read any educational materials and consent forms carefully. Ask questions until you understand the process well enough to make a decision.
Egg donor acceptance process
If you are not responding to an egg donation advertisement, and your application is acceptable, we will place you in our database, anonymously, so that potential recipient couples can review your information and determine if you are a good match for them.
The information you answer on the egg donor application will be shared with potential recipient couples. However, the recipients will never be given any of your identifying information. The only identifying information that recipient couples will have is a donor code that we will assign to you.
If you are asked to come to the office, there are several visits that may be necessary in order to determine your eligibility.
At the initial consultation, we will review the questionnaire with you. Based on your answers to certain questions, there may be additional questions asked. We will then review the entire process of egg donation with you. We will also review the potential side effects and risks. If you decide that you want to proceed with egg donation, then your next step will be to complete a physical exam. The egg donor physical exam may occur at the same visit as the initial consult or it may be scheduled at a separate appointment.
An egg donation will not occur unless you are accepted, matched with a woman who will receive your eggs, and give your consent. After you are screened, you should have access to the results of your medical tests – whether or not you become a donor.
Physical exam: As a potential egg donor, you will have a physical examination, including a pelvic exam. If you donate eggs more than once, you will need to have the physical examination repeated every six months. During your pelvic exam, a small swab from your cervix will be taken to test for gonorrhea and chlamydia. Blood will be drawn to test for syphilis, hepatitis B and C, and HIV which is the virus that causes AIDs. If you have an infection, seek medical treatment to protect your own health and fertility.
A note about Infectious disease screening: When blood or tissue is transferred from one person to another, it can carry viruses or bacteria. To minimize the risk that a donor egg could cause illness in the recipient, donors are tested for a variety of infections. The screening is closely regulated by the FDA and will be performed an a few times during the process. An initial screen will be performed once you are matched with a recipient and after you have your initial consultation. A second screen is performed after you have started treatment and shortly before your eggs are removed.
Determining your ovarian function: Most women who are young, will have good ovarian function and could do well as a donor. However, some women may have poor ovarian function and not realize it. Women with poor ovarian function will not be accepted as egg donors. To look at your ovarian function, blood will be drawn to check your hormone levels. Ultrasound (which uses sound waves, not X-rays) will be used to examine your uterus, ovaries and other pelvic organs. These tests might reveal poor ovarian function or an existing health problem. If anything is found, ask about your options for treatment (either from the program or another health professional).
Screening for inherited disease: At IVF1, we will attempt to learn all we can about a donor’s genetic make-up in order to minimize the chance that a baby will have a birth defect or serious inherited disease. You will be required to provide your complete medical history. You will be asked medical questions about your biological parents, grandparents, brothers and sisters. The program may tell you what information to collect, or they may have you work with a genetic counselor to identify:
- Any birth defects that required surgery or resulted in medical problems (such as a cleft lip, spina bifida or a heart defect).
- Certain genetic disorders (such as Huntington’s disease, hemophilia, Tay Sachs disease or sickle cell anemia).
- Inherited diseases that are of special interest to a recipient couple because of their own family history.
- Any major medical problems, surgeries, mental retardation, or psychiatric problems.
For any close blood relatives who have died, you should try to find out how old they were and the cause of death. Some common diseases (such as cancer or heart disease) that strike when people are middle-aged or younger are influenced, at least in part, by genetics.
If you do not have access to the necessary information, either because you are adopted or are unable to find out the details, you may still be eligible to be an egg donor. In these cases, the potential recipient couples will be advised of the missing information and they will then decide whether they want to proceed with you or not.
In addition to determining your family medical history, you will have blood testing obtained to check for disease genes that are common in your ethnic group. In addition, a blood test will be performed to look at the number and structure of your chromosomes.
Genetic tests usually involve a simple blood test. However, genetic testing may give you information for which you are not prepared or need help to understand. For example, what if you carry a gene that indicates that you are a carrier for cystic fibrosis (a gene that might create a risk of serious disease in your children)?
The results of your testing, including genetic tests, will be seen anonymously by recipient couples. Your results will never be given to anyone else without your permission.
Psychological screening: Donating eggs requires you to confront complex ethical, emotional and social issues. The screening process should help you evaluate your desire to donate and to think through these issues.
You will have a chance to ask questions and express any concerns. Many programs require donors to take psychological tests – at IVF1 we do not have this requirement.
Before you decide to participate, you must try to foresee how you will feel about donating your eggs and the possibility that children will be created who are genetically related to you. You may want to discuss these issues with your spouse, a relative or a trusted friend.
Organized religions hold various opinions about whether it is appropriate to use donor eggs and sperm in the creation of children. If these views are important to you, you may want to consult a religious advisor before you decide.
The American Society for Reproductive Medicine suggests that a woman should not donate eggs if she:
- Has a serious psychological disorder.
- Abuses drugs or alcohol or has several relatives who do.
- Currently uses psychoactive medications.
- Has significant stress in her life.
- Is in an unstable marriage or relationship.
- Has been physically or sexually abused and not received professional treatment.
- Is not mentally capable of understanding or participating in the process.
If any of your close, blood relatives have serious psychiatric disorders, the program needs to know, because some psychiatric disorders may be inherited.
It’s natural to feel rejected if you are not chosen. Sometimes the decision is made to protect you from medical harm. Or, it might become apparent that you may find the process too time-consuming or emotionally difficult. In some cases, it simply means that the right match has not been found.
Egg donation is a treatment option for women who do not produce enough normal eggs but are otherwise able to be pregnant. Some of these women have malfunctioning ovaries or entered menopause at an early age. Others are at an age when they produce eggs less readily, even with fertility drugs. Still others tried standard IVF but produced poor quality eggs or embryos.
Less commonly, women decide to use donor eggs because they are aware of an increased risk for inherited disease in their biological offspring. For example, the woman herself may be healthy, but she and her partner may both carry a gene for the same disease. This creates a risk in the child if it inherits the altered gene from both parents. Using an egg donor who does not carry the gene eliminates this risk.
Most often, donor eggs are used by women in their late 30s or 40s who are attempting to become pregnant. Very few women under the age of 36 use donor eggs. At IVF1, we do not have an upper age limit for the recipient of donor eggs. It is possible that women who are in their 50s or even 60s may receive the eggs you donate.
At IVF1, we do not discriminate based on sexual preference or marital status. It is possible that your eggs may be used by a single woman who may also use donor sperm. Lesbian couples may opt to use donor eggs with a known or anonymous sperm donor. Male couples may also use donor eggs with a gestational carrier as long as one of the males provides the sperm to fertilize the eggs.
At IVF1, we do not split a donor’s eggs between multiple recipients. It is very important to realize, however, that once the eggs are removed from your ovaries in the egg donation process, they become the property of the recipient or recipient couple. They can then determine the disposition of those eggs or any embryos created from those eggs.
For example, if a couple uses the eggs to produces embryos and they are successful at delivering a baby, they may opt to donate extra embryos to IVF1 as part of our donor embryo program. The embryos may then go to additional other couples to use to try acheive a pregnancy.
If you have concerns about who might receive your eggs, you are probably not a good candidate to become an egg donor.
At IVF1, we keep the identity of donors and the recipients confidential (this is called “anonymous egg donation”). However, it is very likely that at some point, the recipients or their children will learn your identity. New technologies such as facial recognition (which identifies you based on a picture) are now widely available. DNA testing services such as 23andMe and AncestryDNA can identify a person’s relatives from a large database. This is true even if you have never used those services. If a relative of yours has used these services then it can be used to find your identity.
At IVF1, the recipient couples are able to search available egg donors and choose for themselves a donor they are comfortable with. If you are identified as a possible egg donor by a recipient couple, we will contact you to determine whether you are still interested and available to participate in egg donation cycle.
Some women donate eggs to help a relative or friend who has been unable to have a child. These are often called “known egg donors.”
If someone asks you to donate eggs, it does not automatically mean you can. A “known” donor must undergo the same screening as an “anonymous” donor. In addition, the program will make certain that you are not feeling pressured to take part because of your emotional or financial ties to the recipient. Because of the risk of inherited disease, you will not be allowed to donate eggs if you are a close blood relative of the intended father.
As a known donor, you must be ready for problems that might emerge later. How will your relationship with the recipient change? What will the child and other family members be told? Will you feel comfortable being an “aunt” or “family friend” to your genetic child?
Even when pregnancy does not occur, egg donation can still have a long-lasting impact on a donor’s relationship with her relative or friend.
The following articles detail the process involved in donating eggs:
Egg donation is time-consuming. During the donation cycle, you will be given medications for about four to six weeks, and you will make several visits to the office for blood tests and ultrasounds.
You will be responsible for arranging your work or school schedule to fit the demands of egg donation. Some donors find it difficult to continue their normal activities. They have trouble keeping up at school or on the job, and in fulfilling their family responsibilities.
You will be required to refrain from drinking alcohol, smoking cigarettes and using illegal drugs. To decrease the risk of infectious disease, you will be required to refrain from getting any new tattoos or piercings. You will not be able to use any prescription or non-prescription drugs without permission. If you are in a sexual relationship, you must abstain from unprotected intercourse during specific weeks of the treatment cycle. You should try to avoid sexual contact with new partners.
You must be aware that many things can happen to your eggs after they are removed from your ovaries:
- No embryos may be formed. This may be due to a sperm problem, the condition of the eggs, or a problem in the laboratory. Immature or unfertilized eggs can be discarded as medical waste or used in research.
- Pregnancy may not occur or may end in a miscarriage.
- The recipient may become pregnant with more than one fetus. At IVF1, we limit the number of embryos that may be placed in to the uterus at one time. when the embryos come from donor eggs, we limit the number of embryos transferred to two. Therefore, in our program, it is very rare to see triplet pregnancies. In fact, this can only happen if one or more of the embryos split. Pregnancies involving two or more fetuses are at higher risk of various complications, including miscarriage, premature birth and infant death. If the recipient becomes pregnant with a dangerously high number of fetuses, she may choose to undergo multi-fetal pregnancy reduction. This is the process of selecting aborting some of the fetuses in order to increase the chances that the remaining fetuses may survive.
- More embryos may develop in the laboratory than can safely be transferred to the woman’s uterus. The remaining embryos may be frozen and kept in storage for later use. You cannot be certain when a genetic child of yours may be born – it could be nine months or even years after your donation.
- The original recipient may never use the frozen embryos. The program may ask the recipient to: donate the embryos to another couple; donate the embryos to research; leave the embryos frozen indefinitely; or allow the embryos to be destroyed.
Once you donate your eggs, their fate is entirely up to the recipient. You have no say about what happens. If you are not comfortable with this, you are probably not a good candidate to be an egg donor.
A doctor must obtain your informed consent before treating you. But informed consent is more than a form to be signed. It is the process of helping you fully understand and agree to the medical procedures. Before you give your consent, the doctor will meet with you and answer your questions. You will be asked to review the consent forms which are posted on our website. when you come to the office to sign consent forms, you will be given another opportunity to ask questions. you should only sign the consent forms if you are comfortable with the risks and have had all of your questions answered.
You can change your mind even after you sign the consent forms. You cannot be forced to undergo medical procedures against your will. Be aware, however, that changing your mind may affect the compensation that you receive.
Contracts: You may be asked to sign one or more contracts with the recipient. IVF1 does not require egg donors or egg recipients to sign outside legal contracts. Egg donors will sign a document stating that from the time the eggs are removed from her ovaries that they become the property of the recipient couple.
Confidentiality: During this process, we will gather a great deal of information about you from your application and throughout the screening process. This information will be given to potential recipients of your eggs. If you are donating anonymously, the recipient will not be given your name or any information that can be used to identify you. you can obtain copies of any of your medical information. This can be done directly through the patient portal on our website. Alternatively, you can fill out a document called a record release form to receive a printed copy of your medical records. This process is the same as for any patient.
Currently, there are no laws in Illinois that require disclosure of the identity of an egg donor for any reason. However, it is possible that confidentiality laws and regulations may change in the future. For example, there are currently attempts underway to pass laws to allow children who were given up for adoption to obtain their birth certificates. In addition, we cannot guarantee that someone will not discover confidential information by unauthorized means.
There are circumstances when we might contact you in the future. For example, we would contact you if a child born from eggs you donated has an inherited disease or needs a bone marrow transplant. It will be up to you whether you want to disclose your identity or not.
Parental rights and responsibilities: Once your eggs are retrieved, you have no control over what happens to them. You bear no responsibility for the outcome of the pregnancy. The recipient is legally and financially responsible for any children that result, no matter what their condition. You may review the documents that the recipient couple will sign or our consent form page.
Payments: The recipient couple may offer payment to egg donors for their time, effort and discomfort. They may not issue payment for the eggs themselves and the payments to you will not depend on the outcome of the donation.
Through no fault of your own, if a cycle must be canceled before eggs are retrieved, you will receive partial compensation (based on the number of days of treatment completed). After egg retrieval, you will receive the full, agreed upon amount no matter the number or quality of the eggs. If the cycle is canceled due to your own actions (not taking medication, failure to come when scheduled for monitoring), then you will not receive any compensation.
If you are recruited by a donor egg agency or broker, payments will be handled through the agency. If you are donating directly through IVF1, donor compensation is handled in a very specific way. Before any medications are started by either the egg donor or the recipient, the recipients will write a check to IVF1 for the full amount of the agreed egg donor compensation. This money will be held in a special account until after the treatment has been completed either due to an egg retrieval or after the cycle has been canceled. We will then write a check to you generally within two to three weeks.
According to the Internal Revenue Service (IRS), you must pay taxes on any money you receive for donating your eggs. We must report how much we pay you, and you will receive a Form 1099 to use in preparing your tax return.
Expenses: Think about what it will cost you to participate. This may include days off from work, transportation to the office for monitoring, transportation to the surgical center for the egg retrieval, baby-sitting, or other expenses.
Insurance: At IVF1, all recipient couples are required to provide medical insurance to their egg donors. This is to cover any costs that might occur due to complications from the egg retrieval process that need additional medical care. The egg donor does not need to pay any premium for this insurance, it is paid by the recipient couple. If you wish, you may use your own health insurance if you have any.
If you are having a problem related to your egg donation treatment, you must contact us at IVF1 immediately.
Yes. After each donation, we will review the results very closely. Donors that were reliable and who responded well to fertility medications, may be asked to donate again. We require that a pregnancy be achieved at least once in order to donate a third time or more. we will allow egg donors to donate eggs a maximum of six times.
You are not required to donate multiple times. It is your choice to donate again if you are asked.
Adapted from The New York State Task Force on Life and the Law guidebook for Egg donors