Egg Donation 101 & What to Consider When Choosing an Egg Donor
Egg donation can provide the missing link for those struggling to conceive, who want to avoid passing down a genetic disease, or for singles and gay couples who know they cannot conceive on their own. In this article, we’ll explain what the egg donation process looks like: how egg donors are screened, the factors to consider in your search for the ideal donor, the types of egg donation arrangements that exist, and the key differences between fresh and frozen donor eggs.
The egg donation process - an overview
Through egg donation, a donor chosen by the intended parents provides her eggs to be transferred via IVF. Fertility clinics follow a rigorous screening process when it comes to clearing egg donors. Prior to starting the egg donation process, the egg donor undergoes a thorough medical screening to ensure that she is fit to receive the stimulation medication required (more on this below). Her egg reserve is assessed, her medical history as well as family and genetic history evaluated, and blood tests check for undiagnosed medical conditions or infectious diseases.
Once the egg donor is cleared by the clinic, she’s prescribed hormone medications to stimulate ovulation and the production of multiple eggs. If it’s a fresh cycle, the intended mother will be prescribed estrogen and progesterone to build up the uterine lining, preparing it for implantation.
Retrieval & Fertilization
The next step is the egg retrieval and fertilization with sperm from the intended father or a sperm donor. The best embryo is transferred to the uterus using a thin catheter, a procedure known as a fresh embryo transfer (FET). Meanwhile, the intended mother continues her medication (progesterone). If the transfer is successful, once a heartbeat is confirmed, the pregnancy progresses from there, hopefully making it successfully to term.
With all that said… the first step in deciding if egg donation could be a solution for you is to schedule a consultation with a reproductive endocrinologist (RE) or your fertility clinic. Egg donation may be recommended in the case of a specific medical diagnosis, such as diminished ovarian reserve, primary ovarian insufficiency, poor oocyte or embryo quality or inheritable genetic diseases. Once you decide to grow your family through an egg donor, it’s time to start searching for ‘the one’ who matches all of your preferences.
Factors to consider when selecting an egg donor
Choosing your specific egg donor is one of the most personal and important decisions you’ll make. Many intended parents choose to seek the services of an egg donor agency - however, choosing an agency is a big decision in itself and many intended parents go to multiple agencies before they find their perfect donor.
To make the process easier, GoStork provides the largest free online database of over 10,000 egg donors from various egg donor agencies all in one place, allows you to compare egg donors side-by-side then connect directly with the agencies of your favorites.
Egg donor profiles you review include the donor’s physical attributes, education level, medical history, as well as family history, among other elements such as ethnicity and religion. Undeniably, you’re presented with a large amount of information, but in this case, the more info the better! To get started, you’ll want to decide what characteristics matter personally to you.
Here’s a list of criteria you might consider:
Your donor should be between 21 and 30 but if you have a preference within this spectrum, that's a key factor to consider.
Must have a healthy Body Mass Index (BMI) of 18-27, but as far as the donor’s specific weight - that may be a consideration that’s important to you.
Personal health history (for example, a non-smoker, non-drug user and non-alcohol dependent, has no STDs - these elements are pre-vetted and indicated for you to consider), family health history (for example, you may be looking for egg donor profiles with no family history of genetic disorders, and no significant family history of cancer).
If applicable, you’ll see information about ‘proven fertility’ in egg donor profiles, ie. a previous successful pregnancy shows that the donor has the potential to provide healthy eggs. You may also learn that the donor has donated eggs prior that resulted in a successful pregnancy.
You’ll see the donor’s photos (ideally current as well as from childhood) and - when available - videos, natural hair color, eye color, height, and, as already mentioned, weight. Many intended parents are interested in donors with similar physical features to themselves, while others prefer dissimilar features. Again, these are personal decisions and any preference is valid.
This can range across heritage, religion, characteristics, education, career, and criminal record. That’s obviously a wide range of criteria - so just to explore one example; a donor with a graduate degree or high test scores may be what you’re ideally looking for - so you could, as a starting point, filter your options through the lens of your desired standard of education. Also, many intended parents look for egg donors with a similar heritage or religious background as themselves.
Fees can range from $8,000 to $20,000 - donors may charge more when they have proven fertility, or a higher level of education, among other factors.
An egg donor close to your IVF clinic can help save you money in covering her travel costs. That said, this may not be the most important criteria on your list - in which case it’s totally up to you to prioritize other factors over where the donor lives.
Egg Donor Arrangement
Another decision you’ll have to make concerns the type of egg donor arrangement. In open egg donation, the intended parents get to meet the egg donor (possibly virtually) and exchange contact information. In a semi-known match, the intended parents may want to meet but not exchange contact information. In an anonymous egg donor arrangement, no contact occurs between the egg donor and the intended parents and everything is taken care of anonymously through the agency.
Choosing Between Frozen or Fresh Donor Eggs
Both fresh donor eggs and frozen donor eggs have specific pros and cons which you should consider:
Advantages of using fresh donor eggs
1. Better odds of live birth
IVF with fresh donor eggs has been widely researched and found effective. A national study published in the journal Obstetrics and Gynecology found that the use of fresh donor eggs in IVF has a small advantage in birth outcomes. According to the study’s lead author, Jennifer L. Eaton, M.D., “the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference.” Data from the Centers for Disease Control and Prevention (CDC) also shows that, overall, 55.3% of embryo transfers from fresh donor eggs resulted in a live birth vs. 46.7% for embryo transfers from frozen donor eggs.
2. Larger number of eggs
A fresh egg donation cycle can potentially give intended parents anywhere from ten to twenty eggs - this is a good start if you plan on having more than one child.
3. No need for ICSI
With frozen eggs, an extra procedure known as intracytoplasmic sperm injection (ICSI) becomes a must (which also adds to the overall cost). The freezing and thawing process makes the shell surrounding the egg hard for the sperm to penetrate on its own. ICSI bypasses this as a single sperm is injected directly into the egg.
Caveats with fresh donor eggs
1. Longer timeline
Using fresh donor eggs is a longer process: it takes time to match a donor to the recipient and then to synchronize schedules and cycles.
2. Greater cost
Fresh donor egg IVF is typically more expensive than the frozen alternative: as noted by what to expect, at an average of $25,000, fresh donor eggs amount to around twice the cost of frozen eggs.
3. Potential for cancellation
Donation cycles can on occasion get cancelled due to poor medication response or issues, or because of an insufficient amount of eggs obtained. Medical issues more specifically may include uterine cysts or bleeding, which can have a negative impact on implantation, preventing the cycle’s success.
Ultimately, when choosing between fresh or frozen eggs, it all comes down to your personal situation. There is no easy answer as success rates can depend on each individual’s specific case, as well as the expertise of the clinic you’re working with. A doctor and the clinic can help you assess your options based on your medical history and specific circumstances.
We hope that this helped provide the information you need to start your journey. And remember - the right decision is whatever feels right for you. All the best!
About Eran Amir
With more than 20 years of experience, Eran Amir has worked as both a software development and product management executive in Israel and the Greater New York Area. The development of GoStork combines his professional skill set with a personal mission. After undergoing a long, difficult, and costly process to expand his family via surrogacy and egg donation, Amir vowed to help other intended parents avoid the complexity and confusion he experienced. His passion led to the creation of GoStork, which proudly names Amir’s two-year-old daughter as its co-founder.