Egg Donation Basics
Donor Eggs and the Path to Parenthood
Donor Eggs and the Path to Parenthood
Donor Eggs and the Path to Parenthood
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9
min read
Infertility is more common than most people think, and there is no single road to egg donation. Some intended parents turn to donor eggs after IVF with their own eggs has not worked. Others learn early on that donor eggs give them a better chance of creating embryos. Single fathers and male couples often plan for an egg donor from the start. Whatever brought you here, this guide walks you through what to expect.
Infertility is more common than most people think, and there is no single road to egg donation. Some intended parents turn to donor eggs after IVF with their own eggs has not worked. Others learn early on that donor eggs give them a better chance of creating embryos. Single fathers and male couples often plan for an egg donor from the start. Whatever brought you here, this guide walks you through what to expect.
Infertility is more common than most people think, and there is no single road to egg donation. Some intended parents turn to donor eggs after IVF with their own eggs has not worked. Others learn early on that donor eggs give them a better chance of creating embryos. Single fathers and male couples often plan for an egg donor from the start. Whatever brought you here, this guide walks you through what to expect.
Venus Egg Donation
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Information created to help intended parents and egg donors better understand the egg donation process.
When Are Donor Eggs Considered?
When Are Donor Eggs Considered?
Donor eggs may be considered when using an intended parent’s own eggs is unlikely to provide the desired chance of success or is not an option. The American Society for Reproductive Medicine identifies several circumstances in which donor eggs may be appropriate. These include diminished ovarian reserve, advanced reproductive age, poor egg or embryo quality, certain genetic conditions and previous unsuccessful fertility treatment. Donor eggs may also be used by intended fathers who plan to create embryos for transfer to a gestational carrier. The decision to use donor eggs should be made with a reproductive endocrinologist. An agency does not determine whether someone medically needs donor eggs. Source: American Society for Reproductive Medicine
Donor eggs may be considered when using an intended parent’s own eggs is unlikely to provide the desired chance of success or is not an option. The American Society for Reproductive Medicine identifies several circumstances in which donor eggs may be appropriate.
These include diminished ovarian reserve, advanced reproductive age, poor egg or embryo quality, certain genetic conditions and previous unsuccessful fertility treatment. Donor eggs may also be used by intended fathers who plan to create embryos for transfer to a gestational carrier. The decision to use donor eggs should be made with a reproductive endocrinologist. An agency does not determine whether someone medically needs donor eggs. Source: American Society for Reproductive Medicine
Why Complication Insurance Matters
Egg donation is a medical process, and even when it goes well, some donors have complications from the medication or the retrieval. Complication insurance is a temporary policy bought for the cycle. It is separate from a donor's regular health insurance, and it is meant to pay for care related to the donation. For intended parents, it also reduces the chance of an unexpected medical bill that could otherwise become their responsibility under the donor agreement.
What Does an Egg Donation Cycle Involve?
What Does an Egg Donation Cycle Involve?
What Does an Egg Donation Cycle Involve?
Once intended parents decide to pursue egg donation, the process involves much more than choosing a donor. A potential donor generally completes medical screening before being approved for a cycle. Depending on the clinic and circumstances, screening may include bloodwork, infectious-disease testing, genetic evaluation, an ultrasound and review of personal and family medical history. Psychological evaluation or counseling may also be part of the process. After a donor receives medical clearance and the required legal agreements are completed, the clinic can begin preparing for the treatment cycle. The donor typically takes injectable medications that stimulate the ovaries to develop multiple follicles. The clinic monitors the donor through blood work and ultrasounds. Once the follicles are ready, the donor receives a trigger medication and later undergoes the egg retrieval procedure. The retrieved eggs can then be fertilized according to the intended parents’ treatment plan.
Once intended parents decide to pursue egg donation, the process involves much more than choosing a donor. A potential donor generally completes medical screening before being approved for a cycle. Depending on the clinic and circumstances, screening may include bloodwork, infectious-disease testing, genetic evaluation, an ultrasound and review of personal and family medical history.
Psychological evaluation or counseling may also be part of the process. After a donor receives medical clearance and the required legal agreements are completed, the clinic can begin preparing for the treatment cycle. The donor typically takes injectable medications that stimulate the ovaries to develop multiple follicles.
The clinic monitors the donor through blood work and ultrasounds. Once the follicles are ready, the donor receives a trigger medication and later undergoes the egg retrieval procedure. The retrieved eggs can then be fertilized according to the intended parents’ treatment plan.
Screening the Donor
Screening the Donor
Screening the Donor
Egg donors are generally between 21 and 34, according to ASRM, though each clinic sets its own requirements. Donor testing covers infectious diseases, including HIV, hepatitis B and C, gonorrhea, chlamydia, and syphilis. Genetic screening is also part of the process. Cystic fibrosis screening is considered essential, and further testing depends on the donor’s ethnic background and on personal and family history. Some programs add chromosome analysis or Fragile X testing. Donors also complete a psychological evaluation and must disclose their own and their family’s medical history.
Egg donors are generally between 21 and 34, according to ASRM, though each clinic sets its own requirements. Donor testing covers infectious diseases, including HIV, hepatitis B and C, gonorrhea, chlamydia, and syphilis. Genetic screening is also part of the process and further testing depends on the donor. Some programs add chromosome analysis or Fragile X testing. Donors also complete a psychological evaluation and must disclose their own and their family’s medical history.
Preparing the Recipient
Preparing the Recipient
Preparing the Recipient
The intended mother, or the person who will carry the pregnancy, also goes through an evaluation. This includes a medical history, blood type and Rh factor, infection testing, a pelvic exam, and an assessment of the uterus. A mental health professional should counsel the recipient and any partner on the decision to use donor eggs. If the recipient is over 45, ASRM says a more thorough evaluation is appropriate, including heart function and the risk of pregnancy-related conditions, and she may be referred to a doctor who specializes in high-risk pregnancy. The partner’s sperm is analyzed too, and genetic screening may be recommended based on family history.
The intended mother, or the person who will carry the pregnancy, also goes through an evaluation. This includes a medical history, blood type and Rh factor, infection testing, a pelvic exam, and an assessment of the uterus. A mental health professional may counsel the recipient and any partner on the decision to use donor eggs. If the recipient is over 45, ASRM says a more thorough evaluation is appropriate, including heart function and the risk of pregnancy-related conditions, and she may be referred to a doctor who specializes in high-risk pregnancy. The partner’s sperm is analyzed too, and genetic screening may be recommended based on family history.
Fresh and Frozen Donor Eggs
Fresh vs Frozen Donor Eggs
Fresh and Frozen Donor Eggs
Donor eggs are generally used in one of two ways. In a fresh cycle, the donor and the recipient are matched, and their cycles are timed so the embryos can be transferred soon after retrieval. The recipient’s uterine lining has to be ready at the same time as the donor’s eggs. If she still has regular periods, she may first take a medication that quiets her ovaries. Once the donor begins stimulation, the recipient starts estrogen to build the lining, and around the time of retrieval she begins progesterone to prepare the uterus for implantation.
In a frozen cycle, the eggs were retrieved earlier and stored by an egg bank or clinic. They are thawed when the intended parents are ready, fertilized, and the resulting embryos are transferred or frozen. No coordination between two schedules is needed. A fresh cycle depends on two schedules lining up. A frozen cycle depends on what the bank has available and how many eggs are in each group. Costs, timing, and the number of eggs received can differ between the two, so it is worth asking the clinic how they handle each one.
Donor eggs are generally used in one of two ways. In a fresh cycle, the donor and the recipient are matched, and their cycles are timed so the embryos can be transferred soon after retrieval. The recipient’s uterine lining has to be ready at the same time as the donor’s eggs.
In a frozen cycle, the eggs were retrieved earlier and stored by an egg bank or clinic. They are thawed when the intended parents are ready, fertilized, and the resulting embryos are transferred or frozen. Costs, timing, and the number of eggs received can differ between the two, so it is worth asking the clinic how they handle each one.
Retrieved Eggs and Embryos Are Not the Same Number
Retrieved Eggs and Embryos Are Not the Same Number
Retrieved Eggs and Embryos Are Not the Same Number
There can be a reduction in numbers as the laboratory process progresses. Some retrieved eggs may not be mature. Not every egg that undergoes a fertilization procedure will necessarily fertilize. Not every fertilized egg will continue developing. A retrieval number should not be read as an embryo count or a prediction of how the cycle will ultimately turn out. There is no single percentage that can accurately predict what will happen in every cycle. Individual results vary. The treating fertility clinic is the appropriate source for explaining results from a particular cycle.
There can be a reduction in numbers as the laboratory process progresses. Some retrieved eggs may not be mature. Not every egg that undergoes a fertilization procedure will necessarily fertilize. Not every fertilized egg will continue developing. A retrieval number should not be read as an embryo count or a prediction of how the cycle will ultimately turn out. There is no single percentage that can accurately predict what will happen in every cycle. Individual results vary. The treating fertility clinic is the appropriate source for explaining results from a particular cycle.
If Fertilization Occurs
If Fertilization Occurs
If Fertilization Occurs
The laboratory continues observing resulting embryos. Embryo development takes place over several days. During this period, embryology professionals evaluate development according to the clinic’s laboratory practices. Some embryos may continue developing while others may stop developing. For intended parents, this is when the days following retrieval can bring separate updates rather than one final result on retrieval day. The treating clinic may provide information about fertilization first. Later updates may concern embryo development and the options available for embryos that continue developing.
The embryos can be transferred to the recipient’s uterus or frozen for later. Transfer usually happens three to five days after fertilization. The recipient keeps taking hormone medication until the pregnancy test and, if it is positive, into the early part of the first trimester.
The laboratory continues observing resulting embryos. Embryo development takes place over several days.
During this period, embryology professionals evaluate development according to the clinic’s laboratory practices.
Some embryos may continue developing while others may stop developing. For intended parents, this is when the days following retrieval can bring separate updates rather than one final result on retrieval day. The treating clinic may provide information about fertilization first. Later updates may concern embryo development and the options available for embryos that continue developing.
The embryos can be transferred to the recipient’s uterus or frozen for later.
Choosing a Donor
Choosing a Donor
Choosing a Donor
Intended parents can work with a known donor, such as a friend or relative, or with a donor they have not met. Donors from an agency or an egg bank usually come with a profile that may include medical history, education, physical traits, and sometimes photos or personal essays. The clinic’s own donor program may offer another route. Each option affects timing, cost, and how much contact there will be, so the choice is as much about the kind of relationship the family wants as it is about the donor’s profile.
A known donor often means a shorter wait for matching, but she still has to complete the same medical and psychological screening as any other donor. ASRM advises caution with donors found through advertisements and recommends that known donors be screened through a third party. Some donors are open to future contact and others prefer to stay anonymous. Intended parents should understand what has been agreed in writing and what the donor expects, since those preferences are part of the agreement. It also helps to ask the clinic how it screens donors, how it keeps their records, and how health information would be shared if questions come up later.
Intended parents can work with a known donor, such as a friend or relative, or with a donor they have not met. Donors from an agency or an egg bank usually come with a profile that may include medical history, education, physical traits, and sometimes photos or personal essays.
The clinic’s own donor program may offer another route. Each option affects timing, cost, and how much contact there will be, so the choice is as much about the kind of relationship the family wants as it is about the donor’s profile.
A known donor often means a shorter wait for matching, but she still has to complete the same medical and psychological screening as any other donor.
ASRM advises caution with donors found through advertisements and recommends that known donors be screened through a third party.
Some donors are open to future contact and others prefer to stay anonymous. Intended parents should understand what has been agreed in writing and what the donor expects, since those preferences are part of the agreement. It also helps to ask the clinic how it screens donors, how it keeps their records, and how health information would be shared if questions come up later.
Legal Agreements and Parentage
Legal Agreements and Parentage
Legal Agreements and Parentage
Egg donation involves a legal process alongside the medical one. Intended parents and donors usually sign agreements before any medication begins. These agreements commonly cover consent, the donor’s role, and what happens to any unused eggs or embryos. Parentage laws differ from state to state, and sometimes from country to country, and the steps needed to confirm legal parentage can depend on where the child is born and who the intended parents are. ASRM strongly encourages recipients to speak with a lawyer before starting, especially when the donor is not anonymous, and many attorneys recommend that the donor and the intended parents each have their own counsel. Intended fathers and single parents should also ask early how the law handles parentage when a gestational carrier is involved.
Egg donation involves a legal process alongside the medical one.
Intended parents and donors usually sign agreements before any medication begins. These agreements commonly cover consent, the donor’s role, and what happens to any unused eggs or embryos.
Parentage laws differ from state to state, and sometimes from country to country, and the steps needed to confirm legal parentage can depend on where the child is born and who the intended parents are.
ASRM strongly encourages recipients to speak with a lawyer before starting, especially when the donor is not anonymous, and many attorneys recommend that the donor and the intended parents each have their own counsel. Intended fathers and single parents should also ask early how the law handles parentage when a gestational carrier is involved.
Deciding Whether to Tell
Deciding Whether to Tell
Deciding Whether to Tell
Many intended parents wonder if, when, and how to tell a child about their donor-conceived origins. There is no single answer, and the decision belongs to the family. ASRM has a patient fact sheet on this topic, and some clinics offer counseling to help families think it through before treatment starts.
Many intended parents wonder if, when, and how to tell a child about their donor-conceived origins. There is no single answer, and the decision belongs to the family. ASRM has a patient fact sheet on this topic, and some clinics offer counseling to help families think it through before treatment starts.
Emotional Support Along the Way
Emotional Support Along the Way
Emotional Support Along the Way
Using donor eggs can bring up feelings that are hard to sort out. Some intended parents feel relief that there is a workable path forward. Others feel grief about not using their own eggs, even when they are certain about their choice. Both reactions are common, and neither one means the decision is wrong. Partners may not feel the same way at the same time, and that can be hard to talk about.
Many clinics offer counseling with a mental health professional who works with fertility patients, and some require it before a donor egg cycle begins. The sessions can help intended parents think about what to tell family and friends, how to approach telling a future child, and how to cope with the waiting and uncertainty that come with treatment. Support groups and patient communities can also help, since hearing from people who have been through it can make the process feel less isolating.
Using donor eggs can bring up feelings that are hard to sort out. Some intended parents feel relief that there is a workable path forward. Others feel grief about not using their own eggs, even when they are certain about their choice. Both reactions are common, and neither one means the decision is wrong. Partners may not feel the same way at the same time, and that can be hard to talk about.
Many clinics offer counseling with a mental health professional who works with fertility patients, and some require it before a donor egg cycle begins. The sessions can help intended parents think about what to tell family and friends, how to approach telling a future child, and how to cope with the waiting and uncertainty that come with treatment. Support groups and patient communities can also help, since hearing from people who have been through it can make the process feel less isolating.
Questions to Ask the Clinic
Questions to Ask the Clinic
Questions to Ask the Clinic
Intended parents should feel free to ask any program direct questions before committing. A few useful ones:
How does the clinic screen and approve its donors?
Does the program use fresh cycles, frozen donor eggs, or both, and how do they differ in timing and the number of eggs provided?
What counseling and legal steps does the clinic require?
What happens to unused eggs or embryos?
How does the clinic report its own results, and can it share its SART data?
Intended parents should feel free to ask any program direct questions before committing. A few useful ones:
How does the clinic screen and approve its donors?
Does the program use fresh cycles, frozen donor eggs, or both, and how do they differ in timing and the number of eggs provided?
What counseling and legal steps does the clinic require?
What happens to unused eggs or embryos?
How does the clinic report its own results, and can it share its SART data?
Intended parents should feel free to ask any program direct questions before committing. A few useful ones:
How does the clinic screen and approve its donors?
Does the program use fresh cycles, frozen donor eggs, or both, and how do they differ in timing and the number of eggs provided?
What counseling and legal steps does the clinic require?
What happens to unused eggs or embryos?
How does the clinic report its own results, and can it share its SART data?
Where to Learn More
Where to Learn More
Where to Learn More
ASRM’s patient site, ReproductiveFacts.org, has pages on egg donation, third-party reproduction, and embryo donation. It offers fact sheets and booklets in English, Spanish, and Chinese, patient videos, and a tool for finding a health professional. The embryo donation page also lists the fact sheet on deciding whether to tell.
The Society for Assisted Reproductive Technology (SART) publishes patient information and clinic-level results at sart.org.
This article is for general information only. It does not replace medical or legal advice, and every situation is different. Intended parents should speak with a reproductive endocrinologist about their treatment options and with an attorney about the laws that apply to them.
ASRM’s patient site, ReproductiveFacts.org, has pages on egg donation, third-party reproduction, and embryo donation. It offers fact sheets and booklets in English, Spanish, and Chinese, patient videos, and a tool for finding a health professional. The embryo donation page also lists the fact sheet on deciding whether to tell.
ASRM’s patient site, ReproductiveFacts.org, has pages on egg donation, third-party reproduction, and embryo donation. It offers fact sheets and booklets in English, Spanish, and Chinese, patient videos, and a tool for finding a health professional. The embryo donation page also lists the fact sheet on deciding whether to tell.
The Society for Assisted Reproductive Technology (SART) publishes patient information and clinic-level results at sart.org.
This article is for general information only. It does not replace medical or legal advice, and every situation is different. Intended parents should speak with a reproductive endocrinologist about their treatment options and with an attorney about the laws that apply to them.
The Society for Assisted Reproductive Technology (SART) publishes patient information and clinic-level results at sart.org.
This article is for general information only. It does not replace medical or legal advice, and every situation is different. Intended parents should speak with a reproductive endocrinologist about their treatment options and with an attorney about the laws that apply to them.
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