Potential egg donors acting for altruistic, financial, or other reasons need to understand the process of egg donation thoroughly before making the decision to donate eggs. The process requires a fairly substantial allotment of time as well as the willingness to undergo fertility injections and minor surgery, so the donor must be fully informed and committed to fulfilling her obligation.
Women decide to undergo the egg donation process for a number of reasons; however, altruism and financial compensation are the most prevalent. Becoming an egg donor requires a dedicated commitment to a process that takes time and is somewhat invasive. Potential egg donors should become thoroughly knowledgeable about the process before making the decision to contact egg donation agencies about donating eggs.
Finding Egg Donor Agencies
Egg donation agencies and clinics assist donors and recipients by providing professional services that fully cover medical and psychological screenings and the legal aspects of the egg donation process. Egg donation agencies act as recruiters, soliciting donors through advertisements on college campuses, the Internet, and in other media. They generally maintain extensive databases of donors, oversee the screening process, handle financial and contractual matters, and facilitate the egg donation process by working with egg donation clinics to complete the egg donation procedure.
Sometimes egg donation agencies place come-on ads offering high compensation in order to gather a large list of applicants whose application information is then used on the broker's site to attract couples seeking in vitro fertilization. For this reason, the prospective egg donor should always carefully research an agency's background to ensure the legitimacy of its offers before submitting an application.
Egg Donor Anonymity
If the egg donor recipient chooses to go through an egg donation agency or egg donation clinic that provides donors, the recipient will remain fairly isolated from the egg donation process. The agency will make the necessary arrangements, and in most cases the recipient will have no contact with the donor. Should the recipient desire contact with the donor, arrangements may be possible on a case-by-case basis.
Financial Compensation for Egg Donors
Financial compensation for egg donors is intended to cover a donor's time, effort, and commitment, as well as any inconvenience involved in the egg donation process. The amount of recompense a donor receives is dependent on several factors, including the agency through which she donates; financial capacity of potential recipients; health risks or ethical concerns of the donor; and a donor's unique personal or ethnic characteristics. Specific items covered by donor compensation may include:
- Donor compensation: According to a study reported by the American Society for Reproductive Medicine (ASRM), financial recompense for egg donors can range from around $3,000 to over $50,000, with the average recompense being around $5,000. ASRM Ethics Committee guidelines also define compensation exceeding $5,000 as requiring justification and reimbursement exceeding $10,000 as exceeding what is appropriate.
- The cost of screening and donation process: This includes medication and hormone therapy, the egg retrieval surgery, and aftercare.
- Premium and any deductible for supplemental short-term accidental health insurance: This insurance is purchased by the potential recipients to cover (a portion of) medical expenses incurred as a result of the egg donation procedure.
- Reasonable travel, lodging, and meal expenses: This can include expenses involved in donor screening, selection, egg retrieval surgery, and aftercare.
Although some egg donation agencies and clinics regularly advertise compensation in the tens of thousands of dollars for donating eggs, the typical donor receives around $5,000. Some egg donation centers pay partial compensation if for some reason eggs cannot be harvested, so careful examination of a contract is essential before signing the document.
Some agencies pay donors a "deposit" when they begin taking medications, with the remaining compensation paid after the egg retrieval surgery. Others pay the donor the entire sum after the surgery. Women considering donating eggs should get all the information on how much and when they will be paid. They should also be aware that this compensation is taxed, so they will not pocket the entire sum.
Egg Donor Screening
When a woman applies to be an egg donor, she undergoes a screening process designed to ensure her candidacy for the procedure. To donate eggs, a woman must typically be between the ages of 21 and 34. The screening process is rigorous, since egg donation has physical, legal, psychological, and emotional components. Women considering egg donation can expect to undergo a medical exam, psychological evaluation, and assessments of their physical and personality characteristics.
- Medical Evaluation: The initial medical evaluation involves a physical exam, including a pelvic exam, drawing of blood samples, screening for infectious and inherited diseases or disorders, and measurement of hormone levels. These tests are designed to detect preexisting health conditions that would affect a woman's candidacy.
- Family History: If no outstanding problems are found, the potential donor completes a detailed questionnaire about her family's medical and psychological history, as well as her lifestyle and substance use. This provides a background of genetic problems and health hazards that could impair the egg donation process.
- Psychological Evaluation: Since egg donation involves complex ethical, emotional, and social issues, potential egg donors should be in a sound psychological state to face these issues. The psychological evaluation process is designed to help a woman discern her stance on egg donation, prevent emotional trauma, address her concerns about the process, and help ensure that she will fulfill her obligations to the recipient.
- Assessment of Personal Characteristics: The potential donor's personal characteristics and preferences are assessed in order to provide potential recipients with an understanding of possible genetic traits of the fetus. Some characteristics may include height, weight, race, eye color, interests, IQ, and hobbies. These characteristics are compiled into a profile, which recipients will use to make their donor selection.
Egg Donor Selection by Recipients
Once a fertility organization deems a woman eligible to donate eggs based on her screening process, her selection is entirely up to potential egg donor recipients. Some recipients choose their donor based on her profile, while others choose a donor whom they already know. Donor selection is a complex process that involves several influences. Factors that Affect Donor Selection
Several issues will play a role in the selection of an egg donor by recipients. Some of these factors include:
- Age: As a woman reaches her late 30s, the quality of her eggs diminishes, potentially reducing the recipient's chances of successful impregnation.
- Physical/personality characteristics: Recipients may base their choice, in part, on a donor's personality or physical traits that could be passed on to the child, including ethnic or cultural background and IQ.
- Availability for future donations: A donor's willingness to contribute eggs in the future is important to recipients seeking to parent genetically related siblings.
- Ability to fulfill obligations in egg donation: Potential recipients may be wary of choosing a donor who has not proven the mental stability to follow through with her obligations in the egg donation.
- Infectious or genetic diseases: An infectious disease can be passed from donor to recipient, and a genetic disease from donor to child.
The Donor-Recipient Relationship
Some recipients prefer a "designated donor" (with whom they have a preexisting relationship), while others prefer an "anonymous donor" (with whom they have no relationship). Anonymous programs keep the identity of the donor completely confidential, while open programs allow donors to permit contact by the child at a later date; to meet the recipients; or to establish relationships with the recipients. The donor-recipient relationship affects the privacy of both parties as well as the amount of genetic information a recipient has for the child in the future.
The Donor Egg Retrieval Process
Once a candidate is chosen for egg donation, she undergoes a process to synchronize her menstrual cycle with that of the recipient. Next, she is given hormones to stimulate her ovaries so they produce several eggs at once, and finally, those eggs are retrieved. While each case varies, the egg donation process typically takes about 2 to 3 months: a few weeks for screening, a few for menstrual synchronization, about 10 days for egg stimulation, and one day for retrieval surgery.
- Synchronization: To synchronize the menstrual cycles of the donor and recipient, the donor takes hormones, often birth control pills, and suppresses her natural cycle through daily injections. After a few weeks, the donor stops taking the birth control pills and has a menstrual period that is synched with the recipient's cycle. During synchronization, donors may experience menopausal-like symptoms, including hot flashes, fatigue, breast tenderness, bloating, and mood swings.
- Donor Stimulation: Once the cycles are synchronized, the donor is given high doses of follicle-stimulating hormones that cause her ovaries to produce several eggs at once. The donor must inject the hormones under the skin or into a muscle once a day for about ten days. Donors are carefully monitored to follow their progress and prevent over-stimulation of the ovaries. Symptoms during stimulation may be similar to those during synchronization. Donors experiencing abdominal pain, pressure, and swelling should contact their infertility specialist immediately, as these may be symptoms of a more severe complication (ovarian hyperstimulation).
- Egg Retrieval: When the eggs are ready for harvesting, they are removed from the ovaries in a minor outpatient surgical procedure that takes about 30 minutes. The donor is first given anesthesia for the surgery. Once the anesthetic has taken full effect, a thin probe is inserted into the cervix, through which a tiny needle is inserted into each follicle. The eggs are removed from the follicles using gentle suction. After the surgery, donors should relax for the rest of the day, and sometimes for several days afterward. The same day, the eggs are combined with sperm during the IVF process.
After Egg Donation
An egg donor should be aware of potential medical complications and preventative after-care options following egg retrieval surgery. Having a thorough understanding of the recovery process and of how her eggs may be used will help a donor to adjust smoothly after egg donation.
With proper aftercare, most donors will not experience surgical complications or negative effects on their ability to become pregnant in the future. Aftercare generally includes:
- Prescription of antibiotics
- Post-operative check-ups
- Psychological counseling
- Instructions on what to do if a donor needs medical attention
Possible Risks and Complications
Although complications of egg retrieval surgery are extremely rare, donors should be aware of the risks associated with the procedure. Risks can include:
- Injury to the ovaries, bladder, bowel, blood vessels, uterus, and other pelvic structures
- Vaginal bleeding and lacerations
- Adverse reactions to anesthetic
- Ovarian hyperstimulation
Returning to Normal
A donor can expect to have a menstrual period about 10 days after surgery, and she will be more fertile for about a month. As her hormone levels even out, donors may experience mood swings, bloating, weight fluctuation, cramping, and spotting. Within about a month, the donor's menstrual cycle, hormones, and fertility return to normal.
How Donated Eggs are Used
There are many possible uses for a donor's eggs, all of which are entirely up to the recipient. Some possible outcomes include:
- No embryo is formed.
- Eggs may go to more than one recipient.
- The recipient may become pregnant.
- If a recipient becomes pregnant with more than one fetus, she and her doctor may choose how many fetuses to develop.
- Embryos may be frozen indefinitely or for future use.
- Unfertilized or immature eggs may be discarded or used in research.
Consult a Fertility Specialist
Egg donation is a highly involved process and should not be taken lightly. DocShop provides a directory of fertility doctors throughout the country who can address specific questions about egg (oocyte) donation and any other aspects of fertility treatment. Contact a fertility specialist in your area today to learn how modern medical science can help those who experience fertility problems.