What is Egg Donation?
It is when a young woman undergoes ovarian stimulation and an egg retrieval procedure. The eggs are then fertilized and the embryos are transferred to the intended mother who will carry the pregnancy.
How Many Eggs Does A Woman Have?
Women are born with about 250,000 eggs. A donor is not depleting her own eggs or diminishing her own ability to conceive.
Steps in Becoming a Donor
Women may apply to egg donor agencies or to fertility clinics. The application process consists of a detailed questionnaire regarding personal and family health history and a personality questionnaire.
Applying to an agency means that she may be matched with couples from various fertility clinics. If applying directly to a fertility clinic, she can only be matched with couples at that clinic.
Couples are looking for healthy women, generally age 20 to 28 with a healthy family history. Some agencies and clinics will work with donors as young as 18 or as old as 32.
- Matching with Intended Parents
Being matched with a couple can take anywhere from a few weeks to a year or more. When donating eggs to be frozen until they are used, she does not have to wait to be matched. That is discussed further below.
- Psychological Screening
The donor meets with a mental health professional to discuss her feelings about the process and to ensure that she feels fully informed and comfortable with moving forward. She is also given a standardized personality test such as the PAI (Personality Assessment Index) or the MMPI (Minnesota Multiphasic Personality Inventory).
- Medical Screening
This consists of a physical exam, a blood draw, and an ultrasound of her ovaries. She is tested for infectious diseases and a panel of genetic diseases. Her hormone levels are evaluated and her ovaries are visualized on ultrasound. She will also meet with a physician and nurse coordinator who will explain the process in detail and answer any questions.
Next the clinic will create a calendar that tells the donor exactly what to do each day throughout the cycle.
The Egg Donation Process
- Synchronizing of Menstrual Cycles of Donor and Recipient
The recipient’s and the donor’s menstrual cycles must be synchronized and this is done by putting both of them on birth control pills and then stopping their active pills at the same time.
- Injectable Medications
The donor will take injectable medications for 10 to 12 days. These are FSH meds (follicle stimulating hormones). FSH is produced normally in a woman’s body, but she only produces enough to cause one egg to mature. When donating she is given additional FSH so that 10 to 20 eggs will mature.
The clinic will instruct the donor in how to give herself the injections in either the abdomen or thighs. While on injectable medications she will have 3 to 4 monitoring visits and the meds will be adjusted upward or downward. The monitoring consists of a blood draw and an ultrasound.
- Retrieval Procedure
When the physician determines that the eggs are sufficiently mature they will be retrieved. The eggs are retrieved through a catheter that is inserted vaginally and guided by ultrasound along the side of the cervix and into the ovaries. The donor is given a mild anesthesia so that she is asleep for the procedure. The donor will then remain in a recovery area for about 30 minutes. Her part of the process is complete.
Donors are generally paid between $5000 and $12,000 after the retrieval procedure depending on what part of the country they are in and the policies of the particular clinic or agency they are working with.
- Fertilization, Incubation and Transfer
The eggs are placed with the sperm and the resulting embryos are incubated for 5 days. The best quality embryo will be transferred to the uterus of the intended mother and the remaining good quality embryos will be frozen. If the first embryo does not implant, they will continue transferring the frozen embryos until either she is pregnant or they have used all of the embryos.
Success rates have improved dramatically in the 35 years that egg donation has been in use. Now almost everyone who works with a donor is able to achieve a pregnancy.
Donor and Recipient Contact
Some donors and their couples will choose to meet. This is based on the preference of the parties. Different agencies and clinics have different policies in this regard. Anyone considering donation should consult with the agency or clinic to find out what their policies are.
Most women who donate find the process relatively easy and will choose to donate multiple times. The American Society for Reproductive Medicine recommends that an individual donate not more than six times and there are many donors who choose to donate six times.
Frozen Egg Donation Process
Some fertility clinics are now establishing “egg banks” of frozen eggs.
Donors can donate their eggs that will then be frozen until there is a couple that wishes to work with those eggs. The eggs will then be thawed and placed together with the intended father’s sperm to be fertilized and become embryos.
The advantage for the donor is that she does not have to wait to be matched with a couple. As soon as she is accepted and passes the medical screening she can undergo the donation process.
The disadvantage is that frozen eggs (as opposed to frozen embryos) are very fragile. They consist of a single cell and they do not tolerate well the process of being frozen and thawed.
When fresh eggs are used they are immediately fertilized and then the embryos are frozen. The embryos are 70 to 100 cells. Thus the probability of achieving a pregnancy with a frozen embryo is much that greater than when working with frozen eggs.
For that reason many couples prefer to work with a donor and obtain 10 fresh eggs to be fertilized right away.
Also when a donor is matched to donate for one couple she may have the opportunity to meet them and to know if and when they achieve a pregnancy. For that reason many young women prefer to be matched with a couple before donating.
Anyone considering egg donation should make sure that the agency and/or clinic that she is working with will provide her with enough information and answer all of her questions so that she feels comfortable in her knowledge of what to expect.