All potential egg donors undergo various tests to confirm that they are in good medical health, including a physical exam and laboratory and genetic testing.
Choosing an egg donor will be one of the most exciting — and perhaps daunting — parts of your surrogacy journey. There are many factors that may influence your choice. If you are part of a two-dad couple, and don’t plan to be the biological father, for instance, you may wish to have an egg donor with a similar genetic profile to your own. Or perhaps you will want a donor with a certain education level, athletic background, or music ability.
The good news is that you will most likely be able to find an egg donor with close to the exact characteristics you are looking for. The bad news is that our genetics only influence who our children will become so much — so most experts advise against placing too much emphasis on one factor over another. Before we dive into some of the considerations you should keep in mind when selecting a donor, let’s first review the screening process egg donors must go through.
Egg donor screening
Certain screening guidelines set by both the American Society of Reproductive Medicine (ASRM) and their are regulations in place by the Food and Drug Administration (FDA). Each potential donor will first need to complete a 14-20 page questionnaire about their medical history, personal lifestyle choices, and other factors that may impact their ability to be a successful donor. Donors will then undergo multiple health screening to test for infectious diseases, recessive genetic diseases, drugs and alcohol and more. She will also undergo a mental health testing and screening to examine her mental health, motivations for donating, and to ensure she understands the implications of her donations. Most egg donors will also be between the ages of 21 and 30, and with stimulation can produce a large quantity of eggs — anywhere between 15 to 40. This rigorous screening process ensures only the best candidates proceed to becoming egg donors. “Truth be told, only about five to ten percent of donors who apply actually make it through the screening process,” said Dr. Mark Leondires of RMACT.
Among the most important parts of screening a donor will involve checking her ovarian reserve — which refers to the number of healthy eggs a donor is able to produce each cycle. This will involve a blood test called anti-mullerian hormone (AMH) and an ultrasound assessment of her basal antral follicle count and these two pieces of information predict how many eggs a donor will produce during a treatment cycle. “Selection of your egg donor is one of the most important parts of the process, because her egg quality has a large impact on embryo quality, which will impact your success rate,” said Dr. Guy Ringler of California Fertility Partners.
To help improve your chances of partnering with an egg donor that will produce a high quality and quantity of eggs, you may consider working with a “proven” or “experienced” donor who has successfully donated in the past. This will increase your costs slightly. “But what you’re paying for is information,” said Dr. Skora. “You’ll learn how many eggs they retrieved, how many of those fertilized, how many reached the blastocyst stage, how many of those were normal genetically, and if a child was a result of that donation.”
Where do I find an egg donor?
There are several different places you can source an egg donor:
Internal egg donor: An “internal egg donor” will be one associated with a donation program run by the fertility clinic you’ve contracted with for your journey — not all fertility clinics maintain such programs, but many do. There are a couple advantages to using an internal egg donor. “Generally, that donor will be local to that clinic, leading to savings for you on travel,” said Dr. Daniel Skora of Fertility Specialists of Texas. “And she will have a history with that clinic in terms of previous donations that you will have access to.” There are some drawbacks as well. “You might have less options in terms of variety of egg donors,” Dr. Skora explained.
Agency egg donor: This type of donor comes from an egg donation agency. These agencies tend to have a much wider variety of egg donors to choose from — increasing the possibility that you will find a donor with the exact characteristics important to you. “Egg donor agencies recruit donors from all across the country,” said Dr. Skora. “As such, they have more ability to have more people from different races and ethnicities.” The drawback is you will have to pay an agency fee, and will have to pay for travel costs for your egg donor since she likely won’t be local.
Egg bank: Another option for sourcing a donor is through an egg bank. “These are places that have cycled egg donors previously and have frozen their eggs,” said Dr. Skora. You will often be able to purchase 6 to 8 eggs from an egg bank to help you in your embryo creation process. These are therefore experienced egg donors. “But egg banks vary widely in terms of the guarantees provided in the number of blastocysts created,” Dr. Skora explained. Egg banks can provide significant cost savings.
Anonymity and disclosure
There is a wide variety of arrangements between egg donors and intended parents dictating the level of contact between the donor and the resulting child.
Anonymous donor: The first is a completely anonymous donor. “An anonymous donor has expressed a desire to never know you, and never be in contact with your child,” said Dr. Mark Leondires of RMACT. For some dads to be, this may be exactly what they’re looking for — but increasingly, more intended parents are searching for donors willing to maintain at least some level of contact with the children they help bring into the world.
Open door donor: One type of donor arrangement that allows for the possibility of contact once the child reaches maturity is called an “open door” donation. In this arrangement, “once a child turns 18, she’s able to contact a lawyer who holds the donor information, and may be able to set up a meeting between the child and the egg donor,” said Dr. Jerold Goldstein of Fertility Specialists of Texas. “This is becoming much more common.”
Known donor: Lastly, you may choose to work with a known donor, who could be a friend or relative who is willing to undergo the egg extraction process to help you create your family. This is more commonly also a young woman who is happy to meet you if she is donating her eggs to you. Using a known egg donor allows you to meet them. It does require an extra layer of legal support and protection for both parties called a known donor agreement. Using a friend or familial egg donor can certainly help reduce the costs of your overall surrogacy journey if she has agreed to forgo compensation. However, a known donor will still be subjected to a rigorous screening process — oftentimes intended parents hope to use a certain known donor, only to later find, following the screening, that she isn’t a suitable fit for any number of reasons. There is a trend towards known donors through clinics and agencies as well. “Over the past twenty years, the door has really swung towards known donation, which is partly because we can’t guarantee anyone’s anonymity anymore,” said Doctor Ringler of California Fertility Partners. With the advent of genetic testing sites like 23andMe and Ancestory.com, and easy access to people worldwide via social media, it is much easier to find genetic relatives than it used to be.
What’s important when choosing a donor?
Beyond certain obvious considerations, like family and medical history, there are any number of characteristics that may prove important to you when making your egg donor decision. These could include things like level of education, race, ethnicity, athletic ability, hobbies and interests, or even religion. “I think the most important characteristic is whatever resonates with you,” said Dr. Goldstein. “Look at qualities that are really important to you.”
Additionally, it’s important not to place too much emphasis on any one donor. “I’ll say this honestly,” said Dr. Leondires. “Don’t ‘fall in love’ with your egg donor until she’s passed screening — there’s been a lot of dads out there who have had some disappointments. It’s your fertility doctor’s job to let you know whether your donor is a good donor for you on a biological basis.”
You also need to find your donor and consider the future conversation with your child. Consider what she wrote about herself, her likes, and dislikes. What she does for work and her personality characteristics. All dads are going to have that conversation one day with their son or daughter about who their donor is. Have your information, pictures and talking points ready.
CONGRATULATIONS! You've completed Chapter 6: Choosing & Screening Your Egg Donor.
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