Egg Donation and Surrogacy

What are the qualifications to be an egg donor?

You must be over 21 and in excellent health with a normal height and weight (your body mass index, or BMI, should not exceed 27). You must be familiar with the medical history of your parents and extended family (so women who were adopted traditionally are ineligible). You should not smoke, drink, or engage in risky behaviors.  Distinguished academic achievement and attractiveness are especially valued characteristics. The ethnic backgrounds in greatest demand are Caucasian and Asian (especially Chinese and Indian). There is no official maximum age, but the best candidates are under 30. Most candidates over 30 are hard to match unless they have donated successfully before.

In order to be an egg donor, you will fill out a lot of forms and answer a lot of questions. It is important to be as honest as possible, so the right match can be made for you. Your honesty, maturity, and responsibility levels will be evaluated during your psychological screening, so only the dedicated need apply.

What are the side effects and risks of egg donation?

Most women tolerate the egg donation process very well. Towards the end of the stimulation phase you may experience symptoms similar to early pregnancy or PMS: bloating, fatigue, etc. You may be a little sore and tender after the retrieval, but that will go away after a day or two. Although rare, the most common complication is ovarian hyperstimulation syndrome, which results in bloating and pain. When hyperstimulation occurs you go back to the clinic and have it treated.

There are about ten thousand donor egg cycles in the US every year.  Many more women go through this same process in order to get pregnant using their own eggs. It is a common procedure but not without risks. It is important to go over all the side effects and risks with the nurses and doctor at the clinic to gain complete understanding. You will need to abstain from sexual activity during the stimulation phase, and must follow all the directions precisely. The fertility nurses at the clinic are there for support at all times. You should have all your questions answered and feel fully informed before going ahead.

Click here for Conceiving Through Egg Donation (Part 2 of 10): Adoption.

Who Would Want to Be an Egg Donor?

IVF clinics and independent egg donor programs reach potential donors through advertising, mostly through Web and classified ads in local and college newspapers. Put “egg donor” into any search engine and you will see how various programs vie for applicants through both altruistic (Help a Family in Need!”) and monetary (“Generous Compensation!”) incentives.

People often ask why women want to donate. Some are inspired by a friend or relative who has experienced infertility. Others feel that they have “good genes” and their eggs would make healthy babies. We’ve encountered a few candidates who consider themselves very fertile, or may have just terminated an unwanted pregnancy, and feel a donation would make up for the loss in some way. But even when these reasons are involved, the compensation is the most powerful incentive.

However, it takes more than just desire for money to be an egg donor. Egg donation is not an easy way to make a quick buck. Donors generally do not get paid until after the retrieval, which can take weeks or even months after they first apply. Before they see any money, they need to go to many doctors’ appointments, answer many questions, endure medical tests and procedures, and follow a slew of directions.  All this takes intelligence, maturity, and a great sense of responsibility.

Furthermore, women who donate their eggs are not impoverished or desperate for money. Many donors are ambitious, educated, intelligent, and independent women in their 20s from middle class backgrounds, who could use some extra cash to supplement their incomes.  Indeed, the majority of recipients are white, educated professionals seeking donors with ethnic, class, and educational backgrounds similar to their own. In our experience, white, educated women are the most sought after donors. The second largest demand is for educated Asian American women, especially those of Indian and Chinese heritage.

Most programs make their applications available on their Web sites to submit electronically or by regular mail. The most basic requirements:

• age between 21 and 30
• good health and habits (no illnesses or conditions, no smoking or drug use)
• good family medical history
• body mass index under 27.

About half the applications submitted to my egg donor program are not qualified for one reason or another. Many applicants can technically qualify, but ethnic background, attractiveness, and education level determine their ability to be matched.

How long does egg donation take?

From screening to retrieval, an egg donation cycle takes up to about three months. About four weeks of this period is waiting for test results, when there is little for you to do. You should know the cycle dates far enough in advance to adjust your schedule accordingly. You may be able to start right away or you may have to wait a few weeks to get matched with a recipient (more on the egg donation matching process below).

In my egg donor program it typically takes between four weeks and four months for egg donors to get matched. The medical screening begins only after the match is made.

Click here for Conceiving Through Egg Donation (Part 1 of 10): Introduction.

If it’s Not My Baby, Why Not Just Adopt?

Yes, using donor eggs means that your child or children will have a maternal genetic relationship to another woman, typically a complete stranger. This random aspect makes it somewhat analogous to adoption. But the similarity ends there. First and foremost, egg donation allows the intended father to be the biological father, establishing a true genetic relation. Most couples consider this a tremendous advantage.

Knowing the precise source of both egg and sperm provides health assurances that adoption cannot. The sources of donor eggs and sperm (from intended father or anonymous donor) have been screened for infectious and hereditary diseases. In adoption, the health and medical care of the mother and baby may be unknown and are not guaranteed.

In adoption, the birth mother typically cannot make a legally binding commitment to prospective adoptive parents until after a postpartum waiting period. But a child created through egg donation, when carried by the intended mother, is her child, starting from conception. The intended mother becomes pregnant, nurtures the child in the womb, receives prenatal medical care, and gives birth. Although it was not her egg that formed the embryo, the uterine environment has a connection to fetal health and development in ways that scientists are still investigating and discovering. So you are giving a part of yourself to your child in a real physical way.

Adoption remains a wonderful option for many other reasons. However, egg donation takes advantage of the latest technologies to create a child partially related to the intended parents under the strictest medical supervision from conception to birth. For some, this greater amount of control makes egg donation worth the investment.

What medical procedures are involved with egg donation?

Egg donation requires stimulating the ovaries with hormones to bring a number of eggs to maturity, then retrieving the eggs through a minor surgical procedure.

In order to be an egg donor, you will need to make a number of trips to a fertility clinic. First, you will need to be screened to make sure you qualify. For your screening, you will meet with a social worker or psychologist, a geneticist, and a doctor. You will have a gynecological exam and blood tests to check for genetic and infectious diseases.  Additionally, on the third day of your period, you will probably be asked to have a blood test at a local lab to check your hormone levels (a “day 3” test). If you are on hormone-type birth control, such as the pill or Nuvaring, you will have to go off it temporarily in order to take this test. It takes about four weeks to get these screening results back. Most egg donors pass their screenings.  If you don’t pass your screening, the clinic will tell you the reason.

The clinic will then set a schedule for the egg donation (or the “cycle”) and you will go on birth control pills or a drug called Lupron that will temporarily stop ovulation. This gets your cycle synchronized with the recipient’s. Then you will begin your daily injection of hormones which lasts about eight to twelve days. You do the injections yourself. The nurses teach you how; it is easy and does not hurt. Then every other day or so you will have to stop by the clinic, usually first thing in the morning, to test your blood and (sometimes) have a sonogram. These monitoring visits usually take no more than a half hour or so, but they are important to see how you are responding to the drugs. Once the doctor sees enough mature eggs the retrieval will be scheduled.

During the retrieval, the eggs (from about eight to twenty) will be aspirated through a needle through the vagina. It usually takes about a half hour, and you are given light anesthesia. You need to take a full day off from school or work the day of your retrieval. The screening will require a few hours off, while the monitoring can usually be worked into your everyday routine.

This is Part 1 of a 10-part series entitled “Conceiving Through Egg Donation.” Throughout the series, I will be providing practical advice for those seeking to conceive through an egg donation program.

Beginning to think about using donor eggs? Here is an introduction.

Conceiving with donor eggs occurs in three stages: the donor search (which can take anywhere from a few days to a few months), the donor screening (about six to eight weeks), and the IVF cycle (about four to six weeks). About 10,000 donor cycles are performed in the US every year, and the number continues to grow. As a commercial enterprise, egg donation only started in the early 1990s. Since then technology, regulations, and attitudes toward this practice have been constantly evolving.  The medical aspects of IVF may be familiar to you, but you may not have a full understanding of the logistics when a third party becomes involved. This blog should provide a sensible guide to the process.

Most patients consider using donor eggs after going through a number of unsuccessful IVF cycles. You may have a diagnosis for your infertility, or you may not. Sometimes doctors just can’t tell why a patient isn’t getting pregnant. In these cases, egg donation is offered as the next, more advanced level in the long ART road. Since it often follows an extended period of struggle and disappointment, most patients don’t begin their search for an egg donor in an encouraged state of mind.

Try not to feel that you have wasted precious time in your previous efforts to conceive. Egg donation’s distinct advantage allows you to turn back the biological clock, since it is generally the age of the egg, not the uterus, which predicts results. Take comfort in the fact that egg donation is one of the most successful fertility treatments available right now.  About one half of all embryo transfers from fresh donor eggs result in live births. That’s an amazing statistic. (For non donor egg, it ranges from about 37% to 10%, diminishing incrementally as maternal age increases.)

Take a look at your own clinic’s statistics to learn how many IVF cycles they do per year (donor and non donor, fresh and frozen) and what their success rates are. Compare their numbers to some other clinics in your area, as well as the overall statistics provided by the CDC. Remember that some of the better clinics take on more difficult cases, therefore success rates can be misleading. (SART data reports can be found on www.sart.org and the CDC Web site.) Of course, trust in your doctor is paramount, and you should feel comfortable asking him or her any questions about these statistical reports.

Just twenty years ago egg donation was inaccessible to the general public. It has since created thousands of dearly wanted children. But this success is achieved at a price, and not only a financial one. Everyone needs to reconcile these advantages in technology with their own sense of “family values” (for lack of a better term).  No one can do this for you. You should be fully informed of the issues to consider along the way.