STANDARD INTRODUCTION
Welcome back to Fertility Café. For many hopeful parents out there, the hardest part of the journey to parenthood is deciding which path to take. If having a baby the “traditional” way isn’t an option for you, for whatever reason, you’ve probably spent hours weighing all the different options out there. Adoption, IVF, egg and/or sperm donation, or surrogacy… the good news is there are many paths to parenthood these days. What’s difficult is choosing when and how to move forward.
Today’s episode is all about finding your ideal egg donor. We’ll cover topics like why someone may choose to use donor eggs, the qualities you should look for when searching for a donor, pros and cons to the various methods of finding a donor, and more. We’ll also cover some of the more frequently voiced worries or fears we hear from intended parents as they weigh their decisions.
For more clarity on the biology and process behind egg donation, check out Episode 4 of the Fertility Cafe, where I go into detail about how egg donation works. For now, let’s dive into the topic at hand: the ins and outs of finding your ideal egg donor.
So let’s start with who might choose to use donor eggs.
Women with fertility problems, LGBTQ families, and single individuals who want to become parents are among those who can benefit from using an egg donor. Third-party reproduction can be socially, ethically, and legally complex. As egg donation has become more common, there has been a reconsideration of the social and ethical impact this technology has had on intended parents, their offspring, and the egg donors themselves.
A brief recap of the egg donation process
While I go into more detail about the process in Episode 4, let’s take a moment to recap some of the options you have with egg donation, as well as the basics of how it works. Egg donation is not a new technique. The success rate for pregnancies from donor eggs has increased. While success varies depending on a variety of factors, overall, the CDC reports that 55% of all embryo transfers using donor eggs result in a successful pregnancy. Donor eggs can be used by the recipient mother or can be used in tandem with a gestational surrogate. Egg donation requires in vitro fertilization (IVF), as the eggs are removed from one woman, fertilized in the laboratory, and the resulting embryo is transferred to the recipient’s uterus.
Is Egg Donation right for you
So what are the steps in finding an egg donor? Honestly, the first step is ensuring you are mentally prepared. I get a lot of phone calls from intended parents that they need to find a donor but don’t know where to start. Before I ask what characteristics and criteria they’re considering in a donor, I ask them, are they mentally prepared?
As crazy as this sounds, especially when you have gone through years of infertility, have you mourned what could have been to prepare for what is to come? Sometimes, we must mourn the loss of what we thought was going to be how we complete our family to give space for what is supposed to be our family. It may not look like anything you ever thought of. And sometimes, you really must question yourself. Do you want to have a child, or do you want someone who is genetically related to you if you can’t have both?
Is it fair that you must choose, absolutely not? But this is where you are, and you need to decide what is the most important to you.
Once you are mentally prepared, then you can begin making decisions on the other aspects of egg donation.
Anonymous vs known donors
As you begin your search for the right egg donor, you’ll have a lot of questions to consider. One of the earliest decisions you’ll want to make, though, is about the level of anonymity you’d like to have. The reason I say you should decide early on is because your preference here will affect where and how you go about finding your donor.
In the most general sense, you’ll need to think about your ideal journey. Do you want to have a personal connection with your donor? Do you want your child to know they were donor conceived or perhaps to know who the donor is? And at what point in the child’s life will you have that discussion? If you favor openness and personal connection, how you go about selecting your donor is going to be important. You may have to consider searching for a donor through an agency or egg bank that allows open donations.
On the other hand, you might prefer an anonymous donation. Anonymous donations are more common practice, but it’s your journey, so reflect carefully on how you’d like to proceed.
A couple of in-between options include semi-anonymous or identifiable donor agreements. Semi-anonymous agreements are becoming more common. In that type of agreement, limited donor information is shared with you. Usually it’s limited to first names and geographical location, but sometimes it can include the option to connect via phone or email.
With an identifiable donor agreement, all parties agree to release the egg donor’s information to any child born from her eggs once the child turns 18. Some people like this option because it gives the child control over his or her own information once they reach adulthood.
One modern innovation that can’t be discounted in this discussion is the popularity and prevalence of genetic DNA testing. With companies like 23 and Me and AncestryDNA becoming more and more mainstream, anonymity is harder to maintain. Thirty years ago, in the early days of egg donation, parents never fathomed their future child taking a DNA test and finding out they have a different biological mother. Uncomfortable family discussions may have been swept under the rug years ago. I’m sure you’ve heard or read sensational news stories about people finding out they were adopted or born of an egg or sperm donation after taking an at-home DNA test. Talk about an awkward family holiday!
Those types of family secrets just aren’t possible anymore – and I, for one, think that’s a good thing! The last thing you want is for a child to “accidentally” find out there’s a hidden genetic family history.
No matter what level of anonymity you choose for your donation, it’s vital that you think through and prepare to share your journey with your child someday. Openness and transparency between a parent and child are the basis of trust in the relationship, especially in non-traditional family situations. Honesty is always the best policy, even when it’s complicated.
Any reputable fertility clinic or agency will require you as intended parents to go through psychological screening and counseling to help you work through tough questions like these.
Where to look for an egg donor
Once you’ve decided that egg donation is right for you, it can be hard to pinpoint where to begin. Well first and foremost, you need to discuss your possibilities with your fertility clinic and physician. The clinic will likely be the first place you’ll look for information, but it’s not your only option when it comes to finding a donor. Beyond an in-clinic program, you can also find donors through personal connections, agencies, or even through social apps or matching websites.
Each method has its own pros and cons, including cost, level of anonymity between you and the donor, and waiting time. There’s no right or wrong choice to make here, but I think it’s important to have as much information as possible before deciding which route to take.
First, let’s talk about one of the more common methods of finding an egg donor: using a frozen egg bank. This option can be one of the most cost-effective for recipients. Egg banks pre-screen all their donors, and each has its own set of qualifications. As with any organ or tissue donation, the industry is highly regulated by the FDA, so there are certain standards that must be met. All donors are screened for medical and genetic health issues, and donors are always tested for infectious diseases such as HIV and Hepatitis to name a few.
Beyond that, donors are asked about their medical and psychological backgrounds, including any medications, surgeries, illnesses, and more — either personally or in their immediate family. Genetic screening is also quite standard.
Egg donation agencies are another option. These agencies act as a go-between with you, the clinic, and potential donor. Agencies can help you with harder-to-find donor requests, like donors of certain ethnicities or religions, or educational background.
In this age of DIY-everything, of course there are options for finding a donor on your own. You may have a friend or family member in mind who you’d like to ask to become a donor for you. Or perhaps you’d like to try connecting with someone through an online community or social network.
A word of caution: whoever you choose still must be screened and approved by your fertility clinic, and this process can sometimes be frustrating. With a personal donation from a friend or family, there can be very complicated emotions you’ll need to work through. And with a person you find online, well, you know there are all sorts of risks and complications that can come up. Proceed with caution.
What qualities do you look for in an egg donor
Beyond the general health qualifications, what should you look for in an egg donor’s profile? What information will you even have access to? Again, the level of information you receive can vary a lot depending on the type of donation you choose and where you look for a donor. Profiles range from basic demographics and background to extensive personality, intelligence, and educational histories.
I’d like to mention a slight word of advice. It’s easy to get a bit carried away in the particulars of your ideal egg donor. I’ve seen intended parents get bogged down in a laundry list of details, then get frustrated when the perfect donor doesn’t appear right away. It’s a good thing to have non-negotiables, but if you keep an open mind and are willing to compromise in a few areas, you’ll be more likely to find your match, faster.
So before we look at the multitude of criteria you might consider, think about what your non-negotiables are. Is it important to you that the child looks like you or your partner? Are you looking for someone with exceptional intelligence or standout talent in one area or another? Or are you looking for a donor who has had several successful donor cycles in the past, which might promise a better chance of having a successful pregnancy? There’s no right or wrong answer here because this is your journey.
For some intended parents, time is of the essence, so you may have greater compromises to make. For others, it’s worth the wait to find a very particular donor. Discuss your options with your fertility clinic and be open to possibility during your search.
Lastly, don’t discount your intuition. I’ve heard many times that something about a profile “just clicked” for an intended parent. As you read through profiles and personal essays, think to yourself “Can I see this person fitting in with my family? Would we get along well?” Often, it’s the intuitive side of you that will know when you’ve come across the right donor.
Okay, now that we’ve gotten all of those disclaimers and words of caution out of the way, let’s look at the many different criteria you can specify when looking for your donor. Again, this is your personal journey, so what’s important for one person may be irrelevant to another. I’ll try to touch on a little bit of everything here.
Right off the bat, one factor to consider is whether you would like to work with an experienced donor. Meaning, she has successful donated to another family in the past and that donation lead to a pregnancy. Obviously, the advantage being a history of past success. Experienced donors can cost a bit more, however. Your doctor can help you decide how important using an experienced donor is for your situation.
By far, the most requested criteria seem to be physical appearance and intelligence. Whether it’s the natural desire to have a child who looks like you, or the hope that your child grows up to be smart and attractive, or a combination of both, intended parents tend to be especially interested in these details about their donors.
First, physical traits. This is one of the more obvious and perhaps one of the easier criteria to search for. Eye color, hair color, complexion, height, and other basics will be readily available to you in the most basic of donor profiles.
Yes, it’s natural for a person to want their child to share physical traits in common, but it’s certainly not a requirement, and some intended parents aren’t married to the idea of a child with a similar appearance. Perhaps the details aren’t quite so important to you, but you’d prefer a donor of a similar ancestry. You could search for donors of Italian descent, for example, with the idea that the child may share features common to that ethnicity.
If you decide that appearance is an important factor, you can certainly begin to narrow your donor search by looking for specifics. Just remember, nothing is certain when it comes to babies! We all remember doing those genetic square diagrams in grade school, right? What were they called? Punnett squares, I think. Dominant and recessive genes can play tricks on us, so even if your donor has blond hair and blue eyes, there’s no guarantee your child will have the same. Sometimes those red locks surprise us!
Either way, if there are certain physical features you favor, make that known to the bank or agency you’re using. They can help you narrow your search. Typically, the frozen banks will provide you with baby or early childhood photos of the donor so you can imagine what your child may look like. Agencies tend to offer you childhood and adult pictures of the donors.
One factor worth mentioning here alongside the physical trait search is the donor’s blood type. While you can’t tell someone’s blood type from looking at them, I do hear concerns about this from time to time. Do you need to find a donor whose blood type matches one or both intended parents? The short and sweet answer is no, you don’t. Blood type does not normally impact your journey from a practical or medical standpoint. That being said, some still have questions about it.
One of the more common reasons I see is so that intended parents can have a close match to their child in case of a medical issue down the road. Should the child ever need a blood or tissue donation, the parents could potentially be a match. Remember, modern medicine does offer us many options these days so there may not be a compelling reason to limit your choices based on blood type alone. Definitely speak to your doctor about it. I also hear some parents who worry that different blood types could cause an incompatibility during IVF. Let me just say that there’s no evidence of poor IVF outcomes caused by blood type issues. Again, speak to your doctor.
Okay, now that we’ve discussed most of the physical traits you may want to consider, let’s dive into personality and intelligence. These can be a bit harder to quantify than hair or eye color, but this is where I see intended parents get excited about choosing a match. It’s also where you can get a bit carried away, so remember what I said earlier about finding someone who “clicks” with you? Trust that intuition!
So, where to begin with personality and intelligence? Should you pick a donor with a 4.0 GPA or someone who is an accomplished gymnast? How about someone who fits both bills? Is it important that your donor have musical ability and a creative side? Does your donor’s personality, hobbies, and abilities really matter? Will getting too specific with your criteria limit your options too much?
Of course, all parents want to give their children the best leg up in the world, so it’s tempting to look for a donor with exceptional qualifications. When you choose an egg donor who has certain favorable personality traits – like kindness or generosity – the thought is that your child may inherit those traits.
Nature versus nurture has been an ongoing debate for ages, and I certainly don’t have a definitive answer for you! Is there a kindness gene that can be passed on? Will the child of a naturally outgoing person turn into an extrovert? Is the fact that your donor is studious, hard-working, and resilient an indication of how your child will approach adulthood? I don’t really know, but I do know that personality profiles are an important part of the decision-making process for many intended parents.
Personally, I think the big advantage to this type of information is that it helps you feel a connection to your donor. Many agencies and egg banks will provide intended parents with personal essays written by the donor or videos, to give you an even clearer picture of the type of person she is. In the case of anonymous donation, reading something written directly by the donor can be the best way to feel a connection to her.
What about intelligence? The science is mixed on how much of a role genetics play in a person’s intelligence, with the general consensus being that yes, genes do play some role. Environmental factors can make a huge difference, though. Nature versus nurture again, right?
So how do you search for an intelligent donor? There are a few factors to think about. What’s the highest level of education the donor has completed? Are you looking for someone with an advanced degree, exceptional academic achievements, or a certain course of study? Is an Ivy League education important to you?
Do keep in mind that most egg donors are in their early to mid-twenties, so many are right in the midst of their higher education career. While you may get an idea of the career path they hope to pursue, you’ll often see that donors are currently working toward their degrees. Nonetheless, you can usually find out about their general academic performance, their major, and their academic and career goals.
In addition to academic background, intended parents often like to know about any special interests, talents, or athletic ability the donor has. Does she play a musical instrument, speak four languages, or excel at certain sports? Again, there’s no guarantee your child will be a basketball star if your donor is starting point guard for her college, but it’s one more way to get to know your donor and narrow down your choices.
The donor’s family background is another piece of the puzzle. Of course, family medical history is important and will be shared with you as part of the prescreening process. That’s a given.
Beyond their health history, though, some intended parents like to know if the donor comes from a large or small family, or how they feel about having children of their own one day. Do they already have children they are raising? For some, these details are neither here nor there, but for others, this can make a difference.
On to a couple of potentially complicated criteria: ethnicity and religion.
While it’s much easier today to find a donor of a specific ethnic background than it was a decade or more ago, it can still be challenging in some cases. If it’s important to you that your donor be of a particular ethnic background, you may have to search a little harder. The good news is that there are many agencies that focus on recruiting donors of particular ethnicities.
Because of cultural taboos and general community disapproval, there are some ethnicities that are particularly hard to match. Nothing is impossible, but if you require a donor to be of Asian, Indian, Jewish, or Middle Eastern descent, your search may require more time and patience, and it may come at a higher cost. As assisted reproduction techniques become more commonly accepted, more women from these backgrounds are learning about and choosing to become egg donors.
For some, the religious background of the donor is an important factor. Whether you desire a spiritual connection to the donor based on your personal beliefs, or you adhere to a religion that has specific requirements regarding assisted reproduction, you absolutely have the option to narrow your search based on the religious faith of the donor.
There are some very particular guidelines for egg donation in some religions. In the Jewish faith, for example, it’s traditionally believed that religious faith passes to the child through the woman who gives birth. When using a surrogate or genetic material from a donor egg, this can cause complications depending on the Jewish tradition the intended parents practice. Some Orthodox rabbis, for example, teach that for the child to be Jewish, both the egg donor and the woman who carries the child must be Jewish. Other Jewish sects have a more permissive view. There are boutique agencies out there that specialize in matching Jewish families with Jewish donors, should your faith tradition require that.
In a more general sense, many intended parents want to have a spiritual connection to their donor. For that reason, you may look for a donor who is a practicing Catholic, Buddhist, or Hindu, or you may prefer someone who doesn’t practice a religion at all. I always recommend reaching out to trusted clergy or teachers in your religion to get guidance if faith is important to you.
No matter what, make your preferences known to your fertility team. They should be able to point you in the right direction.
Legal Aspects of egg donation
Let’s touch on the legal aspects of egg donation for a moment. If you decide to work with a frozen egg bank you most likely will not have an Egg Donation Agreement with your donor. Both you and the donor will sign consent forms through the clinic but that is about it.
If you decide to work with an egg donor through an agency or independently, it is recommended you have an attorney, who specializes in Family Formation law, to draft an Egg Donor Agreement. This agreement will be between you and your donor. Even if the donor is anonymous, an agreement can still be drafted. This agreement is drafted to protect all parties involved in the egg donation arrangement, state the intended parents’ and donor’s intentions and legal obligations, and dissolve the donor’s custody over any child that is born through the process.
It may also detail your expectations for contact after your child is born and your expectations should some medical issue arise down the line in the donor’s life that could potentially affect your child, that is shared with you.
The egg donor agreement gives intended parents control of all eggs retrieved from the donor as well as any resulting embryos. Intended parents can use them as they wish, including IVF to reproduce children of their own, donation to a third-party, or medical research.
In some states and foreign jurisdictions, for the IP’s to be recognized as the legal parent of any resulting child, there must be a written contract between the parties before any egg retrieval takes place. Without a contract, the parental rights of the IP’s may be in jeopardy.
Most clinics, if you select a donor from a third party will require an egg donor agreement be drafted and executed before the begin the donor’s cycle.
Costs of egg donation
Are you feeling overwhelmed with all the possibilities? I know, it can feel like a lot to think about. I hope the next topic — money — doesn’t add to the overwhelm too much. But since I’m a firm believer in laying out all the information upfront, let’s get to it. How much does all this cost?
As with any type of assisted reproduction, pursuing parenthood via egg donation can be costly. In searching for average costs, you might see anywhere from $20-60,000. Costs of course vary depending on a variety of factors, but this type of ballpark figure includes compensation for the donor, management and legal fees, IVF, medications and fertility clinic fees, travel, and other miscellaneous expenses.
Don’t give up, though! There are ways to save on costs. And I’ve seen many creative and inspiring ways to afford family building via egg donation. Where there’s a will, there’s a way!
The type of donor you choose can make a big difference in overall cost. For example, whether your donor has experience or not, or whether she possesses hard-to-find qualities will have an effect.
First-time donors without evidence of successful cycles generally receive the least amount of compensation. In the US, this starts at around $6,000. Experienced donors, those women who have donated eggs that resulted in successful pregnancies can receive upwards of $10,000. A third-tier, often called “elite” or “exceptional” donors are the costliest. Compensation for donors of a rarer ethnicity or who possess highly-sought after traits — like an Ivy League education — can begin around $20,000. As you can see, if cost is a major issue for you, and your doctor believes you have a good chance using a first-time donor, you can save yourself a significant amount of money.
There are other ways to afford egg donation, though. And most of it begins with planning ahead!
If you know egg donation is something you want to consider, be sure to investigate your health insurance plans. Believe it or not, in some states, private health insurers are required to provide coverage for people being treated for infertility. This can include the cost of using donor eggs in some cases. You can research your home state’s laws, but understand that you’ll still need to call your insurance provider to ensure that your plan is currently set up to cover these expenses.
Just because the state is required to offer this type of coverage does not guarantee that every plan offers it. You may need to get a new plan, or request these coverages be added to your existing plan. As you can imagine, you’ll want to have that proper plan in place before you start incurring expenses. Some plans will also have a mandatory waiting period between when the coverage is added and when it may begin to be used. Be sure to ask about this.
Since the law only requires coverage be extended to those undergoing fertility treatments, this will not help same-sex intended parents where both parents are male. In these instances, you may want to consider looking into your FSA for related expenses.
Yes, you can use your FSA or HSA to pay for your expenses! Your funds can be used for egg donor fees for the individual, spouse, or dependent, and include legal, donor cost, testing, and agency fees. Your use of a donor has to be deemed medically necessary by a doctor, but this can be a great way to put away tax-free money to pay for your journey.
Another little-known way to fund egg donation is by applying for grants. Yes, these exist! As you can imagine, the waiting list for these can be quite long. But if you plan, do your due diligence, and can afford to wait a year or so, you may be able to qualify to offset some costs.
Loans are another option. Some intended parents take out 401k loans, home equity loans, or you could investigate financing companies that specialize in funding fertility costs for intended parents.
Beyond that, it’s always possible to get creative! Can you host a fundraiser, start a side gig, or ask friends and family for donations? When you share your goals and dreams of parenthood with people who love you, you might be surprised at how supportive they can be!
One last tip about minimizing medical costs: be sure to shop around with different pharmacies. Prices can vary wildly with different companies. You may just be surprised at how wide the price gap is between competing pharmacies for the exact same medications.
Don’t forget to shop online and physical pharmacies, and don’t be afraid to shop out of state. Often shipping from another state is cheaper than buying in your own hometown. GoodRX.com is a great place to begin seeking out better prices on medications. Just don’t solicit unused drugs from other intended parents. Fertility medications are still controlled substances and asking for them openly and publicly isn’t a smart idea.
Conclusion
I’d like to wrap up today’s episode by easing some common fears and concerns I hear from intended parents.
Sometimes people worry that the donor will have some sort of parental claim to the child one day. What if the donor is identified through a DNA test at some point, and she decides she wants to be a part of my child’s life? What if she changes her mind after we’ve already begun the process?
From a legal perspective, you have nothing to worry about here. If you go through the proper channels and work with a reputable agency, bank, and/or clinic, of course. Donor eggs are treated with the same laws as other human tissues: a kidney donor absolutely cannot ask for her kidney back once the papers have been signed and the procedure has been completed. Same with egg donation. Once the i’s are dotted and t’s are crossed, the donor has no legal claim to those eggs anymore.
On the question of DNA identification, as I touched on before, that may become an issue down the road for your family to grapple with. It’s one of the main reasons why known donations are becoming more popular lately. Still, donor agreements are very clear about patient privacy, and an anonymous agreement is legally binding. That won’t stop a determined young adult from investigating on his or her own later in life, but from a legal standpoint, your privacy is protected. Donors have absolutely zero ability to claim parental rights or any other sort of relationship.
Perhaps the biggest worry of all, though: “Will I be able to bond with a baby who isn’t genetically mine?”
In short: YES! We all know genetics does not guarantee a person will be a good parent. Biology does not equal love, which is unfortunately evident when we look at statistics on child abuse and neglect. Also, can you think of anyone you know in your life who has adopted a child, or who has had a child through the help of a donor? I bet you would never think to question their love for that child, would you? Of course not! Show yourself the same kindness and compassion and realize that love and family are so much more than the genes we carry.
When you hold that baby in your arms for the first time, trust me, all that doubt will melt away.
I hope today’s episode has been helpful to you as you think through the process of finding your perfect egg donor. Check out the resources page on our website, thefertilitycafe.com, and until next time, remember: “Love has no limits. Neither should parenthood.”
