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No one's journey to becoming a parent is the same. For some people, it may involve IVF, and part of that might mean using an egg donor in order to conceive and then either carrying the pregnancy or working with a gestational carrier to carry the pregnancy. But how do you even begin this process?
It can be daunting to choose the right egg donor. You’re making a pivotal decision in your future child’s life, and it’s nothing to take lightly. If you need a little bit of guidance in the process, we’ve got you. Read more about the right time to decide on an egg donor and tips on how to approach the process of choosing the right one.
Who might be the right candidate to use donor eggs?
There are many scenarios in which someone might use donor eggs, or oocytes, to conceive. One common reason is infertility due to advanced maternal age (most commonly, those over 40) or diminished ovarian reserve (low number of remaining eggs), explains Dr. Tomi Fisher, a reproductive endocrinologist and co-medical director of Spring Fertility Portland.
Other potential health reasons for using an egg donor include previously undergoing chemotherapy or radiation treatment, having had a hysterectomy to surgically remove the uterus, or an oophorectomy to remove the ovaries and/or fallopian tubes (typically because of endometriosis, ovarian cancer risk, or ovarian cysts).
Also, not every family structure is the same: Same-sex, queer, and transgender couples, or people who choose to parent solo and do not produce eggs might choose to use donor eggs to build their family, Dr. Fisher adds.
The egg donor process
You can work with an egg donor through an agency or a fertility clinic. Agencies can act as mediators between the intended parent or parents and egg donors and often have access to a wide selection of candidates to be donors, explains Dr. Fisher.
However, there are some advantages to seeking out an egg donor through a fertility clinic. “A fertility clinic may have their own databases of egg donors, allowing the intended parent(s) to select a donor directly,” says Dr. Fisher. The fertility doctor can also perform testing of the potential donors right at a clinic, such as medical screenings and evaluations. Ultimately, when everything is done in one place, it speeds up the process. Spring Fertility’s in-house donor egg bank, Nest, helps to streamline donor selection while providing a diverse range of fresh and frozen donor tissue options for intended parents.
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Factors in choosing the right egg donor
“Choosing the ‘right’ egg donor is a highly personal decision, and finding one that resonates with you is paramount,” says Dr. Fisher. It is mostly subjective, though: Some people might prioritize a donor who has a similar lifestyle or hobbies, the same hair color as them, or someone with a certain education level. Other people, like those who have certain genetic conditions that run in their family, may be more concerned with the medical screening process for egg donors.
Fresh vs. frozen eggs
While the decision is ultimately a personal one, choosing between a frozen egg donation and a fresh egg donation involves weighing several factors. Some of the benefits of frozen egg donation include increased flexibility in regard to the timing of your IVF cycle, wider donor selection, reduced time and stress, lower costs, as well as more predictable outcomes.
Identified vs. Non-identified donor
Once called “anonymous” vs. “known” donors, the American Society of Reproductive Medicine (ASRM) changed the terminology to “identified” vs. “non-identified” donors in 2022. Because of the rise of digital DNA testing services, there isn’t absolutely guaranteed anonymity for egg donors. That’s a choice intended parents will have to make based on their own personal comfort level.
Some people choose to hand-pick a family member or friend to be an egg donor, but that person still needs to go through the screening process, including medical testing, according to Dr. Fisher.
First-time vs. recurrent donor
Most donors, in order to retrieve the highest number of healthy oocytes, are between the ages of 21 and 30. Surprisingly, eggs from younger donors under the age of 25 do not always yield the most successful pregnancy outcomes, per a 2019 study in the Journal of Assisted Reproduction and Genetics. That’s because people under 25 may not have proven evidence of safe pregnancy and birth outcomes. For the best egg quantity and quality, it is generally best for the donors to be under the age of 30, according to the study results.
Dr. Fisher points out that egg donors who have donated before will have a designated record of how well the first donation went. But don’t discount first-time donors, as they can also be successful, he adds. In general, the ASRM states that there is a limit of six total egg retrievals per donor to limit health risks to the donor.
Medical history
For some intended parents, this might be the most important factor in choosing an egg donor. Donors typically have genetic screening and testing, mental health screening, a physical exam, and infectious disease tests (for infections including HIV, Hepatitis B and C, gonorrhea, chlamydia, and syphilis). It’s required for egg donors to offer this personal medical information (and to be non-smokers), and intended parents have the opportunity to ask any questions about any findings from any of the screenings.
It is also critical for donors to disclose any chronic health conditions that could affect the donation process and to have a regular menstrual cycle, so that the ovulation period in which the donor egg retrieval will take place is as predictable as possible.
How to prepare for the egg donor selection and IVF process
One key aspect of the donor egg IVF process is the Intended Parent Psychoeducational Consultation. The intended parent or parents who are pursuing either egg donation, sperm donation, or gestational surrogacy meet with a mental health professional, per ASRM guidelines. “In addition to providing an overview of information regarding donor conception or surrogacy processes, it provides an individualized opportunity for patients to explore and address any specific concerns in areas such as grief, loss, or worries related to third-party family building, strategies for coping with stress or emotional challenges in the ART or family-building process, disclosure of surrogacy or donor-conception to family members or the community as well as future children, the limits of gamete donor anonymity, and the impact and decision-making around treatment failure or other possible medical risks,” Dr. Fisher explains.
“Overall, the goal of this consultation is to make sure the intended parent(s) are fully informed about the process and feel supported and empowered to navigate emotional challenges that may arise along the way,” says Dr. Fisher. However, you might find that you need even more emotional support along your journey, which is when a follow-up session with a mental health professional who specializes in reproductive or fertility counseling might be helpful.
Mara Santilli is a journalist reporting on health and wellness and how social and political systems influence the well-being of certain groups, including but not limited to Black and brown communities, women, and the LGBTQ+ community. Her editorial work has appeared in publications such as Shape, Marie Claire, Cosmopolitan, Women’s Health, InStyle, Glamour, and more. Outside of reading and writing, she enjoys traveling (especially to Italy), singing, dancing, musical theatre, and playing guitar and piano.