Egg donation can provide the missing link for those struggling to conceive, who want to avoid passing down a genetic disease, or for singles and gay couples who know they cannot conceive on their own. In this article, we’ll explain in more detail what the egg donation process looks like, how egg donors are screened, the factors to consider in your search for the ideal egg donor and the differences between fresh and frozen donor eggs.

The egg donation process – a quick overview

Through egg donation, a donor chosen by the intended parents provides her eggs to be transferred via IVF. Fertility clinics follow a rigorous screening process when it comes to clearing egg donors. Prior to starting the egg donation process, the egg donor undergoes a thorough medical screening to ensure that she is fit to receive the stimulation medication required (more on this below). Her egg reserve is assessed, and her medical history as well as family and genetic history are evaluated. Blood tests are done to check for undiagnosed medical conditions or infectious diseases.

Once the egg donor is cleared by the clinic, she is prescribed hormone medications to stimulate ovulation and the production of multiple eggs. In the meantime, the intended mother is prescribed estrogen and progesterone to build up the uterine lining and prepare it for implantation.

The next step is the egg retrieval and fertilization with sperm from the intended father or a sperm donor. Then the best embryo is transferred to the uterus using a thin catheter, a procedure known as a fresh embryo transfer or Frozen Embryo Transfer (FET), if you choose to test your embryos and transfer them at a later date. Throughout this process, the intended mother continues her medication (progesterone). If the transfer is successful, once a heartbeat is confirmed, the pregnancy progresses from there, hopefully making it successfully to term.

While there are various reasons why the use of an egg donor may be recommended, the first step is to understand if egg donation is right for you. 

Is egg donation right for you?

Deciding to grow your family via egg donation is not easy, however it may be an ideal solution if conceiving naturally isn’t possible. The first step is to consult a Reproductive Endocrinologist (RE) or your fertility clinic to go over your options. Egg donation may be recommended in the following scenarios:

1. Advanced age: fertility naturally diminishes with age as changes start occurring in the ovaries
2. Diminished Ovarian Reserve (DOR): when the ovaries no longer produce quality eggs in adequate numbers. This generally occurs with ageing and menopause, but genetic abnormalities, medical treatments or injury may also lead to an earlier DOR. As patients with DOR do not have many eggs left, they may not respond well to stimulation protocols used in IVF 
3. Primary Ovarian Insufficiency (POI): women naturally experience reduced fertility around 40 years old but for those with POI, this starts earlier – in some cases even as early as the teenage years
4. Absence of the ovaries: due to surgery or a congenital malformation
5. Poor oocyte quality: an oocyte is an immature egg cell. During ovulation, the oocyte matures and becomes an egg. The number of oocytes decreases with age, as does their quality 
6. Poor embryo quality: this could be due to a genetic abnormality in the egg or sperm of the male or female partner, or a genetic abnormality in the embryo
7. Prevention of genetic diseases: if you are aware of a condition you have that could be inherited by the baby
8. Previous IVF failure: if you’ve experienced repeated IVF failure due to abnormal eggs, it may be time to discuss the option of donor eggs with your doctor
9. Men: who are single or in a same sex relationship need the help of donor eggs to conceive

If a medical issue is keeping you from growing your family, the news that you will need an egg donor can be difficult to take. It’s important that you seek the support you may need to come to terms with the news and to discuss the way forward. It’s also completely understandable that you may feel wary of using an egg donor for some time, but chances are the desire to have a baby will help you overcome your reservations and concerns. 

So, give yourself the time you need. Remember that, donor eggs or not, you will still 1000% be your child’s parent. And then once you and your partner feel ready, it’s time to start searching for the ideal egg donor, one that matches all of your preferences.

Factors to consider when selecting an egg donor.

Choosing your specific egg donor is one of the most personal and important decisions you’ll make. Many intended parents choose to seek the services of an egg donor agency – however, choosing which agency to work with is a big decision in itself and many intended parents go to multiple agencies before they find their perfect donor. To make the process easier, GoStork provides over 10,000 egg donors combined from over 50 egg donor agencies all in one place, allows you to compare egg donors side-by-side to save you time and help you make more informed decisions, then connect directly with the agencies of your favorites all in one place.

When reviewing egg donor profiles you’ll find the donor’s appearance and physical attributes, education level, medical and fertility history, as well as family medical history, among other elements such as ethnicity and religion. Undeniably, you are presented with a large amount of information, but in this case, the more information the better! To get started, you’ll want to decide what characteristics matter personally to you. Here is a list of criteria you’ll be able to consider before you make this important decision:

• Age – Donor must ideally be between the ages of 21 and 30 but if you prefer one on either the younger or older end of that spectrum, that’s a valid decision
• BMI – Donors must have a healthy Body Mass Index (BMI) between 18-27, but as far as the donor’s specific weight – that may be a consideration that’s important to you.
• Medical History – Personal health history (ideally, a non-smoker, non-drug user and non-alcohol dependent, has no STDs, and is not undergoing treatment for depression or anxiety – these elements are pre-vetted and indicated for you to consider), family health history (ie. you would be looking for egg donor profiles with a low risk of passing on a genetic disease, paying attention to the disorders that are of highest concern to you).
• Reproductive history –  If applicable, you’ll see information about ‘proven fertility’ in egg donor profiles, ie. a previous successful pregnancy shows that the donor has the potential to provide healthy eggs. You may also learn that the donor has donated eggs prior that resulted in a successful pregnancy – and you’ll see how many eggs her prior cycles yielded.
• Appearance – You’ll see the donor’s photos, (ideally current as well as from childhood) and when available, videos as well, natural hair color, eye color, height, and, as already mentioned, weight. Many intended parents are interested in donors with similar physical features to themselves or their partners, while others are interested in dissimilar features. Again, these are personal decisions and any preference is valid.
• Personal Background – This can range across heritage, religion, characteristics, education, career, and even criminal record. This is obviously a wide range of criteria – so just to explore one example; a donor with a graduate degree or high test scores may be someone you’re ideally looking for – so you could, as a starting point, filter your options through the lens of your desired standard of education. Also, many intended parents look for egg donors with a similar heritage or religious background as themselves.
• Compensation*: The Egg Donor’s fee can range from $2,500 to $30,000 – and even upwards. Donors may charge more when they have proven fertility or a higher level of education, among other factors.
• Location – An egg donor close to your IVF clinic can help save you money in covering her travel costs. That said, this may not be your most important criteria – in which case it’s totally up to you to prioritize other factors over where the donor lives to open up your search.

*It’s important to note that the donor’s fee does not reflect the full egg donation journey cost, which can range from $35,000 to $65,000 if you were to include all costs related to the agency’s compensation, egg donor fees, screening costs, legal fees and IVF clinic fees. We’re the first database that lists all costs upfront, helping you plan your financial journey ahead (including where you may be able to save money).

Choosing Between Fresh or Frozen Donor Eggs

Both fresh donor eggs and frozen donor eggs have specific pros and cons which you should consider:

Advantages of using fresh donor eggs

1. Better odds of live birth – IVF with fresh donor eggs has been widely researched and found effective. A national study published in the journal Obstetrics and Gynecology found that the use of fresh donor eggs in IVF has a small advantage in birth outcomes. According to the study’s lead author, Jennifer L. Eaton, M.D., “the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference.” Data from the Centers for Disease Control and Prevention (CDC) shows that, based on 2018 data, chances of a live birth with fresh embryos from fresh eggs is 57.1%, while that for fresh embryos from frozen eggs is 44.2% . As technology continues to develop, the gap in success rates between frozen and fresh eggs continues to decrease. As Dr. Gad Lavy, Medical Director and Founder of New England Fertility noted in an interview with us at GoStork, “the viability, the success with frozen eggs is essentially the same as it is with fresh eggs”.
2. Larger number of eggs – A fresh egg donation cycle will give intended parents anywhere from ten to twenty eggs (as compared to a cohort purchase of six to eight frozen eggs from an egg bank). This is ideal if you plan on having more than one child: a fresh donation cycle may provide you with a good number of embryos to pursue more than one pregnancy. 
3. No need for ICSI – with frozen eggs, an extra procedure known as intracytoplasmic sperm injection (ICSI) becomes a must. The freezing and thawing process makes the shell surrounding the egg hard for the sperm to penetrate on its own. ICSI bypasses this as a single sperm is injected directly into the egg. This also adds to the overall cost of frozen eggs, though as you’ll see in the next section, these costs are still less than fresh eggs.

Caveats with fresh donor eggs

1. Longer timeline – using fresh donor eggs is a longer process: it takes time to match a donor to the recipient and then to synchronize schedules and cycles. In a frozen cycle, the eggs are already cryopreserved and there’s no need to synchronize your cycle with that of the donor so you can start the process whenever you’re ready. It can take as little as four weeks to complete a cycle using frozen donor eggs, vs. six months for a fresh cycle.
2. Greater cost – fresh donor egg IVF is typically more expensive than the frozen alternative: as noted by what to expect, a fresh donor egg cycle costs an average of $25,000 (which excludes your hormone shots, IVF clinic appointments and travel and legal fees), and may amount to around twice the cost of frozen eggs.
3. Potential for cancellation – donation cycles can on occasion get cancelled due to poor medication response or issues, or because of an insufficient amount of eggs obtained. Medical issues, such as uterine cysts or bleeding can have a negative impact on implantation, preventing the cycle’s success. 

Ultimately, when choosing between fresh or frozen eggs, it all comes down to your personal situation. Success rates can depend on each individual’s specific case, as well as the expertise of the clinic you’re working with. A doctor and the clinic can help you assess your options based on your medical history and specific circumstances.

We hope that this helped provide the information you need. And remember – the right decision is whatever feels right for you. All the best on your journey!