Top Questions Egg Donors Ask by Kathy Benardo
Top Questions Egg Donors Ask
by Kathy Benardo, Director of the Egg Donation Program at the Northeast Assisted Fertility Group,
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. 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.
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. If working through an egg donation agency, 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 matching process below).
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.
Will egg donation affect my future fertility?
No relationship between egg donation and future fertility has been clearly established, although research is continuing.
Egg donation does not deplete your ovarian reserve. Each month you release a number of eggs, but only one comes to maturity, generally. The hormones administered in the donation process stimulate more than one to reach maturity. Women in their 20s have hundreds of thousands of viable eggs, although the number diminishes over time.
How much do egg donors get paid?
It varies. Most clinics offer between $3,000 and $8,000; clinics in large cities offer more than other places in the country. Egg donor agencies (as opposed to clinics) tend to offer compensation in the upper range. Most egg donors get paid all at once after the retrieval; some agencies pay in stages. The amount is agreed on beforehand and does not correspond to the number or quality of the eggs retrieved.
There are no laws regarding how much you can get paid to be an egg donor. However, the American Society for Reproductive Medicine (ASRM) establishes ethical guidelines for egg donor compensation, and the current cap is $10,000 per cycle (donors get paid for the time and effort of the cycle, not for the eggs retrieved). All clinics and some agencies establish the fee for you; some agencies allow the egg donor to determine her own amount. You may be offered more than $10,000, but keep in mind that you, your recipient, and clinic will be working unethically in order to carry out such a plan.
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.
How are egg donors matched with recipients?
At this current stage in technology, donor eggs are not frozen for later use. So a specific recipient has to choose you before you can donate. You can be matched anonymously through a clinic or agency, or, less commonly, work directly with a known recipient.
To find a clinic near you, you can go to SART.org (the Society for Assisted Reproductive Technology’s Web site). If you are a good candidate you could probably start at your local clinic right away. Once you pass your screening, the nurses will offer your profile to prospective recipients, who typically have been waiting a few months to be matched. Clinics often do shared cycles, when the retrieved eggs are divided between two recipients (this is a cost savings measure for the patients, and does not increase the donor’s compensation). Not all clinics have their own egg donor programs, however.
You can find an egg donor agency through an online health directory such as IHR.com or through a search engine. You may choose an agency near you or anywhere in the country, since most serve clients nationally. When working with an agency, a recipient will select you from the agency database, and only then will you begin your medical screening. You may work with a local clinic or one in a different city, if that is convenient for you.
Although agencies may take a little longer than clinics to match you with a recipient, agencies usually pay more and will reimburse you for travel expenses and even lost wages. When matched with a recipient through an agency, before you start your medications you will be presented with an egg donor contract and provided an attorney to review its terms with you (clinics present donors with consent forms rather than contracts).
If you want to work directly with your recipient, you may also choose to answer an ad placed by an individual looking for a specific type of egg donor (be aware that some of these ads are actually placed by agencies). These ads can be found in college newspapers and on Web sites that carry classified ads. The recipient avoids agency fees by finding an egg donor this way. We would recommend that in these private arrangements you have a contract reviewed by your own lawyer to protect your interests.
No matter which type of organization you approach, we recommend that it and/or the clinic involved be registered with the ASRM or SART to ensure its legitimacy. Also, be aware that compensation claims over $10,000 are not illegal, but they are unethical.
What are the costs involved for me and do I need medical insurance?
If you donate eggs locally through a clinic, you will be responsible for your own transportation costs. If you go through an agency, whether donating locally or in another city, your travel and related expenses should be paid in advance. You are not responsible for any medical costs.
A special egg donor insurance policy will be purchased for you to cover any complications, whether you have your own insurance or not.
What happens to donor eggs after they are retrieved? Do I get to know the results? Do I meet the recipients or potential offspring?
After the retrieval, the eggs are fertilized and then observed for a few days. Not all will fertilize or develop. Between one and three embryos will be transferred to the recipient. If any viable embryos are left over, they will be frozen (embryos hold up better in the freezing process than eggs do). It takes about six weeks to find out if a pregnancy results.
The majority of egg donor cycles in the US at this time are mutually anonymous: the recipients and donor may know general information about each other, but they do not know each other’s names and they never meet. If working in a mutually anonymous arrangement, you may be informed of the number of eggs retrieved, but not the number actually fertilized or whether a pregnancy or live birth resulted. If you are working non -anonymously, you may get more information, depending on the arrangement. Some donors do meet their recipients with the supervision of a social worker provided by the agency or clinic, and leave the opportunity open to meet any potential offspring. Both parties agree to the anonymity level before the match is made.
Can I donate eggs more than once?
Yes, egg donors can undergo up to six cycles. Indeed, most egg donors choose to do it a few times. A period of about twelve weeks is recommended in between each egg donation cycle.
What if I change my mind before I start the egg donation process?
At no point are you legally bound to donate your eggs, even if you sign a contract. Contractual penalty clauses requiring egg donors who breach to pay medical expenses incurred by the recipients are generally unenforceable, but they should be avoided nevertheless. Most donors receive no money until the retrieval, so all they lose when they back out is their time.
Recipients, however, lose much more. They may have spent money on screening tests and other medical procedures, in addition to previous costly but unsuccessful IVF cycles. There is also the extreme emotional toll. It may be hard to imagine the pain and stress of infertility unless you experience it yourself. A canceled egg donor cycle will only intensify the disappointment and heartbreak.
Egg donors are very special women: healthy, vibrant, intelligent, responsible, ambitious, adventurous, and compassionate. They also need to have some flexibility in their schedules. Egg donation is not for everyone. If all this inspires you, you may want to apply to be an egg donor. If your reaction is less enthusiastic, it’s probably better not to consider it. Only you can decide how you feel and what is best for you.
For Follow up questions contact Northeast Fertility Assisted Group