How Does Egg Donation Work? Experts & Egg Donors Share What They Want You To Know
In a world where fertility isn't always a sure thing, egg donation is an option to which some people turn — either to become pregnant themselves, or to help out a couple who want to have a child. You might have heard a friend of a friend of a friend's ex-girlfriend who got paid $20K for a few of her eggs back in 2011. "It's so easy!" you might have heard down through the grapevine. These stories have gotten more common as the procedure has, too. But while egg donation might seem like a great way to pay off student loan debt or give the gift of life, the process isn't easy. Experts and people who've gone through it tell Bustle that there are some important things to know about how egg donation works before you begin the process.
"Egg donation is when an egg from a fertile woman is donated to an infertile woman to be used in an assisted reproductive technology procedure such as IVF (in vitro fertilization)," Dr. Janelle Luk, a reproductive endocrinologist and medical director and founder of Generation Next Fertility, tells Bustle. "The woman receiving the egg will not be biologically related to the child but will be the birth mother on record."
If you’ve been thinking about donating your eggs, the first thing to know is that it’s very common. According to the Centers for Disease Control's 2014 Assisted Reproductive Technology National Summary Report, the amount of cycles performed with donated eggs or embryos was 20,481 in 2014, up 27% from 2005. This amount is expected to be higher when the next ART report is released by the CDC.
In theory, it seems like donating your eggs would almost be easy — someone swoops in and takes some eggs — but the reality is that it's far more complicated than that. From how the process works to how you can expect to feel about it, experts and people who've undergone the process say that there's a lot to know before you donate your eggs.
Although the money end of things can sound like a great deal, donating your eggs isn't without a lot of commitment and responsibilities.
“Egg donation requires a time commitment,” Julia Alkire, the founder and CEO of Family Creations, an egg donor and surrogate program, tells Bustle. “First a donor waits to be matched with a recipient parent (which can be a matter of days or even months). Once matched with a recipient couple, it is generally three months until an actual egg retrieval procedure takes place.”
But that’s just the beginning. Cary was 25 when she donated her eggs right after college to pay off her student loans. “You will need to go through a series of hormone shots which will make your abdomen extremely swollen and make you frisky,” Cary, now 47, says. “You will produce a lot of eggs, potentially five to 10 in each ovary, and you will have to go in for weekly blood tests and ultra sounds.”
According to Dr. Luk, the whole process takes about a month. During this month, a potential donor will have to go to several doctor appointments, as well as stay away from sex and drinking.
"When chosen as an egg donor, the donor will begin taking oral contraceptive pills to prepare body for an egg donation cycle," Dr. Luk says. "An egg donation cycle takes around two weeks and involves self-administering hormonal injections to produce multiple eggs in one month. [You can] expect to visit the office five to seven times within those two weeks to monitor the process. Egg donors are to abstain from sexual intercourse, strenuous activity (including exercise), and alcohol for the month of egg donation."
(In case you were wondering, the process is the same for people who want to freeze their eggs. The only difference being that instead of being fertilized upon retrieval, the eggs are frozen in subzero temperatures — a process called cryopreservation — so they can be used in the future.)
Self-administered injections, no sex, no exercising, and you can kiss happy hour goodbye — at least for a month. Once the physicians decide those eggs are good and ready for removal, you, the donor, will give yourself one last injection to trigger ovulation. Then 36 hours later, the eggs are retrieved in an inpatient surgical procedure.
“The only day you'd likely need to take time off work is the the day of the egg retrieval procedure,” Dr. Frank Yelian, a board certified obstetrician and gynecologist, and founder and medical director of Life IVF Center, tells Bustle. “This likely takes two hours or so, though the procedure itself is short, under half an hour. As you will be sedated (hence you shouldn't worry about pain), you may need someone to help take you home safely after the procedure, but you should be back to normal next day.”
Possible Side Effects
As with any procedure, there is always a risk of side effects when you retrieve your eggs. The most common risks are hormonal-based, like moodiness, cramping, spotting, and bloating.
“[There is a] small risk of injury, bleeding and/or infection to the surrounding tissue or organs from egg retrieval procedure,” Dr. Luk says. “Also a small risk of ovarian hyperstimulation syndrome (OHSS), [where the] ovaries become enlarged and fluid may collect in the abdominal cavity. OHSS may cause bloating, weight gain, and severe pelvic pain.”
In Cary’s experience, she was in a lot of pain and bled a lot post-procedure. She also claims she went through menopause earlier because of it, saying, “We are born with a certain amount of eggs.” However, research by Johns Hopkins University School of Medicine reports that early menopause is not a side effect of egg retrieval. "You shouldn't worry about losing too many eggs or early menopause," Dr. Yelian says. "While you might think of only normally losing one egg per menstrual cycle, the truth is you actually lose maybe 1,000 eggs that 'activate' per cycle, even if only one is ovulated." Johns Hopkins explains that only 400-500 of our eggs will develop to the point of ovulation, out of the 400,000-500,000 that we're born with, so retrieving some eggs for donation will not have an effect on menopause onset.
If side effects are hormonal, Dr. Yelian suggests talking to your doctor about “minimal or low-stimulation protocols to minimize the potential risks or discomfort.” But, ultimately, the process is safe and the minimal risks that come with donating your eggs aren’t necessarily enough to dissuade someone from donation — if your eggs are accepted.
Why Your Eggs Might Not Be Accepted
Although there are basic requirements for every potential egg donor, they vary from clinic to clinic, according to Dr. Luk. While some of them are obvious, like having both ovaries in working order, not being a smoker, having the time to donate your eggs, and being able to actually give yourself injections, others are less obvious.
“To become an egg donor at Generation Next Fertility, [you must] have a BMI less than 30, be between the ages of 21 and 29, have regular menstrual cycles, be physically and emotionally healthy, [and have] no family history of inheritable genetic disorders,” Dr. Luk says. (It should be noted that BMI is widely seen as an inaccurate measure of health.) At Dr. Yelian’s clinic, in addition to Dr. Luk’s list of requirements, you must not be younger than 20 or older than 32, or have any infectious diseases like STIs. But if the latter are treatable, you could be approved after treatment.
While you may think you can say whatever you want on your application, you better believe fertility clinics are going to dig a lot deeper. You’ll also have to undergo blood work, ultrasounds, intensive family history questioning, and a psychological assessment.
“[During that evaluation], you will need to let [the doctors] know if you are open to the child meeting you should a child be born,” Cary says. Definitely something to seriously consider even before you sit down to fill out the application.
Compensation And Legalities
Although we’ve all heard the urban legend about the tall, blonde Harvard student who got something like $500k for her eggs, in reality, compensation for donated eggs is a lot less than that. According to 2016 research about the ethics of buying and selling human eggs by the United National Library of Medicine National Institutes for Health, the American Society of Reproductive Medicine recommended that "payments to donors in excess of $5,000 require justification and sums above $10,000 are not appropriate." But, as the research also found, not every clinic adheres to those guidelines because they're self-regulated, and the ASRM has since lifted this cap.
“Donors typically make $8,000 for their first donation and can make much more for subsequent cycles,” Alkire says. “Many recipients are specifically looking for ‘experienced’ egg donors who have donated their eggs previously. This is because there is some ‘proof’ to the donor's fertility and ability to produce quality eggs.”
If it’s your first or fourth time donating your eggs, you should know that you get to choose the compensation you’ll receive, no matter what the clinic might tell you. “The American Society for Reproductive Medicine (ASRM) previously provided guidelines for donor compensation with a $10,000 cap,” Madow says. “This cap has since been removed from the ASRM’s guidelines. Some agencies/clinics are still citing the ASRM’s old guideline/cap as a way to try to keep the donor’s fee lower. Donors should know that any agency/clinic that tells them this is misinformed and behind the times. Donors may always set their own compensation.”
Yes, this compensation is taxable (you'll receive a 1099, as if you were a freelancer) and, yes, you are entitled to compensation if the cycle is cancelled. It’s just extremely important that you have that details of the latter spelled out in a contract between you and the intended parents.
But even before the actual process begins, you need to choose what kind of egg donor you’d like to be. “As an egg donor, you can choose the type of egg donation you would like to pursue,” Gina-Marie Madow, an egg donor and attorney at Circle Surrogacy, a full-service surrogate parenting agency, tells Bustle. “You can choose to donate anonymously, with a semi-known arrangement, or with a fully known arrangement. Some agencies/clinics only offer anonymous egg donation. If that is the only option offered by the clinic/agency, that is OK. But, if you want a semi-known or known donation, you should know that there are plenty of agencies/clinics that will support this type of arrangement.”
Having donated her eggs four times, Madow experienced all three types of options. One donation was fully known, meaning the donor and intended parents chose to have contact and exchange information about each other, while another one was semi-known, meaning there was limited contact, with no exchange of information. If a child results from a donated egg in either of these situations, there is contact between the parents and donor, but unless stated in the contract, a donor can't contact the child on their own. Anonymous, of course, means neither the donor nor the parents knew anything about each other, and there is zero contact.
“While all of my donations were special, the known and semi-known donations stand out to me in a different way,” Madow says. “I was able to develop beautiful friendships with my intended parents and I was able to cheer them on during the donation process. I am fortunate that the intended parents share photos and videos of their children with me — this reaffirms my decision to donate. I chose egg donation because I wanted to help intended parents provide children with a loving and happy home. Being able to see the photos and videos of their loving families and happy homes means everything to me.”
As a donor, you are your own best advocate.
During Madow's second egg donation, the parents wanted an anonymous donation. “My focus was on the intended parents and making the process easier for them so I wanted to accommodate the type of donation they requested," Madow says. "However, I have since realized that anonymous donations are short-sighted because they only address how the intended parents and donor feel at the time of the donation — it does not take in to account the best interests of the child and whether the child may have a natural curiosity about [their] genetic origins.”
"The biggest thing I wish I had done was get all the policies about contacting the receipts in writing," Megan, who was an egg donor in 2003 and 2004, tells Bustle. "I didn't do that and now, I don't remember the policies. Since a child could potentially be close to 18 (in theory, that would happen around 2021 or 2022) I would like that child and their family to contact me if needed for health concerns or just curiosity."
While the initial plan may be to keep everything tight-lipped with an anonymous donation, with today's technology, anonymity is hardly a promise. Also, any children that result from the eggs aren't bound by a contract.
"The children born from my anonymous donations may be able to find me some day through a DNA test service or other forum," Madow says. "It is always possible for a donor-conceived person to find the donor through 23andme, Ancestry, or another DNA service; this is true whether the donation is anonymous, semi-known, or known. The donor-conceived person is not a party to the contract between the intended parents and donor, and therefore cannot be bound by those contract terms."
If all of this is looking good to you and you’re thinking you want to apply to donate, then it’s time to get to the legal end of things. Just as much as you need a contract for compensation should there be a cancelled cycle, you also need every single other detail covered, including details about whether the child will be able to contact you in the future, and ways in which to prevent the possibility of your offspring — either through donation or your own potential pregnancy — romantically partnering up in the future. This can be prevented by insisting the necessary information, like the birth date and sex of the offspring involved, be shared.
“As a donor, you are your own best advocate and you can and should have a conversation with the doctor/medical team who will be handling your care,” Madow says. “The most important takeaway… is to ask questions and be your own advocate! Any woman considering egg donation should do her own scholarly research before proceeding. Egg donation is not for everyone, but if you educate yourself and advocate for yourself, you are on your way to a successful cycle.”
But for some people, egg donation isn't without its emotional baggage. You are, after all, donating something that could potentially become a child that looks just like you, or has your laugh. Because of this, it's important to know what you're getting yourself into and, as Madow points out, be your own advocate.