Ads for potential egg donors are everywhere, if you know where to look. They're online, of course, but they're also lurking in the back pages of magazines, and on the subway. The demographic for most of these ads is young, college-educated women in their early 20s These ladies are compensated for their donation, of course - around $800 per egg, but this varies depending on the location of the clinic, the cost of living in that area, and more.
Egg donation involves a rigorous schedule of hormones, contending with those side effects, followed by the actual retrieval of eggs. You're giving someone else the opportunity to have children they otherwise wouldn't be able to have, and, as an egg donor, you also get paid.
It's an intense procedure, and you should have all the information before you decide if it's right for you. We're going to break it all down for you, including the stories of two women who donated their eggs and talked to us about their motivation to do so, their experiences with the process, and how they feel about their decision to donate years later.
Emily donated her eggs three times, fifteen years ago, when she was 21, 22, and 23. She knew then that she didn't want to have children of her own, so she viewed donating her eggs like donating blood. "I had something that people needed," she said. After she met with someone who had created a family after receiving a donor egg, she decided to apply to be a donor. While the procedure itself likely isn't very different than it is now, Emily did have to complete a psychological evaluation to confirm that she "had her wits about her." She doesn't remember the questions, but she does remember that they "had nothing to do with egg donation."
"I did the whole thing - birth control for 2 months to sync my cycle, the injections, the surgery," she said. "There was discomfort that came with the surgery, I had abdominal pain afterwards, like I'd done too many sit ups, followed by a really heavy period." It's important to note that, just like in any other medical procedure, recovery is different for everyone.
Emily, who's 36 now, said she doesn't think very much about the actual experience of donation these days. She often finds herself educating her doctors, who aren't fertility experts, about her experience. She's able to be more empathetic to her friends who are going through IVF (remember, egg retrieval is part of the process of IVF). "Watching my friends try to have children makes me glad I did it," she said.
Now, let's meet Molly, who had been thinking about donating her eggs since a family member used an egg donor ten years before, but what ultimately confirmed her decision was a friend who was going through her third round of IVF. "I did some research on it and spoke with my family member about how it had been such an amazing gift in her life." After that, she submitted her application to be a donor through the clinic's website. Four months later, she was selected by a couple and began the process of donation. "I didn't get much information on the couple except that they had been trying for a long time to conceive and the woman had been through multiple unsuccessful rounds of IVF. The whole process is pretty anonymous, which I liked."
The first few days of injecting herself were hard, and not just because the injection have to happen at the same time every day. "I have a pretty big fear of needles and this helped me get over that," Molly, who was 22 at the time of donation, said. "The clinic staff treated me so well, they were great about checking up on me and making sure I felt comfortable through everything."
While Emily didn't have children of her own and didn't plan to, Molly had a three year old daughter when she donated her eggs. She was assured that donating wouldn't impact her ability to have children in the future, and she gave birth to her second daughter in 2016 after a healthy pregnancy. Like Emily, she's not preoccupied with thoughts of whether or not those eggs became people. " I hope the couple I donated to were able to become parents. So many couples struggle with this and it’s heartbreaking. I really hope they were able to start a family."
Egg donors are paid; how much is determined on a case-by-case basis, and varies by region and if the donor has donated before (if you have, and it was successful, you can be paid more). Donors are also reimbursed for all costs incurred, including medical expenses, insurance, attorney fees, and travel.
Molly, who lives in the Southwestern U.S., received around $2500 -she doesn't remember the exact amount. "I knew I would be missing a lot of work since I had to go in for screening and the procedure, and it kind of equaled what I wouldn't be getting paid from work." Emily was compensated about $1200 when she donated in the Midwest in the early 2000s. It was a plus to get paid - she was in her early 20s, just out of college, and beginning to work, but she decided she wouldn't use the money on anything she deemed "superficial," and it ended up going towards a down payment on a house.
The Essentials of Egg Donation
Let's get into more detail about what actually happens when you donate eggs. There's an application to become a donor, which includes not just your name, address and birthday, but also information about your lifestyle - if you smoke or use drugs, if you were adopted, what kind of birth control you use, if you've donated eggs before, if you've ever been diagnosed with an STI, if said STI was treated, and when. You also have to have a physical and, depending on the clinic where you're donating, be interviewed by a counselor to verify that you understand all that you're undertaking. You'll likely be asked to include photo of yourself as a child, a current photo, and photos of your family.
It's pretty difficult to be chosen as an egg donor - many clinics, such as the Center for Human Reproduction in New York City, accept only 1 - 3% of those who apply. (Your SAT scores aren't just useful for getting into college, they could also help you land an egg donation gig at a clinic looking for "elite" donors.)
Those looking to use donor eggs will be directed to a database of donors. Once you're accepted as a donor, your name is exchanged for a number. You create a profile in the database at your clinic, where you get into specifics about your motivations for donating, what your own goals are, and more about you as a person. This information helps those in search of a donor distinguish you from the other numbers.
If you're selected by a couple or an individual who wants to use your eggs, which can happen quickly after you enter the database, you should be aware that this could also take years, or you might not get matched at all. If you don't match, you can decide to stay in the donor pool until you do match, or remove yourself.
Once you do match, there's the matter of making sure you're available within their desired time frame - if they wanted to start the process tomorrow, could you? There's also another round of testing for you to go through, these tests are required by the FDA. They include tests for HIV, hepatitis (B and C), gonorrhea, syphilis, as well as genetic testing, another physical exam and a medical history intake.
The medication you take when you're preparing to donate eggs are the same as those you'd take if you were readying yourself for an IVF cycle. You and your doctor will decide on a schedule and dosage for this medication, depending on where you are in your menstrual cycle when you begin the process.
“Donor oocyte stimulation protocols involve approximately 12 days of injectable gonadotropin medications, followed by an egg retrieval under anesthesia," says Dr. Jessica Rubin, MSCI of Reproductive Biology Associates (RBA). "Given that egg donors have a favorable ovarian reserve, a common protocol is a cycle with a Lupron trigger. Lupron triggers the release of follicle stimulating hormone (FSH), to produce estrogen, build the uterine lining, and create follicles for eggs, and luteinizing hormone (LH), to trigger release of the egg in ovulation. You'll inject yourself with Lupron into either your thighs or abdomen (also, you should be cool with needles if you're going to be an egg donor), and while you're undergoing all of this, you'll be monitored by doctors and have to show up for blood tests and ultrasounds.
When it's determined by ultrasound that your follicles are mature enough, you'll give yourself an injection of human chorionic gonadotropin, also known as HCG, or the "trigger shot," so that the eggs in the follicle will ripen and be ready for retrieval. About two days later, you'll show up at the doctor's office and the eggs will be retrieved in a procedure that takes about 20 minutes for the actual retrieval. There is a puncture involved, as you go through the vaginal wall with a needle to get to the ovaries. It's about 2-3 hours for the whole event, since there's prep and recovery time involved. You'll also get an antibiotic to avoid any potential infection. The last step is a post-retrieval follow up with a doctor to see how it all went.
You can definitely donate eggs more than once, but should you? "The decision to perform multiple egg donation cycles should be determined after a careful assessment of the benefits and risks," says Dr. Jessica Rubin. She clarifies that there are short term risks associated with egg donation, including ovarian hyperstimulation syndrome (OHSS) - more on this later, allergic reactions to anesthesia, and surgical risks like hemorrhage or infection. Because of these risks, and because donating a lot within a small geographic area can result in potential inbreeding, the American Society for Reproductive Medicine recommends a maximum of 6 cycles per egg donor.
FYI - If you've ever contemplated freezing your eggs, but felt overwhelmed by the cost, egg donation might be a good option, in the form of Freeze and Share, a program developed by Dr. Aimee Eyvazzadeh. Freeze and Share allows folks interested in freezing their eggs, but whose insurance won't cover the procedure, to do so, while enabling those in need of donor eggs to benefit as well - they will receive half of the freezer's eggs.
Is Egg Donation in Your Future?
It should go without saying that deciding to donate your eggs is a super personal decision. It's not without unpleasant side effects, not just from the retrieval, but from the hormones, which can leave you with symptoms of PMS. There's also the rarely occurring Ovarian Hyperstimulation Syndrome (OHSS), which is when your ovaries overreact to all the medicine you're taking, and the symptoms include bloating, nausea, and abdominal pain. This is usually caught quickly, since you're having a lot of tests when you're preparing to donate. When OHSS does occur, doctors will tinker with your dosages or perhaps stop the process altogether.
During her final donation, Emily hyperstimulated. The doctor waited an extra day before retrieving her eggs, and the procedure went fine, but the days following the retrieval were painful. "I had a lot of abdominal discomfort and fluid began to pool around my ovaries," she said. "More than once I returned to the clinic to be given intravenous fluids because I was dehydrated. By the end of the week, they decided they needed to drain the fluids. I was anesthetized and 2 liters of fluid were drained from my ovaries. I recovered quickly, but I was told that I wouldn't be able to donate again."
There's also the question of the long term impact of egg donation. For example, can donating lead to cancer? "Current literature doesn't support an association between egg donation and an increased risk for malignancy," says Dr. Jessica Rubin. " The American Society for Reproductive Medicine acknowledges fertility treatments have not been shown to increase cancer risk, however, they do recognize there is a paucity of data on this subject.” There simply isn't a lot of research on the long term effects of egg donation, and without it, it's hard to know if, for example, breast cancer is a risk for egg donors.
The egg donation procedure provides you with crucial information about your reproductive health, including your hormone levels and what's going on with your ovaries and in the rest of your body. If you're thinking about donating your eggs, it's super important to educate yourself about it. Modern Fertility is here for you when you're ready to start thinking about your reproductive future - we'll help you get the facts you need to move forward.