Explore the differences between donor types, and the legal, emotional, and medical considerations for each.
June 25th, 2024 | 12 min. read
Considering using an egg or sperm donor to help build your family? Here's what you should know about the various types of donor arrangements, the pros and cons of directed (known) versus nonidentified (anonymous) donors, and the legal implications of your decision.
In this article:
The Truth About Donor Conception
The path to parenthood is rarely linear, and every journey is unique. For those who are unable to conceive on their own, donor conception offers a beacon of hope - the opportunity to build their family with the help of a donor.
It's important to acknowledge that while some intended parents (such as LGBTQ+ couples) may feel excited about the possibilities donor conception offers, others (such as those who are unable to conceive a biological child due to infertility) may find it exceptionally difficult to accept that they will need the help of a third party to grow their family.
This guide breaks down common terminology, the various types of donor arrangements, and an overview of the medical, psychological, and legal aspects of each in order to help you to make the most informed decision possible.
Do I need an egg or sperm donor?
Perhaps you've just gotten the difficult news that you may need a donor to build your family after years of infertility. Maybe you're an LGBTQ+ couple curious to learn more about donor conception or a prospective single parent planning for the future.
No matter who you are or where you are on your journey, information is empowering. Let's begin by exploring the most common reasons someone might use an egg or sperm donor.
Fertility Issues
Low sperm count, poor sperm quality, or a lack of sperm production can make it difficult or impossible for a man to conceive a child biologically, while conditions like blocked fallopian tubes, endometriosis, or diminished ovarian reserve can hinder a woman's ability to conceive or carry a pregnancy.
In some cases, when no clear cause of infertility is identified (even after extensive medical evaluation), couples may opt to work with a donor and/or surrogate in order to achieve a healthy pregnancy.
Same-Sex Couples & Single Parents
- Same-sex male couples require an egg donor and a gestational carrier (surrogate) to have a biological child.
- Same-sex female couples may choose to conceive using their own eggs and donor sperm, while others may opt for double donation (both egg and sperm).
- Single individuals: Solo parents by choice can utilize sperm or egg donation to fulfill their desire for parenthood.
Genetic or Medical Considerations
If there is a known risk of passing on a genetic condition to a future child, intended parents may choose donor conception to minimize that risk. Certain medical conditions (such as estrogen-positive breast cancer) might also prevent a person from carrying a pregnancy safely, leading an intended parent to choose surrogacy.
Note: The decision to use an egg or sperm donor is a deeply personal one, and intended parent(s) may have reasons beyond those listed above for utilizing a donor.
Types of Donor Arrangements
Disclaimer: We strongly recommend seeking the guidance of a reproductive attorney in order to fully understand the legal implications of each type of donor arrangement.
The language of donor conception is constantly evolving, and it can be confusing to see so many different terms thrown around as you research your options. Let's break down the most up-to-date terminology and explore what each type of donor arrangement entails.
Previously referred to as a known donor, a directed donor arrangement involves someone that the intended parents know personally, such as a friend or relative who is willing to contribute their genetic material (egg or sperm) to help conceive a child. This person is typically someone already in the intended parents' lives before they start their family-building journey.
If the donor is a relative, they should not be linked to the genetic intended parent. Here's a quick example of how this might look in real life:
- Alexa and Natalie (a same-sex, cisgender female couple) want to have a baby. Alexa will be the one genetically-linked to their future baby. They know they'll need a sperm donor, and want to use a known donor.
- Alexa's biological brother offers to donate his sperm to help them have a baby. Unfortunately, this arrangement won't work, since Alexa and her brother share the same set of genetics.
- Natalie's biological brother offers to donate his sperm to help them have a baby through IUI or IVF, and their doctor approves the arrangement (after screening him), due to the fact that Natalie's brother and Alexa are not genetically linked in any way.
Legal Considerations
Directed donors may be able to apply to be declared a legal parent, which could mean they are named on the child's birth certificate, required to pay child support, and have parenting orders arranged through the family court system.
A legally binding agreement is essential to establish parentage, address financial responsibilities, and outline expectations regarding any future contact. All agreements should be reviewed by an attorney specializing in family law and assisted reproduction.
Psychological Considerations
Open communication and clear expectations are crucial with a known donor. Discuss topics like the level of involvement you anticipate the donor having in your child's life, the potential emotional complexities that may arise, and ensure both parties agree before moving forward.
The Benefits of Directed Donation
Choosing to work with a directed donor likely means you already know the person well and trust them. If they are a relative, it can allow you to maintain a genetic connection to your child. Directed donation also typically eliminates donor and agency fees.
Is it simpler to work with a directed (known) donor?
Intended parents might assume that it will be easier to use a donor they know, but because the screening of an sperm or egg donor is regulated by the FDA, all fertility clinics must abide by the same rules and regulations. Directed donors are required to undergo infectious disease screening, medical screening, psychological evaluation, and genetic testing.
Potential Downsides
It's also important to consider the potential downsides of utilizing a donor you know:
- If the relationship deteriorates for any reason, the connection you (and your future child) have with this person may become complicated or challenging.
- If you need donor eggs, you will have to pay for your donor's medications and egg retrieval upfront, which can cost anywhere from $10,000 to $25,000.
- The process typically takes longer than it would with an agency donor.
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Nonidentified donors were historically referred to as anonymous donors. They may also be referred to as deidentified donors. In 2022, the American Society for Reproductive Medicine (ASRM) updated this terminology from "anonymous" to "nonidentified" to reflect the fact that genetic testing, social media, and donor sibling registries have essentially eliminated the concept of anonymous donation.
Nonidentified donors are rigorously screened to minimize health risks and ensure a complete understanding of the process. Intended parents are able to access detailed medical histories for each donor, leading to informed decision-making.
Levels of Identifying Information
There can be variations within this type of donor arrangement, including:
- Nonidentified donation: May also be referred to as undisclosed or non-ID release. No identifying information is exchanged between the donor and the intended parent(s). The donor's profile will only contain information that they have provided. The intended parent(s) also sign an agreement stating that they will not try to contact the donor.
- Open ID donation: May also be referred to as identity-release. The donor is willing to have contact and release identifying information to a donor-conceived individual 18 years of age or older, if requested.
Legal Considerations
- Legal parenthood: The donor agreement should always establish you, the intended parents, as the legal parents of the child conceived through nonidentified donation. In some cases, the donor may be considered the legal parent (via their genetic link), so protecting your rights as a parent, as well as your child, are paramount.
- State laws regarding assisted reproduction can vary state by state. Ask a reproductive attorney to advise you on any specific legal requirements in your jurisdiction.
- Anonymity vs. identity release: Laws regarding donor anonymity can vary. In most U.S. states, anonymity is legal. However, some states allow (or require) donors to identify themselves after a certain period. Discuss this with your attorney.
The Benefits of Nonidentified Donation
Cryobanks and agencies offer a larger pool of potential donors. This allows the intended parent(s) to choose from a wider range of candidates based on ethnic background, physical characteristics, education, or other preferences.
There is a significant lack of diversity amongst egg donors in particular, leading many families of color to turn to donor banks to seek out donors they can identify with.
Intended parent(s) may note other potential benefits, such as a clear separation between their family and the donor, additional layers of legal security, and less time to match with a donor.
Potential Complications
- Emotional issues for the donor-conceived child, which can lead to complex feelings, including a sense of not belonging or confusion around their identity.
- Lack of complete medical history: Even though these donors are carefully screened, there's always a chance of undiagnosed genetic conditions or late-onset diseases.
- Future changes in donor anonymity laws that could impact existing legal agreements.
- Half-sibling interactions: Donor-conceived people may unknowingly engage in a relationship with a genetic half-sibling, develop complex sibling relationships, or have unexpected contact.
Psychological Considerations
If you choose to use a nonidentified donor, it is critical to understand the psychological impact of sharing your child's genetic background with them. Donor-conceived people who discover this later in life (particularly when by accident) often struggle deeply with their own sense of identity.
Learning how to communicate this information to your donor-conceived child is essential.
This type of arrangement involves the sharing of more personal information than a nonidentified donor, but usually not enough to allow direct communication between the donor and the intended parents. For example, an egg donor agency may act as a liaison between the intended parents and the donor so the parties are able to share information.
Explore your options:
Download our free Donor Conception Guide to learn more about using donor egg, sperm, embryos or working with a gestational carrier (surrogate).
The End of Anonymous Donation
With widely accessible genetic testing from companies like ancestry.com or 23andMe, there are no guarantees that any donor will remain 100% anonymous. Children conceived with the help of an egg or sperm donor may be able to connect with members of their biological families in the future.
Many donor-conceived adults strongly advocate for open donor arrangements, and research shows the importance of transparency in families created through donor conception.
Open communication and honesty from a young age are vital. Consider utilizing resources like the Donor Sibling Registry, which allow donor-conceived individuals to search for non-identifying information about their donors when they reach adulthood.
Which type of donor will you choose?
If you're feeling overwhelmed or confused by any of this information, know that there are trusted family-building professionals available to help you make the right decision for you.
Tap into resources such as mental health providers who work with intended parents, discuss your legal concerns with a reproductive attorney, and find a fertility clinic with specialized resources and proven experience helping families grow through donor conception.
With the right experts on your side, you can feel confident and empowered no matter which path you ultimately choose to take. Reach out to our team today to learn more about Illume Fertility's third party reproduction team and in-house egg donor program!
Donor Conception 101
Get the facts about donor conception, find emotional support and get empowered to make the best choice for your family.