Your Step-by-Step Guide to Choosing an Egg Donor

Hearing that using donor eggs may be your best option for building a family can bring up a lot of complex emotions and big questions. In this guide, we detail the process of finding an egg donor, donor egg success rates, and the psychological aspect of pursuing donor conception.

In this article:

• Will I need to use an egg donor?
• Who is a good candidate for donor eggs?
• Donor Egg IVF Success Rates
• Egg Donor Screening & Recruitment
• Why do people decide to donate their eggs?
• How to Find Your Egg Donor Match
• Common Concerns When Using Donor Eggs
• Epigenetics & Donor Egg IVF
• The Emotional Aspect of Using Donor Eggs
• Perspectives from Donor Egg Recipients
• How do donor conceived people feel?

Will I need to use an egg donor?

Picture this: You're sitting across the desk from your doctor, trying to absorb the sobering news that using donor eggs may be your best option.

Maybe you've known for some time that the quantity or quality of your own eggs is low, or your cycles keep getting cancelled for poor ovarian response, or perhaps your previous IVF cycles haven't yielded any healthy, normal embryos. 

No matter the reason, you're likely feeling blindsided and overwhelmed. Maybe even devastated or distraught. You may wonder: Aren't there any other options? Where do you even find an egg donor? Will I be able to love a child that isn't genetically linked to me?

If you’re confused, scared, and unsure about what lies ahead, know you are not alone.

Before we break down the process of choosing an egg donor and the emotional complexity of it all, let's talk about the basics of egg donation, the benefits of using donor eggs, the donor screening process, and how IVF with donor eggs actually works. 

What is a donor egg?

A donor egg is an oocyte (the technical term for an egg) that has been donated by a woman with the express intent of helping achieve a pregnancy for someone else. While the egg will have the donor's DNA, it will always be fertilized via in vitro fertilization (IVF) with your partner's (or a donor's) sperm.

The embryo that results from that donor egg develops in an IVF laboratory for around five days before being transferred to the uterus of the intended mother. If that embryo successfully implants in the uterus, the intended mother will carry the pregnancy and experience childbirth in the same way they would using their own egg.

How common is donor egg IVF?

Using donor eggs is probably more common than you'd expect: around 12% of IVF cycles in the United States (that's about 16,000 cycles each year) involve the use of donor eggs. 

Who is a good candidate for donor eggs?

Not long ago, egg donation was only indicated for patients who had surgical removal of their ovaries or premature ovarian failure (POF). This has evolved over the years to include other diagnoses and situations, such as:

• Primary ovarian insufficiency (POI) 
• Trying to conceive after menopause 
• Having a medical condition that impacts egg quality
• Undergoing treatment that damaged the eggs (i.e. chemotherapy)
• Poor embryo quality in previous IVF cycles
• Various heritable genetic conditions 
• Low ovarian response to stimulation

Note: Gay male couples pursuing surrogacy also utilize donor eggs, since modern surrogacy indicates the use of a separate egg donor and gestational carrier. (In traditional surrogacy arrangements, the egg donor and surrogate were one in the same.)

Donor Egg IVF Success Rates

There is no doubt that the move to using donor eggs often increases the chances of pregnancy, but this decision can also unleash a torrent of questions, concerns, and difficult emotions. Before we move into the psychological aspect of using donor eggs, let's discuss the biggest benefit to this path to parenthood.

Because most egg donors are young, their eggs are generally healthier, making the rate of successful pregnancies with donor eggs quite high - the national average success rate exceeds 50 percent per cycle. At Illume Fertility, our success rates for donor egg IVF are even higher - above 60 percent per cycle. 

Remember: Success depends not solely on the quality of the donor's egg, but also on other reproductive factors, such as sperm quality and the health of the uterus. 

Egg Donor Screening & Recruitment

Egg donors are often recruited in-house by a fertility clinic to become a part of that clinic's egg donor "pool" which intended parents can then choose from. However, many egg donors choose to work directly with an egg bank, such as Donor Egg Bank USA, or an agency, such as Circle Surrogacy. 

Anyone wishing to become an egg donor must undergo rigorous screening, which typically eliminates around 90% of applicants. Here are the specifics of what is involved in the egg donor application process here at Illume Fertility:

Step 1: Complete an Application

A young woman who is interested in donating her eggs is first asked to complete a comprehensive application, which includes sharing information about her motivations, lifestyle, and other factors.

Step 2: Phone Screening & Team Meeting

After their application has been reviewed, the prospective donor is screened by phone. If she meets all of the program's criteria, a meeting is set up with the Third Party Team, which usually consists of the medical director, nurses, patient navigators, and financial coordinators.

Step 3: Medical & Psychological Screening

The applicant will then proceed with a comprehensive medical screening, consisting of a complete physical exam with ultrasound, and ovarian reserve, infectious disease, genetic and psychological testing.

Step 4: Egg Donor Approval

If the prospective donor is accepted by the program, her profile, inclusive of all relevant information and photos, is then listed in a database for individuals and couples who are in need of donor eggs (these parties are referred to as the recipients, or intended parents).

General Egg Donor Facts

• Egg donors are usually between the ages of 21 to 32 (under 35 is optimal).
• Egg donors may opt to remain anonymous or be known to the recipients.
• Egg donors are compensated between $5,000 to $15,000 per cycle, on average.
• From screening to egg retrieval, a typical egg donor cycle takes around 1.5 months.
• Egg donors have no legal rights to any future child created using their egg.

Donor Conception Guide

Conceiving with the help of a donor can significantly increase your chances of a healthy baby. Get our free guide now to learn how it all works.

Why do people decide to donate their eggs?

While compensation for their time and effort during the donation process is important, the underlying motivation for women who choose to donate their eggs isn't solely financial. 

Most donors mention an altruistic reason, such as having a friend or family member that has struggled with infertility. Many donors have reported a sense of joy in realizing that they are helping someone build their family.

At some fertility clinics, the intended parent(s) are allowed to write a card to their egg donor and express their gratitude in a personal way. Whether you opt to use a donor from your clinic's "donor pool" or go with an outside egg bank, you may be able to do the same.

How to Find Your Egg Donor Match

There is no one right way to choose an egg donor. However, there are a few specific considerations that most intended parents focus on to help them find the right match.

#1 Physical Characteristics

Many hopeful parents begin the donor selection process by focusing on desired physical characteristics, such as hair and eye color or height. For example, if you hope to have your child resemble both you and your partner, you may look for a donor with similar features to yours to help contribute those characteristics to their genetic makeup.

#2 Medical History

The next set of criteria can vary depending on the interests, concerns, and values of the intended parent(s). Some may have a list of what they don’t want vs. what they do want.

For example, if the male partner has a strong family history of diabetes, a couple may decline an egg donor with a similar medical history, as the child will have a greater chance of developing this disease.

#3 Education

Many intended parents value some evidence of intelligence. However, this is obviously difficult to measure. Most fertility clinics do not perform IQ tests on egg donors, but you will have access to information such as the donor's highest level of completed education.

A word of caution: Try not to assume a donor's intelligence based solely on their level of education, as many women have not yet had the financial means to pursue higher education. In fact, some egg donors plan to use their compensation to pursue college or other degrees.

#4 Personality

When choosing an egg donor, you may also wonder about her personality. Since the questionnaire is completed by the donor herself, you will get a feel for what she is like just by reading her application. Usually, the internal recruitment team gets to know her pretty well and can provide you with some additional insights.

You might seek someone with whom you feel a strong connection, perhaps related to their athletic ability, a musical skill, or a love of animals. Having some common personality traits or passions as your donor may help foster a sense of connectedness and comfort. 

#5 Mental Health Evaluation

Each donor is required to meet with a mental health professional who interviews her and administers a personality test. During their meeting, the donor is counseled on the process of egg donation to ensure they have a complete understanding of what they are agreeing to.

If any concerns arise for the mental health professional after their meeting, scoring her test and/or any serious psychological or mental health issues in the donor’s past, these will exclude her from becoming an egg donor.

During the application process, your team will also look for signs that a donor may not be compliant, such as not responding to phone calls or emails in a timely manner. 

Fertility Clinic Donors vs Agency Donors

Some intended parents may opt to have an agency find their egg donor. This is a more expensive option, but agencies are able to recruit a larger pool of donors, often with more culturally diverse backgrounds.

The highest percentage of egg donors recruited by Illume Fertility categorize themselves as white, with ancestry tied to Europe, so if you would like a donor with Asian or African lineage, for example, you might choose an agency instead.

If you prefer to explore agency egg donors, your fertility clinic can offer guidance and provide a list of reputable agencies with whom they have a close, working relationship. 

Having a hard time choosing your egg donor?

It's not uncommon to feel stuck after reviewed a few donor profiles. How do you choose a donor without even meeting them? This is a valid question, and the answer is that, ultimately, you simply need to go with your gut instincts.

However, if your head is spinning, and you're feeling conflicted or uncertain, go to a quiet space, close your eyes, and visualize the person that is described on donor profile (not her physical appearance, but the essence of her as a person). Ask yourself, "Do I like this person?" or "How do I feel about being connected to this person through my future child?" 

If the feeling is positive and your gut instinct is telling you it feels right, then that is your answer. If something bothers you, even if you can’t put it into words, then that is an important clue that she is not the right donor for you. Honor your intuition throughout this process.

Still struggling? Don't be afraid to reach out to a mental health professional or your Care Team for further guidance and support. 

Common Concerns When Using Donor Eggs

Although the use of donor eggs has become much more commonplace in recent years, there is still an element of mystery around the topic. Let's explore some of the most frequently asked about aspects of egg donation:

Is it safe to use donor eggs?

The process of utilizing donor eggs is strictly regulated by the American Society of Reproductive Medicine (ASRM) and the US Food and Drug Administration (FDA), and includes rigorous testing for infectious diseases and recessive (unseen or hidden) genetic mutations.

Additionally, there has never been a single reported case of an infectious disease having been transmitted via donor eggs.

Will I have trouble bonding with my baby?

After safety, the most common concern is typically the fear of not bonding with your baby. Although this concern is theoretically understandable, the opposite is usually true. Parents who use donor eggs are typically just as happy and connected as those who conceived using their own genetic materials.

Epigenetics & Donor Egg IVF

When we transfer an embryo that is made using a donor egg, we are essentially providing you with a new opportunity, and the genetic building blocks of a baby. The nurturing, growth and development, though, is all your contribution. This concept is helpful to most women who experience self-doubt due to many years of dealing with infertility.

It is not uncommon to feel that you can’t trust your body anymore. But rest assured that just because your ovaries aren’t cooperating doesn’t mean that your uterus is less capable than anyone else’s when it comes to carrying a pregnancy and birthing a baby.

There is even some evidence that the maternal environment has the ability to alter the expression of some genes, meaning your maternal environment can ultimately positively affect the genetics of your baby.

According to a 2022 study published in the Journal of Assisted Reproduction and Genetics, 
"Epigenetic mechanisms in pregnancy are a dynamic phenomenon that responds both to maternal–fetal and environmental factors, which can influence and modify the embryo-fetal development during the various gestational phases."

The Emotional Aspect of Using Donor Eggs

When confronted with the reality that using a donor is going to be the way you become a parent, it is not only common to grieve - it’s necessary. Even if you haven’t had a pregnancy loss that led you to this point, you have still experienced the loss of a dream, probably one that you’ve had since childhood.

Even if you feel grateful for the option, it is completely understandable that news like this can open a floodgate of emotions: uncertainty, shame, anger, and guilt are often among them. Not only are you allowed to feel those emotions, it is necessary to go through these stages in order to find peace and move forward. 

Real Patient Stories

A mom through egg donor IVF shares the raw emotions that surfaced when she and her husband had to face their new reality.

The Trauma of Infertility & Loss

There is no doubt that making the decision to proceed with donated eggs is not simple.

Since the need to use donor eggs may follow months or years of the trauma of trying to conceive, undergoing many unsuccessful fertility treatment cycles, and/or pregnancy losses, you are likely already emotional, exhausted, and discouraged. 

Don't fight those feelings. If you suppress those difficult emotions, they will inevitably pop back up at another time or in a different way. Talk to your partner, a trusted friend or family member, or a mental health professional. Finding a counselor who is familiar with donor conception can be especially helpful in processing your feelings.

Perspectives from Donor Egg Recipients

As with most things, the best perspectives often come from others who have navigated a similar experience. In the words of writer (and mother through donor egg IVF) Becky:

"I have come to realize that, whether they were genetically mine or not, I could still have these experiences and be all of these things to my children. Although they may not have my eyes or smile, these feelings are way more important than the passing down of a family trait. Without the gift of donated eggs, I would have never been able to truly define and experience what is to be a mum."

Illume mom Rebecca shares the importance of resourcing yourself with support after receiving the news that you may need to use an egg donor in order to conceive:

"I’m a social worker and therapist, so I knew I'd need a lot of extra support through all of this. I engaged in Illume's Fertile Yoga classes, utilized acupuncture, and worked with a fertility naturopath to help me become the best version of myself."

Another Illume Fertility patient explores the raw emotions that surfaced when she and her husband were forced to reimagine their dreams for the future:

"Dr. Hurwitz asked us to open our minds and take a break to consider the possibility of donor conception. At first, I was in complete shock and utter denial that we were having this discussion - even though I'd seen my test results and knew our many attempts with my own eggs hadn't been successful. Each attempt was feeling more torturous, and I knew I needed to find a different way to move forward.

I had to open my mind and my heart to a different way of building our family."

How do donor conceived people feel?

Learning about the experiences of donor conceived children is equally (if not more) important. We encourage you to seek out a variety of perspectives from donor conceived people as you move forward with choosing an egg donor.

There are many different resources to explore, including personal stories like Hayley's (a donor conceived child who is also a donor recipient parent), organizations like Donor Conceived Community, and research like this 2021 study from Harvard University.

Take the time to educate yourself and consider the conversations that may arise regarding your future child's desire to know more about their genetic history or communicate with their donor. In addition, think about how you will share your child's story with them as they grow, and what you might want to express to friends and family about your journey. 

Try to Keep an Open Mind

It isn't easy to learn that your best chance of growing a family may be using a donor.

However, as you work to shift your perspective on what pregnancy and parenthood might look like, know that thousands of other hopeful parents have walked in your shoes.

They have navigated the same emotional battles, grieved the loss of what might have been, and eventually made it to the "other side" - a joyous connection with their children, who are undoubtedly theirs, no matter the biology.