The Egg Donor Selection Process
For many, being told that in order to have a child means giving up their genetics is devastating, overwhelming, and incomprehensible. There are so many questions that begin to bubble to surface it’s often hard to make sense of them let alone articulate them. Selecting an egg donor is going to be one of the biggest decisions an intended parent is ever going to make and it’s natural to feel incredibly overwhelmed in the process.
Because this information that a patient might receive from their care provider can be mind boggling it’s important to allow yourself time to think about egg donation, wrap your head around what egg donation means, grieve the loss of your genetics and think about the steps that they will take to complete their egg donor cycle from beginning to end – with donor selection being the prime focus.
It’s important to acknowledge your sadness, frustration and in many cases anger. You might have learned when you were in your early 20’s or 30’s that the egg donor route would be your path to parenthood. That mean your journey is going to be easier than the woman who is in her 40’s and has learned her ovarian reserve is almost gone, or the woman who has cancer and lost her ovaries to chemotherapy. We just want you to know it’s normal to be sad about losing your genetic link. For some women, it can be a lengthy grieving process. We encourage you to give yourself time to grieve this loss. Sometimes seeing a counselor or a therapist can help sort through complicated feelings.
While it may be difficult to look forward – please keep in mind that regardless of which egg donor you select any baby born will be a baby you and your partner (if you have one) created and gave life to. This baby is going to be special, unique and exclusive to your own family. This baby wouldn’t be coming into the world, into your arms, or into your family if it weren’t for the dedication and love you have to give this child. This baby is going to be yours – and the baby you are meant to have is the baby you are meant to have.
By now I am sure there are many different terms running through your head – anonymous, semi-anonymous, known, or directed egg donation.
You might be wondering where do we start?
To begin with it’s important for you and your partner (if you have one) to think about what is important to you regarding contact. This means you will need to decide if you want to select an anonymous donor or a known donor. For some parents it’s important to make a personal connection with their egg donor. They may want to select a donor who will be willing to meet their child one day in the future. Others choose the anonymous donor route, not wanting to know anything other than what a profile states about their donor.
Infertility clinics and/or egg donor agencies usually have websites that allow you to peruse their donor pool and review an egg donor’s profile. As you review profiles pay close attention to the egg donor’s profile. Read carefully, taking into account how the donor portrays herself. Look for a donor that you can relate to, that you could call your friend, or that you imagine could fit in with your own family. Look for a donor who’s physically and emotionally healthy.
All intended parents have different criteria when selecting their egg donor.
For instance some place value on the GPAs, SAT scores, and college education of their donor. Some place value in egg donors who have excelled in athletics, music, science, or other areas. While other intended parents require their donor to be the same faith as themselves. The majority of intended parents convey they would prefer an egg donor to have a physical resemblance with the recipient mother, so that the baby “looks like Mom and Dad.”
It might be important for you to have an egg donor who’s physically beautiful or “model beautiful” This is not an unreasonable request – let’s face it, who doesn’t want their child to be beautiful and brilliant? Therefore, the demand for attractive, exceptional college girls who are willing to donate eggs is high. However, not all attractive, intelligent, college-age girls are going to make good donors. That’s why medical and psychological testing is required and paying close attention to the results of those tests is important.
So keep in mind that the characteristics you desire in an egg donor are unique to you and based on your personal priorities and choices. There is no right or wrong way to go about this! Just keep in mind that as a recipient/intended parent, you are investing a good deal of money in this process. Being a pro-active, smart consumer armed with information is imperative when selecting an egg donor.
Parent Via Egg Donation (PVED) has put together a great information sheet regarding donor selection that we’d like to share with you.
TERMINOLOGY FOR THOSE STARTING OUT:
An anonymous egg donor is an egg donor you do not meet, selected with the help of an IVF clinic or an egg donation agency. You do not know her name or anything else about her that is not stated on her profile. You may or may not see a photo of the donor. The donor would know nothing about the recipient/intended parent(s) or the cycle other than how many eggs were retrieved, and in some instances, whether or not a pregnancy resulted.
A semi-known egg donor is an egg donor who knows the recipient/intended parent(s’) first name(s) and the state in which they live. The donor and recipient/intended parent(s) might exchange emails and photos; however, no specific personal information is provided about the donor or the recipient/intended parent(s).
A known egg donor can be a friend, family member, or someone selected by the recipient/intended parent(s) with the intention of meeting face-to-face. The donor may know the recipient/intended parent(s’) first and last names and/or where they live, and in addition the two parties may be willing to exchange email, telephone calls, and personal information as well as to continue to keep in contact with one another. The donor and the recipient/intended parent(s) may agree upon the child meeting the donor at a future point in time. The recipient/intended parent(s) may or may not send photos of their child with updates to the egg donor as well. The arrangement regarding exchange of information is agreed upon and put into place between the egg donor and recipient/intended parent(s) at the time of the cycle. In many instances, information is shared for medical purposes.
All egg donors should complete an in-depth egg donor profile compiled of several pages of questions covering their medical history, personal history, social history, and reproductive history. You do not want to do business with an egg donor agency, broker, or clinic that does not require their egg donors to complete at least a medical profile. All egg donors should meet with a psychologist to be administered an MMPI* and a psychological evaluation.
*The Minnesota Multiphasic Personality Inventory, or MMPII or PAI is the most frequently used clinical personality test. It is an easy test to administer and provides an objective measure of personality. It provides clear, valid descriptions of the test subject’s characteristics in broadly accepted clinical language. It also provides information about any potential psychological problems or symptoms that may deem a potential donor inappropriate to proceed with the egg donation process. It always needs to be scored, evaluated, and interpreted by a licensed clinical psychologist at the PhD level.
What should I look for in an egg donor?
The following is a list of important qualities to look for in a potential egg donor. Ideally, egg donors should:
Be between the ages of 21 and 30** and exhibit maturity, responsibility, and dependability
Be in good physical health as documented by history and testing
Be in good psychological health as documented by history and testing
Be of proportionate height and weight [being overweight may affect egg quality, as well as necessitate higher doses of stimulation drugs to create follicles, which translates to additional costs for the recipient/intended parent(s)]
Be drug free
Be a non-smoker of tobacco and marijuana
Have regular menstrual periods and is not using Depo-Provera or any other birth control that stops her from having regular monthly periods
Have a normal value for Anti-Müllerian hormone ( AMH ) levels which are between 1.0-3.0 mcg/L
Have an FSH (Follicle Stimulating Hormone) level on cycle day three (3) of no more than eight (8), preferably under six (6)
Have an E2 (Estradiol) level on cycle day three (3) of less than fifty (50)
Have an Antral follicle count*** of at least fifteen (15) combined count
**Egg donors younger than 21 may not be emotionally mature; egg donors older than 30 are not at peak fertility. Always follow your reproductive endocrinologist’s advice regarding age.
***Antral follicles are small follicles (about 2-8 mm in diameter) that a reproductive endocrinologist can see, measure, and count with ultrasound. Antral follicles are also referred to as resting follicles. Vaginal ultrasound is the best way to accurately assess and count these small structures. The antral follicle counts (in conjunction with female age) are by far the best tool that we currently have for estimating ovarian reserve and/or chances for pregnancy with donor eggs through IVF.
Specific questions to ask an egg donor (or to ask the clinic/agency about an anonymous donor) or information you may find on an egg donor profile:
1. Do you have or does anyone in your family have a tendency towards any particular illnesses, i.e., allergies, intestinal problem, cancer, heart disease or psychological problems? Who had one or more of these illnesses, and at what age did the onset occur? (These questions should be answered completely within the donor profile.)
2. Are your blood relatives living, i.e., parents, siblings, grandparents, aunts, and uncles? If not, how old were they when they died, and what did they die of? (These questions should be answered completely within the donor profile.)
3. Have you or any member of your immediate family ever smoked, drank alcohol to excess, or used illegal substances? To what extent are any of these, or have any of these ever been, a problem? Note: Some agencies don’t like to ask this question. However, it is a reasonable and important question, as studies have shown that some forms of addiction have hereditary components. (These questions should be answered completely within the donor profile.)
4. Have you ever been pregnant? What was the outcome? (These questions should be answered completely within the donor profile.)
5. Have you ever donated eggs before? If you have, how many follicles developed? How many eggs were retrieved? How many successfully fertilized? Was there a resulting pregnancy or multiple pregnancy, and a live birth(s)? Note: The donor may or may not have this information.
6. What can you tell us about your family of origin? Who are they and what are their ages? What are their vocations and vocational interests, hobbies, talents and dispositions? What are their physical characteristics, such as coloring, size, weight and height? (These questions should be answered completely within the donor profile.)
7. Do you have any children? If yes, how old are they now? When did they learn to sit up, walk and talk? Were there and are there any significant health issues we should know about? What are their sleeping and eating habits? What are their special abilities and interests? What was their birth weight and length? (These questions should be answered completely within the donor profile.
8. What is your family’s genealogical heritage or history? What country(s) did your ancestors come from, where did they settle here, and when? (These questions should be answered completely within the donor profile.)
9. Why do you want to help us have a baby using your egg(s)? What do you think you will get out of it? If you have already donated, what did you get out of it? If you do not already have children, have you considered the unlikely circumstance that at a later date you might be unable to conceive? (This should be discussed with a psychologist before the donor donates.)
10. If we get pregnant, will you tell your family members including your children? If so, how will you tell them, and when? Would you want your children to know that our child would share half of their genetic heritage? How will you handle their questions?
11. May we see or have pictures of your family, siblings, and children? If we desire [in an known donor agreement], may we meet with your immediate family, including your children?
12. Have you thought about how you’d feel if, after all this interaction and sharing, we don’t get pregnant?
13. Have you thought about whether you would like any ongoing contact such as pictures, phone calls or meeting the child?
A few last words about choosing an egg donor:
Do your homework, research, ask questions, and if something doesn’t sit well, listen to your gut. Don’t be led to believe that if you pay a top price for an egg donor, you will get a premium donor. That’s not the way it works. Also, while we are talking about it, don’t believe that paying a higher fee to an agency or a donor is going to create or produce a top quality (or even a better quality) egg – or, for that matter, increase your chances at becoming a parent. Again, that’s not the way it works.
At the end of the day, we believe that the child you have via this process is the child you are meant to have, and will be the most amazing, beautiful, perfect child you have ever laid on eyes on.