Frequently Asked Questions about Egg Donation
Thank you for your interest in the Egg Donor Program at PAMF Fertility Physicians of Northern California. Egg donation has been used for almost 30 years to make pregnancy and childbirth a possibility for women struggling with infertility. It is a very kind and generous act that is deeply appreciated by the people who are helped by it. The information below is designed to give you a better idea of what it is like to be an egg donor.
- What is egg donation?
- Who may become a PAMF Egg Donor?
- Who needs egg donors?
- Will donating my eggs affect my own fertility?
- What obligations will I have to any children that result from donating my eggs?
- How much does it cost?
- What does the process of egg donation involve?
- How will I be compensated as an egg donor?
- How will I be matched with a prospective recipient?
- What are the risks and restrictions?
- What are the benefits of becoming an egg donor?
What is egg donation?
Egg donation is a part of in-vitro fertilization (IVF), which involves stimulation of a donor's ovaries to promote the maturation of multiple eggs. The eggs are then retrieved and donated to an intended mother, who is unable to conceive using her own eggs. After the eggs are retrieved, they are fertilized in the embryology laboratory with sperm from the intended mother's partner, or a sperm donor, to create embryos. Typically, one or two of these embryos are transferred to the uterus of the intended mother. This process has a high chance of resulting in a normal pregnancy and a healthy child. The rest of the viable embryos are usually frozen to give the couple another chance at pregnancy if the first transfer is not successful. Frozen embryos may also be transferred in the future if the couple wishes to have another child.
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Who may become a PAMF Egg Donor?
Compassionate and responsible women, between the ages of 21-29 years old, who are healthy, live in the San Francisco Bay Area and desire to help an infertile couple have a baby can consider donating their eggs through our program. Women in this age range who have a favorable medical and family history will have eggs of better quality than women who are older. Certain rules concerning who can donate are set in place to increase the chance that a pregnancy will result and to make the process safe for both the donor and recipient. Guidelines made by the American Society for Reproductive Medicine (ASRM) are carefully followed to ensure the privacy, safety and well-being of everyone involved.
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Who needs egg donors?
There can be many reasons why a woman might need the help of an egg donor to become pregnant and carry a healthy baby to full term. Most commonly, egg donation is a successful treatment option for infertile women who do not produce enough normal eggs, have malfunctioning ovaries, have entered menopause prematurely or have had several unsuccessful IVF treatments using their own eggs. Some women will also elect to receive donated eggs because they are aware of an increased risk for inherited disease in their biological offspring. Egg donation is unlike adoption in that the intended mother has the special opportunity to conceive, sustain a pregnancy, give birth and breastfeed her child. This unique experience allows for special bonding as a couple, as parents and as a family.
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Will donating my eggs affect my own fertility?
There is no reason to believe that donating eggs will affect your ability to have children because egg donation does not use up your eggs. Every female is born with about a million eggs in her ovaries. By puberty, about half of those eggs have died naturally. Every month during the menstrual cycle, about one thousand eggs are recruited by the ovary to become eligible for ovulation. However, in a normal menstrual cycle, only one of those eggs actually matures; the rest of those eggs die naturally and are reabsorbed into the body. This normal process is repeated every month until menopause, when all of the eggs are gone.
The fertility drugs that an egg donor takes causes about a dozen of the thousand recruited eggs to become ready for ovulation, instead of just one egg. So, the eggs you would donate are some of the eggs that would normally die during that menstrual cycle anyway, not the eggs that would be used in the future for a pregnancy. If there was a serious complication from the egg donation process (such as infection, which could damage the fallopian tubes), this could potentially affect future fertility. However, such complications are very rare and have a frequency of less than one in every 1,000 egg retrievals.
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What obligations will I have to any children that result from donating my eggs?
None. Before the process of egg donation begins, both you and the recipient of your eggs will sign a contractual legal agreement that releases you from all parental, custodial, legal and financial rights, obligations or liabilities to the eggs, embryos, fetuses or children that may be created as a result of donating your eggs.
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How much does it cost?
The donor does not pay for any of the medical costs. All of the costs incurred for screening, medical appointments, laboratory testing, medications and surgical procedures will be covered by the recipient. Additionally, all recipients are required to purchase a supplemental insurance policy to cover the donor for any other expenses that could result from any rare and unexpected complications.
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What does the process of egg donation involve?
Giving the gift of motherhood is not a simple process, which is one reason egg donors are so generously compensated. Because of the thorough screening process, detailed planning and careful medical attention given to our donors and recipients, the actual egg donation will happen no earlier than four to six months after you first apply to be an egg donor, and will depend on when you might be selected to be a donor. Initially, you will be asked to complete a preliminary online application to determine whether or not you meet the basic eligibility requirements. Eligible applicants will then be contacted by our agency coordinator to schedule a 10-minute phone interview, during which the information submitted through the online application will be confirmed and any questions the applicant may have will be answered.
After the phone interview, you will be given an anonymous login and password to our secure online application site and you will be asked to complete more detailed medical and family history questionnaires, as well as answer questions about your physical characteristics and personality. Upon completion of the online application, your information will be carefully reviewed by our medical staff. If you are determined to be a suitable candidate for egg donation, your completed questionnaires will be used to build your anonymous egg donor profile, which potential recipients will review as they consider you as a potential egg donor.
If your comprehensive online application is approved, you will be asked to come to our office in San Jose for a Preliminary medical screening consists of an appointment with one of our physicians, who will conduct a vaginal ultrasound to exam your ovaries and ensure they are healthy and functioning normally. You will also need to have a blood test on the second or third day of your period to measure the hormones FSH and estradiol, which are associated with your fertility and reproductive health. Our laboratory will also collect a urine sample for a drug and nicotine screen. You will also meet with our Donor Agency Coordinator and have a consultation with our Agency Coordinator. The process of egg donation will be discussed with you in detail and you will learn about the rules and policies you will need to follow if you decide to become an egg donor. Your medical and family history will also be reviewed as well as the risks, obligations and responsibilities associated with being an egg donor.
If you are accepted into the program after screening has been completed, you will be given an anonymous ID number and added to our registry of pre-screened egg donors. It is from this registry that the intended parents select potential donors and review non-identifying information about them.
If you are chosen as a donor by intended parents and you decide to move forward, you will be required to sign a legal agreement and consent forms for the medications and procedures involved with egg donation. The Egg Donor Coordinator will meet with you to outline a plan for your cycle. The egg retrieval will likely be planned to happen three to four months from the time you are matched with your recipient. That way, you will have advanced notice to make the necessary arrangements in your personal schedule to complete the cycle. Sometimes the timing of the egg retrieval can be based on your availability, if it is far enough in advance, but there is always the possibility that a medical delay could change the original plan.
When you are matched with recipients, you will also need to complete some additional screening. PAMF Fertility will refer you to a counselor who specializes in egg donation for a psychological evaluation. A genetic counselor will meet with you on the day of your physician consultation to review your health and family history and order genetic testing. You will then have a prescreening appointment where you will have a consultation with one of our physicians, a complete physical exam, and a cycle review.
The physician will review the medical procedures and risks as well as the obligations and responsibilities you will have as part of your involvement in the egg donor program. The complete physical exam will include cervical cultures and infectious disease testing will also be performed. You will also meet with the Donor Program Coordinator who will review the scheduling of the cycle with you. If you have an intimate partner, your partner will also have blood testing for infectious diseases and be required to sign a legal agreement and consent forms. You will not be responsible for any of the charges associated with this screening. You will also not be billed for any subsequent testing, appointments, medications or procedures pertaining to your care as an egg donor. The entire cycle will be paid for by the recipients.
When all of the required screening tests have been completed, you will be prescribed birth control pills to help synchronize your menstrual cycle with the intended mother's. Once your cycles have been synchronized, you will then follow the cycle plan and take a series of fertility medications to stimulate your ovaries to produce multiple eggs at one time. These medications are given by subcutaneous injections, which you will have to be taught to administer yourself with a very small needle that is similar to an insulin syringe. While using these medications, you will have 5 or more monitoring appointments involving vaginal ultrasounds and blood testing over a period of 10 to 12 days. Most monitoring appointments occur early in the morning, between 7:30 and 9:00 a.m., so that the results can be reviewed and your medication dosage can be adjusted that same day. You may need to make prior arrangements with your employer or school so that you are available for these monitoring appointments at the scheduled times.
Although other appointments for the egg donation cycle can sometimes be scheduled later in the day and around your availability, we cannot schedule these monitoring appointments at your convenience; they must be in the morning on the days determined by the physician based on the results of your previous monitoring appointments. After these monitoring appointments, your time is free for the rest of the day, except the times at which you are instructed to do your injections. While you are on the medications, you will be able to go about your normal activities, like work and/or school, but you will need to take a break from any high-impact athletic activities like jogging and dancing.
You should expect to experience some abdominal bloating, discomfort and tenderness in the days leading up to and following egg retrieval. The pain and bloating is generally reported by patients to be similar to what they experience during a normal menstrual cycle, but it might be stronger. Your doctor may prescribe pain medication for you if it is necessary; it is our goal to ensure you are as comfortable as possible during this process. You can take steps to further reduce discomfort by keeping well hydrated, getting extra sleep, eating a balanced diet with plenty of fruits, fiber and vegetables and reducing your physical activity.
After about 12 days of ovarian stimulation the egg retrieval will be performed through a minor surgical procedure under light anesthesia. The egg retrieval involves passing a special needle through the vaginal wall to retrieve the eggs from the ovaries while the patient is asleep. The entire procedure only takes about 30 minutes and does not involve any incisions. Women who have egg retrievals in our program typically do not feel any discomfort during the procedure due to the type of anesthesia that is used. After your egg retrieval you will rest in our surgical suite for about two hours while the anesthesia wears off. Our nurses will closely monitor your recovery and ensure that you are alert and comfortable before sending you home. You will need a friend or family member to drive you home from your egg retrieval and that person should also stay with you for the first 24 hours after the procedure. It is necessary for you to spend the day of the egg retrieval, and sometimes the next day, resting at home. It is not possible to go to work or school on the day of the egg retrieval. Before the start of the cycle, you will have a general idea about when the egg retrieval will occur, but the exact day is not known until two days before the procedure, as this depends on how your ovaries respond to stimulation.
When the egg retrieval is over you will not need to give yourself any more injections. You will be asked to come to our office for a follow-up visit several days after the egg retrieval. You should expect to have your period in about 10 to 15 days following the date of egg retrieval. Most patients report the period immediately following their egg retrieval to be heavier than normal. However, their subsequent menstrual cycles are usually typical of what they would normally experience. It is strongly recommended that you refrain from vigorous activity and sexual intercourse from the time you begin ovarian stimulation until you get your period, which is about two to three weeks.
Once the eggs are retrieved they become the sole property of the intended mother, as if they were retrieved from her own body. They are then mixed with sperm from the intended father or designated sperm donor in the laboratory. If embryos result, they will be those of the intended parents. Usually, one or two of the embryos will be transferred into the uterus of the intended mother, or a gestational carrier if the intended mother is unable to carry a pregnancy. The rest of the viable embryos will usually be frozen. The intended parents may choose to discard or donate embryos which are not eventually transferred.
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How will I be compensated as an egg donor?
Being an egg donor requires a great deal of responsibility. Egg donors must be mature, reliable and willing to strictly adhere to the cycle protocol. They must attend all appointments, be on time, and do every injection precisely as instructed by the physician. All of this requires quite a bit of time and energy, and that is why egg donors receive monetary compensation. A donor's compensation is not considered payment for her eggs, her genetic material or a child. The $7,000+ paid to PAMF Fertility egg donors is compensation for five things:
This includes the portion of your daily life that you will be dedicating to being a donor while you attend appointments and take your medications at the same time each day. For example, this might require staying home for the evening, instead of going out with friends, to ensure that your injection is done at the precise time your doctor instructs. You will also spend time away from your daily activities, while you are resting and recovering after the procedure.
Effort encompasses all of the dedication you will give this cycle, waking up early in the morning, driving to and from appointments, giving yourself daily injections, following doctors' instructions, being responsible and doing everything you can in good faith to support the success of the cycle.
This involves the time you may have to take off work for ultrasound monitoring, egg retrieval and post-retrieval recovery and resting.
Like any surgical procedure, egg donation is not without its risks. The risk you will be compensated for includes the very small chance of developing complications such as infection or ovarian hyperstimulation syndrome. Your physician will thoroughly counsel you about these risks before you make the decision to be a donor.
The pain involved in this process is different from donor to donor. Some donors do not report any discomfort whatsoever; others need to be medicated. You are compensated for the possibility of experiencing pain from ovarian stimulation, ultrasounds, blood tests, injections and the retrieval.
How will I be matched with a prospective recipient?
Recipients review a list of donors made available to them. The list will include a summary of each donor's physical characteristics. The recipient mother may desire a donor who closely resembles her, including ethnicity, height, body build, skin type, eye color and hair color. Once the recipients have identified one or more potential matches, they will review each donor's written profile, which contains the family and medical history she has provided to PAMF Fertility. Honesty in the information you provide as an egg donor is absolutely essential. No information will be provided to potential recipients that might make your identity known.
You will submit baby, childhood, teenage and current adult photographs of yourself to supplement your online profile. While your online profile will give potential recipients many details about your personality, childhood, family history, lifestyle and achievements, seeing pictures of you as a child and as an adult can be equally valuable to their decision to choose you as their egg donor. To most recipients, it is most important to them that their children grow up happy and healthy, with a sense of belonging and likeness to their family. Any pictures you do choose to provide will be stored in a secure location at PAMF Fertility and will only be viewed by recipients under the supervision of a PAMF Fertility Donor Coordinator. Recipients will not be permitted to retain copies of your pictures and your pictures will never be emailed or posted on the internet; they will be kept in our office at all times. Once a recipient couple has selected you as a potential donor, they will notify the Agency Coordinator and then she will contact you regarding your availability and confirm your willingness to help the couple achieve pregnancy.
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What are the risks and restrictions?
If you have intercourse during the egg donation cycle, it is possible for you to become pregnant, perhaps with a multiple pregnancy. That is why you must abstain from having sexual intercourse from the beginning of injecting stimulation medications until you have your next period after the egg retrieval.
Your ovaries will temporarily become enlarged and somewhat fragile during the stimulation. For this reason, you will need to avoid vigorous exercise or any activity that causes your ovaries to bounce, such as running, brisk walking or mountain biking, during the month of the egg donation cycle. Activities such as these can lead to severe pain or permanent damage to your ovaries.
Before and during the cycle, it is very important that you maintain a healthy, balanced diet, get plenty of rest and keep well hydrated. Smoking and recreational drug use are strictly prohibited. Over-the-counter pain medications, such as Aleve or Advil, should also not be taken during the cycle. You will need to review any drugs or medications you are currently or plan to be taking with your physician before the cycle begins. This includes any vitamins or herbal supplements. If at any time during your cycle you need to take additional medicines that have not been prescribed for the cycle, you must ask your doctor before taking them.
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What are the benefits of becoming an egg donor?
Although donating your eggs is a big commitment of your time and willingness to accept some potential discomfort, it can be a very rewarding experience. The parents who conceive through egg donation are extremely grateful for what you have done to help them have a child. Your efforts are sincerely appreciated and respected. Previous donors have said that the best part about being an egg donor is the feeling that comes from knowing that they changed somebody's life by helping make their dreams come true.
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We encourage your questions about becoming an egg donor. If you would like more information after reviewing the answers to these frequently asked questions, please contact us. We have a dedicated donor team in our San Jose office to answer your questions and assist you through each and every step of the egg donation process.
- Angie Sawyer, MPH
Donor Agency Coordinator
We are happy to meet with you in person and take you on a tour of our state-of-the-art facilities. To schedule an appointment or get in touch with our donor team, please contact our Donor Agency Coordinator at (800) 597-2234.
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