Episode Transcript
[00:00:00] Speaker A: Hey, it's Eloise. Quick heads up before this episode starts. What you're about to hear is from the Fertility Cafe archive. We're bringing some of our past conversations back because new listeners find this show every week, and these stories deserve to keep finding the people who need them. If you've heard this one before, give it another listen. Something always lands differently the second time, and if it's your first time, you're in the right place.
Okay, let's get into it.
In its most simplistic form, an egg donor is a woman who provides an egg to be used in conception for a soon to be parent. Egg donors can come from all different walks of life, and they choose to donate their eggs for a variety of reasons. They can be the missing piece for intended parents who've been trying to build their family without success. But in reality, a woman who chooses to become an egg donor is so much more than the base definition.
[00:00:57] Speaker B: Whoever thought making a baby could be so hard? Luckily, the fertility journey isn't meant to be traveled alone. Eloise Drain has helped hundreds of people build and grow their families over the last 15 years, and she's ready to share her insider knowledge and expertise with you. So grab a seat and let's talk fertility and alternative family building in the Fertility Cafe.
[00:01:19] Speaker A: Welcome back to Fertility Cafe. In episode four, Egg Donation 101, I discussed the basics of egg donation for both intended parents and the woman donating and what it takes to qualify to become an egg donor. If you're curious about those topics, you'll want to refer back to that episode to get more insight. In this episode, we're focusing specifically on the egg donor and answering all of the lingering questions about the egg donation process and diving deeper into what it might look like. It's my goal to inspire you and inform you so that you can move through this journey with confidence. If becoming an eg something that is calling you. It would have been nice to have had a podcast like this when I started my first egg donation journey 20 years ago. Man, the pitfalls I could have avoided.
So today, in hopes of making your journey just as fulfilling as mine has been, only with a tad bit less drama, we're going to take a 365 degree view of becoming an egg donor. I'll address some of the more commonly asked questions potential egg donors have and some of the less obvious ones which are equally as important.
I'll outline the donor process and review what a potential donor will go through. From first thought to successful donation. I'll address medical questions such as safety and the potential side effects of the egg donation process. What you may experience emotionally, both from the decision to donate and as a result of the medications you'll be taking. I'll address the legal concerns such as parental rights and anonymity. And of course, I'll cover the topic of finances and compensation as that is most certainly a big part of the donor process.
So let's get started.
The traditional way of building a family simply does not work for everyone. Couples suffering from infertility, LGBTQ couples, and single intended parents need alternative family building options. The good news is that there are many ways to build a family today. Finding a suitable egg donor is a common and attractive option for many intended parents. Egg donors are needed to fulfill the dreams of countless hopeful parents. It's awesome that you're considering becoming a donor, but you need to know it's a big commitment. Not nearly as long time wise as the commitment of surrogacy, but a big commitment nonetheless. Before you begin, you must understand that the egg donation process is very involved and I'll cover details about the process in depth shortly. But before I get too deep into the whys and the hows, you may be wondering if you even fit the bill. What does an egg donor look like exactly? And might that look in theory, any woman of childbearing age can be an egg donor. In its most simplistic form, an egg donor is a woman who provides an egg to be used in conception for a soon to be parent. Egg donors can come from all different walks of life and they choose to donate their eggs for a variety of reasons. They can be the missing piece for intended parents who have been trying to build their family without success. Unfortunately, infertility is experienced by many and it does not discriminate based on ethnicity, so egg donors of all races, colors and creeds are necessary. In reality, a woman who chooses to become an egg donor is so much more than the base definition. She is a kind and compassionate human being who wants to give a family a part of herself so they can feel whole. I think it's important for you to figure out and ask yourself the question of why. What's calling you to donate your eggs? Most people are attracted to being an egg donor for one reason or another. The life changing event that sent me off into the direction that I now find myself in was when I donated a kidney to my cousin over 20 years ago. After I donated my kidney, I went to visit him in California and I stumbled upon an ad looking for egg donors. It caught my attention as something I might at some point want to do, but I didn't take action on it for another year. If you like to listen to my whole journey, I go into detail in episode eight. But to sum it up, I could have never imagined how my life and the lives of so many would be changed by one simple ad. It just goes to show you that you never know what God has planned for you when you follow a bigger calling. As I go deeper into the process, you'll see that egg donation is so much more than just giving away your eggs. There are physical, emotional and financial considerations that will come into play. Being an egg donor can affect you on an emotional level in both positive and negative ways. It's frequently an emotional decision that drives people to want to become donors. It may sound weird, however I also think it's important to think for a moment about the eggs that you're donating. It's common to wonder what came of your donation or for the child that was created from it. The question though, Will it be something that consumes your thoughts? Will you walk down the street in the coming years wondering if you'll run into a little person that looks like you? Will you be able to detach and let go? How will this decision to donate your eggs affect you, your psyche and your future? Before you dive headfirst into the process, make sure you've thought through your why and are confident in moving forward.
Deciding to donate your eggs is a big decision. Beyond the generous desire to give a family the joy of a baby, there are several requirements and factors to consider. Not just anyone can be an egg donor. Having criteria in place protects the best interests, health and safety of donor candidates and intended parents. So just a quick recap on the basic qualifying criteria of an egg donor. Egg donors are between the age of 21 and 29, in excellent physical health with a BMI between 19 and 30, in possession of both ovaries, has a regular menstrual cycle, is drug and STD free, is in favorable mental health with no psychiatric diagnosis including depression and lastly, egg donors must be comfortable with self administrating injections. And just a quick side note, some fertility clinics will actually allow EG up to the age of 33, but that is really a case by case situation. Once you know you meet the basic qualifiers, the immediate next step is to decide how are you going to find the right intended parents you would like to help? Finding a good program can be the first step in a positive experience.
It's important you feel comfortable. Make sure to do your research and read reviews. This can mean the difference between a positive or a negative experience.
This experience should be fulfilling on all levels for all parties involved. My first experience with egg donation was, well, let's just say a less than pleasant one, but I can't say it had no purpose. It certainly inspired me to start my own agency and carve out an experience for donors that I was hoping for myself. But my subsequent experiences, both as a donor and as a surrogate, have been mostly positive and have shaped me into the person that I am today. My life is full and richer beyond my wildest dreams because of these experiences I have had with the families I've helped.
You have several options as there are different programs in which you can donate through. If you listen to episode four I talked about the various types of egg donor programs, a frozen egg bank, a fertility clinic with an in house donor program, an egg donation agency, or you can choose to go the independent route. There is no right or wrong here. It's understandably a personal choice. Each program offers different options. The program that would most likely offer for a quick selection would be through a frozen egg bank. Banks can be standalone facilities or a part of a fertility clinic. A bank, once you're selected, can move you through the process fairly quickly. You undergo medical screening, sign consent forms, start your meds, have your retrieval, receive your compensation, and you're done. Frozen egg banks typically have a stricter guideline on the donors they allow into their program. Also, in a frozen egg bank, your journey will be completely anonymous. You have no say on who gets your eggs or how many people it's offered to. If that kind of information is important to you or you want more detail on who you're donating to, a frozen egg bank may not be the best option, but if you're okay with not knowing, then you may find donating through a bank is quick, efficient and fulfilling. Another option would be to work with a clinic that offers an in house egg donor program. In house programs typically aren't as quick as a frozen bank. Through these programs, similar to egg donation agencies, you begin your cycle after you have been matched with intended parents. Some clinics will complete the medical screening upfront, but won't have you begin the medication and retrieval process until after you're selected. More than likely, once you're matched, you're completing a donation for one family.
Sometimes the clinic may ask you to complet shared cycle, which means the eggs produced would be split between two families to help with cost, but that doesn't happen all the time. And again, in house programs tend to be anonymous arrangements, so keep that in mind. If having more control of who you're donating to is important to you, then perhaps going through an egg donation agency may be better. The match time will vary and often the in house programs work with donors who are local to the clinic. Egg donation agencies are often separate from a fertility clinic. The agency will work directly with the fertility clinic selected by the intended parents and will help manage the process. But all the medical screening and procedures occur at the fertility clinic. Some agencies complete some medical screenings before you're matched and others wait until after you're matched through an agency. You'll have to wait to be matched to begin your cycle and match times vary. You do not need to work with an agency that is local to you. Often agencies will have donors located located all over the U.S.
most often, you're donating to one family at a time and you decide who you're donating for. It's totally acceptable to ask the agency if they can provide information on the recipients. Of course, how much information is shared will be dependent on the type of arrangement everyone agrees to. And different than with a frozen egg bank or in house clinic program. A legal contract called an egg donor agreement is completed between yourself and your intended parents. Even in an anonymous situation, the last option is to go the independent route, finding your intended parents directly and working with each other. You still must go through the fertility clinic to complete the medical process, but there are no middlemen connecting you. There are various platforms in which individuals advertise that they are either looking to become or looking for a donor. Once you've determined how you will proceed, regardless of the program you choose to donate through, you typically will begin with completing an online application. The applications are personal in nature. It's an opportunity to get to know you better. Your characteristics, personality, background, health and family medical history. When filling out the application, be mindful that your answers are being heavily weighted. So answer with care and most importantly, answer honestly. During your application phase, you'll want to discuss how the program works. How do they go about screening and matching? How long does it take for a match? Have them talk to you about the risks, compensation, contractual issues, their process, the medications, and how long they anticipate it will take. It's your opportunity to discuss in detail all your unanswered questions and concerns. Be aware the match time varies due to the need at that time from intended parents. You may very well sign up with an agency or a clinic and never get selected. Most, but not all intended parents desire a donor that has attributes similar to their own. They may also have very particular requests for a donor prolonging the matching process. For example, if the intended mother was a pianist, she may request an egg donor with a musical background. Or if she or the intended father was an athlete, a donor with an athletic background might be desired. You get the picture. So from the time your egg donor profile is active in the database, it could take anywhere from one week to a year to find a match.
However, you're expected to keep living your life as you normally would until the right match is found. After you're matched, Medical Screening is Required While the screening process can look different from program to program, the objective is the same. The fertility clinic will screen you for general medical health, completing a physical and gynecological exam via transvaginal ultrasound scan, drug, nicotine and infectious disease screening through blood and urine tests, and inherited disease screening through a blood test as well. In addition to that, you'll be required to complete a psychological evaluation in which you'll meet with a mental health professional that'll complete the evaluation in two parts. Part one is a personality test. Pai, or mmpi is what they're called, and it's administered via computer and is a fill in the bubble type of questionnaire. There are no right or wrong answers to these questions, but the results help give an indication of your readiness to be a donor. Part two is speaking to the mental health professional who will go into detail about your life history and family history. Again, this evaluation helps determine whether you can emotionally handle the stress and responsibility of being an egg donor. Once the screening results are back, you'll be notified if you're qualified to move forward with the actual donation process. Depending on the program you selected, or if you went the independent route, you'll either receive a cycle schedule and begin the actual medications, or you begin the egg donor agreement between yourself and the intended.
And remember, this will occur even if it's anonymous. I'll go into detail about the legal aspect shortly. While the entire process, from start to finish, may take roughly about 120 days, the time you're taking the actual medication is about two to three weeks. Through the controlled ovarian hyperstimulation process, you'll take various daily injection medications, which are hormones that stimulate your ovaries to produce the eggs.
Now, what does that mean in English? As women, we're born with roughly about 350,000 eggs already in our bodies. The medications you'll be taking stimulate the eggs to mature and produce faster than they normally would each month in an effort for you to produce multiple mature eggs for retrieval and donation. The type of medications you'll be taking vary depending on your body, the clinic, and the protocol they place you on. Throughout this period, expect to visit the fertility center regularly every other day for early morning monitoring, roughly about seven to 14 appointments to monitor your progress along the way. So as you can imagine, your schedule will have to be flexible enough to allow for the time you'll need to keep appointments.
One of the most common questions I receive is how will donating your eggs affect your future fertility?
I touched on this in Episode four, but I want to dive into the issue more in length this time. I don't want to say it could never happen, however, that would be an unusual case. After your donation, your body will return to its normal cycle and you will return to producing only a few mature eggs each month. The doctors only retrieve the mature eggs, not all your eggs, during the egg donation process, leaving hundreds of eggs in your ovaries.
Recent small study in Belgium which followed up with egg donors after their donation, they found that of 60 women, 54 got pregnant within a year once they started trying to conceive, and three more got pregnant within 18 months, all without needing any help. Personally, after I did my last donation, I went on and had my youngest son, and then I completed three successful gestational surrogacy pregnancies, one of which was a set of twins. The next most common question I receive is what are the side effects from the medications? With every medication we take in life, there are potential side effects, and while this is generally a safe procedure, there are still some things to consider. It would be extremely partial of me to only share one side of the egg donation process and pretend as if there aren't any risks involved. You'll be taking medications that will affect your hormones so that you can produce more eggs. Due to this, you can expect to see fluctuations in mood and weight. It's also common to feel some discomfort during the medication phase of the egg donation process.
Some women develop soreness or mild bruising around the injection site. You may even experience breast tenderness, mood swings, and even mild fluid retention and bloating, just like you would when you have your menstrual cycle every month. Those are considered normal symptoms. The likely side effect, or complication, if you will, is when your body begins to overproduce eggs. This is called over ovarian Hyperstimulation Syndrome, or ohss.
Occasionally the medications can cause more hyperstimulation than intended. This occurs when the ovaries have an exaggerated response to the hormones given to increase egg production. There are varying levels to ohss, mild, moderate and severe. Mild OHSS will cause abdominal pain and swelling. It usually goes away after your next period. Moderate OHSS has similar symptoms. However, the pain can be more intense and pain meds may have to be taken, but again should go away after your next period. Severe OHSS is the rarest but can cause serious medical complications such as blood clots, kidney failure and fluid buildup in the lungs. Severe cases have occurred in about 2% of the population Completing an Egg Retrieval Process As I stated earlier, you're monitored by the clinic very closely each time you attend your monitoring appointment. The clinic will check the follicle or egg count to see how many follicles are growing and the size. They will also complete blood work to ensure your hormone levels are in line and are where they should be. If there is a concern that you may experience ohss, the fertility clinics most likely will cancel the cycle and not move forward on the day of the procedure to retrieve your eggs, you'll be given an intravenous or IVF sedative. You'll be sleeping and won't feel discomfort during the procedure. Once the eggs are removed or harvested, as it is also referred to, they can either be fertilized with the intended father sperm or donor sperm via IVF immediately creating embryos, or they could be frozen to be used later. You may experience mild cramping also after the procedure, but again, this should go away within the next couple of days.
Obviously, the goal is to obtain several mature eggs, which increases the probability of healthy fertilized embryos. It's difficult for anyone to know how many eggs you will produce because it's different for everyone. The entire process takes a few hours, with the actual egg retrieval procedure taking about 30 minutes. Rest and relaxation are suggested for the remainder of the day, and normal activities can start within one to two days. Following the proced out of my six donations, I have experienced hyperstimulation twice with moderate symptoms. At one point I looked like I was five months pregnant. After I had my retrieval though, it took a few days and I got my period and after that I was totally fine. And lastly, about the recovery process. Recovery from the egg retrieval is relatively easy. It just requires rest for the remainder of the day and taking it easy. And I don't know anyone who would complain about taking the day off or a job well done. So there you have it. Okay, so let's touch on the legal aspects of egg donation for a moment. The beautiful thing about our world today is that we live in the age of different strokes for different folks, and we are undoubtedly evolving into a more open society when it comes to challenging the norm. As well as traditional family types, most egg donor arrangements are anonymous. The program will share a considerable amount of non identifying information with the intended parents, such as ethnic background, eye color, hair color, educational background, and the list goes on, but no identifying information.
Ok, some food for thought when it comes to the topic of anonymity. While you can choose open or closed donor relationships with the recipients, or something in the middle, the reality of today's advances in the field of genetic testing, combined with the ease of access and availability to your genetic profile, kind of throws true anonymity out of the window. With companies like 23andMe in ancestry DNA becoming more and more mainstream, anonymity is harder to maintain. There is no telling what will be in place 20 years from now, so just keep this in mind as you move forward through this process.
So a couple of in between options include semi anonymous or identifiable donor agreements. Semi anonymous arrangements are becoming more common. In that type of arrangement, limited donor information is shared with the recipients. Usually it's limited to first name and geographical location, but sometimes it can include the option to connect via phone or email with an identifiable donor agreement. All parties agree to release your information to any child born from your eggs once the child turns 18. Some people like this option because it gives the child control over his or her own information once they reach adulthood. In an open arrangement, donors and recipients get an opportunity to either speak or meet one another. This can be a pleasant experience for all involved. If all parties are willing in the application process, you'll likely indicate whether you're willing to speak or meet the recipients and whether you would be willing to meet their child when the child is an adult. Of course, if this is not what you want, you can opt out. I have experienced just about all three categories I've experienced anonymous situation, a semi anonymous situation, as well as an open donation situation.
Again, if you listen to episode eight and get my whole story, you'll hear of my various experiences. There is no doubt we are deeply tied to our genetics. An egg, donate or not, carries at least 50% of the blueprint to who we are at our core. Obviously, the parents who raise us, love us and nurture us contribute significantly to who we become with what was genetically given to us, which will be the case with egg donation. But it is perfectly normal and natural and almost expected that a child will grow up and at least be curious about where and how he or she began. More and more people are leaning towards open arrangements. Many modern parents are embracing the whole birth story and are leaning towards including all parties that help create the person who was born into that story.
Now remember, if you decide to work with a frozen egg bank or in house clinic, presumably it's an anonymous arrangement and you will not have an egg donation arrangement with the intended parents. You'll sign consent forms through the clinic, but that is about it. If you decide to match through an agency or go independently, an egg donation agreement will be done and must be executed before your cycle can begin. This agreement is drafted by a licensed attorney familiar with fertility law to protect all parties involved in the egg donation agreement, state the intentions and legal obligations of all parties and dissolve custody over any child that is born through the process.
It may also detail your expectations for contact after the child is born and expectations should medical issues arise down the line in your life that could potentially affect the child. The egg donor agreement gives intended parents control of all eggs retrieved as well as any resulting embryos. The parents can use them as they wish. They may choose to keep them cryopreserved or frozen, have more children, donate them to research or dispose of them. You may have some limited say over what happens to unused eggs in the contract, but typically once your donation is complete, you give up any control or rights to the eggs. As eggs are considered property, they're not considered anything else but that it's just property. In some states and foreign jurisdictions, for the intended parents to be recognized as the legal parent of any resulting child, there must be a written contract between the parties before an egg retrieval takes place. Without a contract, the parental rights of the intended parents may be in jeopardy. In addition, the agreement will detail out your compensation and when it gets dispersed, the responsibility of the intended parents regarding all medical expenses, medications, legal and travel. And it also talks about the insurance that would be paid for you on your behalf. This additional insurance policy covers any donor related complications and the duration of the coverage. Should you work with an agency or complete your journey independently, it's important to know you have a right to separate legal counsel to represent you during the contract phase. This attorney will be looking out for your best interest and while any attorney's fees will be paid for by the intended parents, the attorney is working for you, not the intended parents. The intended parents will have their own separate attorney as well working on their behalf. I know this legal part may sound intimidating, especially if you haven't worked with an attorney before, but it's nothing to fear. Just be honest, ask questions and don't sign on the dotted line until you are 100% comfortable with everything outlined in the contract.
Lastly, let me share a bit about the donor compensation. Often in the US if you choose to become an egg donor, you will receive some form of compensation. There are indeed women who refuse to take any monetary compensation, especially if donating to family or friends. These women would be considered compassionate donors or altruistic donors, but most women who donate receive some form of compensation. That compensation covers your time and discomfort during the process and the money you receive is not based on how many eggs are retrieved or based on the number of embryos created. It's based on the time involved, your pain and suffering and the risk. Compensation from the various programs are similar. However, donors that are in higher demand often receive higher premiums.
Typically, first time donors without evidence of successful cycles generally receive the least amount of compensation.
In the US this starts at around $6,000. Experienced donors, those women who have donated eggs that resulted in successful pregnancies can receive upwards of $10,000. A third tier, often called elite or exceptional donors, receive the highest compensation. Harder to find donors of a rare ethnicity such as Indian or Asian, or who possess highly sought after traits like an Ivy League education or supermodel caliber beauty around $20,000. It's important for you to know that the party responsible for all expenses related to the egg donation process is the intended parents. There will be many expenses in this process. This includes the agency fees, medical fees, legal fees, accidental donor insurance, travel expenses, and your compensation. You are not responsible for any of these expenses and will be reimbursed for any out of pocket expenses you incur. Just make sure you fully understand what it is that you're getting your before you sign anything on the dotted line. I hope today's episode has been helpful to you as you think through the process of becoming an egg donor. You have many things to consider. Whatever you decide, I hope you're more confident with the knowledge to make the right decision. And that decision needs to be right for you. Thank you for joining me today. If you've enjoyed this episode of Fertility Cafe, we'd love you to leave us a review on itunes, Stitcher or your listening platform of choice. We'd also love you to share Fertility Cafe with friends and family members who would benefit from the information. I'm Eloise Drain. Remember, love has no limits. Neither should parenthood.
[00:30:05] Speaker B: Thank you for joining us in the Fertility Cafe. Whether you're an intended parent a woman considering egg donation. Thinking of becoming a surrogate yourself? Or a friend or family member of someone dealing with infertility? We're here to help. Visit our website, thefertilitycafe.com for resources on fertility, alternative family building, and making this journey your own.
