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Egg Donation 101

pregnant woman on couch holding glass of water in hand

When Annie first moved to New York City, she was broke and jobless. She remembered an ad from her college newspaper that promised money for the eggs of young women. So she signed up with Reproductive Medicine Associates, a practice that helps infertile couples, and agreed to donate her eggs to a couple that would choose her from an anonymous profile.

"At first I thought it was a way to get some money, because I was having trouble finding a job. But once I started going through the process, I felt like I was really doing a good thing for a couple who would otherwise be childless. I would not have done it only for the money," explains Annie, who asked to remain anonymous.

Roughly 15 percent of American couples struggle with infertility. And when fertility drugs and other fertility technologies don't work, some couples turn to egg donors to help them start a family.

"When ovum donation is first suggested to an infertile couple, it may seem like a huge sucker punch. It can be really devastating," says Pamela Madsen, executive director of the American Infertility Association. "But it gives incredible gains to infertile couples."

3,629 pregnancies resulted from couples who used egg donors, and 42 percent of those pregnancies resulted in more than one birth, according to a Centers for Disease Control study of 384 fertility clinics around the country.

"No woman grows up thinking they're going to go to college, become a lawyer, get married, and then do egg donation," Madsen says. "Many women are caught off-guard by their own biological clocks. What egg donation allows women to do is to have the biological experience of pregnancy. They get to have their blood flowing through the baby's veins, carry the baby in their womb, and they know that the baby is getting good prenatal care."

Most frequently it is older women above the age of 39 who turn to egg donors when they cannot get pregnant. In fact, 76 percent of assisted reproductive procedures (like in-vitro fertilization) in women over 45 used donor eggs.

Kathy*, a mother of three in New Jersey, says she and her husband decided to use an egg donor for her last pregnancy because they wanted to have more children, but IVF wasn't working.

"We went through all the thought processes about adoption. But we were afraid of being promised that we were going to get a particular child and have it not happen. What also came into play was that, by doing adoption I would have been taking away my husband's option to have a genetic link to our child."

The success rates of egg donor pregnancies depend on the age of the egg donor. Madsen explains that younger women's eggs are fresher, and are therefore more likely to mature into a healthy, successful pregnancy. This explains why ads offering sums up to $10,000 for donor eggs are so prevalent in college newspapers. But critics say college students may be too young, and Madsen explains that many egg donation programs won't accept donors who are younger than 20, 21, or even 22.

"We have to be clear between what is compensation, and what is enticement. In the fertility treatment community, awareness of the donor as part of the team that creates this baby is very high. Everything around the creation of this baby has got to be carefully thought out, including the donor's feelings," says Madsen. "Are they really comfortable giving up their genetic materials? Is it an open donation, a closed donation? Are they comfortable having their picture shown?"

Psychological screening of prospective donors is a common practice across the country, because the experience of giving up one's genetic material can be very emotional.

"I filled out a lot of paperwork -- I answered questions about my childhood, about my life, and my perspective on a lot of things, and that's how the agency matched a couple with me," says Annie, who donated her eggs three times. "I like to think when they make a match, they make a good fit with my personality, and the personality of the couple. And I think that's the most important thing, rather than your resume."

Madsen explains, "Giving eggs is a lot of work; women have to go through a lot. We want to make sure we're getting women to do this for altruistic reasons as well -- we don't want them to just see the money."

Though most donors -- and most recipient couples -- prefer to remain anonymous, donating an egg is not about adoption, but about giving a childless couple the opportunity to experience pregnancy and childbirth. And for women like Annie, the money becomes secondary -- a necessity to cover medical costs and health risks.

"The second time I donated, the couple sent me an anonymous card thanking me. They said they felt immediately that we were perfectly matched, and they felt really good about it. It was really emotional, and I was so happy that I could give them something like that," Annie says.

Dr. Richard Scott, Director of Reproductive Medicine Associates, revels in the young women who choose to give their eggs to these couples.

"If you go and ask women why they donate their eggs, you'll find a very substantial portion do it because they know someone who went through infertility," he says. "I think people sometimes look at these woman as mercenaries, and I have to tell you, they're not. They're extraordinary young women, and it's a real treat to work with them."

Dr. Scott has been dealing with egg donors since the mid-80s, and he says that he learned the hard way not to reveal to donors the outcomes of their donations because the donors were so dedicated to helping these couples.

"We stopped telling our donors whether the recipient got pregnant because when it failed, which happens 30 percent of the time, the donors were getting depressed, and felt they had done something wrong. They felt responsible. The women who donate their eggs are very heavily invested in the outcomes, and they really want these couples to succeed," Dr. Scott says.

Annie is glad to remain anonymous. "There could be no babies out there. There could be three. But I think it's better that way. I don't think I need to know."

Critics of egg donation say parents are using it as a means to genetic engineering -- finding a genetically perfect person to donate an egg so their child can be taller, have perfect skin, or be a genius. But Dr. Scott explains that most infertile couples who use egg donors really just want a healthy baby with 10 fingers and 10 toes, like any natural birth parent.

"Recipients are not necessarily concerned about whether these women are beautiful or not," Dr. Scott says. "But they don't want to burden their child with health issues or stigmas like being overweight. Healthy and intelligent almost always end up as the number one and number two factors the recipient parents are looking for in a donor. But beyond that, recipients look for very different things. Someone who looks basically like them, or has a similar religious background, for example."

Someone who looked like her was just what Kathy found when she began her search for an egg donor. "I was all over the board when I first started pursuing it. I didn't think physical characteristics were that important to me -- I wasn't looking for a clone of me," Kathy says. "But when I actually saw pictures of potential donors, it helped me discern that there were certain characteristics I was leaning toward: fairer skin, fairer eyes, both of which are in my ethnic background."

Potential egg donors go through an extensive battery of health tests and psychological examinations before they are considered for most programs. And, Dr. Scott admits, many potential donors are turned away if their health history or psychological makeup is less than perfect.

"The reality is that we actually reject most women who apply to be donors, because they have a disqualifying factor. If someone's father died of a heart attack at age 32, or if the donor has a family history of diabetes or schizophrenia," they would likely be rejected, says Dr. Scott. "We're very picky."

But for the women who do become donors, their anonymous gift to recipient parents is priceless.

"I feel like I hit pay dirt. This is the family I've always wanted," says Kathy. And of the woman who made it all possible, she says, "I often pray for her, and I thank God she gave us this."

*Some names have been changed to protect the anonymity of the women who chose to be interviewed for this article.

Originally published on AmericanBaby.com, July 2004.