Roughly 15% of American couples struggle with infertility. And when fertility drugs, in vitro fertilization, and other fertility technologies don't work, couples who can afford it are turning to egg donors. Some ads in college newspapers offer as much as $10,000 for the right eggs, a sum that could buy half a semester at some private schools. It's a tempting amount of money to many financially strapped college women. But critics say the ads often focus on the desperation of infertile couples and the money they may be willing to spend, and gloss over the obligations and risks to the donor.
The American Fertility Association, which provides information for couples having trouble conceiving a child, says egg donation can mean the difference between no children and a family for a childless couple.
But this lofty contribution by a young woman also requires drugs, at least a monthlong time commitment, and a risk, though small, of medical complications. Psychologists who work with egg donors say potential donors must also realize they are creating a child they can never acknowledge or have a relationship with.
Dr. Fred Licciardi, director of the Egg Donor Oocyte Program and associate director of Reproductive Endocrinology at the New York University School of Medicine in New York City, says every potential donor should ask these questions of the fertility clinic or doctor she works with:
Dr. Licciardi warns potential egg donors to be realistic about their motives for donating. Many women who donate are actually young mothers themselves who want to do something good for someone else. And while ads promise tens of thousands of dollars, those numbers can be misleading. Fees across the country actually range from $5,000 to $7,000, plus medical costs. That's a nice sum, but egg donors will be giving up at least a month of their time, along with many of their day-to-day activities.
While rules vary from program to program, egg donors working with reputable clinics should expect a battery of medical and psychological tests, including a medical exam, blood tests, and cultures for sexually transmitted diseases. Potential egg donors also meet with a geneticist to discuss family medical history in order to identify transmissible conditions, such as cystic fibrosis, that could rule them out as donors. Dr. Licciardi recommends rejecting programs that do screening by phone or by mail.
Once donors are medically, psychologically, and genetically cleared, their anonymous profile will be matched with infertile couples looking for their characteristics. This process could take several months. Couples look for a variety of characteristics in donors, explains Dr. Richard Scott, director of Reproductive Medical Associates in New York City.
"We see all kinds of differing opinions on what couples are looking for in a donor. They are not necessarily concerned about whether these women are beautiful or not," Dr. Scott says. "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."
Once chosen, egg donors endure two to three weeks of hormone injections, which can result in occasional mood changes. Donors also have many blood tests and ultrasounds to monitor the progress of the eggs before the egg retrieval.
"We're actually giving them the same type of medications that an infertile patient would take during a cycle. That's why egg donors have to be monitored carefully, because if you give them too much or too little, it's very dangerous," explains Dr. Scott. "The cycle, when they're actually going through treatment, typically lasts 2-3 weeks. During that time they can anticipate being seen six to seven times, plus the retrieval."
The retrieval takes place in a doctor's office or hospital, usually under general anesthesia. A needle is placed through the vagina into the ovaries, where the eggs are removed. The procedure takes about 15 minutes. Donors are typically able to return home in an hour or two after the procedure, and can go back to normal activities the next day. Exercise needs to be limited throughout the injection period and for two weeks after the egg retrieval. Donors usually get their period about 10 to 14 days after the retrieval.
Physical risks to the donor are rare but possible, says Dr. Licciardi. Overstimulation of the ovaries can occur if the ovaries are too sensitive to the drugs and become larger than usual, requiring hospitalization. Doctors can usually avoid this by lowering the dose of drugs as the cycle progresses, if necessary, or by stopping the cycle, if it looks as though hyperstimulation is occurring. Keeping checkup appointments can help avoid the risk.
Bleeding and infection during egg retrieval is very rare, but can occur and would require antibiotics or a transfusion.
There is generally no risk to the donor's own fertility later on, says Dr. Licciardi, unless she developed a severe infection during the process or procedure.
Originally created for AmericanBaby.com, with additional reporting by Stephanie Jones Wagle, June 2004.