According to the Society for Reproductive Technology, 1,788 fresh and 2,886 frozen donor egg embryo transfers were performed in 2019. The live birth rate for these cycles was 44.7 percent and 40.5 percent, respectively. As the statistics show, fresh donor eggs are more likely to lead to a live birth.
But, what inspired the egg donors who made these births possible? While reproductive specialists and OB/GYNS may frequently work with recipients of egg donation, they may need to learn more about how to guide a prospective donor through the egg donation process.
What Motivates Egg Donors?
A systematic review of 62 studies of the motivations of donors and other psychosocial aspects of egg donation, published in Human Reproduction Update, found the following: "Studies consistently show that egg share donors report altruism and the wish to help another couple have a child" as their primary motivations for donating. In countries where paid egg donation is legal, financial compensation is also a common motivation. Other donor motivations reported by the review included:
- A reduced cost of fertility assessment or treatment
- A wish to donate specifically to a family member or friend
- For same-sex cisgender female couples, a wish to reciprocate their need for donor sperm
A study of egg donors in South Africa published in PLOS ONE reported similar findings: The driving motivation behind egg donation was to help infertile women and couples. However, it is important to note that monetary compensation did factor into, at least in part, the decision for many respondents to donate.
Screening for Egg Donors
In the United States, a set of screenings is required for all egg donors and regulated by the Food and Drug Administration, since oocytes and sperm fall under the category of donor tissue. These include testing for infectious diseases, such as HIV and hepatitis B, as well as a current medical history and physical exam. The American Society for Reproductive Medicine (ASRM) further recommends a complete psychoeducational evaluation that investigates numerous factors, including work history, sexual history, any evidence of coercion, examination for substance use disorders and psychiatric disorders, and any history of abuse or neglect.
ASRM recommends that donors be between 21 and 34 years of age and that in the case of any donors older than 34, the age of the donor "should be revealed to the recipient as part of the informed consent discussion concerning cytogenetic risks and the effect of donor age on pregnancy rates."
The European Society for Human Reproduction and Embryology (ESHRE) echoes these recommendations of medical and psychological screening for prospective donors. ESHRE also recommends genetic karyotype and carrier screening for common diseases, such as cystic fibrosis, sickle cell anemia and Tay-Sachs disease.
Making Donors Aware of the Options for Recipients
Infertility patients need to make several decisions before starting the egg donation process itself. The role of the reproductive specialist is to provide patients thorough information about each so they can make the best decisions for their future family. Donors should know that any recipients of their eggs will be debating the following:
Once those decisions have been made, the medical part of the egg donation process begins.
The Egg Donation Process
If the infertility patient chooses fresh donor eggs, the egg donor must go through an ovarian stimulation cycle — just as the patient would when using their own eggs for IVF.
The egg donation steps include the following:
Even though the eggs are fresh, the transfer can also be either fresh or frozen. If the doctor and patient agree on a fresh transfer, the patient must sync their cycle with the donor's cycle. If the transfer will be frozen, no cycle syncing is necessary.
The process for donating eggs that will be cryopreserved is the same for the donor, except that after the retrieval, the oocytes are cryopreserved and stored until purchased or chosen for fertilization.
OB/GYNs can help their egg donor patients by monitoring for any potential post-retrieval complications after oocytes are retrieved and the donation is complete. For patients who are considering donating eggs, physicians can serve as a trusted source of accurate information on the process.
