Choosing an egg donor can be the most complicated part of the journey for many intended parents (IPs). The first decision that must be made is where will the eggs come from. There are two main options. The first is a known egg donor. Many couples will ask siblings or other relatives to be a part of the journey with them to allow for a genetic link for both IPs. Using a known donor comes with a set of specific requirements that must be worked out prior to the egg donation. Generally, the known donor will have to undergo medical screening, psychological counseling, and a legal contract prior to the start of their stimulation. Factors to consider include age, previous pregnancies and medical concerns that may disqualify them from being an egg donor.
The second, and most widely used, option is anonymous donation. Generally, anonymous egg donors will be under 30 years of age with a relatively uncomplicated medical history. Some will be screened for medical/genetic issues prior to being placed on donor lists. IPs can get an anonymous (or semi-anonymous) donor from a variety of venues. The first is selecting an “internal” egg donor from a fertility clinic. Some clinics have a pool of egg donors that they work with regularly on a rotating basis. The positives of using an internal egg donor include that they have generally been prescreened, have experience at that clinic, and lower cost due to less travel and often legal work already completed. The negatives can be a smaller selection of egg donors in terms of background, race or ethnicity and possibly having to wait longer for availability. Another option is finding an egg donor through an egg donor agency. Agencies gather egg donors from all over the country to give a wealth of options to IPs in terms of every aspect of background, education, race, and ethnicity. The negatives associated with using an agency include higher cost, agency fees, external legal fees and likely increased travel fees associated with the egg donor having to travel to your fertility clinic. The final option is an egg bank. This is a newer option where IPs can purchase “lots” of eggs, generally between 6 and 8, that have already been frozen from a previous cycle with an egg donor. The eggs are fertilized either at the egg bank or are transported to the fertility clinic where they are thawed and fertilized. The positives of using an egg bank include the variety of egg donors and speed (the eggs are already frozen and ready for use). The negatives of an egg bank include the quality (eggs thaw less reliably than embryos), quantity (you will get between 6-8 eggs which is generally enough to get 1-2 normal blastocysts, if split insemination is desired you will likely have to purchase two lots of eggs) and cost. The positive of using a fresh egg donor is that all eggs retrieved in their cycle become the property of the IPs which is often between 10 and 30 eggs.
In the end the decision about where you will find your egg donor comes down to a variety of factors. What is most important to you? Using an egg donor with previous egg donations may cost more, but you will have more information such as how many eggs they retrieved and if those eggs resulted in a live birth. Generally, most egg donors are under 30 and a donation will result in genetically normal embryos however having that extra knowledge that it worked before may be valuable to you. Is cost your most important factor? How about the racial or ethnic background of the donor? If you desire an egg donor from a more rare or specific background, using an agency may give you more options. Do you want to split the eggs between you and your partner? If so, a fresh egg donor may be your best option as you will likely get more eggs. Is timing very important to you? If so, using an internal egg donor that is ready to go or buying frozen eggs may be your best bet. Is a genetic link to the eggs the most important factor? If so, you may want to have a willing relative screened to find out if they are a good candidate and to be informed of the likelihood of success.
In the end, choosing an egg donor can be a dizzying and daunting experience as there are so many options available. Your fertility specialist is there to discuss these options with you and figure out which one makes the most sense for you!