How to Pick the Right Egg Donor for Your Family
If you haven’t read, When You're Told, "I Think It’s Time to Consider Using an Egg Donor" read that first.
6 minutes
Once you have decided to embark on the egg donor route and have begun grieving the losses experienced along your infertility journey, it’s time to make some tough decisions about your egg donor and envision what you want your future to look like.
Egg Bank vs. Fresh Egg Donor
Deciding between an egg bank and a fresh egg donor is a significant step. Here are some pros and cons to consider:
Pros of Egg Banks:
Readily available: Eggs from an egg bank are typically readily available, which means you can proceed with your treatment without waiting for a donor to be identified, screened, and then go through with the retrieval.
Convenience and flexibility: Using an egg bank offers greater flexibility in terms of timing. You can plan the embryo transfer according to your schedule without needing to coordinate with a donor's cycle and schedule.
Embryo creation: Some egg banks offer embryo creation services, which can streamline the process.
Consistency and predictability: The eggs are already retrieved and cryopreserved, so there is no risk of the donor backing out at the last minute. This predictability can reduce stress and uncertainty.
Cost-effective: Egg banks can be more cost-effective, particularly if the first attempt is successful.
Multiple donors: Egg banks often have a large pool of donors to choose from, allowing for more options in terms of physical traits, educational background, and personal characteristics.
Cons of Egg Banks:
Lower success rates: The success rates with frozen eggs can be slightly lower compared to fresh eggs. The freezing and thawing process can sometimes reduce the viability of the eggs; however, with newer technology, there is less risk of this now.
Limited number of eggs: You might need a new donor for subsequent pregnancies if the initial batch of eggs is insufficient. When you purchase eggs from an egg bank, you receive a specific number of eggs. If you wish to have more children in the future, there’s no guarantee that eggs from the same donor will be available. This can be a concern for couples who want full siblings.
Less personalized matching: While you can choose from a variety of donors, the process might feel less personalized compared to a fresh cycle where you might have direct input and interaction with the donor.
Increased chance of more external embryos being created: Using a particular donor's eggs who may have gone through many successful cycles can lead to more genetic ties being established in the world.
Limited contact: You may be limited in any ability to speak with the donor, have any type of relationship, or gather more information that isn’t already part of her profile.
Pros of a Fresh Donor Cycle:
Higher success rates: Fresh eggs are typically more viable than frozen eggs, which can lead to higher fertilization and pregnancy rates. However, it should be noted that with much more advanced freezing techniques in recent years, the gap for that advantage has or is nearly closed.
Greater number of eggs: A fresh cycle usually involves retrieving a larger number of eggs that you get control over.
Potential for more personalized matching: With a fresh donor cycle, you may have more control over selecting a donor whose characteristics and personality you can assess for yourself.
Potential for more information and connection: There is more likelihood to be able to speak with the donor, gather more information, and possibly have a relationship in the future.
Cons of a Fresh Donor Cycle:
Higher cost: Fresh donor cycles can be more expensive due to the costs associated with stimulating and retrieving eggs from the donor.
Donor availability: Finding and coordinating with a suitable fresh egg donor can be time-consuming and may involve delays.
More complex logistics: The process can be logistically more challenging and might require extra screenings, travel, and unforeseen disruptions.
Unpredictability: There's a risk that the donor may not produce enough eggs or could cancel the cycle for personal reasons.
Emotional rollercoaster (again): The process can be just as emotionally draining as any retrievals you went through, with constant anticipation about factors like the number of follicles, eggs, fertilized eggs, blastocysts, and euploid (normal) embryos after testing.
Choosing the Right Egg Donor
Selecting an egg donor involves many considerations and can feel overwhelming and emotionally draining. Here are some important factors to keep in mind:
Genetic health: Prioritize genetic health when choosing a donor. For instance, if your partner has a family history of bipolar disorder, opt for a donor without such a history. Genetic testing can identify potential issues, but it's also essential to gather additional information about the donor's family history with the agency's assistance, beyond what is covered by genetic testing through blood.
Personal attributes: Consider what attributes are important to you in a donor. This may encompass physical appearance, education, cultural background, and their personal reasons for donating. Understanding these factors can guide you in selecting a donor who resonates with your values and aspirations.
Known, Semi-Known, and Unknown Donors:
Directed or known donors: A directed (identified) donor is someone you already have a relationship with, such as a friend or family member. The primary advantage of using a known donor is the level of trust and comfort you have with the person. You can have open communication and a clear understanding of the donor's medical and genetic history. Additionally, your future child will have the opportunity to fully know their genetic background, potentially share some of it with you if it's a family member, and possibly develop a relationship with the donor. However, the process can be emotionally complex and needs to be well thought out because it could potentially strain personal relationships. It’s important to consider the long-term implications and how the child may view this arrangement when they are able to understand.
Open-identity donors: open-identity (semi-known) arrangements are donors with whom you have limited but structured contact. This arrangement provides a balance between anonymity and familiarity. You might have the opportunity to meet the donor and learn about her background, motivations, and medical history without forming a close personal relationship. This can offer some level of reassurance and personal connection without the emotional complexities of using a friend or family member. This also opens the door to flexibility regarding contact after the baby is born, with options ranging from access to information at eighteen to ongoing open access. However, this option still requires navigating the potential awkwardness of semi-anonymity and possibly limited interaction after the child is born.
Non-identified donors: Using an unknown donor means that you have no direct contact or relationship with the donor. In the past, anonymity was seen as beneficial due to privacy and the desire for emotional distance, which at first can make the process feel simpler and less emotionally fraught. Additionally, the selection process can be quicker since many donors are pre-screened and ready for use. However, the fertility community now believes that anonymity does not truly exist anymore in the age of genetic testing and ancestry services. There is evidence to suggest that donor identities may eventually be revealed. Furthermore, many parents who chose this route often regret not knowing more about the donor after their baby is born and no longer fear not having a strong connection to their child (more below on the donor-conceived child).
Making these decisions can be exhausting. Try making a list of priorities and enlist the help of your partner, parents, therapist, doctor, agency, or trusted friends to help you navigate this process. Having a support system can make the decision-making process feel less overwhelming and alleviate the burden of making such an important decision alone.
Remain Flexible
While it’s incredibly difficult, try not to be rigid in your timeline thinking. After dealing with setbacks and finally making this difficult decision, you might be eager to move forward quickly. However, the process can still be lengthy with unexpected challenges. Here are some potential setbacks to consider:
Potential genetic issues may arise.
Your chosen donor may seem perfect on paper, but unforeseen issues can emerge throughout the process. She may not follow protocols or you may not feel comfortable after meeting her.
Donors can back out or request more time due to personal issues.
Fresh donors may not stimulate well, may develop a cyst, or have an allergic reaction to medication.
Communication
Deciding who to inform and when is an important factor that needs to be taken seriously in the early stages. Consider the following:
Transparency: Determine if you want to meet the donor and what information you want to share with family and friends.
Future relationship: Discuss how open the donor is to future contact with the child. Some donors might be willing to maintain a relationship with the child as they grow up, while others might prefer to remain out of the picture. However, as mentioned earlier, with modern DNA testing, maintaining anonymity may not be feasible making it essential to have clear agreements and expectations.
Openness with the child: The fertility community, The American Society of Reproductive Medicine (ASRM), and research on donor-conceived children strongly advocate for openness from the very beginning. While there may be rare circumstances where openness may not be in the best interest of the child or the family, discussing the idea of openness should be thoroughly explored if there are reservations.
Conclusion
Navigating the path to parenthood through egg donation is a complex, emotional journey. It's crucial to take the time to understand your readiness, consult with professionals, and prepare for the various aspects involved. By being informed, flexible, and emotionally prepared, you can make the best decision for your family and future.
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