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Dec 16, 2021
6 min read

The egg donation process: how does it work?

Egg donation is part of assisted reproductive technology or ART. Egg donors need to go through several screenings and meet specific qualifications. They take specific medications and go through a simple surgical procedure for egg retrieval. There are some risks associated with the retrieval process, like ovarian hyperstimulation syndrome, but they’re rare.

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

People pursue egg donation for a variety of reasons. Maybe you’ve heard that you can make money by donating your eggs. Or maybe you feel the pull to help someone have a baby. Perhaps it’s a little bit of both. Whatever the reason, the process is the same (Tober, 2021). 

Women who are egg donors need to meet specific qualifications. They undergo tests, take medications to make their bodies produce eggs, and go through a procedure for egg retrieval. Aside from the process that your body undergoes, there is an application process—along with some legal issues—to consider as well. Let’s take a closer look at what egg donation entails, from start to finish.

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What is egg donation?

Egg donation is when someone “donates” their eggs (medically known as their “oocytes”) so another person can get pregnant. While it is often referred to as egg donation, this doesn’t mean that the donor receives no money. In fact, donors can receive up to $10,000 for donating their eggs (ASRM, 2007). 

Egg donor requirements

If you choose to become an egg donor, you will have to meet certain qualifications. 

Specific qualifications may differ between the facility or egg donor program you go through. However, the Food and Drug Administration (FDA) does lay out guidelines for tissue donation. The other major group that offers guidelines for egg donation is the American Society for Reproductive Medicine (ASRM).

These guidelines include (FDA, 2007; ASRM, 2021):

  • Medical screening: Egg donors need to be free of infectious diseases that they could transfer to the person who gets the donation. This includes conditions like HIV, hepatitis B, and hepatitis C. To ensure the donor is healthy, a medical history, blood and urine tests, and physical exams like a pelvic ultrasound should be conducted.
  • Mental health screening: The mental health of donors is also essential. Mental health professionals should assess potential egg donors through psychological screening.
  • Genetic testing: Potential donors should get genetic tests. These tests will reveal if a donor has genes for certain genetic disorders. Providers also look at a potential donor’s family history. These steps help providers see if a child conceived with the donor’s egg would have certain genetic disorders like cystic fibrosis. Potential donors might not be able to donate based on family history or if specific genes are present.
  • Age requirements: Egg donors should be of legal age and ideally between 21 and 34 years old.

Anonymous donors have to meet all eligibility requirements. In other cases, like when the desired donor is a family member, the intended parents may consent to receive eggs from an ‘unqualified donor’ (meaning a donor doesn’t meet all of the qualifications) after receiving counseling about the risks (ASRM, 2021).

Egg donors should be in close contact with their healthcare providers and ask questions about any information they don’t understand. Healthcare providers will monitor an egg donor’s health throughout the whole process of egg donation (ASRM, 2021).

The egg retrieval process

Egg retrieval is an essential part of egg donation and some common fertility treatments like in vitro fertilization (IVF) and egg freezing. It is a surgical procedure that involves removing mature eggs—also known as oocytes—from the ovaries (Choe, 2021).

Before the surgical procedure, healthcare providers use medications to prepare your body for the process. 

Medications

Healthcare providers use specific medications to help ensure a successful egg retrieval. It starts by stimulating your ovaries to produce eggs (Choe, 2021). 

You will inject hormones that impact your body’s timing of egg production. Each protocol lasts different time frames and uses slightly different drugs. For example, one regimen involves medication injections over two weeks. The medication preparation ends with giving you hCG (gonadotropin), which stimulates egg production. Then egg retrieval happens about a day and a half later (Walker, 2021; Shretha, 2015). 

The goal of stimulation is to encourage egg maturation and to ensure that a number of eggs—ideally at least 10 to 20—are available during the retrieval process.

Egg retrieval

Egg retrieval is a surgical procedure, often under anesthesia (Healy, 2015). Your healthcare provider will then use ultrasound to view your ovaries. Then, they will use a special needle to remove the eggs (Choe, 2021). 

After egg retrieval, providers often fertilize the eggs. Sometimes, these embryos are implanted directly into the recipient. Other times, providers freeze the embryos for later use (Hipp, 2020; Tober, 2021).

Recovery

Recovery from egg retrieval is pretty straightforward. After the procedure, a healthcare professional will take you to a recovery room for a few hours, where they can monitor you. If you were under anesthesia, you need someone to drive you home. You are allowed to return to work the following day, but it is recommended that you do not have vaginal intercourse for four days after the procedure and that you use condoms or a diaphragm until your next period (Hopkins Medicine, n.d.).  

Risks and side effects of egg donation

Complications of the surgical part of the egg retrieval are rare and include bleeding and infections. Less than 1% of women experience them. This risk is low but should still be considered before consenting to egg donation (Gurbuz, 2019; ESHRE, 2019). 

One rare complication during ovarian stimulation is that a donor might develop ovarian hyperstimulation syndrome (OHSS). Symptoms are either mild, moderate, severe, or critical. Mild symptoms include abdominal distention and discomfort, mild difficulty breathing, mild nausea, and vomiting. But in the cases of critical OHSS, the effects could be life-threatening, so it’s important that healthcare providers monitor for OHSS (ASRM, 2016).

In most cases, women get money for donating their eggs, but financial gain should not be the primary motivation for someone to donate eggs. The ASRM notes that the compensation amount should not be so high that women don’t consider the risks of donation and make an informed decision (ASRM, 2021).

While the amount someone gets for egg donation varies, the ASRM calls amounts above  $10,000 “inappropriate” (ASRM, 2007).  

Before you decide to become an egg donor, there are certain legal implications that you need to consider. Laws and regulations will differ depending on your location, so it may be beneficial to consult with an attorney before beginning the egg donation process (ASRM, 2021).  

You should also be aware that children that result from their egg donation may try to contact you, even if you are not legally their parent (Cahn, 2014).  

Egg donation: the bottom line

Egg donation requires not only a physical commitment but a mental one as well. To fully understand what you will need to undergo to be an egg donor, reach out to a fertility clinic in your area. They will have more information for you about your state’s regulations and whether you meet their initial qualifications.

References

  1. American Society for Reproductive Medicine (ASRM). (2016). Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: A guideline. Retrieved Nov. 22, 2021 from https://www.fertstert.org/article/S0015-0282(16)62781-4/fulltext 
  2. American Society for Reproductive Medicine (ASRM-a). (2021). Financial compensation of oocyte donors: An ethics committee opinion. Retrieved Nov. 22, 2021 from https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/ethics-committee-opinions/financial_compensation_of_oocyte_donors.pdf 
  3. American Society for Reproductive Medicine (ASRM-b). (2021). Guidance regarding gamete and embryo donation. Retrieved Nov. 17, 2021 from https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/recs_for_gamete_and_embryo_donation.pdf 
  4. Cahn, N. & Collins, J. (2014). Fully informed consent for prospective egg donors. Virtual Mentor, 16(1), 49-56. doi: 10.1001/virtualmentor.2014.16.1.hlaw2-1401. Retrieved from https://journalofethics.ama-assn.org/article/fully-informed-consent-prospective-egg-donors/2014-01 
  5. Choe, J., Archer, J. S., Shanks, A. L. In Vitro Fertilization. [Updated 2021, Sep 9]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK562266/
  6. ESHRE Working Group on Ultrasound in ART, D’Angelo, A., Panayotidis, C., Amso, N., Marci, R., Matorras, R., et al. (2019). Recommendations for good practice in ultrasound: oocyte pick up. Human Reproduction Open, 2019(4), hoz025. doi: 10.1093/hropen/hoz025. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31844683/ 
  7. Food and Drug Administration (FDA). (2007). Guidance for Industry Eligibility Determination for Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps). Retrieved Dec. 16, 2021 from https://www.fda.gov/media/73072/download 
  8. Gurbuz, A. S. & Cenker, A. (2019). Iatrogenic Ureteral Obstruction During Transvaginal Oocyte Retrieval. International braz j urol : official journal of the Brazilian Society of Urology, 45(2), 396–399. doi: 10.1590/S1677-5538.IBJU.2018.0692. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541139/ 
  9. Healy, M. W., Hill, M. J., & Levens, E. D. (2015) Optimal oocyte retrieval and embryo transfer techniques: where we are and how we got here. Seminars in Reproductive Medicine 33(2), 83-91. doi: 10.1055/s-0035-1545365. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25734346/ 
  10. Hipp, H. S., Gaskins, A. J., Nagy, Z. P., Capelouto, S. M., Shapiro, D. B., & Spencer, J. B. (2020). Effect of oocyte donor stimulation on recipient outcomes: data from a US national donor oocyte bank. Human Reproduction (Oxford, England), 35(4), 847–858. doi: 10.1093/humrep/deaa003. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192536/ 
  11. Khan, Y. S. & Ackerman, K. M. (2021). Embryology, Week 1. [Updated 2021, April 26]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554562/ 
  12. Kool, E., Graaf, R., Bos, A., Fauser, B., & Bredenoord, A. (2019). What constitutes a reasonable compensation for non-commercial oocyte donors: An analogy with living organ donation and Medical Research Participation. Journal of Medical Ethics, (2019)45, 736-741. Retrieved from https://jme.bmj.com/content/45/11/736 
  13. Shrestha, D., La, X., & Feng, H. L. (2015). Comparison of different stimulation protocols used in in vitro fertilization: a review. Annals of Translational Medicine, 3(10), 137. doi: 10.3978/j.issn.2305-5839.2015.04.09. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486909/ 
  14. Tober, D., Garibaldi, C., Blair, A., & Baltzell, K. (2020). Alignment between expectations and experiences of egg donors: what does it mean to be informed?. Reproductive Biomedicine & Society Online, 12, 1–13. doi: 10.1016/j.rbms.2020.08.003. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530253/ 
  15. Walker, M. H., Tobler, K. J. Female Infertility. [Updated 2021, Jan 1]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK556033/