With several IVFbabble readers asking to read more on egg donation, we got in touch with Gail Sexton Anderson, founder of Donor Concierge, to tell us more. Donor Concierge is a search and consultancy service that helps intended parents sort through the gauntlet of egg donor and surrogacy options in the US.
Gail, tell us how couples make the leap to egg donation?
No one grows up with the idea that they may need to use an egg donor or a surrogate to have a baby.
There’s a grieving period that is sometimes unexpected, but necessary to move on to third party fertility. In order to be ready to move into what can seem like Orwellian territory it is vital that you mourn the loss of the biological child you will never have. This is true for both the father and the mother even if the father is able to be part of the genetic equation.
So, what’s important about this feeling of loss?
Like any other loss, it starts with denial. The intended parents must come to terms with the fact that they will not be able to conceive a child traditionally. It is hard to hear this for the first time and it doesn’t get much easier the 4th or the 100th time.
What is important is that you give yourself time to process this information. Denial is the reason intended parents keep trying and will do just one more IVF cycle (for the 5th or 16th time) with their own gametes just in case they might be the rare exception and beat the odds.
What other feelings are you likely to face?
One of the most difficult aspects of conceiving a family through third party fertility is feeling out of control. There will be many demands – on your time, your finances, and your emotions. Coordinating all the moving parts to bring a child into the world can feel complicated and daunting.
It sounds quite a process to reach your end goal
It may feel clinical rather than the creation of love, which in the end is what it still comes down to. You, or you and your partner love each other so much that you want to share your love with a child. This is a child that would not exist were you not taking these steps to open your heart and your home to create your family.
Can you tell us what kind of women choose to be egg donors?
The answer is – all kinds of women! In the US, where compensated egg donation is legal, women can choose to be donors initially for the financial compensation, but more often than not it’s because they want to help a couple have a child.
What’s the first step to finding a donor then?
First step is to talk with your fertility clinic – many have an in-house donor program with women who have had all of their fertility and genetic testing done, who have met with your clinic and are prepared to go through the process.
In the United States where third party fertility treatment is less regulated, there are around 100 egg donation agencies that help facilitate finding an egg donor. Women apply with the agencies to become donors and go through an extensive interview to determine if they may be suitable candidates.
Is it expensive?
This varies but we encourage our clients to budget from $30,000 to $60,000 US dollars. Finding a donor through an in-house clinic program can greatly reduce costs. Some clinics offer shared donor cycles or embryo donation cycles. Using a donor from an egg donor agency can increase costs but also means you will have more choice in the donor that you pick.
What happens when a couple can’t agree on using a donor?
This is a common situation among couples and one that can strain even the strongest of partnerships. Our advice is to talk and be open with each other about your hopes and fears. Don’t be afraid to reach out to a counsellor as it can be very helpful to have a neutral party to help you to sort things out.
It’s best if you work with someone who has experience in counselling other couples facing the same issues.
Is it necessary to find a donor that lives near the intended parent’s clinic?
Not at all. In the US, it’s pretty standard for egg donors to travel to your clinic – we call this a travel cycle. It means that the donor will come to your fertility clinic for an initial screening appointment. She can start the injections to stimulate her ovaries and be monitored at a clinic nearer her home.
With so much at stake, is there a need to hire an attorney?
Absolutely! While agencies may say the contracts they use are standard, and they may very well be standard but they will be new to you and your egg donor.
What’s the difference between an open and anonymous donation?
An open donation means that you may exchange contact information with your donor. This may be as simple as having names on the contract or actually meeting your donor in person. Anonymous donation means you will have no knowledge of the donor’s identity information and she will not know yours. Many people choose a semi-anonymous arrangement so that they have the chance to have future contact through an intermediary.
Should parents tell their child that he/she is donor-conceived?
My standard answer to this question is yes, but with the caveat that you know your family culture. Psychologically I think it is better for the child to always know of their creation story, because after all it is how your family was formed. It is usually best to tell them when they are young. I recommend starting when you are pregnant.
Not so much because I think that the child is actually taking it in but because it give you a chance to practice and feel comfortable. You can create a scrapbook of how our family was made with you, and your child as the stars of the story and the donor, doctors and nurses and other family members as the supportive players.
When is the best time to tell a child?
Others advise starting the conversation at five and no later than ten. My only concern with waiting is there is never a perfect time. If you start very early it is always a part of your family’s creation not a surprise that could be disruptive if you put off until they are older. Waiting may cause the child to feel they have been lied to and if you lied to them about such an important issue what else have you lied about. However you form your family is should be a matter to be celebrated and not kept in the closet.
Why do doctors recommend using a repeat donor over a first-time donor?
Every Reproductive Endocrinologist is going to suggest that you choose a repeat egg donor over a first time donor and for good reason. With a repeat donor you can see that they have been successful and if you are lucky enough to have the protocol from her last egg donation your doctor can follow the stimulation protocol that worked for her in her last egg retrieval. The complicating factor is that the donor may have done her last cycle with a different clinic and the cycle information is considered to belong to the last couple that she donated for not to the donor.
Therefore, your RE may not have access to that information, there are times when this information is shared but there is no guarantee. This is another reason REs like to use their own egg donors so that they have all the facts and information at their disposal.
Does that mean repeat donors improve the chances of success?
Statistically, there is no greater success with a repeat egg donor than with a first time egg donor. What you get with a first time donor is someone who is eager to do the right thing and follow directions very carefully because she doesn’t want to make a mistake.
When it comes right down to it, if you have narrowed your options to two egg donors and one is a first time egg donor and the other is a repeat…go with the repeat donor. If you are leaning strongly toward the first time donor ask your RE to order all the necessary tests (such as AMH, FSH and AFC).
You will be responsible to pay for these tests, but it is well worth it to learn if your donor is a suitable candidate before heading into a cycle with her. The agency can arrange for these tests to be done either at your clinic or at a clinic close to where your donor lives and if she is in another town and/or state the results will be sent to your RE for approval.
Thank you so much Gail, and for giving a really good insight into egg donation in the US.