Fertility

Looking for an Egg Donor? Everything You Need to Know About Egg Donation

The Oova Team

Egg donation can be an excellent option for people who are unable to conceive using their own eggs. Here's a breakdown of the screening processes, IVF, and difference between fresh and frozen eggs.

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Dec 14, 2020

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Egg donation can provide the missing link for those trying to conceive, who want to avoid passing down a genetic disease, for single women, or for LGBTQ+ couples who cannot conceive on their own.

>>RELATED: LGBTQ Family Building Options

In this article, we’ll explain in more detail what the egg donation process looks like, how egg donors are screened, the factors to consider in your search for the ideal egg donor, and the differences between fresh and frozen donor eggs.

The egg donation process

Through egg donation, a donor chosen by the intended parents provides their eggs to be transferred via in vitro fertilization, or IVF. IVF is a type of assisted reproductive technology when eggs are fertilized with sperm in a lab to create embryos. Then, the embryo is transferred into a uterus — whether that’s your uterus, your partner’s or a carrier’s.

Now we know the final result of egg donation, how does the egg donation process work?

Egg donation screening process

Fertility clinics follow a rigorous screening process when it comes to clearing egg donors. Prior to starting the egg donation process, the egg donor undergoes a thorough medical screening to ensure that they’re fit to receive the stimulation medication required (more on this below).

Professionals assess the potential egg donor’s egg reserve, their medical history, and family and genetic history. They also run blood tests to check for undiagnosed medical conditions or infectious diseases.

Egg production

Once the egg donor is cleared by the clinic, they’re prescribed hormone medications to stimulate ovulation and the production of multiple eggs. If it’s a fresh cycle, the intended mother will be prescribed estrogen and progesterone to build up the uterine lining and prepare it for implantation.

Fertilization

The next step is the egg retrieval and fertilization with sperm from the intended father or a sperm donor.

The best embryo is transferred to the uterus using a thin catheter, a procedure known as a fresh embryo transfer (FET). The intended mother continues her medication (progesterone). If the transfer is successful, once a heartbeat is confirmed, the pregnancy progresses from there, hopefully making it successfully to term.

When do doctors recommend egg donation?

Deciding to grow your family via egg donation is not easy, however it may be an ideal solution if conceiving naturally isn’t possible. The first step is to consult a reproductive endocrinologist or your fertility clinic to go over your options. Egg donation may be recommended in the following scenarios:

Advanced age: fertility naturally diminishes with age as changes start occurring in the ovaries (see what you need to know if you're trying to conceive over 35).
Diminished ovarian reserve (DOR): when the ovaries no longer produce quality eggs in adequate numbers. This generally occurs with aging and menopause, but genetic abnormalities, medical treatments or injury may also lead to an earlier DOR.
Primary ovarian insufficiency (POI): women naturally experience reduced fertility around 40 years old but for those with POI, this starts earlier—in some cases, even as early as the teenage years.
Absence of the ovaries: due to surgery or a congenital malformation.
Poor oocyte quality: an oocyte is an immature egg cell. During ovulation, the oocyte matures and becomes an egg. The number of oocytes decreases with age, as does their quality.
Poor embryo quality: due to a genetic abnormality in the egg or sperm of the male or female partner, or a genetic abnormality in the embryo.
Prevention of genetic diseases: if the intended parent is aware of a condition that could be inherited by the baby.
Previous IVF failure: when IVF was attempted using one’s own eggs.
Men: who are single or in a same sex relationship need the help of donor eggs to conceive.

If a medical issue is keeping you from growing your family, the news that you will need an egg donor can be difficult to take. It’s important that, if necessary, you seek support to come to terms with the news and to discuss the way forward.

It’s also completely understandable that you may feel wary of using an egg donor for some time, but chances are the desire to have a baby will help you overcome your reservations and concerns.

So, give yourself the time you need. Remember that, donor eggs or not, you will still 1,000,000% be your child’s parent.

Egg donation requirements: Factors to consider when selecting an egg donor

Once you and your partner feel ready, it’s time to start searching for the ideal egg donor, one that matches all of your preferences.

Choosing your specific egg donor is one of the most personal and important decisions you’ll make. Many intended parents choose to seek the services of an egg donor agency; however, choosing which agency to work with is a big decision in itself and many intended parents go to multiple agencies before they find their perfect donor.

Egg donor profiles include the donor’s physical attributes, education level, medical history, as well as family history, among other elements such as ethnicity and religion. Undeniably, you are presented with a large amount of information, but in this case, the more information the better. To get started, you’ll want to decide what characteristics matter personally to you.

Age

An egg donor must be between the ages of 21 and 30, but if you prefer one on either the younger or older end of that spectrum, that’s a valid and personal decision.

BMI

Donors must have a healthy body mass index (BMI) between 18-27, but as far as the donor’s specific weight, that may be a consideration that’s important to you.

Medical history

Egg donors go through various examinations of their medical history. You can look at:

Personal health history: Ideally, you’re looking for a non-smoker, non-drug user and someone who is non-alcohol dependent, has no STDs, and is not undergoing treatment for depression or anxiety. These elements are pre-vetted and indicated for you to consider.
Family health history: You’d be looking for egg donor profiles with no family history of genetic disorders, and no significant family history of cancer.

Reproductive history

If applicable, you’ll see information about “proven fertility” in egg donor profiles. This means a previous successful pregnancy shows that the donor has the potential to provide healthy eggs.

Appearance

You’ll see the donor’s photos (ideally current as well as from childhood) and, when available, videos, natural hair color, eye color, height, and weight.

Many intended parents are interested in donors with similar physical features to themselves, while others are interested in dissimilar features. Again, these are personal decisions and any preference is valid.

Personal background

This can range across heritage, religion, characteristics, education, career, and even criminal record. For example, if you're ideally looking for a donor with a graduate degree or high test scores, you could, as a starting point, filter your options through the lens of your desired standard of education.

Many intended parents look for egg donors with a similar heritage or religious background as themselves.

Compensation

The fee for an egg donor can range from $8,000 to $20,000. Donors may charge more when they have proven fertility or a higher level of education, among other factors.

>>MORE: Infertility is Expensive. Here Are 7 Ways To Save Money When Trying to Conceive.

Location

An egg donor close to your IVF clinic can help save you money in covering travel costs. That said, this may not be your most important criterion—in which case it’s totally up to you to prioritize other factors over where the donor lives.

Choosing Between Frozen or Fresh Donor Eggs

During egg donation, you can choose to either immediately transfer the egg to a uterus—known as a “fresh” embryo—or, to freeze and store the eggs for later use—known as a “frozen” embryo.

Both fresh donor eggs and frozen donor eggs have specific pros and cons which you should consider.

Odds of live birth

While IVF with fresh and frozen donor eggs has proven successful, a national study published in the journal Obstetrics and Gynecology found that the use of fresh donor eggs in IVF has a small advantage in birth outcomes.

According to the study’s lead author, Jennifer L. Eaton, M.D., “the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference.”

Data from the Centers for Disease Control and Prevention (CDC) also shows that, overall, 55.3% of embryo transfers from fresh donor eggs resulted in a live birth versus 46.7% for embryo transfers from frozen donor eggs.

Number of eggs

Sometimes, a fresh egg donation will produce more eggs than a frozen cycle. A fresh egg donation cycle will give intended parents anywhere from 10 to 20 eggs. This is ideal if you plan on having more than one child; a fresh donation cycle will likely provide you with a good number of embryos to pursue more than one pregnancy.

Need for ICSI

With frozen eggs, an extra procedure known as intracytoplasmic sperm injection (ICSI) becomes a must (which also adds to the overall cost). The freezing and thawing process makes the shell surrounding the egg hard for the sperm to penetrate on its own. ICSI bypasses this as a single sperm is injected directly into the egg.

Timeline

Using fresh donor eggs is typically a much longer process than frozen eggs. It takes time to match a donor to the recipient and then to synchronize schedules and cycles.

Cost

Fresh donor egg IVF is typically more expensive than the frozen alternative. At an average of $25,000, fresh donor eggs amount to around twice the cost of frozen eggs.

Potential for cancellation

Donation cycles can on occasion get canceled due to poor medication response or issues, or because of an insufficient amount of eggs obtained. Medical issues more specifically may include uterine cysts or bleeding, which can have a negative impact on implantation, preventing the cycle’s success.

Ultimately, when it comes to choosing between fresh or frozen eggs, it all comes down to your personal situation. There is no easy answer as to which is best. Success rates can depend on each individual’s specific case, as well as the expertise of the clinic you’re working with. A doctor and the clinic can help you assess your options based on your medical history and specific circumstances.

Egg donation: the bottom line

Egg donation is a great way for parent(s) who need eggs for conception to be able to successfully become pregnant. The egg donation process involves screening—which is a very personal process—then egg production and fertilization. It’s completely your choice on who you choose to be your egg donor and what kind of egg donation—fresh eggs or frozen ones—you use. Ultimately, it’s your fertility journey, and choosing what’s best for you will always be the right choice.

About the author

The Oova Team consists of doctors, researchers, and content experts. We collaborate to bring you medically-backed resources to help support your hormone journey. Learn more about our team.

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perimenopause-periods

Should I still see my gynecologist if my periods are just "weird" but not painful?

Yes. Annual visits remain important during perimenopause. Your provider can help determine if your "weird" periods are typical perimenopause changes or something requiring attention. They can also discuss management options to improve your quality of life.

perimenopause-periods

How long do irregular periods last before menopause?

Irregular perimenopause periods typically last 4 to 8 years before your final period, though this varies greatly. Some women experience irregularity for just a few months, while others have irregular periods for over a decade before reaching menopause.

perimenopause-periods

Is it normal to have two periods in one month during perimenopause?

Yes, this can happen, especially in early perimenopause when cycles shorten. You might have a 21 day cycle, meaning you could have a period at the beginning and end of the same calendar month. Track these patterns to distinguish between short cycles and abnormal bleeding.

perimenopause-periods

Why are my periods suddenly so heavy in my 40s?

Heavy perimenopause periods often result from estrogen dominance. When progesterone drops but estrogen remains high, your uterine lining builds up more than usual, causing heavier bleeding when it sheds. This is common in perimenopause but should be evaluated if it affects your daily life.

perimenopause-periods

Can I still get pregnant if my periods are irregular during perimenopause?

Yes. As long as you're having periods, even irregular ones, you may still be ovulating. Pregnancy is possible until you've gone 12 full months without any period. If you don't want to become pregnant, continue using contraception throughout perimenopause.

perimenopause-and-weight-gain

Can you prevent perimenopause weight gain completely?

While you may not prevent all weight changes during perimenopause, you can minimize gain through proactive strategies. Starting strength training before perimenopause, maintaining consistent sleep habits, and managing stress can help your body adapt to hormonal changes more smoothly. Remember, some body changes during this transition are normal and healthy.

perimenopause-and-weight-gain

At what age does perimenopause weight gain typically start?

Perimenopause weight gain can begin in your late 30s or early 40s, often coinciding with the first hormonal changes. Many women notice gradual changes starting 5 to 10 years before their final period. The timing varies greatly based on genetics, lifestyle, and overall health.

perimenopause-and-weight-gain

Does everyone gain the same amount during perimenopause?

No. Perimenopause weight gain varies significantly. Some women gain 5 pounds, others 20 or more, and some maintain their weight. Factors include genetics, starting weight, activity level, stress, sleep quality, and how dramatically hormones fluctuate. Your experience is unique to your body.

Is perimenopause weight gain different from regular aging weight gain?

Yes. While metabolism naturally slows with age, perimenopause weight gain has distinct characteristics. The hormonal shifts cause fat redistribution to the midsection, even if overall weight doesn't change dramatically. This abdominal weight gain pattern is specifically linked to declining estrogen and progesterone, not just aging.

perimenopause-and-weight-gain

Will the weight come off after menopause?

Perimenopause weight gain often stabilizes after menopause when hormones level out, but the weight doesn't automatically disappear. The metabolic and body composition changes that occur during perimenopause tend to persist. However, with consistent healthy habits, weight management becomes more predictable post menopause than during the fluctuating perimenopause years.

https://www.oova.life/blog/progesterone-supplementation-guide

Can I take progesterone if I'm breastfeeding?

Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.

https://www.oova.life/blog/progesterone-supplementation-guide

Is it safe to take progesterone throughout pregnancy?

Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.

https://www.oova.life/blog/progesterone-supplementation-guide

Can progesterone supplementation cause weight gain?

Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.

https://www.oova.life/blog/progesterone-supplementation-guide

Can I switch from pills to suppositories or vice versa?

Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.

https://www.oova.life/blog/progesterone-supplementation-guide

Will progesterone supplementation delay my period?

Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.

https://www.oova.life/blog/progesterone-supplementation-guide

Should I take progesterone pills orally or vaginally?

For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.

https://www.oova.life/blog/progesterone-supplementation-guide

When should I start taking progesterone after ovulation?

Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.

https://www.oova.life/blog/progesterone-supplementation-guide

What's better: progesterone cream or pills?

Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

How can I tell if I have low or high progesterone?

The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

When during my cycle should I test progesterone levels?

Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

What are the main differences between low and high progesterone symptoms?

Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

Can you have symptoms of both low and high progesterone?

Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.