Getting Started with Egg Donation: First Decisions

Those needing an egg donor to achieve a pregnancy have choices to make. The most basic of these is how to recruit a young woman who is willing to donate her eggs. There are basically two options, known and anonymous donors. Known donors are women with whom you have a preexisting relationship, typically relatives or friends. Anonymous donors are strangers who are recruited for you by your medical program or donor agency. In a hybrid version you might recruit your own donor through the internet. We are going to address some of the perceived benefits and disadvantages in selecting known or anonymous donors and some issues unique to each type.

You might decide to work with an anonymous donor because nobody in your circle has offered you her eggs or you don't know anyone you can ask. If you choose an anonymous donor you will receive varying amounts of background information about her, depending on whether she is recruited by a medical program or an agency, and which one. Some provide you with great detail about phenotypic, demographic, medical/health, family, academic, occupational, reproductive, sexual, social and psychological histories, others very little. Some will provide you with pictures, others will not. Some will allow direct contact providing all parties are agreeable. This might include a face-to-face meeting, typically facilitated by a mediator, which can be conducted without exchanging identifying information and no expectation of future contact and still be considered an anonymous arrangement. The information you are given on your donor may vary most based on your geographic location. However, these differences may soon decrease, as the Society for Assisted Reproduction (SART) has just released a Universal Donor Application Form. All donors, no matter how they are recruited, should undergo medical testing based on ASRM and FDA guidelines. All egg donation participants should also undergo in-person psychological screening by a licensed mental health provider familiar with ASRM and MHPG guidelines.

You might prefer an anonymous donor if you want clearer, more rigid boundaries between the donor and you than a known donation arrangement can provide. Likewise, if you are highly concerned about protecting your ability to make independent decisions and maintaining your privacy as parents. Working with an anonymous donor might free you from an obligation to put others' feelings and preferences ahead of your own.

While anonymous donation has its advantages, it is not without risks. Recipients often worry about whether strangers misrepresent their histories and what the implications of lying might be. You might be unable to pay the added fees required in an anonymous arrangement or resent having to do so. You might worry that your anonymous donor will knock on your door one day or want your child. You might be afraid your donor will donate repeatedly, creating a large number of genetic half-siblings for your child. Although more fear than reality, if these worries loom large and can't be tamed, you might feel more comfortable working with a known donor.

For many people, known ovum donation has some distinct advantages. If you choose a family member, you will share some genetic connection with your child. If your donor is your sister, you will share her version of your parents' DNA. Using a known donor means you will always be able to know or access medical information about your child. And, if the child is told about the donation, s/he will be able to talk with his/her donor and ask his/her own questions. Your family may be more likely to love and accept your child if the donor is known. In some cultures where boundaries between family members are less clearly defined, Auntie or Uncle can be used almost interchangeably with Mama or Daddy. For these families, the use of a known donor can feel like a very safe, secure proposition with few downsides.

As mentioned previously, known donation may create complicated relationships. Unless the donor lives far away, she may be in your child's life. While having family close by can be a blessing, having your donor nearby doesn't always feel that way. Although everyone entering a known donation relationship expects all will go well, it does not always. Sometimes parents are surprised by the protective feelings that develop for their child even from loved family members. Some people choose donors who are advice givers and would always feel comfortable offering parenting advice. Will it feel the same if she is your sister AND your donor? Do you worry that your best friend will feel obligated to donate and later regret her participation? Do you fear that your sister will treat your child more like a son than a nephew? Are you concerned that you will be unable to repay this gift, and forever indebted to your cousin, and will have to do whatever she asks for the rest of your lives? Do you feel uncomfortable because it feels like your husband and your best friend are having a baby? The prevalence of these kinds of fears might mean you'd feel more comfortable with an anonymous donor.

What all this suggests is that no arrangement is right for everyone, as there are pluses and minuses on all fronts. If you are having difficulty choosing your path, consult with a mental health professional who can help you clarify it.

Peggy Orlin, MS, MFT, is a Marriage and Family Therapist who specializes in the emotional aspects of infertility and third party family building. She is in private practice in Berkeley and San Francisco. Her professional associations include the American Society for Reproductive Medicine, where she was a former Chair of the Mental Health Professional Group. She is on the Mental Health Advisory Boards of Path2Parenthood.
Peggy can be reached at 510-528-2750

Jan Elman Stout, Psy.D. is a licensed clinical psychologist specializing in infertility counseling who has recently relocated from Chicago, Illinois to Houston, Texas. She is a past Chair of the Mental Health Professional Group of the American Society for Reproductive Medicine and currently serves on the Mental Health Advisory Council of Path2Parenthood. She can be reached by email at