Where do you find a qualified egg donor?
There are three main sources of egg donors, and a fourth option for families who want speed. Each source differs in how large its pool is, how much screening is done before you choose, and how much privacy everyone keeps.
- Egg donor agencies. Agencies offer the largest and most specific pools. If you are looking for a particular ethnic background, height or education, an agency gives you the most choice. The trade-off is that a first-time applicant may have had little screening completed before her profile goes live.
- Fertility clinics with in-house donor programs. Clinics often pre-screen their donors before listing them, so fewer surprises turn up after you choose. Their pools are usually smaller and more local.
- Known donors. A relative or friend donates for you. A known donor can offer familiarity and lower compensation. She also raises more psychological and privacy questions, for her, for you and for your child, so counseling and separate attorneys matter even more.
- Frozen egg banks. A bank sells a set number of frozen eggs from a donor who has already cycled. This is faster, but you buy a lot of eggs rather than a donor's whole cycle. See fresh vs frozen vs egg bank.
Whichever source you use, ask the same question: what screening has already been done for this donor, and what is still pending? Agencies and clinics should complete medical, psychological and genetic screening for each donor in their database, even if you are the first family to match with her.
What are the ten criteria, and which matter most medically?
PLS has used the same ten criteria for years. They are listed here roughly in order of medical weight. The first seven affect the chance of a healthy embryo and a healthy child. The last three are personal choices.
| # | Criterion | Typical range or standard | Verified by | Weight |
|---|---|---|---|---|
| 1 | Age | 21 to 30 at most programs; some accept 18 to 34 | Agency or clinic, from ID | High |
| 2 | BMI | Usually 18 to 27 | Clinic, at the medical screen | High |
| 3 | Personal health history | Non-smoker, no drug use including cannabis, no sexually transmitted infections, appropriate FDA questionnaire answers | FDA questionnaire and clinic testing | High |
| 4 | Family health history | Relatively free of major disease, mental illness and substance abuse, especially in first-degree relatives | Agency or clinic history; genetic counselor | High |
| 5 | Proven fertility | A prior pregnancy or prior donor cycle results, where available | Agency or clinic records | Medium to high |
| 6 | Genetic carrier screening | Same or a similar panel as the sperm provider | Genetics lab; genetic counselor | High |
| 7 | Psychological evaluation | Understands what donation involves and its long-term meaning | Licensed mental health professional | High |
| 8 | Physical characteristics | Height, weight, hair and eye color | Profile and photos | Personal |
| 9 | Personal traits | Ethnicity, religion, education, lifestyle, questionnaire answers | Profile and interview | Personal |
| 10 | Compensation | Usually $6,000 to $20,000, higher for in-demand donors | Donor agreement | Budget |
Why age comes first: the age of the woman who produces the egg is the strongest single factor in egg quality. Eggs from donors in their twenties are more likely to have the right number of chromosomes, which means more embryos that grow, implant and continue. Why BMI matters: both obesity and being underweight can affect egg quality and how a donor responds to stimulation medications. Why personal and family health matter: they shape both the cycle and the long-term health picture for your child.
Read the table from the top. If a donor fails on one of the first seven, keep looking, however good the rest of the profile seems.
What should the donor profile and screening file contain?
A donor profile is what you see when you browse. A screening file is what your clinic and your genetic counselor review before you commit. You need both.
A good profile includes:
- Age, height, weight and BMI.
- Ethnicity and ancestry for both of her parents.
- Education, work and interests, in her own words.
- Childhood and adult photos, if the program offers them.
- Reproductive history: prior pregnancies, prior donor cycles and their results.
- A family health history covering at least her parents, siblings and grandparents.
A complete screening file adds:
- FDA donor eligibility screening: her questionnaire answers and infectious disease test results.
- Her genetic carrier screening report, with the panel name and the number of conditions tested.
- A summary of the psychological evaluation.
- The clinic's medical screen: exam, bloodwork and ultrasound results that suggest how her ovaries will respond.
Ask for the dates on every result. Infectious disease testing has to be repeated close to each retrieval, so a result from a past cycle does not cover your cycle. The egg donor screening page explains each layer in detail.
Why must genetic carrier screening match the sperm provider's panel?
Most people carry one copy of a gene change for at least one recessive condition. Carriers are healthy. A child is at risk only when both the egg and the sperm carry a change in the same gene.
That is why carrier screening has to be read in pairs. If the donor is tested for one set of conditions and the sperm provider is tested for a different set, a shared risk can slip through simply because one of them was never tested for it. Using the same panel, or one that covers the same conditions, closes that gap.
Carrier status on its own is common and usually acceptable. What matters is the match. When the results come back, a genetic counselor compares both reports and tells you whether any condition is shared. If one is, you can choose another donor, or ask your clinic about testing embryos for that specific condition.
Proven donors vs first-time donors: what changes?
A proven donor has completed at least one prior donor cycle, or has had a pregnancy of her own. A prior donor cycle gives you real data: how many eggs were retrieved, how many fertilized, and how the embryos developed. A first-time donor cannot give you that.
What changes in practice:
- Predictability. A proven donor's prior response to stimulation is a useful guide to how she will respond again, though no cycle repeats exactly.
- Compensation. Proven donors are often compensated more.
- Availability. Proven donors are in demand and may be booked months ahead.
A first-time donor is not a weaker choice. Many first cycles go well. Her clinic medical screen, including the ultrasound count of resting follicles and bloodwork, gives your clinic a reasonable estimate of her response. Ask your clinic how it reads those results for a first-time donor.
How much weight should looks and personality carry?
As much as you want, once the medical criteria are met. Physical characteristics are the most subjective category on the list. Medical and genetic criteria affect the outcome. Appearance does not.
Some parents want a donor who resembles them or a partner. Others care more about education, interests or the way a donor writes about herself. Both are reasonable. Two practical suggestions:
- Rank your preferences before you browse. Decide which two or three traits matter most to you, and which you could let go. It keeps you from rejecting a strong medical match over a detail you would not miss later.
- Think about what you will tell your child. If you choose an identity-release or known donor, your child may meet her one day. Personality and values may matter more to you than hair color.
What if your first choice falls through?
Expect it. Finding the right donor often takes longer than parents plan for. A donor may become unavailable, your clinic may decline her, or a screening result may change the picture.
The advice PLS has given families for years still holds: be patient, be thorough, be flexible and stay open. Keep a shortlist of three or four donors rather than one favorite. If one donor does not work out, the next conversation is about the second and third, not about starting over. For many families, the donor who becomes the match is their third choice, and she turns out to be the right one.
How does PLS guide the selection?
Nancy Block, RN, runs matching herself. She founded The Center for Egg Options Illinois in 2000 and ran egg donation and surrogacy matching there for 15 years before founding PLS. Here is what PLS does at each step.
- Sets the criteria with you. At the first consultation you agree on medical must-haves and personal preferences, and decide on a fresh cycle, a bank lot or a known donor.
- Reviews files before you see them. Mark Silverberg, DDS, MD, reads the medical records in each donor file before a match.
- Checks screening status. PLS tells you what is complete and what is pending for each donor on your shortlist.
- Coordinates carrier screening. PLS makes sure the donor and the sperm provider are tested on matching panels, and that a genetic counselor reviews both.
- Keeps your shortlist moving. If a donor falls through, PLS brings the next candidate forward.
Every donor and every intended parent has an independent attorney, and donor compensation is paid through an independent licensed escrow agent. For the full program, see the egg donor program overview.
Sources
- American Society for Reproductive Medicine (ASRM), guidance on gamete donor screening and selection.
- US Food and Drug Administration (FDA), donor eligibility rules (21 CFR Part 1271).
- SEEDS, Society for Ethics in Egg Donation and Surrogacy.
- Private Label Surrogacy, "Advice from PLS: 10 Considerations When Choosing Your Egg Donor."