While any woman can choose to use an egg donor, most women who do so are unable to produce their own healthy eggs due to early menopause, poor egg quality, chromosomal or genetic disorders and age -- most women who use donor eggs are over the age of 39 [source: CDC]. Women who have had radiation, chemotherapy or ovarian surgery, as well as those who have had poor luck with fertility drugs, are also candidates.
Women typically make their decision to work with an egg donor along with their physician and go through the process with a fertility doctor or clinic. Many fertility centers work with individuals who also require sperm donation or with couples.
The egg donation process begins with a basic medical screening, usually including blood tests, cultures, a Pap smear and uterine evaluation. Recipients of egg donations must have a normal uterus or choose to work with a surrogate mother. Women who are over the age of 40 are given a mammogram, and those over the age of 45 are also given a chest X-ray, an EKG and a fasting metabolic panel, a basic blood test [source: Washington Fertility Center]. Recipients participate in psychological evaluations and legal and financial counseling.
Assisted reproductive technology, including egg donation, is costly. The costs vary among clinics but range between $15,000 U.S. to well over $50,000. The fee structure, which can include pre-screening and diagnostic testing, donor compensation and fees, medications, in vitro fertilization, embryo transfer and embryo freezing (cryopreservation), greatly affects the cost. Medical fees are usually listed separately.
Egg donation also requires a legal contract. The egg donation contract should establish the recipient's financial responsibility for all expenses incurred, address confidentiality and privacy, specify each party's responsibilities and establish parental rights. In the 1998 case Buzzanca v. Buzzanca, the court decided that genetics was not necessarily the primary factor in determining parental rights (and the names that appear on a child's birth certificate). Parental rights are instead established when intended parents initiate and consent to reproductive treatment such as surrogacy, sperm donation or egg donation.
After deciding to use an egg donor, recipients work with their clinic or an egg broker to select potential donor candidates. Candidate selection is usually done through anonymous donor databases, many of which are at least partially online, and are searchable by race, ethnic origin, religion, hair and eye color, height and education. The recipients also complete a personal profile letter to be shared with the donor. Personal profiles are non-identifying and contain details about the recipient, the recipient couple and the couple's struggle with infertility. Once the recipient (or recipients) has selected several desirable donors, the clinic or broker contacts those donors to confirm availability and to share the recipient profile. If the donor and recipient agree, it's a match.
Next, we'll learn about the women who choose to become egg donors. What criteria are considered? Does it matter where donors live? Let's find out in the next section.