assisted reproduction

Second in a series of posts for intended parents from HRC’s Dr. David Tourgeman…

Perhaps the most difficult and emotional decision a person or couple is confronted with when trying to have a child is choosing whether or not to use an egg donor.  For some, the decision may be relatively straightforward.  Perhaps the adoption process has reached a dead end, or the woman has premature ovarian failure or another medical condition in which the ovaries will not produce eggs.

In most cases, the intended parents have already attempted  many rounds artificial insemination and/or in vitro fertilization without success by the time they come to consider egg donation, and have been burdened with the bad news of multiple negative pregnancy tests.  For most, the decision to move forward with a donor comes at the end of a long road of struggle and disappointment.

One biggest issue intended parents considering egg donation must confront is deciding whether they feel their genetics must play a part in conceiving a child, or if having a baby (despite the maternal genetic origin) is most important.

Intended parents are faced with two options: working with an anonymous donor, or choosing a donor who is willing to be “known” (non-anonymous).   If the couple decides to move forward with  known donor, typically a sibling or relative is chosen (although many egg donor agencies also have a list of donors who are willing to engage in an open cycle) and ideally that person is less than 35 years old and has children of her own.  This provides a “bridge” in which (in the instance of choosing a family member) there can still be some genetic link to the intended mother.  There are many patients who choose not to have a known donor because they either do not feel comfortable asking, do not have an age-appropriate relative, or simply do not want anyone to know that they’re using an egg donor.

On the other hand, choosing an anonymous egg donor can be a challenge.  There are certainly many factors that the intended parents may want to address in their search.  Physical attributes and similarities are often paramount, however, intelligence, ethnic origin, and family heath are also significant.  From a medical standpoint, there are also many desired qualities to keep in mind that will help optimize the likelihood of success.  I typically recommend that the donor be less than 30 years old, and that she have had testing for ovarian reserve that returned normal.  She should have had all appropriate genetic screening tests and have been evaluated by a psychologist to make sure she is in a healthy state of mind and that her motives are genuine.  Whenever possible I recommend choosing an anonymous donor who is “proven” (meaning she has done at least one successful donor cycle in the past – resulting in at least 15 eggs and a successful pregnancy).

Above all, the most important thing for the intended parents to consider is whether they will be fulfilled as parents if they decide to use a donor egg.  As parents, you’ll have the opportunity to nurture and nourish your child in the way you have envisioned.  The pregnancy and birth is the beginning of an amazing experience and, hopefully, the beginning of the intended parents understanding that, despite the egg donor’s genetic contribution, this baby is completely their own.

- David E. Tourgeman, MD, FACOG

HRC Fertility