egg donor agency
Thursday, April 18th, 2013
Understandably, couples faced with the decision of choosing an egg donor typically have concerns about the donor’s genetic makeup. Fortunately, there are options available to help a couple identify any genetic disorders their donor might have and reduce the risk of passing these traits on to the child/children born from the donation.
There are two approaches when it comes to donor genetic screening, which are not mutually exclusive. The first and more traditional approach begins with genetic counseling. The genetic counselor will take a detailed family history from the donor and recommend specific genetic tests based on this history (and the ethnicity of the donor). Though this is still considered the standard approach in the industry, it has two potential flaws. First, the donor may be unaware of a specific genetic disease in her family or, worse, may choose not to disclose it. Also, single gene testing can be very expensive, especially when it comes to the “Jewish Panel” (performed on Ashkenazi Jewish donors), which can cost over $2,000!
A new alternative that has become more prevalent in recent years is Universal Genetic Testing (UGT). With UGT, a single saliva or blood sample can be analyzed for the presence of multiple recessive genes at a relatively low cost. Currently, the first such test available is called “Counsyl.” This test costs $350 and evaluates 100 recessive traits, including the Ashkenazi panel).
If a serious recessive trait is discovered, the intended father needs to be tested for that gene, or the donor should be excluded. Most doctors tend to encourage the latter choice.
Critics of UGT are uncomfortable with its “shotgun” approach. Detection rates for diseases not common in specific ethnic groups can be low, however, these women would not ordinarily be tested for these diseases so not much is really lost. In contrast, the cystic fibrosis screen in Counsyl contains more mutation than most of the traditional single gene tests currently available. Also several less-serious diseases (that do not have life-threatening affects) are included in Counsyl, and finding such a disease may unnecessarily create anxiety on the part of the recipient couple. Some doctors have started customizing the panel to exclude such conditions. One genetic disorder not included in the Counsyl panel is fragile-X. Women carrying this mutation can produce boys with severe mental retardation and autism. Fragile-X is the most common cause of mental retardation in boys and one of the few proven genetic causes of autism.
Both the traditional approach and UGT are appropriate options for screening egg donors. I personally recommend Counsyl and fragile-X testing on all new donors. If for some reason Counsyl is not desired, Caucasian non-Jewish donors are screened for cystic fibrosis, spinal muscular atrophy (SMA), fragile-X, and Tay-Sachs enzyme. I also recommend that a complete blood count be donor to screen for thalessemia. As always, your doctor and genetic counselor will be able to help in deciding which genetic tests are most appropriate for your donor.
- Michael Feinman, MD
Medical Director, HRC Fertility
Friday, September 23rd, 2011
While it may seem logical to assume that “more is more” in terms of increasing your chances of getting matched for a donation, registering with multiple agencies can actually work against you — and lead to a host of problems down the road when and if you do get chosen by a couple.
At BHED we ask all of our active donors to sign an exclusivity policy before being added to our database, in which the donor agrees not to register with, or commit to a donation through, any outside agency or clinic during her first six months with us. We adopted this policy after years in the industry and countless conversations with intended parents, doctors, and colleagues about the issues that come up when a donor is registered with more than one agency. We know that our donors are eager to get matched and help a couple in need (and the sooner the better!), but our clients have frequently told us that they’re very uncomfortable seeing donors listed on multiple websites and often shy AWAY from booking those donors who seem to be spreading themselves too thin. Beyond that, we’ve had clients who have gone to reserve a particular donor for a cycle to start right away, only to find out that she’s already accepted a match elsewhere and is – in reality – not available for several months. For intended parents who have spent weeks, months, and often longer searching for their perfect donor, this can be incredibly disappointing.
Of course, if a donor hasn’t been matched through BHED by the time her exclusivity policy expires we completely understand that she may want to register elsewhere. After six months, donors are free to sign up with one outside organization provided they notify us in writing and inform us within 24 hours of accepting an outside match.
Donors can always feel free to contact a member of our staff with any questions or concerns about this policy. As always we appreciate your commitment to our program and look forward to working with you to help create a family.
Wednesday, August 31st, 2011
From our companion site, Ask Kate:
Q: Do you ever think about the kids that are running around out there with your genes? I told my parents about my decision to donate when I was getting information about my family’s medical history, and this is their number one concern. How did you deal with that question?
A: Great question. First of all, my parents don’t know for that very reason – most people don’t know for that reason. I’m not sure they’d have a problem with it, but – at the same time – it wasn’t open for discussion, so I didn’t even want to go there. And this is what I mean when I say over and over: You need to do this for you. One hundred million percent, the decision to donate your eggs has to be something that you have thought through in every respect. Assuming your donation is successful, yes, of course, you will have a half-You running around out there the second you sign on the dotted line. That is a fact. That is not a possible variable, that is simply the outcome of this process.
But to answer your question, no, I don’t think about it. I’m sure I could, but I’ve chosen not to consider it. I can’t. My donations – all 6 of them – were anonymous for that very reason. I didn’t want to walk into a restaurant and see the recipient couple and my half-child. That would not be something I’d be able to let go of, so I eliminated that facet of possible anxiety from the equation. I really don’t know what else to say about it other than you’re either going to think about it, or you’re not. I don’t. I’m really good, in general, about picking my battles and picking what I’ll obsess over and picking when I’ll argue. And this was easy for me: I have chosen not to consider it, so I don’t ever. It doesn’t cross my mind.
It’s okay to be a little iffy about how you feel about the weight of the commitment while you’re considering it all – how do you feel morally (what will mom and dad thing)?… how do you feel spiritually (am I playing God)?… how do you feel ethically (is it wrong to be excited about the money)?… but then once you’ve decided to, in fact, commit, you need to have resolved these issues, or decided they are not issues worth resolving. Move forward owning the process and be, maybe, more discriminating with information that will garner critique or questions from the peanut gallery.
- Kate Lee, 6-time BHED donor
Monday, August 29th, 2011
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
Tuesday, June 14th, 2011
I’d like to dedicate this entry to my needle fearing friends. You know who you are. The gal that hears the word “needle” one moment and finds herself hanging upside down from the ceiling fan the next. The thought of having blood taken is a minor inconvenience for some, but, for you, it’s a nightmare equal to that of having a spider crawl in your ear and hang a finely crocheted web on your cochlea. The smell of rubbing alcohol at a doctor’s office triggers a sort of Pavlov’s Dog response to pull down your shirt sleeves and put your veins on lock down. I know who you are because, a few months ago, I was you.
I’ll be honest, when I decided to donate I was so excited about the idea of helping someone have a child that I had sort of “overlooked” the logistics of injections and having weekly blood draws. This honeymoon phase vanished the moment I received my box of medication, which included about 30 needles. I quickly ran over to my roommate and showed her in horror. She shrugged and said, “They’re tiny”. Yeah, okay, tough guy, they’re tiny. But, let us not forget, they’re still NEEDLES. A tiny cockroach is still a cockroach. Besides, it’s all relative. Your tiny is my huge. Your “it’s just a needle” is my nightmare on ice with a sprig of nausea.
Fast forward to my first injection. The staff at my doctor’s office thoroughly explained the process of how to do a self-administered injection, so I did feel a little more at ease — empowered with knowledge as they say. **Side note: the staff at the office I went through were simply amazing. Take the opportunity to get to know the staff at whatever office you go through. They are an invaluable asset to the entire process, like your medically trained cheerleaders. Back to my first date with the needle: I got home and paced around like an anxious cat who kept hearing its name being called. I looked at the clock, it was ten minutes until I was scheduled to do my injection. I laid out my supplies — the alcohol pad, the needle, the vile of Lupron and (what I will reveal to you as the holy grain of injections, ladies) my slightly frozen can of diet coke. Who would have thought a diet coke could contain such power that, if wielded correctly, could erase a lifetime of fear. I suppose it did skyrocket Cindy Crawford’s career and make us all go cut our jeans into shorts. So here’s the deal: throw a can of soda in the freezer for a bit and let it get nice and cold. Five minutes before your scheduled injection, numb the area. My nurse suggested numbing it for a minute, but for this first go-around I decided to put every sensation in my skin to sleep… five minutes for me, thanks. I numbed the area, went over it with an alcohol pad, let it dry, and drew up my dose in a syringe. In that moment, I had an epiphany — if Katherine Heigl’s character on Grey’s Anatomy can do it, I can do it. I pinched the skin on my tummy, lined up the needle, took a breath, looked away and put it in (at a 90 degree angle). When I looked back down, the needle was in but I was completely shocked, I couldn’t feel anything. Nothing. Zip. I want to be clear here and say, I am a wus about this stuff and I honestly couldn’t even feel it. I released the tummy pinch, pushed the dose in, removed the needle (pull straight out), wiped over the area with alcohol and did a victory lap, calling about ten of my closest friends to tell them that I was a fearless Goddess Warrior who may have missed her calling as a professional shot giver. As strange as it sounds, I was actually looking forward to my next injection.
I think that my greatest piece of advice in regards to how to cope with injection anxiety would be to remember that we’re often our own worst enemies — psyching ourselves out, telling ourselves “I can’t do this”. I’m here to tell you that if I can, you most certainly can. Think of some of the stuff you’ve overcome in your life. In comparison, I’m sure that needle truly is tiny.
- Evan Ashley, BHED staff member and former donor
Monday, June 6th, 2011
One of the questions Intended Parents often ask is “Can you recommend a good doctor?”. Other variations include “Should I stay with my current doctor?”, “Should I move to a doctor closer to where the egg donor lives?”, and sometimes “I’m not sure if I should move doctors or not – what do you think?”
Here are the answers to those questions, in our opinion…
1) “Can you recommend a good doctor?” Yes, we can provide recommendations for you.
We have been fortunate enough to work with many of the top Reproductive Endocrinologists (“fertility doctors”) in the country, and from those experiences (and client feedback) we have a good sense of who most of the better doctors are. We base our recommendations on a number of factors, including:
- General reputation and feedback from past patients
- Quality and professionalism of the office staff (front office, nursing, etc.)
- General compliance with current “industry standards”, including information such as number of embryos typically implanted, compliance with common testing, administration of medication, etc. (Note that since we are not physicians, we cannot comment, and would not deign to comment, on any particular doctor’s medical protocol. However, when we see a lower success rate and highly unusual protocol used, we get concerned…)
- General office “vibe” (for example, many clinics with in-house egg donor programs are very negative towards working with agencies)
- Specific success rates (sometimes per SART, sometimes per our own information or in-house statistics)
Note that we do not limit our work to any particular group or clinic, but as we gather first-hand information, we will use it to help our clients make the best choice for them.
2) “Should I stay with my current doctor?” “Should I move to a doctor closer to where the donor lives?” That all depends…
We believe that the most important criteria in choosing or keeping your physician include:
- Your comfort level with and trust in your doctor. If you love your doctor and totally trust him or her, as long as they are supportive of using an egg donor from an agency, definitely keep that doctor. We think that if you are calm during the process, and are willing to do what your doctor says because you trust in that doctor, you are more likely to have a successful cycle. This is only said from anecdotal evidence and other’s opinions, but being in a good place psychologically as you’re on buckets of hormones (and going through a somewhat surreal process) can’t help but benefit you.
If finances are an issue (as they generally are) and you choose an egg donor from another city, you might want to consider moving to a doctor in that city. However, if you love your current doctor, the difference in dollars is probably irrelevant — certainly in the long term. If you do choose to use or keep a doctor in a city far from where the donor lives, make sure that you’re aware of the outside monitoring costs as early in the process as possible. (The finance person at the doctor’s office, along with our cycle coordinator, can help you with that.) The less surprises that happen in this process, the better.
All of BHED’s clients are assigned a cycle coordinator — a senior member of our staff who follows your case through from the time you choose your donor until retrieval (and often, beyond.) The Cycle Coordinators will be in regular contact with your doctor’s office from the time you sign your contract with us, and she will alert you if we have any unexpected challenges with the doctor’s office. Most of the time things work out just fine.
Note that we stay with you until you become pregnant or decide to discontinue trying. Your choice of doctor is certainly an important part of this process, and is one of the keys to the success of your pursuit to begin or build your family.
We look forward to helping you realize your dream through egg donation!
Thursday, February 24th, 2011
I have had the amazing opportunity to become an egg donor. It’s extraordinary that such a simple time commitment can have such a big impact!
I think that when a person first considers donation, it’s easy to get caught up in fear of the unknown (and maybe even a little bit of what people will think). When I first thought I might want to donate, I was scared and wasn’t sure if it was worth the risk. But it’s funny – experience truly is the best teacher. After my first cycle, I realized just how simple it really is. You think to yourself, how is it possible to give someone something so special by going through such a simple (relatively) process. The funny thing about becoming a donor is that at first you think that you’re the one giving something of yourself, but after the retrieval you get such a strong feeling of being able to do something even bigger. It’s amazing, and I think it’s something that people don’t tell you going into it.
I’ve done a lot already in my short time on Earth. I’ve been a professional athlete, an NYPD police officer, and have received many accolades. Of all the things I am proud of, being able to help someone in this capacity is the most rewarding thing I have ever been a part of. I can honestly say that becoming an egg donor – giving someone the chance to have a child – is probably one of the most important things I will ever have the opportunity to do.
- Kimberly, BHED donor #9564
Wednesday, January 5th, 2011
We at BHED are so excited to be ringing in 2011, and to have closed out 2010 on such a great note. As you may have noticed, the last couple of pieces we’ve posted on this blog are from two of our international recipients. Our client list stretches far and wide across the globe; in fact, we’ve worked with intended parents from over 50 countries. Whether you’re coming to us from just down the street in Southern California, or based in another city, state or time zone, our staff will guide you through egg donation with experienced professionalism.
2010 saw the launch of “Ask Kate” (www.askaneggdonor.com): an interactive forum for prospective donors, recipients, and anyone else with questions about what goes into being a donor. Ask Kate is helmed by our own Kate Lee (a 6-time previous donor), who brings her unique perspective to “shedding light” on the donor experience.
We would like to wish ALL of our donors, recipients and colleagues a happy and healthy year ahead. If you’re a recipient, we look forward to helping you find your donor match in the coming year. We have more impressive candidates than ever before and are adding new donors to the database every week. For our prospective donors, now is a great time to join BHED. Our donor team is here to be an advocate for you and help guide you through the process to start to finish.
Here’s to a wonderful New Year!
Wednesday, November 17th, 2010
I was inspired to become an egg donor by a family I worked for. They are two of the most amazing and generous people I have ever met. Although they didn’t find each other until later in life, they knew from the moment they met that they wanted to spend the rest of their lives together and start a family of their own. Thanks to egg donation, their dream of having a family became a reality. They now have three amazing and beautiful children. I have always loved kids, and have been working with them since I was 12 years old. Children are blessings, and I know it would be a very rewarding and extremely special experience to be able to give someone the opportunity to have a child of their own, no matter the circumstance. I am looking forward to being matched for the first time.
- BHED donor, Taylor #8329