Abby Smith* was 27 when she heard an ad on the radio about egg donation. She’d considered it before, as a 20-year-old college student interested in a little extra cash, but ultimately realized she wouldn’t be doing it for the right reasons. Still, the seed was planted, and after she started hearing the ad almost every time she got in her car, she decided to finally check it out.
Now on her third donation at the age of 28, Smith is part of a growing group of women choosing to donate their eggs to couples in need. A recent report in the Journal of American Medical Association found thatthe number of egg donors for IVF increased about 70 percent from 2000 to 2010. “It could be that it’s grown more acceptable,” says study co-author Jennifer Kawwass, M.D., a reproductive endocrinology and infertility fellow at Emory University. “It could be that the technology has improved. It also could be that more women are comfortable using an egg donor so there is an increased demand.” And with donor compensations ranging from $5,000 to $7,000 (on top of medical expenses), the lackluster economy may be a factor as well.
That compensation was an added bonus for Brooke Jones*, 36, who was already fascinated with the idea of egg donation. When she was 24, she also heard an ad for a local fertility clinic that offered free information sessions, and she decided to drop in on one. After hearing from physicians, donors, and recipients throughout the session, Jones was sold. “It was really moving and powerful hearing them talk about the joy they had when they finally were able to have a kid,” says Jones. “I thought, ‘Why not? I have a really healthy family, I went to college, I had good SAT scores, I’m tall—those might be things that would be attractive to recipients.’”
What a Donor Goes Through
Of course, it’s not as simple as just handing over your eggs. The first step includes information sessions, paperwork, and an FDA-regulated screening—complete with DNA testing and a psychological evaluation. “It’s a big decision to pass on your genetic material,” says Kawwass. “This is about going through the implications and making sure you’re comfortable with that.”
Once potential donors are cleared and chosen by a recipient, things get a little more intense. The donor is typically started on birth control to sync her cycle up with the recipient’s, and then comes the ovarian stimulation (or as Jones describes it, “You’re first suppressing your [fertility] and then jacking it up 1,000 times more than normal”). It’s during this time that donors start giving themselves daily hormone injections, which may be difficult for anyone who’s squeamish around needles. “You don’t even feel them going in, they’re so tiny,” says Smith. But that doesn’t mean the process was totally pain-free. “One medication in particular stings a lot when you inject it, but ice helps.”
Oh, and about those hormones—they’re the same ones you would get if you were actually undergoing IVF. “The first one suppresses the signal from your brain to your ovaries,” says Kawwass. “After that, you take the medication to stimulate your ovaries to make multiple follicles—each of which may contain an egg.” The most common side effects from the hormones are a lot like PMS: bloating, tenderness, and of course, moodiness. “We went to get our cars washed, and I was almost in tears,” says Smith. And even though your hormones might be raging, you can’t have sex during the stimulation process and even up to two weeks after the egg retrieval. After all, your body is being pumped with fertility drugs, and it takes a while for your ovaries to return to normal, says Kawwass.
The whole process can also take a physical toll on the body. As the surgery to remove the eggs approaches, some women report discomfort and pain. “I physically didn’t have much trouble until the last week or two,” says Jones. “Then it felt like I was pregnant. I was bloated, in pain with cramps, and not feeling like myself.” Women should also avoid vigorous exercise for a week or two after surgery while their ovaries return back to their normal size, says Kawwass.
About two to four weeks after you’re matched with a recipient, it’s time for the egg-retrieval surgery. “Overall, it’s a very low-risk procedure,” says Kawwass. “Some of the short-term risks are those associated with any surgical procedure and IVF in particular.” That includes bleeding, infection, and ovarian hyperstimulation (a syndrome that occurs when someone over-responds to the fertility drugs; it’s characterized by abdominal pain, bloating, nausea, or tenderness around your ovaries).
What Happens Next
In the days leading up to her first egg retrieval, Smith was a little anxious. “I had never had surgery before,” she says. “And I was nervous about how I would feel when all was said and done and the eggs were gone.” To keep calm, she reminded herself why she was donating and tried to put herself in the recipient’s shoes. “Once I was done with surgery and out of the loopy anesthetic state, I felt immediately really good,” she says. “I knew I had made the right decision.”
But when it comes to long-term implications, there are a few questions left unanswered. “As far as we know, it doesn’t affect long-term fertility and doesn’t have any implications in terms of long-term health,” says Kawwass, though she explains that studies are still being conducted. Another consideration is whether or not a donor’s anonymous status will stay that way. While you can donate eggs to someone you know or even meet the donors you’re matched with, most women (like Smith and Jones) choose to donate anonymously. That means zero contact between the donor and the recipients and no information about what happens to your eggs after they’re donated. But as Jones was told in the information sessions, anonymity laws can change over time. “If one day the kids who have been born by this process get the laws changed, the records could be opened up and they could come find me,” says Jones. “You have to think all of that through. How would I feel if in 30 years someone comes knocking on my door?”
Both Smith and Jones agree that this decision isn’t one to be taken lightly. The process may be more streamlined and lower risk than it was in the past, but patients are still urged to carefully consider their choice before donating. That said, many women see this procedure as an enormous gift that they’re lucky to give. “Knowing I’m OK with this process and can handle it both physically and emotionally, there’s no way I would ever say no when they come back to me and say ‘Hey, are you interested in donating again?’” says Smith.
*Last names have been changed.