What Does ASRM Say About Egg Donation?

ASRM, or the American Society for Reproductive Medicine, is a professional organization dedicated to advancing the science and practice of reproductive medicine. Founded in 1944, ASRM has grown to become one of the most influential organizations in the field of reproductive health, with over 8,000 members from around the world.

The mission of ASRM is to promote excellence in reproductive medicine and science through education, research, and advocacy. The organization provides a platform for physicians, scientists, and other healthcare professionals to collaborate and share their knowledge and expertise in the field of reproductive health.

One of the key areas of focus for ASRM is infertility. Infertility affects millions of people around the world, and can have a significant impact on their physical, emotional, and financial well-being. ASRM works to promote access to high-quality infertility care, and to ensure that patients receive appropriate diagnosis and treatment for their condition.

ASRM is also involved in advocacy efforts to promote reproductive health and rights. The organization supports access to contraception, family planning services, and comprehensive sexual education. ASRM also advocates for policies that support access to assisted reproductive technologies, such as in vitro fertilization (IVF). Let’s take a look at some of the recommendations ASRM has published.

So what does ASRM say about egg donation?

ASRM regularly publishes guidance for professionals and families regarding infertility, including the use of donor eggs. ASRM supports the use of donor eggs and has shared guidelines for success. 

Some of the reasons ASRM states for people needing donor eggs include:

• Women with hypergonadotropic hypogonadism
• Women of “advanced reproductive age”
• Women who have diminished ovarian reserve
• Women who are known to be affected by or known to be the carrier of a significant genetic defect or who have a family history of a condition for which carrier status cannot be determined  
• Women with poor oocyte and/or embryo quality or multiple previous failed attempts to conceive via IVF  
• Men who do not have a female partner or those who have a trans female partner and are planning to use a gestational carrier

For families needing donor eggs, ASRM has created guidelines to help protect both the intended parent and egg donor. 

What ASRM says about egg donor qualifications and screening

ASRM states that egg donors should ideally be between the ages of 21 and 34 years. For donors younger than 21, ASRM says they should undergo psychological evaluation by a qualified mental health professional. For donors over 34, ASRM states that the age and cytogenetic risks should be disclosed to the intended parents. 

In addition to the FDA requirements for egg donor screening, ASRM recommends additional screening of egg donors. This includes:

• Pelvic ultrasound for the assessment of pelvic anatomy and antral follicle count
• Measurement of serum biomarkers (e.g. AMH) of the ovarian reserve to anticipate the response to ovarian stimulation
• Psychoeducational evaluation and counseling by a qualified mental health professional 
• Genetic screening
• Medical history
• Infectious disease testing of recipient and recipient's sexually intimate partners
• Legal consultation, particularly for directed donation

Overall, the goal ​​of donor screening is to increase the chances of success and reduce the risk of infectious agents being transmitted via donor eggs. 

What ASRM says about egg donor cash compensation

ASRM published specific guidance regarding egg donor compensation in 2021. The guidance states that compensation that is fair and professional is justified on ethical grounds. Compensation should acknowledge the donor’s time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and post retrieval recovery. 

However, they acknowledge that excessive monetary compensation could create the possibility of undue inducement and exploitation of egg donors. The guidance points out, “Women may agree to provide oocytes based on their financial need. High levels of compensation also could lead some prospective donors to conceal medical information relevant to their own health or that of their genetic offspring in order to be more likely to be selected for oocyte donation.”

Terminology

ASRM has also shared guidance for the terminology to use regarding egg donation. For egg donor recipients who know their donor, formerly referred to as “known donors”, ASRM now recommends using the term “directed (identified) donor”. For anonymous egg donors (something we don’t believe in at Cofertility), they suggest the word “non-identified” to describe the relationship. 

Maximum number of times an egg donor should donate

While there are no scientifically documented long-term risks associated with egg donation, ASRM still suggests a limit of six cycles (interestingly, there doesn’t appear to be a suggested limit for people undergoing IVF for infertility). 

According to ASRM, the basis for this recommendation is rooted in a concern over the potential cumulative risk accrued after six ovarian-stimulation and egg-retrieval procedures. In a single cycle, the risk of severe OHSS is approximately 1% to 2%, and the risk of acute complications, including pelvic infection, intraperitoneal hemorrhage, or ovarian torsion, is estimated at <0.5%. 

After six donation cycles, these risks aggregate to an overall risk of 8% to 13%. Because of this, ASRM feels it is prudent to limit the number of stimulated cycles for an individual donor to no more than six.

Conclusion

The mission of ASRM is to promote excellence in reproductive medicine and science through education, research, and advocacy. While ASRM fully supports egg donation, they set guidance to ensure that both intended parents and egg donors are protected and set up for success. You can learn more about ASRM at their website: https://www.asrm.org/