Fertility emotions

Breastfeeding is a way of providing nourishment to newborns and infants. It has been widely recognized as the best form of nutrition for infants and has many benefits for both the mother and the baby. However, breastfeeding is not always easy and it's not for everyone. 

And if you are pursuing donor eggs to grow your family, you may be wondering if you will be able to breastfeed if the child is not genetically related to you. In this blog post, we will answer all your questions. Let’s dive in!

First off, what are the benefits of breastfeeding? 

There are loads of benefits to breastfeeding, including:

• Nutritional benefits: Breastmilk is the perfect food for infants as it contains all the necessary nutrients in the right proportions, including proteins, carbohydrates, fats, vitamins and minerals. Additionally, breastmilk changes to adapt to the baby's needs as they grow and develop.
• Health benefits: Breastfeeding can reduce the risk of certain illnesses and conditions in both the mother and the baby. For the baby, it can reduce the risk of infections, allergies, asthma, and obesity. For the mother, it can reduce the risk of breast and ovarian cancer, osteoporosis and postpartum depression.
• Bonding: Breastfeeding can create a special bond between the mother and the baby as it involves physical and emotional contact. Additionally, the release of the hormone oxytocin during breastfeeding can promote feelings of calm and well-being in both the mother and the baby.
• Convenience: Breastfeeding can be convenient as it does not require any preparation, bottles, or clean-up and it's always available and at the right temperature!

But – let’s not act like it’s easy. What are the challenges of breastfeeding?

Breastfeeding can be a wonderful experience for both the mother and the baby, but it can also be really hard, or even impossible. Here are a few common challenges that mothers may face when breastfeeding:

• Physical challenges: Breastfeeding can be physically challenging, especially in the first few weeks. Some mothers may experience sore nipples, engorgement, and mastitis. Additionally, some mothers may have difficulty producing enough milk or have a medical condition that makes breastfeeding difficult.
• Time-consuming: Breastfeeding can be time-consuming, especially for mothers who are working or have other responsibilities. It can be difficult to schedule feedings around other activities and it can be challenging to pump and store milk when away from the baby.
• Social and emotional challenges: Breastfeeding can be difficult in social situations and some mothers may feel self-conscious breastfeeding in public. Additionally, some mothers may experience emotional challenges such as postpartum depression or feelings of isolation.
• Limited flexibility: Breastfeeding can limit a mother's flexibility as it requires the baby to be close by and available for feedings. This can make it difficult to travel or have a night out without the baby.

So can I breastfeed a donor-conceived baby if they are not genetically related to me?

Yes – in general, most mothers are able to breastfeed their donor-conceived child. But, it depends on the individual case and the methods used to achieve the pregnancy. 

If you carry the pregnancy, your body will work the same way it would if you got pregnant any other way. Lactation is a biological, hormonal response that occurs during and after pregnancy. Whether your baby was conceived from your own eggs or donor eggs, your body will trigger specific hormones to initiate milk production. So if breastfeeding is easy or hard for you – know that it would be that way regardless of the genetics of the baby. 

Can I breastfeed if I use a surrogate?

Yes – it is possible for some women who did not get pregnant to breastfeed their child; but it’s  not easy. This process is known as induced lactation, a process in which a woman can stimulate milk production through a combination of techniques such as hormone therapy, breast pumping, and/or breast massage.

The process of induced lactation can take several weeks or months, and you’ll need to work closely with a lactation consultant to ensure the process is done safely and effectively. The amount and quality of milk production can vary greatly and in some cases, it might not be enough to fully sustain an infant, therefore the use of formula may be necessary (and that’s OK!).

Induced lactation is not an easy process and it may require a lot of time, effort, and dedication. You should also consider the emotional and psychological aspects of this process, as it may bring up feelings of sadness, disappointment, or loss, especially if the woman has a history of infertility or has gone through a difficult pregnancy.

Will breastfeeding pass on my DNA?

If you breastfeed a donor-conceived child, they will not receive your DNA through the breastmilk. DNA is the genetic material that is responsible for the inherited traits and characteristics of an individual. It is present in every cell of the body and is passed onto offspring through the egg and sperm cells. Breastmilk is produced by the mammary glands and contains a mix of different nutrients, antibodies, and hormones that are beneficial for the growth and development of a baby, but it does not contain DNA.

The benefits of breastfeeding your donor-conceived child

In addition to providing an important source of nutrition and immune support for your baby, breastfeeding can play a significant role in the bonding and attachment between a mother and her donor-conceived child. The act of breastfeeding can release hormones like oxytocin in both the mother and the child, which can help to promote feelings of love, calm and bonding. 

One study of mothers who breastfeed their children found that they exhibit more maternal sensitivity. Maternal sensitivity was defined as the synchronous timing of a mother’s responsiveness to her child, her emotional tone, her flexibility in her behavior and her ability to read her child’s cues. However, the effect sizes were small, so don’t stress out if breastfeeding isn’t possible.

Summing it up

If you have a baby through donor eggs, and you carry the pregnancy, you can breastfeed just as you would otherwise. Even if you use a gestational carrier (surrogate), breastfeeding is still possible, although more difficult, through induced lactation. This is a process in which you stimulate milk production through a combination of techniques such as hormone therapy, breast pumping, and/or breast massage. There are a lot of pros and cons to breastfeeding, and it’s best to work with your provider to determine what’s best for your family. We are wishing you all the best on your journey!

When conducting your initial research on egg donation you were most likely focused on the short-term process like how to find the right match for your family. But now you might specifically want to know more about the long-term experiences of parents and children in families created using egg donation once the baby arrives. 

As a fertility psychologist, I often get asked what it feels like to have a baby born via egg donation, and if the baby will feel like their child or if they will be able to bond. In this guide, we’ll go over several studies that illustrate the parent-child relationship in families created using egg donation, and hopefully give you peace of mind!

Infant days: bonding with your donor-conceived child

No matter how your child is conceived, the answers to these questions are not black and white. Because just like any other pregnancy, some parents immediately feel a parental connection, even while their child is in-utero. And for some it may take months post-delivery. And even once the baby arrives, it can be very normal to feel uncertain about having a baby using someone else’s DNA. But these feelings tend to dissipate. A recent study conducted in 2020 found that women who were pregnant via egg donation had concerns about whether the child would feel like their own, but by the end of the first year, they felt secure and confident as the child’s mother. 

Early childhood: relationship satisfaction 

In terms of parental psychological health, studies have established that egg donation parents are psychologically well-adjusted in terms of their levels of depression, anxiety, parenting stress, and relationship quality with their partner. They also reported lower levels of parenting stress compared with IVF and sperm donation parents when children were ages three to eight years old.  And, egg donation mothers reported greater relationship satisfaction than IVF and sperm donation mothers. Similarly, fathers' depression scores did not differ between family types, but egg donation fathers reported lower levels of anxiety than comparison groups. At age 12, no differences were found between family types in mothers' levels of depression, anxiety, or relationship satisfaction. So basically, parental psychological health is not much impacted by how their baby was born. 

Another study also found no differences between egg donation, sperm donation, and natural conception mothers or fathers in levels of parenting stress, depression, anxiety, or relationship satisfaction when children were one year of age. At ages two and three, no differences were found between family types for mothers or fathers on any of the psychological health measures. When children were age 10, egg donation mothers did not differ in their scores for maternal distress compared with sperm donation or natural conception mothers.

A US-based study of 31 egg donation families with a child aged six months to five years found that when assessing family interactions, the sample scored lower than norms on conflict scores, and higher than norms on cohesion scores. Meaning, parents whose child was born via egg donation had better perceptions of interpersonal relationships within the family than a normative sample.

Parents whose child was born via egg donation had better perceptions of interpersonal relationships within the family than a normative sample.

Another study found that egg donation mothers expressed greater enjoyment in motherhood and greater warmth toward their infant than natural conception mothers, and greater pleasure in proximity to the infant. Greater emotional involvement with the baby was also found among gamete donation parents compared with natural conception parents.

How do children feel about being donor-conceived? 

What about the emerging research on donor conceived children’s perspectives of the quality of their relationships with their parents and their own psychological well-being? The European Study of Assisted Reproduction found children conceived through egg donation to be well-adjusted in terms of their socioemotional development at ages both three to eight years of age and at age 12. 

Relationship quality collected using a semistructured interview designed to obtain children's perspectives on family relationships indicated that children in egg donation, sperm donation, and natural conception families viewed their parents similarly in terms of their affection, harshness, and anger. No differences were found between groups at either age in children's interview ratings of maternal or paternal warmth and affection, availability, or amount of interests/activities shared with parents. Unlike in natural conception families, egg donation children did not report a decline in shared activities with their mothers and fathers between the two timepoints. And in another study, when children were asked about whether they would change anything about their family, the vast majority said that they would keep their family the same as it is, suggesting contentment with their current situation.

When [donor-conceived] children were asked about whether they would change anything about their family, the vast majority said that they would keep their family the same as it is, suggesting contentment with their current situation

Longitudinal research shows that children born via egg donation do not differ in their psychological adjustment from children born through other forms of assisted reproduction or through natural conception. At all timepoints egg donation, children were similar to comparison groups of behavioral and socioemotional adjustment and in adolescence they showed similar scores for self-esteem and positive psychological functioning. 

Overall, studies that have looked at the long-term outcomes regarding family well being and the quality of relationship between parent and child indicates that families conceived via egg donation function well in terms of child adjustment, parental psychological health, and parent-child relationship quality. Some researchers conclude that this may be because those  who continue to have fertility treatments despite failures may have strong coping skills and thus may not be as affected by everyday parenting issues. With regard to the quality of parent-child relationships, researchers have consistently found a high quality of parenting relationship  between parent and child across studies. 

Religions have their own moral code and teachings regarding family creation. The emerging use and evolving regulation of egg donation and assisted reproductive technologies have brought into focus the views of different religions and religious organizations. While most religions have historical and relatively outdated teachings on reproduction itself, recent years have seen emerging voices from organized religion on egg donation and assisted reproductive technologies. 

Some faith leaders cite beliefs about the purpose of sex - primarily that it is meant to be procreative and unitive, and that fertility options therefore go against or blur the lines of religious morality. Although individual members may accept and support using donated eggs, many faiths do try to limit, if not ban, the practice altogether. In this guide, we’ll go over a few examples on what religions say about egg donation.

Buddhism: 

Buddhism does not have specific teachings on the use of egg donation and ART. Dr. Schenker shares that Buddhist discourse largely accepts egg donation as long as the child has the right to know their genetic parent(s). 

Catholicism: 

One religion that has clear guidelines on the use of egg donation and assisted reproductive technologies (IVF) is Catholicism. The Roman Catholic Church holds that life begins at conception, that children must be conceived during sex, and that any conception outside a physical union is condemnable. Therefore, the Church prohibits any form of artificial reproduction that separates procreation from the conjugal act between a married heterosexual couple. This includes the use of egg donation, because it involves the separation of the procreative and unitive aspects of the conjugal act.

Hinduism: 

Hinduism does not have specific teachings on the use of egg donation and art. However, according to Dr. Schenker, an expert on religious faith and professor at Hadassah University and Medical Center, Hinduism accepts egg donation as long as the child has the right to know their genetic parents. 

Judaism: 

Jewish law and tradition strongly encourages “be fruitful and multiply” and most jewish people embrace egg donation as a way of achieving this. Most rabbinic authorities hold that egg donation and surrogacy are allowed under jewish law. However, the rabbinical world is divided on whether an intended parent should find a donor who is jewish. The conservative and orthodox movements suggest that the egg donor must be fully jewish, while the reform movement suggests that as long as the intended parent is jewish, the child is considered jewish as well. In 1996, the committee on jewish law and standards of the rabbinical assembly declared that a child born to a jewish woman is jewish, regardless of the religious status of the ovum donor. Read more in I'm Jewish. How Should I Be Thinking About A Jewish Egg Donor?

Protestantism: 

Protestant Christianity generally views the use of egg donation and ART as problematic. Unlike the Catholic Church, however, Protestant denominations do not have a centralized authority that can issue official statements on these issues. Nevertheless, the Church of England, one of the dominant voices in Protestant policy, expressed its disapproval at the prospect of offering fertility treatments to single women and gay couples at the time of the passing of the 2012 Human Fertility and Embryology Act in England. The subsequent law however gave access to single women and gay couples to egg donation fertility treatments. 

Shia Islam: 

Given the shia branch of islam is largely seen in iran, the rulings of the ayatollahs in iran have supreme jurisprudence in the Shiite Islamic world. The Iranian law on gamete donation, passed in 2003 and approved by the guardian council, allows for egg donation provided the husband marries the egg donor temporarily. However, sperm donation is forbidden as a sperm donor cannot temporarily marry an already married woman whose husband is infertile. Interestingly, embryo donation, from another married couple, is allowed.

Sunni Islam:  

Sunni Muslims follow the Fatwas issued by religious bodies such as Al-Azhar University in Cairo and the Islamic Fikh Council in Mecca on matters related to everyday life. These Fatwas and guidelines allow for assisted reproduction as long as the sperm and oocyte are those of the married couple, and the embryo is replaced into the wife’s uterus during an existing marriage. Simply, this means that third party egg donation is not allowed. 

Faith and egg donation

Different religions have different views on the use of egg donation and assisted reproductive technologies like IVF. While some religions view these technologies as problematic, others may view them as acceptable in certain circumstances. Generally, with the exception of Catholicism, the lack of a central decision making authority in other major global religions means that gray areas exist in the context of religious views on egg donation.

What if my religion does not approve of using donor eggs?

If your religion does not allow the use of donor eggs or even IVF, it is important to consider your own beliefs and values when deciding whether to pursue these options. It may be helpful to speak with a religious leader or authority within your faith tradition to learn more about the teachings and beliefs of your religion, and to explore how these teachings may apply to your situation. You may also want to consider seeking guidance from a mental health professional, who can help you navigate your thoughts and feelings about the use of donor eggs.

Ultimately, the decision to use donor eggs is a deeply personal one that should be made based on your own values, beliefs, and circumstances. It is important to consider all of the potential risks and benefits of these options, and to weigh them carefully before making a decision.

Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account today!

After years of not being able to build your family through conventional methods, you may have found yourself here because you're considering conceiving using gamete donation. Understandably, you likely have many questions about it, particularly the psychological aspects of the mother-child relationship, questions about how it might feel to use donor eggs, or if the child will even feel like yours. All of these are valid questions and are probably just a few out of a million questions running through your mind. But when using assisted reproductive technology and donor gametes to create your family, there is no such thing as too many questions! The more questions you ask and the more knowledge you gather, the less scary it will feel and the more confident you will be about your decision to use egg donation. So let’s dive in.

More women are turning to egg donation 

Aside from health/medical issues, women are turning to egg donation because they have medically “aged out.” Sadly, age is not just a number. The stark reality is that age is one of the most important aspects when it comes to getting pregnant with your own eggs. Women are delaying childbirth for many reasons, but no one talks to them about the consequences of doing so.

In 2019, there were almost 20,000 IVF transfers using donor eggs. And as topics such as egg donation and surrogacy become more mainstream in the media, more families are starting to share their experiences with third party reproduction and how they are raising their donor conceived children. More resources for families are also becoming available, but still, many continue to struggle to navigate, understand, and experience parenting a child conceived in this way.

The mother-child relationship in egg donation families

A common question for many is regarding the impact of using a donor egg on the relationship between mother and baby. Many are afraid they will not bond with the baby or that the baby will not feel like theirs. But, studies have shown that most mothers using donor eggs to have their baby felt secure and confident as the child’s mother by the end of that first year. Which makes sense since during that first year your entire existence revolves around the baby and not much else. And making it to that first birthday is a huge milestone, not just for the baby but for the parents as well.  In that same study, it was also found that even though over 80% of mothers did think about the non-genetic aspect during pregnancy, two thirds of them reported that egg donation had not influenced their relationship with their child. The bond that was built during that first year only cemented the mother-child relationship. 

Other questions include the idea of anonymity of the donor versus knowing the donor. What, when, and how to tell the donor conceived child about their beginnings, along with deciding on what, when or if to tell family and friends. 

Psychological aspects of using donor eggs

Many parents also want to know about the psychological aspects of using donor eggs. For some the idea of having to surrender one's own DNA and all that entails in order to bring a child into the world can be a difficult idea to process. Even though the United States has one of the highest rates of blended families – consisting of half or step children, step mothers and fathers – where love and family is not based on DNA, this idea of not being genetically related to your child, can still be a difficult one to grasp. But once the longing to be a parent speaks louder than the urge to procreate, that feeling slowly begins to take a back seat. 

But once the longing to be a parent speaks louder than the urge to procreate, that feeling slowly begins to take a back seat.

The emotional journey of finding an egg donor

Another emotionally charged piece can be the process itself. The process of choosing an egg donor can feel impersonal and uncomfortable. The screening process for the egg donor to ensure she is medically and psychologically fit can be time consuming. And waiting for the results of the retrieval can be anxiety provoking. And because using an egg donor comes with extra costs, some families feel that egg donation is out of reach. And for many, the cost to build the family of their dreams may lead to mounting debt that seems daunting.  

The upside

Despite the challenges, people are still choosing to use egg donation to build their families due to the high success rate and probability that they will become parents. Typically, for a woman over 39, using her own eggs has a success rate of about less than 10% per IVF cycle. Whereas an IVF cycle using donor eggs averages almost 50%. And because egg quality and age are the main reasons for miscarriage, those using donor eggs have lower rates of miscarriage. Also, if you are having the embryo transferred to yourself, egg donation can also give you the experience of pregnancy and childbirth and starting the connection with the baby from day one.

The decision to use an egg donor to conceive your child is not easy. Fortunately, parents using third party reproduction are not alone. Cofertility recognizes and understands the sensitive nature of conceiving using donor eggs. We also understand the longing to be a parent.  Our team works really hard to make the egg donor experience a warmer, more human centric process, by offering community and support throughout this journey. Create a free account today to get started.

If you are planning to donate your eggs or are planning to be a recipient of an egg donation, do not be surprised if you are told by your clinic or agency that you need psychological screening before proceeding. For most people, ‘psychological screening’ sounds like a test that needs to be passed in order to donate or to become parents. This can create tension, annoyance, and even anger. Some look at this step as another obstacle to meeting their end goal or just another box that needs to be checked before moving forward. But in essence, good quality programs require this meeting to ensure you understand the consequences, and are mentally prepared for all that comes along with donating or receiving donor eggs. 

As a psychologist who regularly performs these psychological screenings, my goal is to make sure you have explored all the ethical, social, and emotional ramifications that come with egg donation. This meeting allows you to think about both the short and long-term impacts of egg donation. It gives you things to ponder that you may not have thought about, and allows you the opportunity to ask questions that you were afraid to ask in an open and safe space. In this article, I will give you a glimpse into what this screening process can be like for both egg donors and recipients.

Egg donor psychological screening

For egg donors this screening is extremely important because we want to make sure she is fully prepared, ready, and understands what it means to serve as an egg donor. She needs to understand the physical, psychological, and legal risks of donating. We also want to look at why she is donating and identify any potential emotional problems that may be contraindicated to donating. These areas are assessed based on the guidelines set forth by The American Society for Reproductive Medicine (ASRM). If a donor has a spouse or long-term partner, they may also be included in the evaluation to confirm the presence of support and understanding of the process and how the results of donating could potentially impact them as well. 

Typically, this evaluation includes a clinical interview and a standardized test. The whole process can take anywhere from two to three hours to complete. Types of questions asked include: family, education, and work history, motivation to donate, current life stressors and coping skills, traumatic reproductive history, interpersonal relationships and sexual history, along with any personal and family history of mental health issues. During the evaluation the donor’s understanding of the potential emotional and social risks is also discussed and a large portion of the meeting will focus on the implications for the donor, their current or future children or partners, and how the donation may even affect their extended families. 

Donors should be prepared to share health information about not only themselves but also health information about their family. This includes their parents, siblings, grandparents, aunts, uncles and cousins. This is because we need to know if there are any possible heritable traits that could be passed on in the genes. This gives the potential parents receiving the eggs with information to make an informed decision about whether or not to work with the donor. 

Intended parent psychological screening

For those receiving oocytes, a psychoeducational consultation with a qualified licensed mental health professional who has training and education in third-party reproduction is strongly recommended. During the consultation, the implications of creating a family using gamete donation is discussed. Important topics such as disclosure are covered:

• How and when do you tell your child they were conceived via egg donation? 
• What are the long-term impacts of the donation on the family? 
• How do you get past the grief of not having your own biological child? 
• What happens if the transfer does not result in a pregnancy? 
• What is the impact of treatment failure, and do you possibly need to develop alternative plans for the future? 
• What if the embryo transfer does result in a pregnancy, what does this new transition to parenthood look like? 
• What are the challenges of donor anonymity and its implications in the future?
• Embryo management is covered, meaning what will happen to embryos that will not be used? Are they discarded? 

This meeting typically takes about one to two hours and both parents are expected to participate in the meeting.

Some programs do not require meeting with a psychologist and make it an optional meeting. I would strongly advise to meet with the psychologist even if it is not required by your clinic or agency. As you can see from above, the meeting will give you invaluable information that will guide the decisions you make and will impact how you move forward as a family that is conceived via egg donation. This meeting will inform how you think, feel and talk about having this child. Take full advantage of this meeting, take notes and ask all the questions.

The psychological screening for both the egg donor and the recipient helps them make informed decisions about egg donation and provides both parties the opportunity to explore how it may impact all involved, both in the present and in the future. Be open, ask questions. Because what you are embarking on is not easy.

Read more:

• I'm a Fertility Psychologist. Here's What I Want You to Know About Growing Your Family Through Egg Donation
• 10 Facts You Need To Know About Using Donor Eggs
• What to Look For in an Egg Donation Agency

If you are considering conceiving using donor eggs, you may have questions about it, particularly about anonymous egg donation and what the research says about families conceived using anonymous donations. In this article, I break down some of the emerging research behind anonymous egg donations and their long term outcomes including impacts on the parent-child relationship.

To start, should you use an anonymous egg donor? 

This is a question that you need to strongly consider before choosing a donor. Although some agencies/centers tout anonymity, it is important to understand that true anonymity cannot be guaranteed. Because of relatively inexpensive and readily available at-home DNA testing, a child can easily discover their true origins. And now with changing laws, anonymity may not even be an option. 

However, some parents are still wanting to work with donors who will be anonymous. But why is that the case? In a 2011 study, parents who intentionally chose anonymous donation over known donation said they believed that anonymity would allow them to establish clear boundaries between the donor, child, and parent. And because they wanted to minimize any potential links between the donor and child in order to protect the mother–child relationship. In contrast, parents intentionally did not choose known donation as it was viewed as complicating the donor–child relationship and undermining the recipient's (intended mother) ability to feel secure in her role as mother.  But interestingly, the study also found that mothers could both express ambivalence and uncertainties about the non-genetic relationship with their child, but still feel confident and secure in their identity as the child’s mother. So in the end, the anonymity did not make a difference in how she felt about her identity or role as mother. 

So if anonymity doesn’t really impact a mother’s identity or role as a mother, why would someone want to choose a known or identified donor? One major reason for choosing a known donor is that one can have more information about the donor specifically as it pertains to their medical history. Furthermore you can also be kept abreast of any changes to the donor’s medical history in the future. This is so important if your child gets diagnosed with a medical issue or needs some sort of medical treatment. Being able to contact your donor could potentially save your child's life. 

Read more in Undisclosed vs. Anonymous Egg Donation: What’s the Difference?

What do donor-conceived people think?

We have also seen that donor conceived children are curious about their origins. So another advantage of using a known donor is that your child can potentially have knowledge or communication with their donor.  Research has shown that adolescents who were interested in their donor mostly wanted to know more about why they had donated, and some had questions about the donor’s family, or other children (half siblings) conceived using the same donor. In essence, what they wanted was to just better understand themselves. In a study with donor-conceived people, 86.5% believed that they had a right to non-identifying information about their donors; several also believed that they had a right to identifying information. In the end, they all wanted to know something about their donor and not necessarily to establish a relationship with the donor.  

In another study, donor-conceived people who were conceived as a result of anonymous donation and who had grown up knowing about the nature of their conception still perceived donor conception as an acceptable model of family-building, but only when an identifiable donor was used and where parents disclosed their use of donor conception from an early age. And approximatley 25% of the participants endorsed anonymous donation, subject to the availability of some non-identifying donor information. A 2018 study obtained first-hand data from a sample of donor-conceived and surrogacy-conceived children followed from infancy to adolescence, suggest that the concern that children born through third party reproductions (i.e. surrogacy or egg or sperm donation) would be distressed about their origins in adolescence was unfounded, and that children who were informed when young of their conception were accepting of this in adolescence.  The majority of the participants were actually indifferent about their conception, and were either interested in, or enjoyed positive relations with, their surrogate or donor. Not one of the adolescents indicated that they were distressed about their conception. 

A 2021 study recommends if future intended parents are considering gamete donation, for the future well-being of all involved, anonymous donation ought to be discouraged. If individuals want to proceed with anonymous donation, at a minimum they should inform their child about the nature of their conception to minimize any potential harm to their child. Also, whatever clinic or agency you are working with, it will be important that they explain how they plan on maintaining anonymity, and how they plan on keeping the donor’s information, and how the donor can be reached if a medical emergency were to come up. 

When making your decision, only one key fact should weigh heavily on your decision and that is what will be best for your future child's mental, physical and genetic health.

Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.

More and more families are turning to donor IVF to have children. If you are considering using donor eggs as part of your fertility treatment, you are likely weighing the potential pros and cons of this option. Let’s go over egg donor IVF and some of the main pros and cons of using donor eggs.

What is egg donor IVF?

Egg donation is a process in which a woman (called a donor) provides her eggs to be used by another family. The eggs are retrieved from the donor's ovaries and fertilized with sperm in a laboratory setting. The resulting embryos are then transferred to the uterus of the woman who will carry the pregnancy (called the recipient) or a gestational carrier. Egg donation can be an option for women who are unable to produce their own eggs or who have eggs of poor quality. It can also be an option for same-sex male couples or single men who want to have a child using a surrogate.

The egg donation process typically involves several steps. First, the donor undergoes medical and psychological screening to determine if she is a suitable candidate for donation. This includes a physical exam, blood tests, and a review of medical and family history. The donor is also required to undergo psychological counseling to ensure that she is emotionally prepared for the process.

Next, the donor is given fertility medications to stimulate her ovaries to produce multiple mature eggs. The eggs are then retrieved through a surgical procedure called oocyte retrieval, which is performed under sedation or general anesthesia. The eggs are then fertilized with sperm in a laboratory setting, and the resulting embryos are transferred to the recipient's uterus. If the transfer is successful, the recipient will carry the pregnancy to term and give birth to the child.

Egg donation is a complex and often emotional process, and it is important for both the donor and the recipient to carefully consider the legal, financial, and emotional implications of the decision. It is also important for both parties to work with a reputable fertility clinic and egg donation agency (like Cofertility) to ensure that all necessary medical, legal, and ethical guidelines are followed.

Now, let’s review some of the pros and cons to using donor eggs.

Pros:

• First and foremost is the chance to have a baby! Donor egg IVF has a high success rate. Many women who use donor eggs achieve pregnancy and give birth to healthy babies.
• Using donor eggs can allow women who are older (over 40) or who have experienced age-related fertility decline to have a child. Donor eggs may also be an option for women who have certain health conditions that affect their fertility, such as premature menopause or damaged ovaries.
• Donor egg IVF allows women who can’t use their own eggs the meaningful opportunity to carry a pregnancy. With donor eggs, most women can still carry a healthy pregnancy and breastfeed. 
• Donor eggs can be used by LGBTQ+ couples who wish to have a child that is genetically related to one of them.
• Children born through egg donation live happy, normal lives. We now have evidence that both donor-conceived children (from early childhood to adolescence) and their parents are psychologically well adjusted and do not differ from families with spontaneously or own-gamete conceived children. (That being said, there are some parenting best-practices you should know!)

Cons:

• Donor egg IVF can be expensive, with costs in the tens of thousands of dollars. Some insurance plans may cover some or all of the costs, but it is important to check with your insurance provider or employer to understand your coverage.
• Using donor eggs involves a number of legal considerations, including contracts between you with the donor. One thing the contract outlines is the expected relationship and when/if/how your donor-conceived child can know more about the donor. It is important to understand these issues before proceeding with donor egg IVF. If you work with Cofertility, we will ensure you and the egg donor have excellent legal representation and a sound contract.
• Using donor eggs can involve complex emotional considerations, such as feelings of loss or grief for some people. It is important to discuss these emotions with a mental health professional before proceeding with donor egg IVF.

Finding an egg donor

There are a number of ways to find a donor, including using a donor egg agency or searching online databases. It is important to carefully research and consider your options before making a decision. At Cofertility, you can create a free account to begin your journey. Our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

From end to end, we take a more human approach to egg donation. Our pre-qualified donors are ambitious, kind, and excited to help your family. We’re ready to make your parenting dreams a reality.  

According to the CDC, 12% of all IVF cycles in the U.S. involve eggs retrieved from a donor. Donor-egg IVF has the highest success rate of any fertility treatment, and is becoming an increasingly common way for families to grow. In this guide on donor eggs, we’ll cover some important stats we think you should know.

More and more families are using donor eggs

It’s hard to know exactly how many egg donation cycles happen each year in the US, but we can get a good picture through SART, which tracks data for nearly 400 clinics annually. 

In 2019 there were nearly 20,000 IVF transfers using donor eggs at SART-reporting clinics. That is up 14% from the previous five years. Of those transfers:

• 1,776 used fresh donor eggs
• 2,468 used frozen donor eggs
• 15,294 transferred thawed embryos

Donor eggs can increase your chances of success

Around 53 percent of all donor egg cycles will result in at least one live birth. This percentage varies depending on the egg donor, recipient body mass index, stage of embryo at transfer, the number of oocytes retrieved, and the quality of the clinic.

At every age, the chances of birth with donor eggs is better, but those who benefit the most from donor eggs are women over 35 and those with low ovarian reserve. In fact, about one-quarter of women over 40 who succeeded with IVF did so through the use of donor eggs. 

The chart was made using the SART Patient Predictor for an average woman (5’4”, 150 lbs) with diminished ovarian reserve. As you can see, the chances of live birth after one donor egg cycle is 54% for recipients under 40, and only goes down slightly after this.

At Cofertility, the average number of mature eggs a family receives and fertilizes is 12. Some intended parents want to do two egg retrievals with the donor which is definitely possible. We also ask each of our donors whether they are open to a second cycle as part of the initial application — many report that they are!

You can see how many eggs are retrieved in the first cycle and go from there. If, for any reason, the eggs retrieved in that round do not lead to a live birth, our baby guarantee will kick in and we’ll re-match you at no additional match deposit or Cofertility coordination fee.

The success of egg donation depends more on the age of the donor than the birth mother

It’s important to remember that your age when you get pregnant is not as important as the age of the eggs with which you get pregnant. The success of egg donation depends on many factors, but is not considered to be related to the age of the recipient.

So how old should your egg donor be? We follow ASRM guidelines that say egg donors should be between the ages of 21 and 34 years at the time of donation. Donors under 25 do not have better outcomes. So if you find a donor you love who is 30, don’t hesitate. 

Younger donor eggs may not always be better

One study of infertility patients using donor eggs found the chances of live birth among cycles using egg donors < 25 years was 13% lower for those using donors age 25 to 29.

Another older but large study of 3,889 fresh donor egg cycles found that the cycles utilizing donors 30 to 34 years had a higher incidence of live birth than cycles with donors under 30 years, as well as donors over 34.

While many people gravitate towards younger donors under the assumption that she’ll retrieve more eggs, the good news is that the number of eggs retrieved - for donors at any age - is predictable. When you find a donor profile that resonates with you, your doctor will help determine if she’s a good candidate. All the donors at Cofertility are pre-qualified and most of them pass medical clearance upon match. Create a free account today to meet your match!

Similarly, women under age 25 going through IVF have been shown to have a lower success rate compared to women 25-30, and may have higher rates of miscarriage. No one understands why this may be the case for younger women, but it’s one of the reasons we recommend donors aged 25-34. 

The median number of eggs retrieved from donors is 18, with half retrieving 13-25

A Harvard study of 774 egg donor cycles found that across all ages, the median number of oocytes (eggs) retrieved was 18. The middle 50% retrieved 13-25 eggs, meaning 25% of the donors retrieved over 25 and 25% retrieved under 13. Mature eggs were slightly lower, at a median of 15. 

Here is the breakdown of median eggs retrieved (and middle 50%) from the study, by age:

• <25: 19 (14-26)
• 25-29: 18 (13-25)
• 30-34: 16 (10-21)

Three to five donor eggs generally leads to at least one genetically normal embryo

A 2015 study of 647 frozen donor eggs found that:

• 97.1% survived thawing
• 85.3% of the eggs fertilized
• 59.1% made it to blastocyst
• 84.2% of blastocysts were euploid (genetically normal)

So three donor eggs would yield a little over one genetically normal embryo on average while nine donor eggs would be expected to yield three to four euploid embryos on average. 

So what does that mean for bringing home a baby? One study found the pregnancy rate from a single euploid is nearly 70%, and that having three euploid embryos gives you a 94.9% chance of achieving pregnancy. Since the study is from a group of infertility patients, these numbers could be even higher for donor eggs.

The number of eggs your donor will retrieve can be predicted by her AMH levels and antral follicle counts. However, it’s important to keep in mind that overall fertilization rates will vary depending on factors beyond the egg, including the quality of the sperm and the quality of the clinic. 

Read more in How Many Donor Egg Cycles Does It Take To Have A Baby?      

Fresh donor eggs may be better, but the jury’s still out

There is some evidence that the success rate with fresh donor eggs is higher than with frozen donor eggs. A 2021 study of 323 donor egg transfers found the following live birth rates:

• Fresh eggs: 49%
• Frozen eggs: 30%

Another study found that thawed frozen eggs were less likely to fertilize and develop into healthy embryos. Howeverly, ultimately, they found no difference in pregnancy outcomes between the fresh and frozen donor egg cycles. 

Regardless, even with fresh eggs, most families decide to freeze the embryos after fertilization. This way, the embryos can undergo genetic testing and be saved for future sibling transfers. Some studies have found that frozen embryos have a higher implantation rate compared to fresh embryos, while other studies show just the opposite.

Read more in What's the Difference Between Fresh vs. Frozen Donor Eggs?

Children born through egg donation live happy, normal lives

While we still need more research into the experiences of donor-conceived people, there have been a few important studies that give us confidence that donor-conceived children have the same well-being as other children, and may even be closer to their mothers than others.

A study of 40 children born through egg donation found:

• Children in egg donation families view their relationships with their mothers as warm and enjoyable, even more so than other children
• There is no difference in the father-child relationship for children born via egg donation
• There is no difference in the egg-donor children’s rating of their own psychological well-being 

When researchers asked the children about whether they would change anything about their family… The vast majority said that they would keep their family the same as it is. 

Similarly, another study found that mothers through egg donation find their relations higher in joy than other mothers. And egg donation mothers have low rates of disappointment and anger. So while it may feel daunting to pursue donor eggs at first, parents quickly come to terms with the situation and have similar, if not better, experiences compared to other parents. 

Read more in How Can I Come to Terms with Using Donor Eggs?

Donor compensation can be problematic

A 2021 Harvard study found that 62% of donor-conceived adults felt the exchange of money for donor gametes was wrong, and 41% were troubled by the fact that money was exchanged around their conception. 

Researchers have also found that payment may incentivize donors to falsify information, which could compromise the welfare of the donor child and family. ASRM suggests that a reasonable compensation should not exceed $5,000 US dollars per cycle.

At Cofertility, we have a unique model that does not include cash compensation. Instead, egg donors keep half the eggs retrieved for their own future use. This has led us to be able to recruit a more diverse, high-caliber group of donors while serving families in a more ethical way. 

Telling donor-conceived children how they were conceived is paramount

Most experts agree that it’s best to be honest with children about how they were conceived and normalize their conception from an early age. 

One study found a lack of communication about the child’s genetic origins may interfere with positive interactions between mothers and their children (the study did not mention fathers). And secrecy surrounding the child’s donor conception was associated with less positive mother-child interaction. Another study of donor conceived adults found that greater parental avoidance of the topic was associated with poorer family functioning.

Sharing this information is good for the parents too. Mothers who disclose the information to their children by age 7 or 10 show lower rates of depression than those who do not disclose, and fathers have lower stress levels.

But we don’t need studies to know that honesty is important. Secrecy assumes shame, and there is nothing shameful about donor egg conception. 

Read more in How to Talk to Your Donor-Conceived Child About Their Conception Story

“Anonymous” donation is not a thing

In a world of ubiquitous genetic testing and social media, no gamete donation can be guaranteed to be anonymous. Regardless of the information you have about the donor on paper, the donor-conceived child may grow up and find genetic relatives, or vice versa. Fact is:

• Many donor-conceived children become curious about their genetic origins as they get older
• A medical situation may arise and you have critical questions to ask the donor
• The donor-conceived person may find genetic relatives on a site like 23andMe 
• The laws around anonymity are changing 

We believe, at minimum, families should have access to the name and contact information of the donor. This doesn’t mean the family has to have a relationship with the donor, it just means that if the child grows up and wants to reach out, they can. 

As egg donation becomes a more popular avenue for family-building, the industry is learning more about the nuances of the process. We’ll continue to stay ahead of the research, and use these insights to support our members. If we can be of service, don’t hesitate to reach out.

Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.

Once you are diagnosed with infertility, the medical team steps in and lays out all the available options. Their job is to give you all the facts which include the chances of a healthy pregnancy, delivery, and baby. One of those options, which entails the highest success rates in achieving a pregnancy, may be egg donation. Many times, once the relief of knowing that there is still a possibility of parenthood, the reality of what using an egg donor means sinks in. That is typically when a psychologist comes in. 

The most common questions asked in a therapist's office are much different than those asked in an REI’s office. Questions for a therapist typically revolve around the importance of genetics, the fear of not bonding, how the parent/child relationship will look, and long-term impact of the donation on everyone involved. As an expert psychologist in this field, I have worked with thousands of families pursuing egg donation. In this guide, we’ll walk through common questions and what I want you to know. 

Five common questions about becoming a parent through egg donation

Is the egg donor the biological parent?

No, the egg donor is not the biological parent. An egg donor is someone who provides 50% of what it takes to create human life. The other 50% comes from the sperm. The donor is genetically related to the child, but by no means is the parent. Read Will a Donor Conceived Child Have My DNA?

How does it feel to have a donor egg baby? 

It feels just like any other baby. Although DNA is an important determinant of who we are as people, relationships are not formed by DNA. Think about the terms mother, step-mother, mother-in-law. All of these are relationships, but only one is formed by DNA. What makes a mother / child relationship is the bond that is formed over time while caring for a child.

Will they feel like my child? 

Yes, but for some, it may not happen immediately. Just like with any other pregnancy, some women connect with their child while still pregnant, and for some it takes a few months post - delivery. Once the child is born, it is also normal to feel uncertain about not being genetically connected to your child in fact, one study found exactly that. The study found that many women pregnant via egg donation had concerns about whether the child would feel like their own, but by the end of the first year, most mothers felt secure and confident in their position as the child’s mother. 

Will I bond with my egg donor child?

It is normal to grieve the loss of not having a child that is genetically yours. It is also normal to be afraid that because your child is not genetically yours, that you may have a hard time bonding. The truth is, regardless if your child is born via donor eggs or otherwise, bonding doesn’t happen overnight. Bonding takes place over time. 

Will my donor-conceived child bond with my biological child?

Those facing secondary infertility (infertility after having a biological child) have concerns that the two children will not bond because they do not share 100% of their genes. They are afraid that their donor-conceived child might feel less than their biological child and may have difficulty bonding. Once your child arrives however, you will be a family, just like any other family. Because they are being raised together they won’t see each other as anything but siblings. Again, just like any other relationship, the sibling relationship will also grow and evolve over time.

Here’s what I want you to know

If you’ve been working to build your family through your own IVF cycles, you may have already faced grief and loss. For some people, the idea of increasing chances of success with donor eggs is a relief. But for others, it may take some time coming to terms with using donor eggs. Here’s what I want you to know. 

Nurture is important, and you will truly shape this little human’s life

Nature refers to how genetics influence development, whereas nurture refers to how the environment, such as relationships and experiences, influence development. While some aspects of development may be strongly influenced by biology, environmental influences may also play a role. For example, heredity influences how tall a person will be but if a child grows up in an environment without adequate nutrition, then they may not reach their potential height. At the end of the day, DNA plays a role in your child's development, but the parent who cares, loves and supports their child, greatly contributes to the type of person their child will grow up to become. 

Children in egg donation families do well

We now have evidence that both donor-conceived children (from early childhood to adolescence) and their parents are psychologically well adjusted and do not differ from families with spontaneously or own-gamete conceived children. One study found that "Children in egg donation families viewed their relationships with their mothers as significantly higher in warmth and enjoyment than did children in the control group of IVF families" and "it is possible that having waited so long to have their children, egg donation mothers are especially committed to parenthood when their children do arrive."

It’s okay to seek therapy and support

Talking openly and honestly in a judgment free space is an important aspect to processing feelings, and finding the acceptance and peace to move forward with your journey to parenthood. Speaking with a therapist who specializes in fertility can be an invaluable resource. So can speaking with others who have either already been through the egg donation process or are contemplating using a donor. Find comfort that everything you are feeling has been felt by parents before you. All your doubts and fears have surfaced in many parents as well. We are here to support you on this journey. 

Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.

In order to build your family, you need to use donor eggs, and you may have mixed feelings about it. On the one hand a part of you is relieved that you will increase your chances of having a baby, but on the other hand you think, “if I use donor eggs, will I regret my decision?” 

It makes sense as to why that thought may cross your mind. A study done by Greenfeld and Klock found that 61% of recipients found the decision to use donor eggs a difficult one. Unless using donor eggs is something you have always known you will need, coming to terms and changing your beliefs about how your family will be formed, is not easy. 

Among the many concerns that come along with using donor eggs, there are fears that the child may not look like you, fears that you may not bond with your child, or fears that once your child finds out how they were conceived, they will want to find their “real parent” and no longer look at you as their parent.

When learning that a genetic connection is no longer an option, what is most fundamental for coming to terms with infertility, as discussed by Sachs and Burns, is defining your goal. What is most important to you? Is your goal reproduction or is your goal parenthood? Play your tape forward and imagine how you want your future to look. If reproduction is the goal, and a biological child is the most important facet, then you must accept a child-free life. But if the goal is to be a parent, to raise a child, and have a family, then alternatives, including egg donation, need to be considered.

Once you have settled on your decision that being a parent is what you want, then listing all your fears and working through them will help you answer the question of ‘will I regret it?’ Here are a few common fears that intended parents think will cause regret about donor conception.

Fear 1: What if the child doesn’t look like me?

It is normal that the appearance of your child is something you think about. You may think that if your child doesn’t resemble you in some form, you may have a harder time bonding and loving your child. 

The truth is, even if you selected a donor with the same hair and eye color, recessive and dominant genes will determine what traits actually come through. A couple with blonde hair and blue eyes may very well have a child with dark eyes and hair. 

A baby does not need to look like you to bond with you, but for some families, similar physical traits are very important. A way to alleviate some of this concern is to find a donor who has the traits that you deem are important. Make a list of criteria (physical, and non-physical) that are important and choose a donor based on those criteria. Know that you may not find 100% of what is on your list.. Here is the thing, the appearance of your child does not have any bearing on whether you bond with your child. So what necessitates bonding? That leads us to fear number two. 

Fear 2: What if I don’t bond with my baby?

It is normal and acceptable to grieve the loss of having a child that is genetically related to you. It is also normal and acceptable to worry that because your child will not be genetically yours, that you may have a harder time bonding with your child. 

The truth is, a donated oocyte is but one piece of the building block required for human life. But you as a parent will play an essential, and even more important, role in your child’s entire life. It will be you who will be waking up at all hours of the night feeding, changing and comforting your child. It will be you who will be raising, disciplining, educating, and loving your child. It will be you who will be introducing and teaching your child about all the hobbies, sports, places, music, and holidays you love.  

Whether your child is born via donor eggs or otherwise, bonding doesn’t happen overnight. Those who have been adopted or raised by parents who are not genetically related will tell you one thing, DNA played no role in the bond and love that was formed between them. What formed the bond was the love and caring that took place over time. 

But what if you create this beautiful parent/child bond and when you tell your child about their conception story (which you should do early, and often, as we discuss here), they want to meet their donor? What does that mean? Does that mean they don’t think of you as their real parent? That takes us into fear number three. 

Fear 3: What if my child doesn’t see me as their parent?

From the second your child is conceived, you are their parent legally, emotionally, and spiritually. As discussed above, the bond you make is not necessitated on DNA alone. There are many factors that contribute to bonding and the love between a parent and child only grows stronger and deeper as time goes on. 

Before embarking on their egg donor journey, some parents may have a fear that the child born via donor conceived eggs may one day reject them as parents. Sometimes they are afraid to tell their child about their origins because of this fear. But research shows over and over about the importance of being upfront and honest with your child about their conception.  

As your child grows older and begins to understand more, it is absolutely natural for them to be curious about their genetic make-up and to want to know more about their donor. Questions do not mean that your child is wanting to build a relationship with their donor and end their relationship with you. All of us are curious about our genetic make-up and family background so help them learn more about how they came to be. 

So, will I regret using donor eggs to have my family? 

Ask anyone who has had a child, born with or without some type of assistance, and they will all tell you the same thing: parenting is the greatest - yet hardest - thing they have ever done. It doesn’t matter how the child came into their lives, the role and relationship of parent and child is the same. 

When working with parents who had donor conceived children, their only real regret was they wished they had done this sooner. They wished they had let go of their preconceived notions that a baby who looks like them or who shares their genes is the only way to be a parent. That bringing a child into their lives using alternative methods means the child won’t see them as their real parent, or that they will not bond. 

Know this, when your baby arrives, your baby will know exactly who you are - their parent. And you will know exactly who they are - your baby.

If you’re a hopeful parent beginning your journey to family building through egg donation, this guide is for you. I am a Clinical Psychologist with over 10 years working with families just like yours — here’s everything I want you to know about how to work through the process. 

Turning to donor eggs 

After trying for what feels like a lifetime of treatments, listening to well-meaning but unhelpful advice, and countless negative pregnancy tests, your doctor gives you the news that using your own eggs is no longer an option. Donor eggs, your doctor says, will significantly increase your chances of having a child. You are told that this is not only practical but also the only real viable solution. 

Although intellectually you understand, emotionally it may be gut wrenching to hear and something you are not ready to accept. Maybe you mull over the idea of changing clinics or asking your doctor for a more aggressive medical protocol. You are ready to do and try anything. How can this be happening? You look around and see all your friends and family easily having babies. You retreat inwards and start to feel completely alone. 

You are not alone

The first egg donor pregnancy was delivered in Australia in 1984. Since then, approximately 3400 frozen donor eggs are used to have a family. Although egg donation was first intended for women with primary ovarian insufficiency, it is now used for a variety of medical and non-medical reasons such as men without a female partner.

It can be surprising to learn how many people have problems with conception. One out of every eight heterosex couples has problems conceiving or carrying a child to term. Even though egg and sperm donation and surrogacy are becoming more mainstream topics, many couples are still not open about their troubles. There can be a feeling that you are the only one which can create feelings of embarrasement, failure or shame. 

This journey is not easy and having a strong social support system is very important to help create resiliency. Lean on friends and family. Find others also on this journey — through  our community or your clinic. Learning you are not alone can give a  sense of peace and camaraderie in sharing your experience.  

Educate yourself

Before making any type of decision, the first step is to educate yourself. Take the time to learn about egg donation. Our “Learn” section is a great place to check out factual information regarding the science and history of egg donation. Being armed with solid and accurate information will help you be more confident and comfortable when making decisions. 

Give yourself space to grieve the loss of not having a biological child

Learning that you need to turn to egg donation to conceive your family can create feelings of loss, sadness, anger, and possibly even shame. You may feel a deep sense of grief over not having a genetically linked child.  Even though the child was never physically there, it is the loss of that dream that can create an anguish that only those on this journey can truly understand. 

After learning that you may not have a biological child of your own, you may walk through different stages of grief, such as the ones listed below (proposed by British Psychologist John Bowlby.) How might this grief look or feel? 

1. Shock-numbness
   During this first phase of grief, the idea of not being able to have a biological child does not feel real and seems impossible to accept. This stage may feel especially difficult for those who have worked hard their entire lives and have always set and met their goals. This loss can send shock waves through the body which can even result in somatic symptoms, such as physical pain or fatigue.
   
   
2. Yearning-searching
   In this second stage, you begin to acknowledge the significance of this loss and realize that the future you once imagined is no longer a possibility. You may turn to unhealthy outlets to try and fill this void and you may become preoccupied by feelings of emptiness.
   
   
3. Disorganization-despair
   In this stage, you accept the fact that a biological child is not possible and things will not be the way you imagined.  You might now feel a sense of hopelessness and despair. There may be anger, questioning and withdrawal from others. You may find yourself avoiding friends with children, birthday parties or family events. 
   
   
4. Reorganization and recovery
   In this phase, you start to realize that your longing for a child is stronger than your desire for them to be biologically related to you. You start setting new plans on how to grow your family.
   

Some things you can do to help you during these stages of grief include:

• Write in a journal to process your thoughts and feelings
• Join a grief / loss group 
• Write a letter to your child and include all the hopes and dreams you had for them, and then let the letter go
• Lean on family and friends
• Speak with a therapist
• Learn relaxation techniques such as progressive muscle relaxation, deep breathing, meditation and yoga.

You may find yourself cycling back and forth during the different stages and in different orders. Just remember, you need space to express your feelings and time to process this loss. Avoidance and distraction can only be helpful for so long. Allow yourself to sit with your feelings. Give yourself permission to move forward at your own pace.

Remember, DNA is a small part of who we are

Although you may not be genetically linked, you may still have the option of carrying your child, chest-feeding your child, cutting the umbilical cord, or having skin-to-skin the moment they arrive. Remember, DNA is a small part of who we are. All human beings are 99.9 percent identical in their genetic makeup and nurture plays an enormous role in who we become and who we bond with. 

To help you psychologically come to terms with building your family through egg donation, seeing a piece of yourself in your donor can alleviate some anxieties. So you may decide to work with a donor who had an upbringing similar to yours, someone with similar appearance, hobbies, interests, education, culture, or religion. 

If you have any worries about attachment or bonding to your baby conceived through the use of donor eggs, know this: I have worked with thousands of families and not one of them regretted their decision. Once you hold your baby in your arms, you will not only see the love in those eyes, you will feel the love in every part of your being. Any idea that they are not yours, forever disappears. Family is based on relationships you create and develop and not solely on your DNA.  

Supporting your donor-conceived child 

Most experts agree that it is best to be open about how your child was conceived as early as possible. Telling your child early on about their conception story helps normalize it for your child. Start early. While up for those midnight feedings, start telling your baby the story of how they were conceived. The more you practice saying it out loud, the more comfortable and confident you will become. The more comfortable and confident you become in your role as a parent, the more you will impart these feelings to your child. 

If you are hesitant to share this information with your child, ask yourself why? What makes you hesitant or afraid? Play the tape forward and imagine two scenarios. One where you are open with your child and one where you are not. How do the two scenarios play out? Which situation do you believe is the best for you and your child?

One study out of Cambridge found that in families in which parents disclosed donor conception to their children before the age of seven showed more positive mother–child relationships and higher levels of wellbeing at age 14. 

How to help your child when they get curious 

Questions about their conception, especially questions about their donor, are normal.  Questions do not necessarily mean that they are looking to meet and build a relationship with their donor. And it doesn’t mean they love you any less. All of us are curious about the make-up of our family background. This is why at-home DNA testing has become a billion dollar industry. 

Try your best to create a loving and open family dynamic so your child feels comfortable openly discussing their questions. If you normalize their origin story  as part of a bigger family narrative early on, they won’t feel any shame or confusion. Children are more resilient than we give them credit for. It is us adults who complicate things and make them more difficult than they need to be. Be open and honest. The old adage that honesty is the best policy, is undoubtedly the case when it comes to egg donation. 

In summary 

The despair that comes from learning that you are not able to conceive your own biological child can forever change the story of your life. However, it does not mean the end of your story. With egg donation being just one chapter, Family by Co can work with you to keep your dream of having a family alive. 

Every family has a story about how their child came into their lives, whether it be a story of adoption, foster care, natural conception, surprise conception, or via assisted reproduction. A child born via egg donation is no different than any other child. Your story is really no different than any other family, but there are a few things we think you should know.

1. It’s best to be truthful with your child. 

You may be asking yourself if you should tell your child how they were conceived? And if so, when and how? Remember, this is your family story and your child. You get to tell them how they were conceived and you also get to choose when to tell them. But telling them is the key phrase. Most experts agree that it is best to be open about how your child was conceived and talk to them about their conception as early as possible. Telling your child early on helps normalize it for both you and your child. By being honest and telling your child how they were conceived, you are building the foundation of trust. And trust is one of the most important facets of a parent-child relationship. 

If you are hesitant to share this information with your child, ask yourself why? What makes you hesitant or afraid? Play the tape forward and imagine two scenarios. One where you are open with your child and one where you are not. How do the two scenarios play out? Which situation do you believe is the best for you and your child?

One study out of Cambridge found that in families in which parents disclosed donor conception to their children before the age of seven showed more positive mother–child relationships and higher levels of wellbeing at age 14. 

2. Don’t wait to normalize their conception story

When should I tell my child? As soon as they are born. While up for those midnight feedings, start telling your baby the story of how they were born. The more you practice saying it out loud, the more comfortable and confident you will become. Early on you may find yourself stumbling over your words. That is okay, soon enough you will craft the perfect bedtime story. By the time they are old enough to fully understand, they will have already heard the words egg donation and IVF. In other words, to them, these are things that are just a part of their life story. 

What should you tell them? The truth. You wanted a family, but due to medical or biological reasons, you were unable to do so yourself. You were not going to ever give up your dream of having a family, so with the help of a very giving woman, caring doctors and the advancement of medicine, you were able to piece together the building blocks of life. In the beginning keep it simple and use words you know your child will understand. As they get older and their questions and understanding changes, you can start to give more details. 

3. Start with a baby book 

Aside from telling them verbally, another great way is to start a baby book. In your baby book, include a letter written to your child about why you chose this path to parenthood. Keep it simple. Let them know how much you longed to be their parent and how much you loved them before they were even born. Include this letter in your book along with information about their donor, the IVF clinic, your doctor, agency,  etc. The rest of the book will look like any other baby book, full of milestones and sweet memories.  

4. Your child may have questions, and that’s okay 

Questions about their conception, especially questions about their donor, are normal.  Questions do not necessarily mean that they are looking to meet and build a relationship with their donor. And it doesn’t mean they love you any less. All of us are curious about the make-up of our family background. This is why at-home DNA testing has become a billion dollar industry. 

Try your best to create a loving and open family dynamic so your child feels comfortable openly discussing their questions. If you normalize their origin story  as part of a bigger family narrative early on, they won’t feel any confusion or shame. Children are more resilient than we give them credit for. It is us adults who complicate things and make them more difficult than they need to be. Be open and honest. The old adage that honesty is the best policy, is undoubtedly the case when it comes to egg donation.

5. It’s best to tell your family too 

If you have already told or are planning on telling your child about their conception, then it only makes sense that others close to you know as well. By not being open with others or telling your child to keep their birth story a secret, only makes them feel that their conception was shameful or wrong in some way. There is no shame or embarrassment about how your family came to be. You should be proud that you moved mountains to have your baby.  It was your love and deep longing for this child that made you a family. Furthermore, educating others around you about egg donation can help normalize the process even more. Ensure you and your partner are on the same page regarding disclosure to family and friends. Come up with strategies on how, when,  and what you will disclose. So, when Aunt Susy asks “whose side of the family did that red curly hair come from?” you and your partner will know what to say.

6. Transitioning to parenthood

According to Glainsky¹ there are six stages of parenthood. The first one is image-making. This stage is particularly important for raising a donor conceived child. In this stage, it is important for parents to let go of their identity as an infertile person. This includes old thoughts and feelings of inadequacy and incompetency. Letting go of relationships with doctors and nurses, throwing out old medications, or deleting fertility webpages, can be difficult because these things have been a part of your identity for so long. Replacing your “old identity” with parenting classes and books, play dates, and even changing out their pristine white furniture,  can be ways to make space for your  new identity as a parent. 

7. Ways to bond with your child

Parents sometimes ask if there is anything they can do to increase their  bond with their child. Regular skin-to-skin contact, baby massage after bath time, and consistent bedtime rituals can help with bonding. Bonding also naturally occurs during feedings, whether chest or bottle feeding. Playing, talking, reading, making eye contact, and singing to baby are all ways to bond.  

8. Being overprotective

Some parents may find themselves being overly protective of their child. They may become excessively involved or not allow independence.  Others may find it difficult to discipline their donor conceived child out of fear of damaging their relationship. Every family has rules and boundaries set by their culture or own upbringing. Having a donor conceived child does not change how you enforce those rules or boundaries, or how you foster independence or emotional growth. Learning to manage your own feelings and expectations is an important skill to master as a parent. Joining parenting groups or utilizing the assistance of a therapist can be beneficial.  

9. Trust your instincts

Parenting is hard. No matter how your child came to be, there will be moments of insecurity and fear that you are “doing it wrong.” All parents at some point or another feel this way. But just because your child was born via IVF or egg donation does not mean that this isn’t your child or that you need to do anything different than what you are already doing.  You know what is best for your child. You are the best parent this child could ever have. Trust your instincts. Love your child and give yourself the grace that you deserve. You got this.

‍

References

1. Galinsky E. Between Generations: The Six Stages of Parenthood. New York Tmes Books, 1981.

If you’re hoping to grow your family through egg donation, you may have started to consider the type of relationship that you — and any donor-conceived children — will have with your donor.  We want to help you understand the difference between a disclosed and undisclosed match so that you can ultimately make a decision that’s best for you and your family. 

Defining disclosed and undisclosed matches

In a disclosed relationship, you exchange contact information and can communicate directly. The scope and degree of communication (both during and post-match) is what both parties make of it. With an undisclosed donation, you could arrange to have the information available to your child down the road (this is sometimes called Open ID).

In an undisclosed relationship, you do not exchange contact information and only communicate through Cofertility. 

Regardless of the relationship post-birth, if both parties are interested, we can facilitate a phone or video meeting between you and the donor during the matching period. This can be done with or without sharing contact information. 

What do these relationships entail? 

Although we provide these relationship categories, every relationship is unique and depends on the desires of all parties involved: you, the donor, and any future donor-conceived children. Truly, your relationship options range on a broad spectrum that can be determined in your legal agreement with the donor. 

For instance, in a disclosed relationship, you may decide to share an annual holiday card with your donor, communicate around milestone events, from first steps to graduations, or even facilitate direct communication between the donor and any donor-conceived children. On the other end of the spectrum, you may also decide to keep direct communication to a minimum, but keep the lines open if a need or issue arises. 

While an undisclosed relationship may not have any direct communication, you may still communicate through Cofertility and do things like share a photo of the baby when s/he is born, communicate meaningful updates such as first words, or ask about medical questions if they arise.

Also, if new information comes up about the donor’s own medical history, we ask her to let us know so that any relevant information can be shared with your family. This is the case regardless of the relationship you maintain. 

Who decides on the disclosure status? 

When a woman applies to our Split program, she indicates the types of relationships she may be open to. Her preferred status will then be made visible on our platform so that you can match with a donor whose desires are in line with your own. We find that a lot of donors are open to a wide range of options and then determine the specifics after getting to know you and your family. 

How should I weigh the pros and cons? 

At Cofertility, we want to honor the perspectives of all parties involved in the family-building process. This includes intended parents, donors, and especially any future donor-conceived children. While the fertility industry has historically relied on secrecy and anonymity, more research shows the benefits of being open with children about their donor-conceived roots and any available donor characteristics. As such, we encourage you to be open with your own children about their conception story. 

Also, as noted in Our stance, in a world of ubiquitous genetic testing, no gamete donation can be guaranteed to be anonymous. We work with everyone involved to build a relationship that feels right for them, and we encourage both donors and intended parents to consider the donor-conceived child’s best interest.

Birth via donor conception shapes the donor conceived child’s identity. And as your children grow up, they may want to reach out to their donor with their own questions. This is something that we make our Split members aware of. We are also upfront with donors about the fact that it’s now impossible to guarantee anonymity in egg donation. With widely available genetic tests and more state laws giving donor-conceived children access to information about their donors, it’s increasingly likely that a donor’s identity and shared genetics can be discovered. 

If you have concerns about how any future children’s relationship with their donor will affect you, rest assured that you are not alone. But most importantly, remember that you will always be their parents and they will always know that you brought them into this world and raised them with love. 

What’s next? 

If this is sounding like a lot to decide, we’re here to help you parse through what communication options feel right for you at this point in time. If you have any questions or want to talk through your personal situation, please don’t hesitate to reach out. 

All over the internet, there are articles about what miscarriage is from a technical standpoint but it’s rare that, as women, we can find the actual nitty-gritty details about what symptoms to expect during and after a pregnancy loss. The more we know, the better we can advocate for ourselves and receive support from those around us.

When I went through my first miscarriage, it was three weeks after learning that our baby was no longer growing. It took my body three whole weeks to recognize what was happening and those weeks were torture for my husband and I. Even though it took three weeks to recognize the loss, it only took about three hours from start to finish, to miscarry our first child. I have never been so broken in my entire life, nor had I ever been so unprepared for something.

Within six months, we suffered a second pregnancy loss and chose to undergo medical treatment to prompt uterine cramping to miscarry at home, thinking we would be more prepared the second time around. Unfortunately, that did not prove to be true and I had to have a D&C a few days later. What I’ve learned from my experiences could save you from feeling as unprepared as I was.

Obviously, we know that during a miscarriage, we go from being pregnant to no longer being pregnant. But what does miscarriage really look like? What symptoms should you expect during the physical loss and the weeks that follow? Here’s everything you need to know about miscarriage symptoms.

Important things to know about miscarriage

You have options

In many instances, you have options when it comes to how you miscarry. If you are afraid of miscarrying at home (which we totally get), ask your doctor about having a dilation & curettage (D&C). This scenario may, however, be the other way around — your doctor may recommend a D&C, but you may have a hard time affording the procedure, even through insurance. It’s important to know what your options are. And, as always, don’t be afraid to ask questions.

How to physically prepare for a miscarriage

• You won’t be able to use tampons during your recovery, so make sure to stock up on extra wide, large maxi pads. The overnight ones work best.
• Other items to buy would include adult diapers for comfort during the first few days after loss, especially if you miscarry at home without any intervention.
• A heating pad will work wonders for cramps you may experience for 2-4 weeks after your loss as your uterus shrinks to it’s pre-pregnancy size.

What miscarriage symptoms to expect

The most important thing for you to know about miscarriage (and pregnancy loss in general) is that it’s in no way your fault that this is happening to you and your family. Most women will feel self-blame during and after a miscarriage but it’s important for you to know that this is happening to you, not because of you.

If you think you might be miscarrying, here are some tips for what to expect. Of course, we *in no way* mean to freak you out. We just want you to be prepared. If you do miscarry, it will undoubtedly be incredibly tough in so many ways. But hopefully, these tips help give a heads up for what you might expect.

At-home miscarriage

What you should know:

• While some women experience bleeding that’s heavier than their period, other women experience intense cramping during a first-trimester miscarriage. If you do not already experience heavier PMS or cramps during your period, you may be caught off guard with your miscarriage experience.
• Even at a young gestation, these miscarriage symptoms can be physically taxing
• Many women describe miscarriage as labor, with painful contraction-like pains (even during the first trimester)
• If you are miscarrying at home, here are some reasons to go to the nearest emergency room/call your doctor.
• Abdominal pain that cannot be tolerated, despite treatment with over the counter medications such as tylenol or motrin.
• Heavy vaginal bleeding, or more than 2 pads per hour in the first few hours of bleeding. If you are feeling lightheaded, dizzy, have palpitations, chest pain, or shortness of breath, it could be a sign that your blood pressure is low from losing large amounts of blood.

What you might see:

• It’s possible that you’ll see a mixture of dark and bright red blood mixed with blood clots that range in size from dime size to as big as a lemon
• During the process of a miscarriage, you may pass tissue, or even an intact pregnancy sac that is recognizable.
• Depending on the gestational age of your pregnancy, you may be able to identify the pregnancy after the birth.

How to prepare:

• Don’t be afraid to ask your healthcare professional for a pain reliever recommendation or prescription. During the thick of miscarriage, the pain may be heightened, and having something available to alleviate pain will be one less thing to worry about.
• Have your partner, a family member, or friend with you during the physical loss. Although it seems like something you would rather do on your own, you will need support from others.

Recovery may look like this:

• Once you have passed the pregnancy, recovery will begin. You may experience heavy bleeding for another few days and then the bleeding will start to fade into lighter and lighter until it stops. Some women bleed for a few days to a few weeks after their physical miscarriage.
• You may feel sore and physically weak during the first few days after your miscarriage. This is normal as your body just went through a lot, both physically and mentally, and needs to rest. Give yourself the time to rest and begin to heal. If possible, take off of work for at least 3-5 work days. Taking more time off from work may benefit your mental health as you cope with your miscarriage. Don’t be afraid to ask your employer for bereavement leave.
• It’s important to check in with your doctor and partner during your recovery period. This may also be a good time to look into therapy or behavioral therapies. Experiencing miscarriage may be traumatic and taking care of your mental health is a priority.It can take 3-6 weeks (sometimes even longer) for the pregnancy hormones to leave your body entirely, which will ultimately trigger your first period post-miscarriage. Give your body time to recover chemically, and remember that recovery looks different for everyone.

Taking Cytotec (Misoprostol) for miscarriage

What you should know:

• Cytotec is not the same medication given to terminate a pregnancy. It’s actually most commonly used to induce labor at all gestations, including live births in the third trimester.
• The medication can be given orally, vaginally, or be dissolved in between the gums and the inner cheek.
• From the time you take the medication, you may start to feel the effects 30 minutes after to a few hours.

After taking the Cytotec, many of the same tips above for an at-home miscarriage will apply. The only change to look for would be intensified cramping due to the medication. At any point in your miscarriage if you fill a pad in under an hour or feel that your blood loss is more than expected, please call your OBGYN or go to the nearest emergency room.

Having a D&C (Dilation & Curettage):

What you should know:

• Most often performed in the operating room and under general anesthesia, but may also be performed in your doctor’s office with controlled pain medications.
• They’re covered by most insurance plans but could require high out-of-pocket costs.

How to prepare:

Follow the directions of your physician and prepare yourself for the recovery period. There may be restrictions on eating prior to the procedure, requirements with hydration, or other protocols to follow.

Recovery may look like this:

• You may experience bleeding for a few days to a few weeks after the D&C.
• Slight cramping is considered normal for multiple weeks after the procedure.
• Even though having the procedure seems like a less physically demanding process compared to miscarrying at home, the recovery may look very similar and the emotional recovery still exists. Give yourself time to begin healing, but don’t put expectations on yourself to grieve and move on within a week.

We’re here for you

Although there are a few different options for experiencing a miscarriage physically, each comes with its own aspects and recovery process. It’s important to know your options, understand what they mean, and move forward from a knowledgeable place.

After you physically miscarry, it’s so important to take the time necessary to grieve, or begin to grieve, and think of how you want to move forward with your family. This may look like taking some time off to heal — although, let’s be honest, you don’t ever fully heal and these experiences stick with you. For those undergoing fertility treatment, speaking to your doctor about how the miscarriage may impact the treatment timeline, especially if you want to try to conceive again as soon as possible.

Know that this is a difficult part of the journey, but you will get through it. And we’re right here with you.

First of all—and most importantly—if you have recently miscarried (or think you may have), we are so, so sorry. Experiencing a miscarriage is probably one of the most, if not the most, emotionally painful things you’ll ever experience. Having your baby’s life taken away from you is so incredibly gut-wrenching and life-changing...and we really wish we could just give you a giant hug right now.

Know that you are not alone, and we’ve been there. In fact, the March of Dimes estimates that as many as half of all pregnancies result in miscarriages, though the majority of those happen before someone even realize she’s pregnant. Of women who do see that plus sign on a pregnancy test, 15 to 20% will experience a miscarriage—most often, those occur in the first trimester.

There are actually a few different types of miscarriage, but the one thing they share in common is that no miscarriage is your fault. As incredibly awful as a miscarriage is to experience, please, please, try not to place blame on yourself.

Here are some of the most common types of miscarriage:

Chemical pregnancy

A chemical pregnancy means that your body may be producing some of the hormones like you’re pregnant, but no placenta or fetus forms. The embryo is usually lost right after implantation, and this type of miscarriage often occurs very early in the pregnancy, maybe even before you’re aware you’re really pregnant.

Blighted ovum (AKA missed miscarriage)

This type of early miscarriage is similar to a chemical pregnancy—except you start to grow the placenta and surrounding tissue, but there’s no fetus inside it. Unlike the chemical pregnancy, you might even start to develop pregnancy symptoms.

A missed miscarriage is usually discovered by your doctor, when you go in for your first ultrasound and discover there is no fetus. Chromosomal abnormalities are usually what leads the baby to fail to grow and thrive.

Incomplete miscarriage

An incomplete miscarriage happens when a miscarriage starts, but some of the fetus or the placenta is left behind in your uterus. If this happens, your doctor will need to monitor you—or she may prescribe misoprostol or perform a D&C (dilation and curettage) to help things along.

“Intervention becomes necessary if the woman is unstable from blood loss or if she becomes infected,” says Dr. Marra Francis, MD, FACOG, executive medical director at Everly Well. As long as you remain stable and don’t experience significant blood loss, your doctor can just monitor you and do a final ultrasound to confirm that all of the tissue is out of your uterus.

Complete miscarriage

When all of the pregnancy-related tissue has left the uterus, and the bleeding has ended, you’ve had a complete miscarriage. The doctor will likely conduct an ultrasound to ensure that nothing’s left behind that could lead to an infection or another complication.

Ectopic pregnancy

This dangerous condition occurs when the egg and sperm meet somewhere other than your uterus—and then stays there. The embryo latches on and starts growing in your fallopian tube or your ovary, where eventually, it could rupture and cause a hemorrhage of your tube.

In an ectopic pregnancy, if it isn’t caught early, you’ll develop severe pelvic pain and heavy bleeding that will likely need emergency care to manage.

Stillbirth

A stillbirth happens when the baby dies in the uterus later in the pregnancy—at least 20 weeks in. Only one percent of pregnancies end in stillbirths, according to the March of Dimes. You may experience some bleeding and cramping if it’s happening, but most often, the baby’s lack of movement is the only sign that there’s a problem.

Usually, labor starts on its own within two weeks of the baby’s death, but your doctor may induce labor or conduct a dilation and evacuation to remove the baby to help protect your health.

When should I see a doctor?

“If you see (or feel) something, say something,” should be your motto throughout your pregnancy. If you experience something that doesn’t seem quite right, don’t consult Doctor Google or us—see an actual doctor.

Common signs of a miscarriage or stillbirth that definitely need to be checked out immediately include cramping, pelvic pain, and spotting or bleeding—or later in pregnancy, a lack of fetal movement. But you should mention any changes that seem unusual to your doctor: It’s better to have a false alarm than to miss a warning sign that could potentially put you or your baby in jeopardy.

If you know you’ve had a miscarriage or are in the process of one, watch out for symptoms that you’re developing a uterine infection. If the bleeding and cramping continues beyond two weeks, or if you develop a fever, tenderness in the abdomen, or a foul-smelling vaginal discharge, see a doctor immediately.

This is so hard. How can I cope?

No matter how early in the pregnancy a miscarriage happens, it can be absolutely devastating. What makes it even tougher is that for centuries, people have been conditioned to stay silent about miscarriage and keep their grief to themselves.

Maybe it’s time to change the idea that you should deal with the pain of a miscarriage on your own. Being open and sharing your sadness with loved ones could help reduce the stigma of talking about miscarriage, and bring you strength and support from your circle.

Jessica Zucker, Ph.D., a clinical psychologist who specializes in reproductive and maternal mental health and the creator of the Instagram account @ihadamiscarriage shares, “The sooner we address the antiquated silence surrounding pregnancy and infant loss, the sooner women and families will receive the necessary support they deserve while grieving. It is time to disband the age-old silence when it comes to miscarriage and replace it with storytelling.”

Once again, sending virtual hugs and support. Take your time to grieve, and know that we’re right here with you.