Fertility

Maybe you have already found the perfect donor on Family by Co, or maybe you have just started exploring the platform. Either way, it is time to have a candid discussion with your reproductive endocrinologist (REI) so you can be crystal clear on next steps, their involvement with the donation process, and what this could mean for your family-building journey.

Do not worry if at first you are confused and overwhelmed about what questions to ask. Many times I hear, “I don’t know what to ask because I don’t even know how any of this works!” This process can definitely be overwhelming and confusing. First of all, you are not alone and you are not expected to be an expert on all things IVF. But by the end of it all, you might as well have your medical degree because you will learn more than you ever thought you wanted to know about the reproductive system!

You eat an elephant one bite and a time, so grab a notebook or create a folder in your phone. Keep a working document with all your questions and answers in one place so when you get home you can review what was said (trust me, you will forget) and have time to process and call back to ask more questions.  

Take a deep breath. Your laces are tied and you have started the race and we are here to help you up that hill. Below are some questions and discussion points to have with your REI regarding egg donation. 

First, ask the clinic about their egg donor screening protocol. Protocols and screenings can potentially differ if you are using a donor who is experienced vs. someone doing this for the first time. So you need to ask questions regarding their donor screening and approval process.

1. I am working with an agency to find my donor. What information do you need to move forward and work with my chosen donor? Will you accept testing/screening that was done outside your clinic?
2. What is involved with the egg donor screening in terms of medical, genetic and psychological screening? What should I be looking out for? What happens if the donor fails one or all the screenings?
3. How long can we expect the process to take? What is your appointment availability - one week or one month out? How long does it take to get results?
4. How many in-person visits are required? This can be important if your donor lives far from the clinic, as you may be expected to pay for donor travel costs. 
5. Does the donor’s partner need to be involved in the screening process? If yes, what screenings and costs are involved?
6. What can delay the screening and approval process?
7. My donor doesn’t live close to this clinic, can she be monitored close to home? If so, do you have a list of clinics you recommend? 

If you have never done an egg retrieval, you may want to learn more about the process, the medications and side effects.

8. What does the donor need to do to prepare for retrieval?
9. What are the side effects of the medications and the retrieval process?
10. Is there anything she can do to make this retrieval successful?
11. Can I have a copy of her calendar with medication instructions and anticipated lab or ultrasound visits?
12. Who will teach her how to do the injections?

You may have already discussed success rates with your clinic but if not, you want to ask specific questions. Sart.org is a great place to research and understand clinic success rates. You can use this online calculator from SART to get an idea of your success rates.

13. Given my history, will donor eggs increase my chances of success?
14. What is the success rate for my particular case using this particular egg and sperm?
15. How is success measured? Is it defined as embryo creation, pregnancy or a live birth?
16. What percentage of women get pregnant and deliver a baby after the first embryo transfer?

Sperm is 50% of the equation so you also need to ask some questions about sperm, regardless if you are using a donor, a partner, or your own. 

17. When will sperm need to be deposited? Day of retrieval or can it be deposited earlier and frozen? 
18. Is there a difference in outcomes if fresh vs frozen sperm is used to create embryos?
19. What tests will be required of the sperm?
20. What test results can make the sperm unusable?
21. How many appointments will be needed?
22. What if I already have frozen sperm? How do I get it to your clinic?

If you are participating in our split program and sharing the retrieved eggs with your donor instead of cash compensation, you should have a solid understanding about how it works. 

23. When will I find out how many eggs were retrieved? 
24. How will the clinic split the batch of retrieved eggs? 
25. How will they decide who gets which eggs? 
26. What happens to the eggs I keep vs the eggs the donor keeps after retrieval?

It is Cofertility’s policy that if an odd number of mature eggs are retrieved, the parents get one more egg than the donor. And if there are any immature eggs retrieved, the donor gets to keep those. 

Some clinics recommend or maybe even require a minimum number of eggs to be retrieved in order to create one embryo. So, finding out your clinic's minimum is important. 

27. What is the minimum number of eggs you recommend / require to create one embryo?
28. What happens if I do not have enough eggs?
29. Do you do genetic testing on the eggs or do we wait until the embryo is created?
30. How do I know about the quality of the eggs?

Once the eggs are retrieved, the clinic will then fertilize and grow the embryos to blastocyst stage. 

31. How is the embryo created? What are my options? Does one option create higher success rates?
32. Do you recommend we transfer fresh vs frozen embryos?
33. Do you recommend we genetically test the embryos? What are the risks and benefits of doing these tests?
34. If using frozen, when should they be dethawed and transferred?
35. How many should be transferred at one time? What are the risks of multiples?

At the end of the day, although you are not expected to be an expert and understand every single aspect of donation, you do need to feel comfortable, confident, and knowledgeable about making decisions regarding your journey. Do not feel ashamed to ask a lot of questions! Knowledge is power, and a good physician will be there to guide you. 

Problems typically occur when people are not on the same page as the clinic, or have unrealistic expectations because they do not fully understand the process. Ask the question over and over until you understand. 

Just remember, even though it may feel as if you don’t have everything figured out, or that you still don’t understand how it all works, that is okay. So if you’re feeling overwhelmed, remind yourself that you are doing the best you can and that you are not alone. We got you.

If you are over 40 and trying to grow your family, you may be wondering what path gives you the best chance for success. You are not alone! In fact, births among women ages 40-44 have been rising since the early 1980s, even as the overall U.S. birth rate fell to a record low. This is partly due to more people putting off parenthood for a variety of reasons, plus better access to assisted reproductive technology like IVF and egg donation.

It is absolutely possible to get pregnant and carry a healthy pregnancy in your 40s — let’s dive into the data around your possible paths to pregnancy.

Getting pregnant naturally over 40

While getting pregnant naturally over 40 tends to surprise people, it’s totally possible. Researchers found that for women 40-45, the crude probability of getting pregnant after trying (“naturally”) for a year was 55.5%. This compares to nearly 80% for women ages 25–27. However, it’s important to note that chances of miscarriage go up significantly. For women 40-45, one study found the chance of miscarriage is about 33.3% and goes up to 57% for women over 45.

But some people don’t want to wait a year to see if they are part of the lucky 55% who get pregnant, or they want to reduce their chances of miscarriage. If this is the case, read on to see the chances of pregnancy with fertility treatments over 40.   

Getting pregnant with IUI over 40

Let’s look at the data from 2,262 patients pursuing IUI, or intrauterine insemination. IUI is often used because it’s relatively inexpensive (at least compared to IVF), and quick. For the women aged 40-41, the chances of pregnancy per cycle were 9%. That number dropped to 6% for women 42-43, and to 3.5% for women over 43. 

The odds of IUI working at any age aren’t great. And it still doesn’t solve for the increased chance of miscarriage due to chromosomal abnormalities. That’s why some families turn to IVF.

Getting pregnant with IVF over 40

What are the chances of getting pregnant with IVF over 40? Age is one of the biggest factors in the ability to get pregnant. And even with IVF, the chances of success with our own eggs declines as we reach our 40s. The great part about IVF is that you can find out if an embryo is genetically normal (and thus less likely to miscarry) before you attempt a transfer. This can save time and heartache. 

Data from the Society for Assisted Reproductive Technology shows the following chances of a live singleton birth using your own eggs via IVF:

• 38.3% for women 35-37
• 25.1% for women age 38-40
• 12.7% for women age 41-42
• 4.1% for women over 42

 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.

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. That means your chances of success getting pregnant, no matter your age now, is better with younger eggs. But how do you get younger eggs? For some lucky women, they can use eggs they froze years ago. But for most of us, getting younger eggs means turning to egg donation. And that brings us to our final section: getting pregnant with donor eggs. 

Getting pregnant with donor eggs over 40

IVF can be thought of in three parts. First, there’s retrieving the eggs. Second, there’s fertilizing the eggs to make embryos. And third, a healthy embryo is transferred to the uterus to begin a pregnancy. When you use donor eggs during IVF, everything is the same except it’s the egg donor who undergoes the egg retrieval in the first part.   

Many women in their 40s still carry the pregnancy, even when using donor eggs. Although some need to use a gestational carrier for a variety of reasons. 

The good news is this: studies show that your chances of success using donor eggs does not diminish in your 40s. You read that right! Using donor eggs can greatly increase your chances of a successful and healthy baby well into your 40s.  

How many tries does it take to get pregnant with donor eggs?

For many people beginning the journey to use donor eggs, you may have already tried unsuccessfully with your own eggs and are eager to get pregnant as quickly as possible. Well here’s the good news: it is estimated that the probability of success reaches roughly 90% after three embryo transfers. This of course varies patient to patient, and your doctor should be able to give you a better idea of your chances based on your medical history. 

Can I use donor eggs over 50?

In a study of women who became pregnant from egg donation, researchers at Columbia University found that women over age 50 do not appear to face any greater risk than those under 43. That doesn’t mean there’s no risk in pregnancy over 50, and anyone in this age group should undergo thorough medical screening before attempting pregnancy to ensure the best possible outcome.

If you are pursuing donor eggs, we’d love to help. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey and are in an endless pursuit to make these experiences more positive. Sign up for a free account today. 

Read more: 

• I'm Over 40 and Considering IVF: How Do I Prepare For The Journey Ahead?
• How Does Donor Egg IVF Work?
• Will a Donor Conceived Child Have My DNA?

Families come in many forms and everyone’s path to parenthood is unique. No matter those differences, anyone striving to build a family should have equal access to resources on their journey. We’ve compiled the below list of resources that we hope will help you navigate any challenges when it comes to starting a family.

LGBTQ+ family-building resources

• The Gay Dad's Guide to Egg Donation was written by Dr. Saira Jhutty, and discusses the process of using donor eggs to build a family.
• Connecting Rainbows is a resource for people in the LGBTQ+ community who are building their families. They're particularly knowledgeable on the topic of second-parent adoption.
• Family Equality is the leading national nonprofit organization advancing equality for LGBTQ+ families.
• Gay Parent Magazine: Gay Parent features personal stories of lesbian, gay, bisexual, and transgender parents about their experiences with international and domestic adoption, foster care, donor insemination, using a surrogate and what it is like to raise their children.
• Parents, Families, and Friends of Lesbians, Gays, Bisexual and Transgender (PFLAG): PFLAG is devoted to educating and supporting everyone involved in the life of a sexual minority individual. There are local chapters all over the United States
• Men Having Babies (MHB) is a non-profit dedicated to providing gay men with educational and financial support to achieve parenthood.
• The National Center for Lesbian Rights works to ensure that LGBTQ+ parents and their children are fully recognized as families under the law, including low-income parents using low-cost assisted reproduction, both married and unmarried parents, families with more than two parents, adoptive parents, and parents conceiving using surrogacy.  
• Resolve vigilantly tracks state and federal legislation pertinent to LGBTQ+ family building across the United States, and works to support positive family building bills and to stop harmful legislation from being enacted. You can view the legislation they’re working on here. 
• Trans Fertility Co. was created by trans community members to make the world of fertility easier to understand and navigate.
• Fertility Within Reach has resources to support transgender youth and their families with fertility preservation support.
• Gay Parents To Be is an informational resource and a starting point for LGBTQ parenting.

Family-building resources for BIPOC women 

• BMMA (Black Mamas Matter Alliance) is a Black women-led cross-sectoral alliance. with resources covering a broad spectrum of maternal health issues and advocacy tools.
• Black Women and Infertility is an organization based in Boston that provides online support for Black women experiencing infertility.
• The Broken Brown Egg provides support and resources for people in the Black community experiencing infertility.
• Fertility for Colored Girls provides education, encouragement, and support to Black women and other women of color experiencing infertility and seeking to grow their families. They aim to empower Black women to take charge of their fertility and reproductive health, and provide grants to help ease the financial burden of fertility treatments or domestic adoption.
• The Infertilidad Latina Podcast is a space for women to listen and share stories about their infertility and IVF experiences.
• The Infertility and Me podcast is a Black woman-hosted show covering reproductive justice, pregnancy loss/miscarriage, and infertility.
• Moms in the Making have infertility support groups in Spanish.
• The Resilient Sisterhood Project’s mission is to educate and empower women of African descent regarding common yet rarely discussed diseases of the reproductive system that disproportionately affect them.
• This article discusses why infertility isn’t discussed enough in Latinx communities.
• This article discusses overcoming stigma in the Asian American community

Religious family-building resources

• The Jewish Fertility Foundation is a resource for members of the Jewish community to seek support for infertility. Part of their work includes destigmatizing infertility within the Jewish community and educating community leaders on how to support those with infertility.
• Resolve has resources regarding the intersection of infertility and religion for community leaders, as well as links to support groups for those of Islamic, Jewish, Christian, or Catholic faith. This can serve as a good starting point for conversations about religion and infertility.
• This article from MuslimGirl.com shares the experience of infertility for Muslim women.
• Catholic Mom is an infertility support group for Catholic families.
• ATime provides guidance and support for Jewish families facing infertility. In addition to having therapists, they have a 24-hour helpline. 
• Uprooted’s work allows those struggling to turn toward the Jewish community as they navigate their fertility journey, to break through feelings of isolation and shame, and to connect with others traversing the same path. 
• Amal Fertility is a Mississauga-based support group for Muslim women struggling with infertility.
• Hasidah offers peer support as well as financial aid for those seeking to build Jewish families.
• Stardust Jewish Fertility Foundation is a nonprofit that offers grant opportunities from $1K - $25K to Jewish singles of couples, regardless of sexual orientation or marital status.
• Jewish Family and Children’s Service of Greater Philadelphia (JFCS) provides grants to Jewish families living in the Philadelphia area facing infertility.

Military and veteran family-building resources

• Resolve has a list of affordable infertility treatment options for military personnel.
• Bob Woodruff Foundation provides up to $5,000 funding to veterans eligible for the BWF Veterans In Vitro InitiAtive (VIVA) Fund. 
• Read the Tricare white paper on why expanding service members’ access to infertility treatment is easy, affordable, and the right thing to do.
• The Military Family Building Coalition is a non-profit organization to support military members in building their families through ART, IVF and Adoption.

Cancer-survivor family-building resources

• The Alliance for Fertility Preservation is a 501c3 made up of a team of professionals who advance the field of fertility preservation for cancer patients.
• The Expect Miracles Foundation provides grants for cancer patients for family building (adoption, fertility storage, IVF, & surrogacy).
• The Banking on the Future grant is available to adolescent oncology patients through the age of 21.
• Team Maggie provides financial assistance to teens and young adults with cancer seeking fertility preservation. 
• Duke has a monthly support group for women facing fertility concerns due to cancer.

Resources for all

• Resolve is the largest and most well-respected infertility non-profit offering advocacy, support, and education for anyone facing infertility.
• The Starfish Fertility Foundation is a 501c3 nonprofit group committed to providing financial support for those struggling with infertility in the United States.
• The Gift of Parenthood provides grants that can be used to cover any expenses associated with assisted reproduction including egg donation.
• Baby Quest makes grants for family building ranging from $2,000 - $15,000 plus medications. 
• Ferring Pharmaceuticals Heart Beat Program provides select fertility medications at no cost to female patients with a cancer diagnosis.

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.

Egg sharing programs exist worldwide to help make fertility care more accessible. Egg sharing generally describes when a woman undergoes an egg retrieval, and the resulting eggs are used by more than one person or family. In some programs, two families needing an egg donor will share the cost of one donor egg retrieval. In other programs, women will donate their eggs to pay for IVF.

In Cofertility’s Split program, women can freeze their eggs for free when they donate half of the retrieved eggs to a family who can’t otherwise conceive. Families pursuing egg donation to build their family can match with an egg donor on our Family by Co platform.

Egg sharing programs in your area

We work with families and egg donors around the world! Cofertility is unique in that we are clinic-agnostic, as long as the clinic reports outcomes to SART and has a CAP certified lab. Some clinics have specific requirements related to working with outside donors and have policies in place for how they handle those cases. If you already have a clinic in mind, reach out to our team and we can send a list of questions that we recommend you ask them before getting started. 

Benefits of egg sharing

We stand for reproductive choice. And egg freezing is just that — a choice that a woman makes over her own body and future. The American Society for Reproductive Medicine (ASRM) states that egg freezing “promotes social justice by reducing the obstacles women currently face because their reproductive window is smaller than men's.” We couldn’t agree more, and we’re proud to do our part to lessen constraints placed on women by offering more accessible egg freezing options.

The benefits for egg sharers (or who we call Split Members) include:

• Freeze and store your eggs for 10 years, entirely for free 
• Connect with others going through the process in our private online community
• The opportunity to make someone’s family building dreams a reality

Building your family through a shared egg donor program 

There are many reasons you may be looking for an egg donor to help build your family. Cofertility’s 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 the cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

Shared vs. one-on-one egg donation

Shared egg donation (when the egg donor gets to keep half of the eggs retrieved for her own personal use) is a wonderful way to build your family while supporting the reproductive options of the donor. A 2003 UK study of egg sharing amongst IVF patients found that participating in an egg sharing program did not compromise the chance of achieving a pregnancy or live birth for the egg sharer or the recipient.

The concept of egg sharing is not new, but we are excited to scale this amazing offering to women and families around the globe in a new way.  At Cofertility, we’re reshaping fertility preservation and third-party reproduction so it’s more accessible, human, and community-driven, recognizing that the way we build families is more dynamic than ever and that everyone deserves a great experience. If we can help you on your journey, please reach out.

Interested in freezing and donating half your eggs to a family that can’t otherwise conceive? Check out our Freeze by Co program.

Interested in building your family through egg donation? Check out our Family by Co platform.

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. 

Many states require insurance companies to cover part, or all, of fertility care expenses. But this can be very tedious to sift through, and it varies by locale. For anyone even considering fertility testing or treatment, it’s good to know just what’s up in your state. 

Can you expect some help on the testing front? What about in vitro fertilization (IVF), are there any mandates for coverage here? So with no further adieu, here’s what you can expect in terms of your state’s fertility insurance:

Alabama

No fertility insurance here. Currently out of luck.

Alaska

No fertility insurance here. Currently out of luck.

Arizona

No fertility insurance here. Currently out of luck.

Arkansas

With Arkansas fertility insurance, you do have some benefits, albeit limited. If you have an individual or group policy that includes maternity benefits, IVF must also be covered, as well as cryopreservation. 

But, there is a lifetime cap of just $15,000 here. You also can’t just move right to IVF. First, you must try a less costly fertility approach such as undergoing an intrauterine insemination (IUI). Also, HMO’s and employers who self-insure are exempt.

California

California fertility insurance looks promising, but may be far less helpful than meets the eye. You will only receive coverage here if your employer decides they want to provide fertility coverage as part of their benefits package.

Fact is, here insurance companies only have to offer infertility coverage. It’s then up to employers to decide whether they want to include fertility treatment coverage for employees or not. 

Colorado

Thanks to some new legislation, as of January 1, 2023. Colorado fertility insurance now offers eligibility for three egg retrievals with unlimited embryo transfers covered. This is true provided that your insurance coverage is from a large group of 100 or more people. 

Those with individual or small group plans will unfortunately not have access to this coverage. Also, religious organizations, even large ones, are not required to provide fertility coverage.

Connecticut

With Connecticut fertility insurance, diagnosis and treatment of medically necessary infertility expenses must be covered. You may be entitled to up to two cycles of IVF, zygote intrafallopian transfer (ZIFT), or gamete intrafallopian transfer (GIFT), up to four cycles of ovulation induction and up to three cycles of intrauterine insemination.

But, only those who have had coverage under the policy for at least one year will be eligible. Also, if your employer self-insures, they do not have to provide this coverage, or, if they are a religious organization, this is also not mandated.

Delaware

Delaware fertility insurance offers an array of services that includes IVF with eggs, sperm, or embryos from a donor, and even allows for a surrogate or gestational carrier. You are even entitled to six egg retrievals with unlimited embryo transfers. 

But there is a hitch. This coverage is restricted to those with fertility issues as a result of a medical treatment such as chemotherapy, surgery, or radiation. Also, any egg retrieval must be done before age 45 and any embryos transferred before age 50. 

Florida

No fertility insurance here. Currently out of luck.

Georgia

No fertility insurance here. Currently out of luck.

Hawaii

While you can get some Hawaiian fertility insurance coverage that may be beneficial, it’s limited. You’re entitled to one and only one IVF cycle. That’s for those with a minimum of a five-year history of issues such as endometriosis, blocked or removed fallopian tubes, DES exposure, or male infertility factors.

You also can’t move on to IVF until you’ve tried other covered fertility treatment first. So, if you are eligible, you truly don’t want to give away your shot…

Idaho

No fertility insurance here. Currently out of luck.

Illinois

With Illinois fertility insurance coverage, provided you have tried lower-cost treatments under your insurance umbrella first without success, you do have coverage for IVF, GIFT, and ZIFT. What’s more, you get four bites at the apple and if you are successful and a live birth occurs, you’re actually entitled to two more covered egg retrievals.

But this only applies to work-related group policies that cover more than 25 full-time employees. There is, however, some additional good news. As of January 1, 2022, this fertility protection extends to same-sex couples and single-women over age 35 who have a medical issue keeping them from getting pregnant.

Indiana

No fertility insurance here. Currently out of luck.

Iowa

No fertility insurance here. Currently out of luck.

Kansas

No fertility insurance here. Currently out of luck.

Kentucky

No fertility insurance here. Currently out of luck.

Louisiana

The Louisiana fertility insurance law provides a fig leaf of coverage. You are only eligible here for diagnosis and treatment if your fertility issues are the result of a correctable medical condition. Even that has exceptions. There is no requirement to cover fertility medication or to offer IVF or even other fertility treatment. Also, if you or your partner have undergone a tubal ligation or vasectomy, any reversal here is on you.

If your employer self-insures, then even if you would be eligible otherwise, there’s no requirement that you be covered.

Maine

While this state doesn’t have any coverage at the moment, a Maine fertility insurance law will kick in beginning January 1, 2024. Then, fertility patients who have health plans here will be entitled to fertility diagnostic care, treatment and fertility preservation services. 

Coverage is expected to include both individuals and couples battling infertility, those who carry a heightened risk of transmitting a severe genetic disorder to an offspring with natural conception, and those who don’t have the needed reproductive cells to conceive. This coverage will exclude anything experimental or any non-medical related cost.

Maryland

With Maryland fertility insurance, you are golden. This insurance offers coverages not only to traditional heterosexual couples, but also same sex couples and unmarried patients. Those who qualify are entitled to undergo three IVF rounds for every live birth. There is, however, a $100,000 lifetime cap here.

But, this coverage is not a requirement for religious employers, those with fewer than 50 employees, or those employers who self insure.

Massachusetts

Massachusetts fertility insurance stipulates that insurers that provide pregnancy-related benefits are also expected to offer coverage for diagnosis and treatment of infertility. This means access to artificial insemination procedures such as IVF and GIFT. It may also include procurement of eggs or sperm, processing and banking for fertilized eggs and sperm. 

There’s also no state lifetime cap on the amount of fertility insurance available and no limit on the number cycles. But, insurers are able to use their clinical guidelines and patient’s medical histories to set some limits here. 

Michigan

No fertility insurance here. Currently out of luck.

Minnesota

Not only is there no Minnesota fertility insurance, but also there’s a law prohibiting coverage for meds specifically used to enhance fertility. Talk about kicking those already down… 

Mississippi

No fertility insurance here. Currently out of luck.

Missouri

No fertility insurance here. Currently out of luck.

Montana

Montana fertility insurance offers some vague help as long as you get your insurance through an HMO. But unfortunately, there’s no definition of infertility that’s given in the law and no description of the type of services that need to be covered. So, it appears to pay only lip service here. Anyone with non-HMO insurance has absolutely no coverage.

Nebraska

No fertility insurance here. Currently out of luck.

Nevada

No fertility insurance here. Currently out of luck.

New Hampshire

If you have a group policy that offers benefits for medical or hospital expenses, the New Hampshire fertility insurance mandate provides for medically necessary fertility treatment. This includes coverage for evaluations, laboratory testing, and medication. If fertility preservation is needed, such as if you must undergo chemotherapy or radiation treatment, coverage includes both procurement and cryopreservation of reproductive materials such as eggs, sperm, and embryos, and may even include storage for a time.

But experimental infertility procedures are not included. Also, anyone covered through the Small Business Health Options Program (SHOP) or have an Extended Transition to Affordable Care Act-Compliant Policy funded by the state, is not eligible here. 

New Jersey

With New Jersey fertility insurance, as long as you are under the age of 46 and have a group policy that includes at least 50 people, with pregnancy-related benefits, you are potentially eligible for a variety of infertility treatments. This includes a menu of items such as up to four IVF cycles with ICSI, GIFT, or ZIFT, as well as use of donor eggs and even the potential to use a gestational carrier or surrogate. 

But except in cases where the patient must undergo treatment that puts fertility at risk, such as chemotherapy, cryopreservation is not covered.

Also, there are some exceptions to which insurers must follow the mandate – neither religious employers or those who self-insure are required to provide this coverage.

New Mexico

No fertility insurance here. Currently out of luck.

New York

As part of a new law enacted in 2020, New York fertility insurance offers those who have large group insurance plans of 100 or more, up to three IVF cycles. Also, those that include prescription drug coverage must provide medication for the diagnosis and treatment of infertility. 

What’s more, it’s now necessary to cover egg freezing for all private insurance companies in medically necessary cases. So, you are eligible if you have a condition such as sickle cell anemia, are undergoing chemotherapy, or are undergoing sex-reassignment surgery. 

Those who self-insure are exempt here.

North Carolina

No fertility insurance here. Currently out of luck.

North Dakota

No fertility insurance here. Currently out of luck.

Ohio

Ohio fertility insurance must be covered in cases where this is medically necessary, by HMO’s that offer “basic health services.” But don’t count on coverage for IVF, GIFT, or ZIFT. None of these are legally required. 

What you may be covered for includes diagnostic procedures to detect fertility issues, or surgical treatments to correct issues with the reproductive organs such as endometriosis or issues with the fallopian tubes.

Oklahoma

No fertility insurance here. Currently out of luck.

Oregon

No fertility insurance here. Currently out of luck.

Pennsylvania

No fertility insurance here. Currently out of luck.

Rhode Island

The Rhode Island fertility coverage is mandated for all of those with an HMO or other insurance policy that includes pregnancy coverage. Beginning at age 25 and extending up to age 42, women here with such a plan are entitled to coverage for diagnosis and treatment of infertility. 

Also, if someone is undergoing a procedure that may result in infertility, insurers must cover fertility preservation treatment. There is, however, a $100,000 lifetime treatment cap. 

South Carolina

No fertility insurance here. Currently out of luck.

South Dakota

No fertility insurance here. Currently out of luck.

Tennessee

No fertility insurance here. Currently out of luck.

Texas

With Texas fertility coverage, although insurance companies must provide this as an option, there is no mandate that any group is required to actually offer this as part of their health plan. In instances where such coverage is offered, it only pertains to those who can show that they’ve been infertile for at least 5 years or who have a medical issue such as endometriosis, tubal blockage or removal, or DES exposure. 

Also, IVF won’t even be considered until less costly measures, like IUI, have been tried. 

Utah

Utah’s fertility coverage involves a pilot program through 2024. This targets those who are on a Public Employee Health Plan. Here, if you have a maternity benefit, then you must likewise be able to receive $4,000 toward a “qualified reproductive technology cycle.” With this, just a single embryo is transferred during a cycle using reproductive technology.   

This, however, is not a mandate. The aim of the program is to determine the efficacy of providing this kind of coverage. 

Vermont

No fertility insurance here. Currently out of luck.

Virginia

No fertility insurance here. Currently out of luck.

Washington

No fertility insurance. Currently out of luck.

West Virginia

The West Virginia fertility insurance mandate is low on details. While HMOs that offer basic health services are required to cover infertility, what “infertility” actually means here is not defined. All in all, this is way too vague – more clarity needed here.

Wisconsin

No fertility insurance here. Currently out of luck.

Wyoming

No fertility insurance here. Currently out of luck.

When coverage is lacking

If you’re lucky enough to live in one of the 20 states that offers a fertility insurance mandate, that’s, of course, a big win. Still, as you can see, even these can leave you wanting. If your state doesn’t deliver on fertility coverage or if the coverage is, in a word, lacking here, reach out to Resolve: The National Fertility Organization to find out who to contact to lobby for improvements.

For those who are deep into the nuances of their own fertility, the idea of needing donor eggs is something that may not come easily at first. This may have been something that you vaguely considered as an option. Now that it appears this will be your best route to parenthood, all kinds of emotions can surface.

But don’t let that deter you from moving forward with a fertility plan that may offer you a chance to build the family you’ve hoped for. Building your family via an egg donor can be an option that brings you greater chances of success in building the family of your dreams. Still, it doesn’t come without concerns, all of which are incredibly normal.

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 getting used to.

Common concerns

All kinds of fears may be percolating. You might have questions like:

• What if I can’t bond with the baby?
• What if my child doesn’t look like me?
• What if the child is mad when they find out?
• What if my family rejects the donor-conceived child?
• What if I just can’t forget that we aren’t genetically related?

Believe it or not, many successful parents of a donor-conceived child had to move through these same fears to get to a place where they felt comfortable claiming this route for themselves. So, while these fears may feel overwhelming and feel like you can’t possibly overcome them, nothing could be more untrue.

Strategies for gaining confidence

Begin by giving yourself credit for the journey you’ve already been on to put yourself in a position to have this child. Be proud of yourself for all the early mornings in traffic shots given, time in waiting rooms for bloodwork and ultrasounds, and, yes, for handling the expense of it all.

Think about it, many times children are conceived with virtually no thought. But you can one day tell your child about all the steps you took to get them to be a part of the family. How wanted and loved they were. I think of this as a story of loving a child so much that you would have done anything to bring them into the world.

If you’re worried about your child perhaps one day looking at you differently, the answer is to be transparent and open from the beginning (research shows normalizing the truth early on leads to better outcomes). If you speak to your child from the start about how they came from an egg given by a very generous woman and you and your partner weave it into your family narrative of how much you wanted this egg and how lucky you were to get it, this can help decrease any shame or stigma attached to it. Your child will always know where they came from and how wanted they were, and will look at you with that in mind.

Handling fears

But what about not being able to forget that this child doesn’t share your DNA? In my opinion, fears like this are not something to move past, they’re something to move through. It’s about living with this in whatever shape it takes. It's about coming to realize that love is boundless, as is the definition of family.

I have met with many families who have been built via egg donation. And all of them say the same thing. After the child is born and they begin their new life, they rarely think about it. All the worry melts away. The child is yours and you know that this exact family is the way things were meant to be.

Throughout your fertility journey, you’ve already had to continue to adjust your expectations about how this was going to go and how your family was going to look. This has not been easy and likely has taken a toll. This can be very draining. You need to be gentle with yourself and your partner. Show yourself some compassion and grace as you hold these feelings and process them. The idea is to get inside the feeling and move through it.

If a negative feeling comes up, allow yourself to have it. Give yourself permission to experience these feelings. Then, make space to safely indulge yourself in whatever way helps you to cope.

This may mean designing a ceremony such as lighting a candle or planting a garden to deal with your grief. You might think about writing a letter to the child you were unable to conceive and how hard you tried. The fact is, not being able to use your DNA can still feel like a loss. Some find this kind of approach very meaningful, however, it is not for everyone. If it feels somewhat forced to you, try something else.

Some look to the donors themselves for connection. They may point out how they also played the violin in middle school, or ran track, or even how they also had dark curly hair or were the same height.

Airing your worries

Talking is also an effective way to allow yourself to process feelings. This may mean talking honestly with your partner if you have one, a close friend, or a therapist. It’s all about having a safe space to discuss your feelings. .

For those who do choose to speak to a therapist, I would recommend trying to find somebody who specializes in the fertility or third party-reproduction space. There are many great general therapists who can help you with a wide variety of issues. But working with a specialist means you don’t have to spend time helping your therapist understand what you’re going through.

It can also be extremely helpful to talk with others who have either already been through the donor egg process or who are considering this like you. With having what may be conflicting emotions, being able to share your concerns with others who can relate can be invaluable. Don’t forget to check out our Instagram community to find others who are building their families through donor eggs.

Throughout it all, be gentle with yourself. Pick and choose the strategies that feel right to you in building a family this way. You may imagine yourself in 15 or 20 years telling someone else how happy you were with the family you built and the strategies that worked for you.

For many, using donor eggs wasn’t part of the original plan. You may have simply wanted to seek some assistance with your own fertility with an eye toward in vitro fertilization (IVF). But now the doctor is saying that you have a very low chance of successfully conceiving with your own eggs, and you and your partner should consider using a donor egg.

If you’re like most people in this situation, you may not be sure what to do next. But not to worry, others have already been down this road. You will be able to navigate this situation as well. It’s just a question of breaking things down into manageable steps.

Finding an egg donor

The first thing you need to do is find the right egg donor for you. This may mean doing some research on how to find an egg donor, assuming you are not using someone you know.

Donor egg banks

One option is to use a frozen donor egg bank, which might be quicker than using an egg donor agency. The eggs in a donor egg bank are already frozen and available. With this, you have a good idea of when your embryo transfer can be. You can browse through detailed profiles of available donors, which may include everything from her interests, education, physical characteristics, and family health history.

In some cases, you may also have some flexibility in whether the donor will remain anonymous or is open to some type of contact. Keep in mind, nothing is truly anonymous in today’s day of genetic and ancestry testing.

Donor egg agencies

Another option is to use an egg donor agency that can help you identify women with specific characteristics or interests that you and your partner find important in an egg donor. An egg donor agency can function a little like a matchmaker.

With this approach, you decide the qualities you are looking for in an egg donor and the agency will look for someone who fits your description. Many agencies have a list of potential donors ready to go. Usually, though, these donors provide “fresh” eggs, meaning their eggs are not already frozen. You’ll have to wait for the donor to undergo a retrieval cycle.

Your own fertility clinic

You may also find that whatever fertility facility you are already working with has a donor egg program available. Keep in mind, however, that depending on your clinic, limited donor options may be available. So, particularly if you have a set of characteristics that you’re looking for, you may find yourself wanting more.

What to expect from a fresh donor cycle

Once you’ve selected a donor, the next steps depend on whether you are doing a fresh cycle or a frozen one. If you are using a donor who has not yet frozen her eggs in the egg bank, there will be some extra steps.

The medication involved

If you have done IVF before, you may already be somewhat familiar with the process. Your egg donor will take stimulation medications and undergo an egg retrieval similar to the process for IVF. The recipient who will carry the pregnancy will also take medications to prepare the uterus for an embryo transfer.

Often, you will first use medication to quiet your own cycle, such as birth control pills or the drug Lupron. You will then be put on estrogen to mimic what would happen during your normal cycle. Once your lining reaches a good thickness, your doctor will start you on progesterone. This progesterone will stabilize your uterine lining for embryo implantation.

The fertilization process

It's also important for the male partner to coordinate and produce a semen sample during the same day that the eggs are retrieved from the donor. Some couples use already frozen sperm, which works also. Then, using in vitro fertilization, the eggs are fertilized with this sperm and the potential embryos are created. At this point, some intended parents opt to genetically test the embryos to rule out any abnormal embryos.

Keep in mind that if there are more embryos created than you need for one cycle, some can be frozen and saved for later.

What to expect when using frozen eggs

As we mentioned earlier, if you do a frozen egg cycle, the definite upside is that these eggs are already available to use. You don’t have to worry that the donor may not produce as many as you were hoping for.

The eggs are there, ready when you are. The recipient does not have to synchronize her cycle with the donor’s, which can mean more flexibility for you. Also, you may have wider geographic choices since the bank can get egg deposits from all over. With a fresh cycle, you are limited to donors in the area or willing to travel (another expense).

Frozen donor eggs may be offered as a package with lab tests, genetic screenings, and medications bundled together at an overall lower cost than for a fresh cycle. With frozen eggs, as opposed to a fresh cycle, you know exactly how many eggs you are getting. Once your clinic receives the frozen donor eggs, they will thaw them and fertilize them with sperm. Similar to a fresh donor cycle, you will use estrogen to thicken your uterine lining, followed by progesterone to stabilize your lining and prepare it for an embryo.

Summing it up

Hopefully this helps you feel confident in knowing that, while it contains many steps, the donor egg process can be manageable. But the more informed you are, the better. Do check out our other resources that can answer other questions you might have about the donor process. Whether you’re just beginning to consider the idea of using donor eggs, or on the cusp of starting a cycle, we’re here to help make this process a little bit easier.

When it comes to using donor eggs to build your family, even those who are veterans of traditional in vitro fertilization (IVF) may not be clear on what to expect from the donor egg process. But you’ll be happy to hear that those who have already worked with a fertility clinic using their own eggs will absolutely not be starting from the beginning. If you’re in this situation, you already have a solid understanding of what goes into an IVF cycle, which is the foundation of the donor egg process.

Women consider using donor eggs for various reasons. Some have low ovarian reserve (egg supply). Some have been through several IVF cycles before without success. Others have been told that their egg quality makes it unlikely that they will become pregnant using their own eggs. In these situations, using a donor egg can significantly improve the chances of having a baby. Especially if someone is over 40, the success rates with donor eggs will be considerably higher than many women can expect with their own eggs.

According to the Society for Assisted Reproductive Technology (SART), if someone is over 40, IVF success rates after one cycle can range from five to twenty percent if she uses her own eggs. But when using donor eggs, the success rate for one cycle is around 50%. So, depending on the situation, using a donor egg can significantly increase your chances of having a baby through IVF.

For others, donor eggs may be the only way to build a family. Whether you are a single dad, LGBTQ+ couple, or cancer survivor — every conception needs an egg.

Getting started

If you’ve already been through IVF before, you’re most of the way there in terms of understanding the how a donor egg cycle will go. There are just some additional steps with a donor egg that you may not be aware of yet.

Before beginning any donor egg treatment, many clinics will have you and your partner initially speak with a counselor.  He or she will talk through using donor eggs to help ensure that this is the right path for you. The idea is to consider how you feel about using a donor egg to help create or expand your family. You may also consider how you will talk to your future children about using an egg donor, including what information you will share and when.

You will then go through an egg donor selection process to find the best donor for you. There are tons of factors to consider here: the egg donor’s education, medical history, values…the list goes on. So it’s worth spending some time with your partner to decide what factors to prioritize.

Also, if you are over age 45, the American Society for Reproductive Medicine notes that you may need to undergo more intense screening, such as a visit with a high risk obstetrics doctor or a heart workup, to make sure that you are a good candidate for an embryo transfer and can carry a healthy pregnancy.

If you choose a matching platform like Family by Co or an egg donor agency, your egg donor will go through a screening process at your clinic to determine if she is eligible for egg donation. You will also sign a legal contract with her regarding the details of the egg donation process. If you match with a donor in our fresh egg donation program, after her screening, she will do an ovarian stimulation cycle and an egg retrieval. If you have been through an IVF cycle before, you are well aware of all the medications and monitoring she might need during her cycle. If you match with a donor in our frozen egg program, we will help ship the already-frozen eggs to your clinic.

Fertilizing and growing embryos

Whether you obtain donor eggs from a fresh egg donor cycle or from a frozen egg bank, once your clinic is in possession of the eggs, they will need to be fertilized and grown into embryos. Your IVF clinic will update you to let you know how many of the eggs fertilized and how many developed into embryos. Some intended parents decide to do genetic testing on embryos. If so, the clinic will biopsy the embryo at the blastocyst stage (day 5-6) and then freeze the embryos while they wait for the result. 

It’s important to remember that not all eggs become embryos. In general, approximately 70% of eggs will fertilize and of those, about 50% will grow into day 5 embryos.

Preparing for embryo transfer

If you’ve already gone through IVF, you may have already been through the pre-transfer testing. This testing includes infectious disease testing and an assessment to make sure your uterus is normal. Your clinic may do a saline ultrasound or a hysteroscopy to evaluate the inside of your uterus before a transfer. This test rules out fibroids or polyps inside the uterus that could interfere with pregnancy.

At some centers, doctors like to also perform a mock embryo transfer. During a mock embryo transfer, the doctor will pass a transfer catheter into your uterus in advance so they’ll know the embryo transfer catheter will pass easily on the transfer day. If you’ve already done IVF with your own eggs, they may already have this information and can skip this step.

Prior to an embryo transfer, you (or your gestational carrier) will first likely use medication to quiet your own cycle, such as birth control pills or the drug Lupron. Then, you will then be put on estrogen to mimic what would happen during your normal cycle. The estrogen can be given orally, vaginally or with an estrogen patch depending on the protocol your doctor chooses. 

Once your lining reaches a good thickness (many clinics have a goal of 7-8 mm), you’ll then start taking progesterone. The progesterone can be in the form of vaginal suppositories and intramuscular injections. This progesterone will stabilize your uterine lining for embryo implantation. Keep in mind, though, that if by some chance you ovulate on your own during the first stage, any embryos will be frozen and the transfer will be postponed.

Embryo transfer

Your clinic will then schedule your embryo transfer. The embryo transfer is typically performed on the sixth day of progesterone, in order to synchronize the embryo development with your uterine lining.

On the day of the embryo transfer, your doctor will perform a speculum exam and clean the cervix. They will then place the embryo transfer catheter through your cervix into your uterus. An abdominal ultrasound is typically performed so that you and your doctor can see the embryo transfer catheter inside the uterus. The embryo is often loaded into the catheter with a small amount of fluid and an air bubble. At the time of the embryo transfer, you may see a small flash of bright white on the ultrasound screen - that’s where your embryo was placed!

Pregnancy

Your clinic will schedule a pregnancy test following your embryo transfer. If you are pregnant, you’ll need to continue to take estrogen and progesterone during the first part of your pregnancy. Although taking these hormones may seem inconvenient (especially the injectable progesterone!), keep in mind that they are essential to sustaining your pregnancy until your body can effectively take over. If a pregnancy test shows that you are in fact pregnant, you will need to continue to take hormones until your placenta can ultimately support the embryo at around week ten.

Hopefully, this provides a solid overview of the donor egg IVF process. The first step here, however, is to find a donor match. We encourage you to take a look at our incredible donors, who are ready to match with your family. Unlike egg donation agencies and banks out there, our donors aren’t motivated by traditional cash compensation. Rather, they get to freeze their own eggs for free when they give half of them to another family — so every donor we work with is not only altruistic and kind, but also motivated for her own future fertility. 

No matter what avenue you choose, we’re wishing you all the best!

For anyone who’s thinking about using donor eggs, there’s of course lots of focus on the odds of success. But some of you may also be thinking, is it even safe to use donor eggs in the first place?

You may wonder if there is anything about this process that could possibly put you, your partner, or your baby at risk. And these are important questions to ask! However, rest assured, every step of the donor egg process has been carefully thought through with the egg donors’ and the recipient’s health in mind.

Egg donor screening

Before an egg donor can even be considered for donation, Family by Co (along with any other egg donor agency or bank) will ask many questions and conduct extensive testing. This is not something that just any woman is eligible to do. 

The United States Food and Drug Administration has established eligibility requirements for anyone who wishes to donate tissue. This includes those donating eggs.

Egg donors must demonstrate that they are free from any communicable diseases.  A clinic will test potential donors for infectious diseases and for a variety of bacteria and viruses. These include chlamydia, gonorrhea, syphilis, hepatitis B and C, HIV, and HTLV-1 (a virus that has been linked to some cancers). This process helps ensure that there are no infectious diseases associated with the transfer of an embryo made from a donor egg.

There are also many other requirements for egg donors, according to the guidance of the American Society for Reproductive Medicine.

The donor must:

• Provide a detailed medical and psychological history about themselves and any close relatives. The potential donor disclose alcohol and drug use; some programs even conduct random drug tests.
• Undergo a physical exam, as well as a pelvic examination. She’ll also do an ultrasound and bloodwork to evaluate her ovarian reserve (egg supply).
• Provide a detailed medical history for herself and her close family members. This will help identify any serious genetic conditions that could run in her family. The clinic will screen her for family history of birth defects or required surgeries like a heart defect, a cleft lip, or a spinal condition. The clinic may also perform genetic carrier screening. Their goal is to identify if she is a carrier for genetic diseases such as Tay Sachs Disease, Sickle Cell Anemia, or Huntington’s Disease. If your partner or sperm donor is a carrier of a genetic disease, you will want to make sure that your egg donor doesn’t carry the same disease.
• Undergo psychological screening to ensure that she is truly a good fit for egg donation.  In some programs, psychological tests will also be part of the process.

All of this will help to ensure that using an egg donor is as safe as possible, with the donor free of diseases and also in good physical and psychological shape.

Recipient assessment

You and your partner will be evaluated as egg donor recipients as well. Before you can begin, you will both need to give an extensive medical history. Your doctor will test for things like blood type and RH factor. They will also screen for any sexually transmitted diseases such as chlamydia, syphilis, gonorrhea, hepatitis, and HIV.

Both you and your partner may meet with a mental health counselor. This will help ensure that using an egg donor is right for you.

Your doctor will perform an analysis of the sperm you intend to use. The quality of the sperm may help to determine the technique the lab will use to fertilize the eggs. Also, genetic carrier screening to assess for any recessive genetic diseases.

Meanwhile, the person planning to carry the pregnancy will need to undergo some testing. First, she will have a complete examination of the uterus to help ensure the inside of the uterus is normal. This may include a saline ultrasound or a hysteroscopy. The doctor will look to see if there are any fibroids or polyps in the uterus that may get in the way of implantation or safely carrying a pregnancy to term.

If you are over age 45, you may undergo a more extensive evaluation. This may include a consultation with a maternal fetal medicine specialist, an evaluation to make sure that the heart is functioning properly, an evaluation of blood pressure and other exams to ensure that there is minimal risk of any pregnancy-related diseases.

Older recipients may also be advised to find an obstetrician who specializes in high-risk pregnancies, who can help ensure that all proceeds smoothly.

Moving forward

When deciding whether to move forward with the donor egg process, discuss any safety concerns with your doctor and ask questions. The more you know about the process, the more confident you are likely to feel.

The moment you make the decision that you’d like to use donor eggs to help grow your family, you’ve got a big question on your mind: How do I find an egg donor? Or really, how do I find the very BEST egg donor out there?

The best egg donor is pretty subjective, we know. Some intended parents may feel it’s important to find a family member who shares their DNA, asking them to donate their eggs. Others may want to find an egg donor who isn’t related, but is a kind, altruistic person who may or may not look like them. Some might decide the best egg donor for them is one whose eggs are already frozen or whose schedule aligns with theirs for a retrieval. So how do you choose? And how do you know who is the very best?

Finding an egg donor

First things first: There are three common paths for finding an egg donor that can help get you started on your journey to find the best egg donor for your family. It’s important to pick the right path because it can be the key to finding the best donor for you.

Options to consider are:

A matching platform

When you work with Family by Co, you’ll have access to view our donors for free. All women on our platform are incredibly impressive, if we do say so ourselves. 

With a matching platform like ours, you can evaluate various donor matches based on criteria you’ve set forth. Our goal is to be as human-centered, transparent, and ethical as possible — giving you a real glimpse into who all of our donors are as true humans, including their personalities, values, and backgrounds. Of course, this is in addition to their medical profile, genetic history, and more. 

When you select a match, the donor has the opportunity to learn more about you and accept the match, ensuring the matching is the right fit for all before moving forward. And we’ll walk with you every step of the way. You can read more about our matching platform here.

A donor egg bank

Donor egg banks help connect intended parents to donor eggs that have already been frozen. There are a few big differences between banks and agencies. In addition to compiling all the helpful and necessary information you’d want to know about your egg donor, donor egg banks screen for both health and genetic concerns ahead of time.  They also cover the process of egg retrieval and freezing the eggs. 

When you turn to a donor egg bank, you don’t need to plan how she’ll donate, because the eggs are already there.This process is usually the fastest path when using donor eggs, and you’ll know exactly how many eggs you are getting.

An egg donor agency

Egg donor agencies can connect you to willing egg donors and share information about them — the same information that you’d get from an egg bank — like family medical history and education. The agency will work with you to figure out which donor is the best for your family. 

With an agency, any donor you choose would need to go through a medical screening and an egg retrieval cycle. If you find the right donor, you’ll move forward with her, paying the agency for making the connection. If she is an “anonymous” donor (keep in mind, “anonymous” doesn’t truly exist, read more about this here), the agency will continue to manage the process. In other cases, you and the donor will then hammer out your relationship directly and the donor will begin the medical processes required for egg retrieval and donation.

Ask a friend or family member

This is known as a “directed donation” — meaning the egg donor directly chooses who they want to receive their eggs. This can be a great option for intended parents who want to have a continued relationship with their donor or who want to use eggs that they themselves are tied to biologically.

But how do I find the best egg donor?

Okay, so there are different paths to finding an egg donor, but you want the best egg donor out there. After all, you’re talking about making a baby, one of the most important decisions of your life.

The best egg donor is going to be different for every single family, and you’re probably going to find your best donor isn’t the same as the donor your best friend might choose! Maybe you want a donor who is super creative, just like you. Or a donor who is outgoing. Or a donor who is really tall!

In short, things can get pretty personal when it comes to finding an egg donor.

Here are some of the things every intended parent should consider when making this important choice:

• Will your fertility clinic work with the egg donation partner? It may sound obvious, but not all clinics work with all egg donation partners. A simple check can save you a lot of headaches down the line. 

• What is your donor’s genetic background? Some intended parents opt to use an egg donor due to genetic concerns, and knowing your donor’s genetic background can be vital to ensure they’re not carrying the very gene you’re trying to avoid. If you use a donor egg bank, that sort of testing will likely already be done for you.
• How does your donor feel about a relationship with you or the child? This is as much about your feelings on the subject as it is the donor’s — do you want them to be involved? You’ll want to make sure you and the donor are on the same page. Read more about the spectrum of donor relationship options here.

To find the best donor for your family, we highly recommend doing some soul searching with your partner. What attributes are most important to your family? How important is it that the child looks like you? Think about the donor-conceived person you hope to bring into this world. This is a huge decision, and it’s better to get on the same page before you begin the search.

Bottom line

There is a LOT to consider when you’re looking for an egg donor, so we’ve got your back. 

One of the things that those considering using donor eggs may wonder about is whether any child born from those eggs will have their DNA. Every embryo will contain DNA from both the egg and the sperm in equal amounts, so any embryo made from the donor egg will contain the egg donor’s DNA. If this embryo was made from sperm from you or your partner, it will also contain that DNA.

Some of what is being asked here is, of course, what may it mean if your DNA is not part of the embryo (and your child’s) makeup? This is something that many may wrestle with as they navigate this journey. And understandably so — it’s complicated!

Concerns about connection

It can be natural to worry about raising a child that does not necessarily share your DNA. For years you may have dreamed about having “mini-me,” who everybody would know immediately was yours. And you’re not sure you can think of them as yours without this connection. This is a very valid concern, and one that so many intended parents face.

It may take a little time, but it is possible to overcome concerns about lacking a genetic connection. A 2014 Reproductive BioMedicine Online study shows that once the child is born, for many parents, concerns about genetics fade away. On the other hand, belief in the importance of parenting increases. This is what you hear of as “nurture” vs “nature.”

The idea of conceiving via donor egg may take some getting used to. But, it doesn’t necessarily impact how you and your child will interact. A 2007 Journal of Psychosomatic Obstetrics & Gynecology survey of women pregnant with donor conceived babies showed that 80% of mothers had some concerns about not being genetically related to the child during pregnancy; however, that feeling dissipated after giving birth. For most mothers, having a donor conceived child did not ultimately influence the relationship they had with their child. The concerns are real and very common. But take heart in the fact that others who were in your shoes are happily parenting children who got their start from donor eggs.

Strategies for embracing donor eggs

While conceiving via donor egg may initially be daunting, it is very possible to successfully navigate this. As the American Journal of Psychology discusses, there are some strategies that have helped other donor recipient parents successfully embrace their roles as parents:

Understanding the role that epigenetics plays in development

While the egg donor contributes 50% of the DNA to the genetic makeup of the child, research discussed in a 2014 Frontiers in Cell and Developmental Biology article shows that it is actually the birth mother or surrogate who determines which of these genes get turned on or off. Things like maternal diet, stress during pregnancy and smoking can all make a difference in what genes get expressed.

Leaning into the decision-making process about the type of egg donor to use

Focus on where you have control of the situation. Think about the criteria for the type of egg donor that would be a fit. What’s most important to you and your family?

Emphasizing the importance of having carried the child during pregnancy

With this approach, you can focus on the fact that it was your body that supported your baby through the developmental process. Your body made it possible for your child to be born.

Thinking about the fact that there are all kinds of families

In a blended family, someone may feel closer to a step-sibling who’s nearer in age or more similar in personality than to a genetic one. Think about friends, in-laws, or step family in your life who you have strong ties to. As you know, biology is only one part of what makes a family.

Connecting with the baby

For most intended parents who use a donor egg, a strong bond with their baby begins in the womb or at birth, and helps them to feel a closeness, even without a genetic tie.

Embracing how wanted the child is

Focus on how much you have been through, how hard you worked to have this child and how irreplaceable this baby is. You may view this as meant to be, looking at all the steps that had to align for this specific child to be yours.

Emphasizing the importance of nurture

Think about how your parenting will influence your child. Knowing how important “nurture” is in the development of children, you can focus on how your parenting will shape who your child becomes. Perhaps, they will have certain mannerisms they have picked up from you or personality qualities that your parenting style may have influenced.

Thinking of egg donation akin to other types of donated tissue

This strategy looks at this as part of a medical procedure like an organ donation. With this approach, you may also consider the fact that the egg donor is just offering a very small amount of tissue as part of the process.

Also, the donor egg selection process itself can make a difference here. The more you know about the donor, the better you can feel about her being the right choice for your family. That’s why our egg donor matching platform is so incredible — you can truly get to know your egg donor on a human level. 

Hopefully, all of these strategies can help you feel comfortable with using a donor egg if that’s the path you choose. Not having DNA in common by no means lessens the parent-child relationship that you will develop and you will still be an amazing parent. 

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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.

If you’re considering using an egg donor, you might be wondering, “just how exactly can I find one?” There are so many different things to think about, like what qualities or attributes you care most about. With all of these new thoughts swirling around your head, you might be wondering where to even begin. Fortunately, we’ve got you covered. Read on to find out what you need to do to begin your hunt for an egg donor.

Here’s how you find an egg donor

Sometimes, the fertility clinic that’s helping you through your in vitro fertilization (IVF) will have a selection of approved and vetted donors for you to choose from. Other times, you may opt to contract with an outside agency or donor egg bank, or a matching platform like ours, to find your perfect match.

You may even already have a donor in mind, especially if you have a close friend, sister, or cousin who has already volunteered for the position.

1. Working with Family by Co

Finding your egg donor match on the Family by Co platform has its advantages. Not only will you know that all women on our platform aren’t doing it for cash (rather, to help another family while freezing their own eggs for free), you can also rest assured that all donors on our platform have undergone a rigorous screening process and are all-around incredible. We’d love to help build your family.

2. Using your clinic

If you’re using your fertility clinic, you may need to go through their pre-approved registry to find a donor. This might mean going on a waiting list, since your clinic is likely to have other hopeful parents interested in donor eggs. 

3. Using an outside agency

For those who are able to pick a donor outside of their clinic’s network, there are egg donor agencies that help to match potential donors with hopeful parents. While they may have a larger pool to choose from than your clinic, you may also find yourself vying for the same donor eggs as several other families. Additionally, there may be additional fees involved in going through an agency.

4. Using a frozen donor egg bank

There are also frozen donor egg banks available for hopeful parents looking to secure eggs from a larger pool of donors. 

If you’re considering a donor egg bank, you’ll just want to confirm that your clinic will allow you to make the transfer from an outside source.

5. Sourcing your own donor

There are two very different scenarios when it comes to finding your own egg donor:

• Using the eggs of someone you know: When you do this, it’s very important that you are both on the same page about what will take place and how you’ll handle everything, from medical payments to potential emotional conflicts down the road. You’ll also need a clear and concise legal contract drawn up by a lawyer spelling out the terms of your arrangement. Some clinics will even require both parties to undergo a psychological evaluation.
• Asking around: Intended parents might post on social media about what they’re looking for, or take out an ad in the paper.

There’s really no wrong way to find an egg donor, but some ways are certainly more complicated than others. For instance, when you’re sourcing your own donor you’ll likely need to take care of all of the legal, psychological, and medical screenings yourself. Additionally, you’ll need to help coordinate pieces of the retrieval process.

Considerations when trying to find an egg donor

It can be overwhelming when you sit down and start reviewing possible egg donor candidates, but some things should definitely be top priorities when it comes to selecting the best potential donor.

Donor health

If you’re hoping to find an egg donor, first and foremost, you’ll want to make sure any candidates you look at are healthy and have no major medical problems. Our matching platform adheres to all industry guidelines when it comes to donor screening. And, for the most part, most donor matching services or fertility clinics will have screened donors in advance. However, you should still give any health records you receive a thorough review. 

You’ll want to not only check for any obvious issues, but also be mindful of how your genetic makeup or that of the person whose sperm you’ll be using, could potentially cause problems. For example, make sure your egg donor does not carry the same recessive genetic disease as the fertilizing male partner.

You will also want to see if they have any family history of any major medical issues that might be genetic. If you have any questions, talk to your doctor about specific concerns. 

Donor appearance

While this can seem superficial, appearance can be important, especially if you’re hoping to use donor eggs from someone that is a close match to your own personal appearance. For example, if you’re petite, you may prefer to use eggs from a petite donor as well. Our platform provides photos of the donor, both as a child and also as an adult as well. This can give you an idea of the donor’s physical traits. 

Donor values, personality, and education

Similarly, if you enjoyed your time at college so much you went back for your Masters degree, you may want to find a donor that shares your passion for learning. It’s okay to want to have certain things in common with your donor — and sharing values is important! When you find your donor match with Family by Co, we’ll conduct a background check to verify education and employment. 

Good luck!

Beginning your quest for the perfect egg donor can feel overwhelming, but it’s also the beginning of an exciting and hopeful time. Choosing a donor can be a special time in your life because it’s the beginning of a new part of your journey. One that we hope will end with you holding a beautiful baby. We’re here to help make that happen.  

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