“What am I looking for when I talk with a potential egg donor?” by Andrea Bryman, LMFT

It has taken many years to create the niche I have in my profession, a mental health therapist specializing in egg donation and surrogacy.  I have learned that people are not gray on the subject of third party reproduction.  They have strong opinions.  Once all the opinions have been aired (this can take awhile), one of the first things I am asked is “What am I looking for when I talk with a potential egg donor?”

I thought I would start this initial blog by discussing four of the main
areas that I emphasize in my evaluation of an egg donor: her family mental
health history, her stability, her desire to be a donor, and her ability to
make an informed decision to be a donor.  

In exploring a donor’s family mental health history it is important to gather information regarding any potential psychiatric diagnoses.  Some diagnoses are linked to genetic predispositions that can be passed onto a child.  If there is a diagnosis, i.e., depression -it is important to determine whether it was triggered by an event, which would be considered situational or whether it is an organic disorder.  I also discuss family history of alcohol or substance abuse.  There is potential for a genetic predisposition to alcoholism that both the recipients and donors should be aware of.  Finally, I explore any emotional, physical or sexual abuse the donor may have experienced and if they have received any professional help.  A donor who has experienced some abuse without seeking help may find the
donation process can trigger unresolved issues related to the abuse.  Above all else, my hope is for the donor to have a positive experience. 

One of the major concerns for many intended parents is whether a donor will be stable enough to follow through with all that she needs to do throughout her cycle.  There is a vast amount of information to digest, forms to be filled out, appointments to attend
and medications to be administered.  A donor will need a lot of support throughout the process.  There are many aspects in exploring a donor’s stability – her living situation, her career, her upbringing and current relationship with her parents and siblings, her social network, her personal relationships and any possible legal issues she may have experienced. It is important that a donor be able to form and sustain healthy relationships as well as manage conflict resolution.   More importantly, you want to be sure that she will to do what she is supposed to do! 

What is the donor’s motivation to donate?  Why would she want to inject herself with medications and undergo medical evaluations and procedures?
While initially enticed by the monetary compensation, most donors after
learning more about the process have an altruistic yearning to want to help
others while helping themselves.  In determining a donor’s desire to help others, it is significant to understand how she learned about the process, why she wants to donate, if she has told others about her desire to donate, what she plans to do with the money she receives from the donation and how she feels about the future contact and
disposition of her eggs and the embryos they create. 

Lastly, after determining a donor’s mental well-being, her
stability and her motivation, it is very important to determine if the donor is
cognitively mature enough to make an informed decision to be a donor.  I gather this information by exploring the donor’s educational background and her self-perception.  This information determines if she knowledgeable enough to have the ability to educate herself about the egg donation process and understand the potential medical and psychological issues that may arise.  Is she able to seek out information and ask questions or does she passively take the information given to her?  Often I encourage donors to talk with other who have donated before to get peer guidance in addition to professional guidance.  The bottom line on informed consent is “Does the donor really understand what she is agreeing
to?” 

To say “Choosing an egg donor is a difficult process” is an understatement.  It is important to realize that many donors have just as many questions about the intended parents as the intended parents have of the donors.  We interpret data and evaluate
information to ensure suitability.  We educate others and ourselves.  We hope
that all parties are being truthful and forthright.  

Andrea Bryman is a licensed Marriage and Family Therapist with a specialty in assisted
reproduction, which includes mental health assessments and evaluation of egg
donors and surrogates. Andrea’s focus on assisted reproduction stemmed from her own personal experience with infertility over 15 years ago when she was beginning her family. Since that time, Andrea has had three children, two with methods of assisted reproduction. She continues her professional growth in the field of infertility through research and involvement as a professional member of the American Society for Reproductive Medicine including their mental health professional group, the American Fertility Association, European Society of Human Reproduction and Embryology and Resolve. Andrea is the Past Psychological Chairperson on the board of directors for the Egg Donation and Surrogacy Professional Association.  

Asian Egg Donors Are in High Demand: A Note to Agencies by Guest Blogger Gail Sexton Anderson Ed. M.

There is an influx of Chinese couples coming to the U.S. for fertility treatment in need of both egg donors and surrogates. Most Chinese couples want only Chinese egg donors but some are open to donors of other ethnic backgrounds. Make sure your egg donor profiles state the donor’s specific heritage, not just that they are Asian. This is too general and your donor will probably be passed over.

The couples who come to the U.S. for fertility treatment tend to be well educated and value education in the donors they seek. While some may be satisfied with egg donors who have a two year degree (AA), most want to see that the egg donor candidates have a four year degree (BS or BA) as a minimum requirement. This helps them to have some measure for intelligence and drive.

Donor blood type is very important to these couples since using an egg donor will, in most cases, be a family secret as egg donation is not culturally accepted by many of their families and communities. If you don’t know the blood type of your Asian egg donors, now is the time to have them be tested at a lab or donate blood since they learn their blood type while doing so. Otherwise, you may have difficulty matching your donors who are not aware of their blood type to Asian recipients.

Age is also a crucial factor. Asian woman tend to not respond as well as Caucasian women to fertility treatment. When it comes to choosing donors, they often ask for donors under the age of 25 to increase their odds. They may be willing to consider egg donors up to age 27 but usually only if these donors are previous successful egg donors. Unfortunately, many of the agencies I visit have Asian egg donors who are over 27 and even over 30. Most reproductive endocrinologist (REs) will not approve an Asian egg donor who is over 27 unless she is a blood relative.

I work with Asian couples every week and have worked with more than one hundred over the years. These are all common issues for Asian intended parents. I hope you find this helpful as you gear up to recruit more Chinese, Korean, Japanese and Vietnamese egg donors as these factors are also true for many other Asian intended parents.

Tips for Egg Donor Agencies: Fill in All the Blanks by Guest Blogger Gail Sexton Anderson, Ed. M.

In a perfect world each egg donor would complete every answer on her egg donor profile. I know this is a nuisance for the agencies who post the profiles to their sites when there are blanks but it is a huge frustration for the intended parents who might have been interested in cycling with an egg donor if she had completed her profile. I know from working with egg donors that sometimes egg donors may not always be cognizant of the fact that information on their application is their opportunity to be known as an individual and can make the difference as to being chosen or not. Sometimes egg donors may forget that this is not a cold and distant decision but a life changing decision for the intended parents.

The intended parents have already had to grieve the loss of a child that is genetically related to the intended mother. At this point the Intended parents are hoping to find someone that feel could fit into their family. Filling in all of the blanks helps to give life to a flat profile and enable the intended parents to have a window into who the donor is so they can say “I like her, she seems like someone who I can relate to.”

These applications are the only way most intended parents can get any sense of what an egg donor candidate is like. If all an intended parent has to go on is a few clipped answers they can be left feeling no connection and no sense of why they would want to choose that particular egg donor’s genes to fill such a monumental role within their family. I have had many intended parents tell me they like the donor profiles were the donors have really put some thought into their answers.

As an agency it’s important to take the time to review every application before it is posted on your site to make sure the donor has taken the time to put a bit of her personality into her profile. It may take you more time on the front end but it will save you oodles of time and money on the matching end. You may not even be aware of how often a donor has been passed over for lack of information.

Gail Sexton Anderson has dedicated her career to helping intended parents from all walks of life to build families. She founded Donor Concierge as a compassionate approach to helping intended parents sort through the gauntlet of egg donor and surrogacy options. Gail has developed working relationships with many excellent egg donor and surrogacy programs, reproductive endocrinologists, fertility attorneys, and mental health professionals specializing in third party fertility counseling she has known and trusted for years.

Egg Donors Verses the ASRM: Antitrust Class Action Suit Filed

Yes, you read that headline right! Lindsay Kamakahi has sued the American Society for Reproductive Medicine (ASRM), the Society for Assisted Reproductive Technology (SART), and the Pacific Fertility Center for "price fixing and reaping the anti-competitive profits for themselves". You can read all about it here in the Courthouse News Service and here is the actual file.


So the question is do egg donors have a case against these parties? I am not an attorney but in general I doubt it. However, this case is bound to shine yet another spotlight on what an egg donor is paid and how the infertility 'industry" is going about self regulation. Comments have been made that egg donors need to be protected and that they might be exploited however there are a lot of educational tools available not only within clinics, agency's, and not for profit sites but all over the Internet as well. But how does someone put a price on their own genetics? What kind of guidelines are being offered? The reality may be is that no one wants to think about selling their genetics...that's why it's called egg 'donation'. The compensation comes into play for the medical trauma and inconvenience of the donation itself. At the end of the day the Intended Parents maybe the ones who need protection. They are the people, after all, that will have to pay the upwards of $10,000.00+ bill. Perhaps the word donation will be removed from the third party family building vocabulary. We will all have to wait and see......