Young women are donating eggs at the time they are most fertile, often times not realizing the implications of what that means. I’ve had patients come to me in their 40s without enough healthy eggs of their own to conceive. When they share with me that they themselves donated their young and healthy eggs in their 20s or 30s, but that none are available for them, I feel frustrated and sad for them.
Frustrated enough that I’m doing something about it. Freeze & Share is a program that helps young egg donors save some eggs for themselves should they need them, while helping another family conceive when they can’t on their own.
Suffice to say, I don’t want anyone to look back at their egg donation and wish they’d known more.
Here is your chance — I want to give you all the information I have so that you’re equipped with the knowledge to make the best decision for your personal situation.
Let’s start with the basics:
What is Egg Donation?
It’s not as simple as answering an ad on Instagram or Facebook, showing up for a consult, and then being done. The truth is that it involves injections, hormones, lots of doctor visits, and ultimately surgery (that’s not risk-free) to extract the eggs.
The recipient of eggs (my patients) ask who would donate their eggs in the first place.
I’ll tell you who — people that are very kind and that want to make a difference in the world. Often times there is a connection they have to the act — be it a personal friend or knowing someone that benefited from egg donation. Sure there is money involved, but it is not an easy way to earn money.
It is not like being a sperm donor where for a man there are many, many sperm that can be produced and donated with ease.
For women, it involves surgery, drugs. and lots of careful effort.
I hope that it gets easier for women, but for now, it’s not and so I want all women who donate eggs to know that I support you and want to protect you and make the process as transparent and safe for you as possible.
Who Can Donate Eggs?
I have women that reach out to me at 42 years old and want to donate eggs to their sister who is 44 years old. At that age the likelihood of having healthy eggs to donate is low, but I will never tell someone no until we collect more information about their fertility.
In this example, I’d ask the patient to check her AMH level — which is a hormone that’s secreted by cells that surround eggs. We run out when we go through menopause. Our AMH level tells us how many eggs you have left and how many eggs you could potentially donate.
At age 42 an average level for AMH may be something between the range of .2 to .4. That means a fertility doctor like me may retrieve about 4 eggs or so. Is that enough to donate to a family member when each egg has less than a 10% chance of being genetically normal? If it’s something you want to do as it’s family and you want to support your sister, then I would talk more with a fertility specialist about it. Otherwise, we look for people under age 32 (in general) and look at the whole picture of the individual — what their follicle count is, mental and physical health, etc. In general, we look for donors with a healthy past medical history. Ultimately I want to make sure you carefully consider your risks and take care of you first.
Who Needs Eggs?
For you who are watching — who needs eggs? If you’re going to be an egg donor your eggs could go to a woman who is in menopause, to a same-sex male couple who is wanting to conceive, or a single father by choice. All of these are options. Then you want to decide if you want to know who has received your donated eggs.
I meet with many people in their 20s that aren’t sure if they want kids, but in 10 years you may want kids. At that point, if you’ve donated eggs without finding out who received them, your future kids may be curious too. Things can get complicated.
When Can You Donate?
When you’re in town! I know that sounds silly, but don’t plan a donation before you are set to go on a vacation to Europe. You will be feeling bloated and you want to make sure that you’re safe at all times and you know the emergency numbers for who you should call if you feel severe pain. If you’re not local with the doctor that knows you then you may not get the same level of care that you require.
When I’m planning an egg donor cycle with a patient (and I refer to donors as my patients too), I make sure that the cycle is convenient for them. At the end of the day, we want to make sure we are doing the best for the egg donor. This doesn’t need to interrupt your work life, or otherwise. I want to work with you and make this convenient for you, and so that’s what we do.
Where and How Does It Happen?
Patients come to my office here in the SF Bay Area and then I put them on medication. A shot each night for 10 nights. Then you come to the office here 5 times. Before you even start the medications, however, there are other screening visits, a legal contract that needs to be signed, psychological evaluation as well. So it’s not as easy as showing up to my office, but certainly, I’m trying to make this topic as easy to understand as possible.
What Meds Do You Take?
You self administer shots. You can mix the medications for yourself or we can do it for you so you don’t need to learn the process. The needle goes into the skin of the tummy.
What Are the Risks and Side Effects?
The risks of going through an egg donation are many. I know that sounds scary, but by being frequently monitored and having the levels of your hormones titrated and being under the care of a physician, you’re going to have a lower chance of any complications.
The risk I’m most concerned about is for a condition called severe ovarian hyperstimulation. This may include experiencing pain, severe bloating, and needing follow-up surgery. You may also experience a ruptured cyst. Or just experience general side effects to the hormones. These can be breast tenderness and bloating. Patients tell me they feel like a potato and my patients who are egg donors they don’t like feeling bloated and they want that feeling to go away immediately after the donation. But what I’ll share with you is that after the egg retrieval your ovaries still feel bloated and swollen. It always goes away and this process doesn’t make your run out of eggs. Your fertility doctor managing your egg donation cycle is rescuing eggs you would have lost that cycle anyways.
That first period after the retrieval is going to be very heavy. It can be very painful and clotty. Don’t tough it out. Take pain meds like Motrin or Tylenol. The other thing that can happen is constipation. I recommend taking stool softeners. It may sound silly, but it’s not silly if you end up in the emergency room with a poop emergency.
What Happens After You Donate?
After the egg retrieval and once you’ve had your period then that’s it. You move on. You’re done. You move on with your life. Sometimes egg donors want to donate again. If you had a really good experience then I recommend you do so. It’s definitely okay not to donate again too.
I want to make sure you don’t have questions unanswered and have what I call egg donor regret.
I often do a phone screening or a video screening and make sure you’re aware of all of the things we’re talking about right now.
So what’s the most important stuff you need to know? I call these…
The Egg Whisperer Pearls of Wisdom
These are the things that egg donors tell me.
One is that they rarely meet the doctor from start to finish except for at the time of retrieval. I don’t think that’s okay. If you’re going to be a donor — please ask to meet the doctor.
Make sure you know the emergency number for that physician.
If anyone needs me after I’ve gone to sleep at night they know how to get in touch with me. I give them my personal cell phone. I could be giving simple advice to take more Motrin or to drink more fluids because you are dehydrated.
I’ve certainly heard stories from egg donors that don’t hear back from their doctor and end up in the hospital. I don’t want that to happen to any of you.
Do this before you sign your legal contract and at the time of your psych evaluation. All egg donors go through legal counseling with an attorney. During that point you are signing things like: do you agree with embryo donation or to allow for eggs to be donated from the family you are giving to should they not use them. What you can say is that you want to know who the embryos are going to before agreeing to anything.
There is no such thing as DNA privacy anymore. If you give someone your egg they have a piece of you forever. If you’re an egg donor and you want to know that information then it’s okay. Your needs should be met, and if they aren’t then that donation is not for you.
I have the joy of receiving pictures from egg donors of the families they’ve helped. Egg donors are improving so many peoples’ lives and creating powerful and positive impacts.
Make sure you know what OHSS Precautions are.
OHSS is Ovarian hyperstimulation syndrome. It can be mild, moderate or severe. It’s the severe stuff that we want to prevent. This is when your ovaries get so swollen that you have a hard time breathing, you need potential hospitalization, and surgery to remove fluid from your abdomen.
There are things that we can do to prevent that from happening. One of the things is this. If you’re a first-time donor. Start low dose and get screened early in the process. I will see a donor every couple of days and make sure everything is okay. I constantly monitor hormone levels and do ultrasounds to protect donors from harm.
Even if you’re going through egg donation for a second time just know that this doesn’t make you immune to OHSS. You may have been safe the first time around, but we want to ensure that’s true for subsequent donations too.
This brings up another point. If you’re an egg donor, please get involved in your care. Know what you’re taking and why you’re taking it. If that cycle worked well for you and you’re going to be an egg donor again bring in your medication protocol to Yue next clinic if it’s a new one. Please don’t show up to the second donation and not know what was included in your care plan. I always ask donors what worked well for them. This is important, so please take notice of what’s happening and why.
Which was the best and worst cycle you experienced? Why or why not?
We then learn from that and replicate the protocol that worked well for you. Help future physicians help you.
Always ask questions. If your dose looks too high or not quite right, please communicate that with the doctor. At the end of the day, it’s about your body so you want to do what’s best and safe for you.
Freeze & Share
I started this program several years ago so that young women could freeze their eggs for “free”. Obviously, it’s not for free as they are donating them to a family in need of healthy eggs. It’s a win-win for everyone involved as the donor gets to keep some eggs for use later in life. The recipient of the eggs pays for the cost of the retrieval and storage in exchange for healthy young precious eggs that they can use to start a family.
My hope is that every egg donor is aware of this program and considers it before giving the gift of life.
As always, thank you for taking all of this information in. I hope it was helpful, and I would love to hear from you.
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