Donor Egg, Donor Sperm and Donor Embryo: A Guide

What is third-party reproduction?

Third-party reproduction means using eggs, sperm, embryos or a uterus provided by someone other than the intended parents. It includes donor eggs, donor sperm, donated embryos and gestational carriers (surrogates). People choose it for many reasons, and most go on to have healthy children.

Who uses it

• People with low ovarian reserve, premature ovarian insufficiency or advanced reproductive age
• Couples with severe male factor infertility
• People who carry a genetic condition they do not wish to pass on
• Same-sex couples and single parents. See LGBTQ+ and solo-parent fertility
• People who cannot carry a pregnancy and use a gestational carrier

How each option works

• Donor sperm is used with IUI or IVF. Sperm banks supply frozen, screened samples that have been quarantined and tested.
• Donor eggs are retrieved from a screened donor after stimulation, fertilized with sperm and transferred to the recipient or a gestational carrier. Frozen donor egg banks are also available.
• Embryo donation uses embryos created by other patients during IVF that they have chosen to donate.
• Gestational carriers carry an embryo created from the intended parents’ or donors’ gametes.

Screening and safety

Donors usually undergo infectious-disease testing, medical and family-history review, and many programs add genetic carrier screening and psychological evaluation. In the United States the FDA regulates donor testing, and professional bodies such as ASRM publish guidelines on donor age and number of births per donor. Always ask programs what screening is done and how many families have used the same donor.

Known, anonymous and open-identity donors

Known donors (a friend or relative) allow a relationship but need clear legal agreements and counseling. Anonymous donors are common but increasingly some banks offer identity-release options so that donor-conceived people can access information as adults. Think about what you will tell your child, and consider talking with a counselor with experience in donor conception.

Legal and emotional considerations

Laws about parentage and donors differ widely. Work with a fertility attorney, especially when using a known donor, a surrogate, or if you are unmarried or in a same-sex relationship. Counseling can help with decisions about disclosure and grief about not using your own genetic material.

Cost and success

Costs add the donor’s compensation, agency or bank fees, legal fees and medical costs to IVF costs. Success rates with young donor eggs are often higher than with a patient’s own eggs at older ages. Ask clinics for their own results. See fertility costs and insurance.

The donor egg cycle in detail

In a donor egg cycle, the donor undergoes ovarian stimulation and retrieval, like an IVF patient, while the recipient prepares the uterine lining with estrogen and progesterone. The retrieved eggs are fertilized and one or more embryos are transferred to the recipient or carrier, with others frozen. Cycles can be “fresh,” where donor and recipient cycles are synchronized, or use eggs from a frozen donor egg bank, which can be faster and more predictable in timing but may produce fewer embryos per set.

Choosing a donor

Programs offer profiles with medical history, education, physical traits and sometimes personal essays or photographs. Many people value health history and screening results most, and weigh other characteristics according to personal preference. Some programs use matching services. Consider how many families have used the same donor, as some banks and professional guidelines limit this, and ask about what updates the donor commits to providing about her health.

Counseling and disclosure

Professional guidelines recommend counseling for recipients and donors. Topics include what to tell your child and when, how you will manage questions from family, and what a child’s access to donor information might look like in the future. Research and expert opinion in recent years have favored openness with children from an early age. Counselors experienced in donor conception can help you find language that works for your family. Resources for donor-conceived people and parents can also be valuable.

Gestational carriers

A gestational carrier carries a pregnancy for the intended parents. Screening includes medical and psychological evaluation, and legal agreements are essential. Costs include medical expenses, compensation, agency and legal fees and insurance, and are substantial. Laws vary widely by state and country, with some jurisdictions restricting or prohibiting compensated surrogacy. Work with experienced attorneys and clinics, and understand your insurance.

Embryo donation

Embryo donation lets people who have completed their families offer remaining embryos to others. Recipients undergo a frozen transfer cycle. It can be a lower-cost route, and it brings its own questions about genetic relationships and disclosure. Some programs match donors and recipients with varying degrees of openness.

International and legal differences

Rules on donor anonymity, compensation, number of families and surrogacy differ widely between countries. Some people travel for treatment. Understand the laws of the places where you will receive care and where your child will be born, and the implications for parentage and citizenship before you start.

Questions to ask

• What screening does your program do for donors and carriers?
• What are your success rates with donor gametes for recipients like me?
• What legal and counseling support do you require or recommend?
• What are the total costs, and what does insurance cover?

Next steps

Ask your fertility clinic about its donor program, read how to choose a fertility clinic, and use the appointment questions planner.