Your infertility struggles have led you to a crossroads. The bad news is that for whatever reason, you or your partner doesn't have viable reproductive genetic material. The good news is your body is capable of carrying a pregnancy if you use a donor to supply the necessary sperm and/or egg. Grab your life's savings and a large chunk of time to dedicate to the project- here's what you need to know about the process of selecting a sperm or egg donor.
How does a pregnancy using sperm/egg donation happen?
Just the facts
If using a sperm donor, the donation can be fresh or frozen and is obtained via masturbation by the donor. Your doctor can insert the sperm during an interuterine insemination (IUI) or utilize the sperm during in vitro fertilization (IVF).
If using donor eggs, the process is the same as that for IVF, except that it's split into two parts. The donor takes the medications to stimulate egg production and gives herself the trigger shot of HCG to produce the eggs, then undergoes the egg retrieval. Meanwhile the recipient takes medications to match her cycle to the donor so that the recipient's uterus will be ready for implantation at the same time the embryos are ready to be transferred. 3-5 days after the eggs are retrieved from the donor, the embryo(s) are inserted into the recipient.
The real deal
If there is any silver lining to being a woman who is using an egg donor to get pregnant instead of IVF with your own eggs, it is that you don't have to undergo the egg retrieval process. Sure, remembering to take multiple pills and injections isn't a picnic, but avoiding having to be sedated and feeling like a bloated balloon is a plus. Also, by using donor sperm or eggs with IVF, you know that the doctor is transferring an healthy embryo. For a couple having difficulty getting pregnant, it can be comforting to know part of the battle is already won.
Who can my donor be?
The are three different types of genetic donors. A known donor is someone you know in real life, who would likely know the child through virtue of their relationship to you, like a sibling or close friend. An open donor is someone you don't know personally but select via the doctor's office or an agency. An open donor is willing to have contact with any children that result from the donation, either during childhood or once they reach adulthood. An anonymous donor is someone who you select via the doctor's office or agency who will not learn your identity and you will not learn theirs beyond basic physical characteristics and health history.
Regardless of which type of donor you chose, your doctor may have requirements that must be met by the donor. The American Society for Reproductive Medicine recommends that egg donors be under the age of 34. Most sperm banks require donors to be younger than 44. The donor will undergo medical testing and examination to be sure that their genetic material is viable and healthy. A screening for genetic diseases and disorders should also be performed. Many states also require a psychological evaluation of the donor to ensure that they understand what they are doing and to assess the motives behind the donation.
There are some advantages to using a known donor. By selecting someone that is already in your life you are aware of looks and personality traits that may get passed onto your child. And if you chose to do so, the donor can be an active part of the child's life and will be there for the child to talk to if they have questions about their conception as they grow. From a practical standpoint, using a known donor is more affordable. While you will still be responsible for any medical expenses for the donor- doctor visits, medications, the cost of preparing the eggs or sperm and in the case of an egg donor, retrieval, you don't have to pay any additional compensation beyond medical costs.
Complications using a known donor could happen if the relationship between you and the donor breaks down, or if the donor tries to interject themselves in your parenting decisions against your wishes. Using your brother-in-law as your sperm donor may seem like a great idea- you child's cousins will be his half siblings, he will grow up knowing his donor. But it could be difficult for some families to define the role of uncle when he is also the donor. If the process doesn't work and you don't get pregnant, or if your child has a disability it could strain the relationship you have with the donor. Imagine going through then process of your best friend being your egg donor and then you don't get pregnant- would you be resentful? Would she forever feel guilty? Or would it bring you closer together?
Using an an open donor allows you to have contact with the donor for the sake of your child's curiosity (if any) as they grow or when they are grown, but also enables you to raise the child without interjection or feeling like you're competing as the "real" parent. As with a known donor, if your child had an extreme medical condition where treatment could be bolstered with a genetic match, like certain cancers, knowing how to contact the donor could be crucial. However some recipients may not be comfortable with the thought of their child wanting to find the donor and may worry that the child will become more bonded to the donor than the parent.
Using an anonymous donor allows the recipient to parent without interjection. Also, some people don't want to share the fact that they are using a donor with friends or family. Using an anonymous donor makes it easier to keep that information private. But while you have a medical history provided for you by the clinic and most clinics try to have donors maintain contact information in the event of an extreme medical issue or question years later, there's no obligation on their part to keep the clinic updated. Also you don't really know the donor's personality. As your child grows up, assuming you tell the truth about their conception, they may have questions about the donor that you can't answer for them. And there is the potential for half siblings, either from other donations or the donor's own children, that your child(ren) may never be aware of.
If I don't want to use someone I know, how do I find and chose a donor?
Your clinic may have a roster of available open and anonymous donors to choose from. If you are seeking specific attributes in a donor, or your clinic has a long waiting list for their donors, you may contact a private egg donation agency or sperm bank that can help you advertise the type of donor you are looking for or will have other donors to chose from.
If using an open donor, you may have the ability to meet with a potential donor over the phone or even in person before making a decision, like a job interview where you discuss athletic skills and natural hair color. If you chose to use an anonymous donor, you'll be given minimal information about the donor when making a choice- typically a photo or two, educational history, hobbies- think an online dating profile, but with genetic screenings and the fact that her grandfather had high blood pressure thrown in. Many people focus on trying to find a donor who is a close physical approximation to themselves so that the child won't feel different from the rest of the family and strangers won't ask rude questions. Others focus on choosing a donor who they find attractive, regardless of how those looks match the parents(before you call this shallow, stop and imagine how beautiful your kids could be if you mixed your eyes with the hair of a Bradley Cooper look-a-like) Still others focus on picking a donor who has a personality and interests similar to that of the person they are standing in for, genetically speaking.
How does using a donor work legally?
Sperm and egg donors are compensated. Sperm donors receive around $35-$50 per specimen from the sperm bank, though the cost of obtaining sperm is on average several hundred to $1500. Because the process is so much more involved, egg donors are compensated much more than sperm donors, with most compensation being several thousands of dollars.
Each state has specific laws regarding ownership of donated genetic material. In general, both the donor and recipient will be asked to sign paperwork indicating that the recipient will be the legal parent of any children born as the result of the donation, and is responsible for them regardless of their health. The donor will be absolved from any responsibility towards the care and maintenance of the child(ren) and also forfeits any recourse over custody and/or visitation, unless the parties agree otherwise.
While most donor cases are open and shut- the donor wants to do a good thing, they do, they move on- every now and then a headline will emerge about genetic donors seeking rights after a child has been born. Most of these legal battles emerge when there was little or no formalized contract at the time of the donation, and your clinic will encourage you to consult with a lawyer before signing the donation paperwork in case you have any questions or concerns.