Considering Egg Donation? Here are Six Common Red Flags to Watch Out For

By Liz Scheier

Egg donation brings in about $100MM to the fertility industry every year in the US alone. That’s big money. So it’s no surprise that some clinics and agencies participate in less-than-ethical practices to convince young women to donate with them. 

We Are Egg Donors (WAED) donors have experienced the good, the bad, and the ugly. We’ve put together a list of industry practices which may put your health, safety, or finances at risk.  If any of these look familiar, consider choosing another clinic or agency, including your own stipulations in the contract, or turning down the cycle. Your health comes first. 

Red flag no. 1: Downplaying the lack of research on the long-term health of egg donors

Transparency about lack of donor studies is important. There have been no longitudinal studies done to date on the effects of donation on donor health. Clinics and agencies frequently phrase this to donors as “there are no long-term risks to egg donation”, which is not true; no one knows the long-term risks. Clinics are not required to monitor or report on long-term health outcomes. Some doctors will go so far as to say that egg donation is the same as own-egg IVF, and is therefore perfectly safe. Extrapolating out risks from one demographic group to a completely different one is not only medically unsound, but coercive. If you decide to donate, know that you are doing so with scant information about on the impact egg donation may have on your long-term health. 

“We hear over and over again that ‘the risks are less than 1%’, but I have not found any evidence to support that claim, and I’m not quite sure where that statistic came from,” shared Dr. Diane Tober, a medical anthropologist driving a current study on egg donors. “With the lack of research, it’s meaningless. So women who go into it really do not have a lot of information to go on when deciding to become egg donors.”

Red flag no. 2: Targeting for high numbers of donor eggs, at your expense

A woman who completes an IVF cycle for her own pregnancy aims to retrieve 10-15 eggs. If she is trying to better her chances of producing embryos which test negative for a serious chromosomal abnormality which she or her partner carry, she might aim for 20. Many WAED donors are now being overstimulated to produce 60, 70, even 80+ eggs, even though a higher egg count means lower egg quality, and there is obviously no reason a recipient could need 80+ eggs.These extraordinary numbers put the donor at a higher risk of OHSS, often requiring a hospital stay and significant pain.  If you’re on track to produce more than 30 eggs, ask your doctor why, and ask what can be done to resolve the problem. You should not be obligated to continue under the care of a doctor who is valuing the recipient’s money above your health.

To illustrate how egg donors are impacted by this issue, We Are Egg Donors created this video with Our Bodies Ourselves:

Red flag no. 3: Shared egg donor programs.

Cycle splitting is advertised as a cost-reducing way for Intended Parents (IPs) to secure donor eggs by sharing them among other recipients. For the reasons outlined above, think very carefully about agreeing to a split cycle. This may bring down costs for recipients, but it results in a much greater risk to the donor’s health by highly incentivizing doctors to overstimulate donors to produce a potentially unsafe number of eggs. This is a great example of a clinic or bank prioritizing the bottom line over a donor’s health. There have also been cases where egg donors are signed up for a split cycle without their consent or knowledge. Make sure your contract stipulates a single recipient.

“I understand the appeal of sharing costs for recipients, but donors are people and we're undergoing medical procedures that carry real risks,” said Sarah, an egg donor in Canada. “We deserve a system that minimizes our risks to the fullest extent possible, while maintaining reasonable success for recipients. Shared cycles put pressure on donors to produce high, and often unsafe, numbers of eggs in order to cut costs for the recipients. It’s not ethical.”

Red flag no. 4: Blocking access to egg donor medical records

Gamete donors are specifically carved out from HIPAA protections, meaning your clinic or agency is not legally required to give you access to the records of your cycle. Some WAED donors have been able to retrieve their records later; some have been denied access completely; some have received records which have had their dosages, numbers of follicles, hormone levels, and other key information redacted. Before your cycle begins, make sure your contract stipulates that you will have immediate and consistent access to your complete records. 

“Unfortunately, I was not given an attorney to review the contract with and I did not have an understanding of HIPAA laws. Donors should make sure they work everything into their contracts and communicate with their agency well in advance,” shared Rae, an egg donor who was denied access to medical records from her egg donation cycle. “It’s best to know how your agency and clinic will handle your records ahead of time and that you’re vocal if you have issues. It’s okay to have deal breakers as an egg donor and it’s important that you stick to them.”

Red flag no. 5: Not having access to your own legal representation

As another “cost saving” method by agencies, some will encourage donors to “share” a lawyer with the recipients. It is a breach of professional ethics for an attorney to represent both sides of a contract. Not only is this common in donor agreements, but some WAED members have been asked to sign agreements which state outright that in the case of a conflict, the shared attorney will automatically act in the interests of the recipient. Many WAED donors have been promised unenforceable clauses in their contracts (i.e., notification of a pregnancy or live birth, contact with the family) or bullied to continue unsafe cycles with threats that they will be required to pay all of a recipient’s medical costs to date. Make sure that anything you sign has been vetted by a lawyer who is answerable to you, not the recipients.

We Are Egg Donors polled 100+ donors on whether they were offered legal representation for their cycles. We received 145 responses:

Red flag no. 6: Pushing anonymous cycles without disclosing the likelihood of identity breach

The rise of consumer DNA kits — which allow people to connect to genetic relatives by mailing a cotton swab of your saliva to a lab — means clinics and banks must revisit guarantees to gamete providers about anonymity. As an egg donor, you don’t need to personally participate in a DNA test to map your genes on one of these consumer kits: even if a close relative joins one, the likelihood of a connection is higher today than ever. Clinics and banks that try to promote anonymous donations must confront the reality that guaranteeing anonymity to their clients is impossible. Early studies and surveys indicate high levels of trauma experienced by the children born of anonymous donations; consider working with an agency or clinic which facilitates known donations, even if that just means that the children can contact you for health information.

Join our egg donor community

We Are Egg Donors’ secret Facebook group is a global conversation among egg donors. Members of WAED’s community come from different parts of the world; we represent differences in ethnicities, religious beliefs, values, socioeconomic backgrounds, and perspectives.

As a volunteer-run organization, we keep a donation policy in which we do not accept donations, sponsorship, or endorsements from any business that profits from donor eggs. This allows us to continue to provide resources to support egg donors with no commercial interest in their choice to donate.

To join the WAED community, click here.