How Are Egg Donors Selected?
If you answer an advertisement, you may be interviewed over the telephone, or be sent an application to fill out. Based on your responses, the program may decide that you are unlikely to be chosen, and you may not hear from them again. If the program decides that you are likely to be chosen, you may be invited to proceed with the selection process. Before you are accepted as an egg donor, however, you will be required to undergo medical and psychological screening.

Before you are screened, the egg donor program staff will thoroughly describe the procedures and risks involved in donation. That way, if you decide not to proceed, you can avoid the screening process. In any case, do not give your written agreement to become an egg donor before the screening process is complete.  After you are screened, the results of your medical tests should be discussed – whether or not you become a donor.

1. GENERAL MEDICAL SCREENING FOR DONORS
   You will have a physical examination, including a pelvic exam.
   Blood will be drawn to check your hormone levels.
   Ultrasound (which uses sound waves, not X rays) will be used to examine your uterus, ovaries and other pelvic organs. These tests might reveal an existing health problem. If anything is found, ask about your options for treatment (either from the program or another health professional).
   You will complete a detailed medical and psychological history about yourself and close blood relatives. It will include questions about your use of cigarettes, alcohol, and both prescription and illegal drugs. Many centres conduct unannounced drug tests during the screening and donation process.
2. INFECTIOUS DISEASE SCREENING
   When blood or tissue is transferred from one person to another, it can carry viruses or bacteria. To minimize the risk that a donor egg could cause illness in the recipient, donors are tested for a variety of infections. During your pelvic exam, a small scrape from the cervix will be taken to test for gonorrhea and chlamydia. Blood will be drawn to test for syphilis, hepatitis B and C, and HTLV-1 (a very uncommon virus that is associated with some cancers). You will have a blood test to see if you have been exposed to HIV. In certain centres the policy requires that you consent to this test in writing, after you read about the pros and cons of the test and understand who can receive the results.
   Centres should not accept any egg donor who is at increased risk for exposure to HIV or other infections. You are not also eligible to donate eggs if, within the last year, you have been diagnosed with syphilis or if you have received acupuncture, a tattoo or body piercing without being certain that sterile procedures were used.
   If you have had more than one sexual partner in the last six months, you are not eligible to donate eggs. The program may also require your sexual partner( s), if any, to be tested for HIV.

Before you are screened for infectious diseases, make sure you understand the tests, and whether and how you will be given the results. If you have an infection, seek medical treatment to protect your own health and fertility.

3. INHERITED DISEASE SCREENING
   Most centres try to learn all they can about a donor’s genetic make-up in order to minimize the chance that a baby will have a birth defect or serious inherited disease. You will be asked medical questions about your biological parents, grandparents, brothers and sisters. The centre may tell you what information to collect, or they may have you work with a genetic counsellor to identify:

• Any birth defects that required surgery or resulted in medical problems (such as a cleft lip, spina bifida or a heart defect).
• Certain genetic disorders (such as Huntington’s disease, hemophilia, Tay Sachs disease or sickle cell anemia).
• Inherited diseases that are of special interest to a recipient because of her own family history.
• Any major medical problems, surgeries, mental retardation, or psychiatric problems.

For any close blood relatives who have died, you will need to know how old they were and the cause of death.
Some common diseases (such as cancer or heart disease) that strike when people are middle-aged or younger are influenced, at least in part, by genetics. If you do not have access to the necessary information, either because you are adopted or there is no informed person to ask, some centres usually advise you should not become an egg donor.

What If A Donor Is Not Accepted?
It’s natural to feel rejected if you are not chosen. Sometimes the decision is made to protect you from medical harm. Or, it might become apparent that you may find the process too time-consuming or emotionally difficult. In some cases, it simply means that the right match has not been found.

To prevent prospective donors from dwelling on the reason they were not accepted, some centres will not provide this information. If that is the policy where you are applying, make certain you are comfortable with that before going through the screening.

Will The Recipient Know The Egg Donor?
Most centres keep the identity of donors confidential (often called “anonymous donation”). If you enter one of these programs, the recipient will have important information about you, but you will never meet or know each other’s names. Other centres are more open.

They may accept:

• Donors willing to be identified later: Some donors give permission to be contacted once the child reaches a given age (18yrs or 21yrs).
• Donors not willing to be identified later: Some donors do not wish to know the recipient at all.
• Donors willing to meet the recipients: In some centres, the donor and recipient meet to get to know each other and to ask questions.
• Donors who want ongoing relationships with recipients: Some centres help donors maintain contact with the recipients, through an occasional photo or card, or a closer role as a special family friend.
• Donors who already have relationships with recipients: A recipient may contact a fertility centre after she has already asked a friend or relative to donate.

No single type of arrangement is right for everyone. Each presents unique challenges during and after the donation.

Who Will Use The Eggs?
Egg donation is a treatment option for women who do not produce enough normal eggs but are otherwise able to be pregnant. Some of these women have malfunctioning ovaries or entered menopause at an early age. Others are at an age when they produce eggs less readily, even with fertility drugs. Still others tried standard IVF but produced poor quality eggs or embryos.

Less commonly, women decide to use donor eggs because they are aware of an increased risk for inherited disease in their biological offspring. For example, the woman herself may be healthy, but she and her partner may both carry a gene for the same disease. This creates a risk in the child if it inherits the altered gene from both parents. Using an egg donor who does not carry the gene eliminates this risk. Most often, donor eggs are used by women in their late 30s or 40s who are attempting to become pregnant. Very few women under the age of 36 use donor eggs. Centres have various upper age limits for recipients. Some, will allow women over age 50 to be recipients.

Most centres will treat unmarried women who are trying to become pregnant without a male partner and who require donor sperm as well as donor eggs. While some centres match an egg donor with more than one recipient. If you have concerns about who might receive your eggs, discuss them with the clinic before agreeing to become a donor. Some centres allow donors to place restrictions on the use of their eggs. However, no program can guarantee how your eggs will be used.

How Are Donors Matched With Recipients?
In most infertility centres that use “anonymous” donors, the staff in charge of donated gametes match a recipient with the donor who most closely resembles her, including ethnicity, height, body build, skin type, eye colour, and hair colour and texture.

Once a possible match has been found, the recipient is given information about the donor and decides whether to proceed or wait for another donor. In some centres, recipients are given information about several possible donors and select the match they would like to pursue. Donors may be asked to take intelligence tests or to provide other information (essays, school transcripts, lists of hobbies, etc.) that will be given to possible recipients.

Other programs, however, do not provide this type of information because it implies, without good evidence, that these characteristics are largely determined by genetics.