One in a continuing series of discussions exploring a variety of issues relevant to our Intended Parents considering utilizing the services of a third-party egg donor.
How to Choose an Egg Donor Agency
As you start your search for an egg donor, you will be introduced to myriad agencies through their respective websites. Each agency, you will soon begin to discern, come with their own unique identities with a mind-boggling combination of policies and procedures. What you believed initially would be a fairly straight-forward process begins to yield to an overwhelming sense of dread as you try to sort through the differences that set one agency apart from another.
No need to worry. We’ll try to spell it all out for you as objectively as possible. It’s no accident that we’ve chosen this as our first topic of discussion. We truly do believe that empowering the Intended Parent with a better understanding of how the agency business works can only lead to a more informed choice, opening the door to the probability of much better outcomes down the road. So let us try and break it down for you:
Does the agency have egg donors that match your criteria?
This is an obvious place to start. Keep in mind that some agencies have hundreds of donor candidates and others may be more niche oriented specializing in a select, more limited demographic. Depending on your requirements, you may need to search the egg donor databases of many different agencies before you find one or two potential candidates. If you find an agency that you vibe with but they don’t have any egg donors that qualify, you can always request that they launch a “custom search” on your behalf. Not all agencies are willing or equipped to do this. Before committing to an agency be sure you clarify upfront if the agency charges an additional fees for such a service.
Are their egg donors “screened?”
We almost hesitate to open this can of worms. All agencies make a good-faith effort to screen their egg donors before listing them in their database. The problem is that each agency uses a different metric for how they define “screening” their egg donor, based on the agency’s size, their financial resources, and what they have determined is important. Keep in mind that any agency “screening” is actually a “pre-screening” to the screening process implemented by your IVF doctor who will most certainly have his or her own set of protocols before medically clearing your donor candidate to proceed to treatment and who will always retain the Final Say. The goal of all agency pre-screenings are to weed out (for lack of a better word) any donor candidate that can not go the distance and to protect you, the IP, the expense, frustration, and disappointment of choosing a donor candidate that fails to be medically cleared. Honestly, at its core, we’re talking about risk reduction--financial and otherwise.
So what kind of specific screening tools do different agencies use on your behalf? Almost all universally use an in-depth questionnaire that at times resembles a beauty pageant interview (e.g. “What’s your favorite kind of music?”) but mostly focuses on extremely relevant questions pertaining to all aspects of the donor and her family’s physical, emotional, educational, religious, medical, psychological, and genetic backgrounds. It is her answers to these questions which will determine her initial eligibility as an egg donor candidate and which will comprise the very profile you will be reviewing when you run a donor search at the agency website.
Beyond the questionnaire, additional screening tools become more diversified depending on the agency. You’ll want to specifically make an inquiry of each agency as to which tests they incorporate as a part of their vetting process and any fees that will be passed on to you to cover the agency’s initial expenditure to run these tests. Let us list some of the possible ones you should be aware of:
--A Psychological Assessment that probes for any mental illness or issues that would make the candidate unsuitable to become an egg donor.
--A Genetic Assessment that looks for any disease states or genetic abnormalities that could be carried in the donor’s DNA and passed on to your baby.
--Additional labs and blood work that could identify infertility issues that potentially impact the quality or quantity of your donor’s eggs.
--A criminal background check.
Be aware that your doctor will have his or her own independent set of protocols which may duplicate certain procedures already run by your egg donor agency.
To what extent does the agency interact with their egg donors?
Most agencies have automated the initial application process for their egg donors. But once approved for listing, contact between the egg donor and the agency may vary from simply talking on the phone to Skyping to adhering to a policy of making an effort to meet the egg donor in person. Some of this will depend on the proximity of the agency to where the donor lives. Some agencies will even accompany the egg donor to important clinical appointments, including the actual transfer, just to provide that extra level of support. This level of personal contact is something that may make a difference for you when considering any given agency.
In a similar vein, what is the agency's policy on facilitating a physical, face-to-face meeting with your chosen egg donor if that is something that is mutually agreed upon by both yourself and the egg donor? Some agencies will not support such an encounter and others are happy to do so as long as this is something that has been properly vetted by both side’s legal representatives.
What is the agency infrastructure?
By “infrastructure” we are addressing all aspects of how an agency allocates its staff to conduct business. Some agencies are much larger in scale, similar to a corporation, have multiple hierarchies of management, tend to run many egg donor cycles at any given time and have sizeable databases of egg donors that are evolving daily across a wide demographic swath. On the other end of the spectrum are the boutique-style agencies that tend to keep their staff deliberately small, offer a more personalized experience, target their selection of egg donors to a specific demographic, and limit the number of supervised cycles at any given time that they have determined is appropriate to the size of their staff.
Both types of agencies can deliver excellent results but your personal preference and trust may be with one over the other. In either case, you’ll want to ask upfront if there will be a continuity of care with a single coordinator who will be acting as your case manager and with whom you will be interacting throughout the entire process. Or will this responsibility be shared by more than one agency representative over the course of the egg donor cycle? Keep in mind that the coordinator is pivotal to the success of any given cycle. They will be your point person, your advocate and the one who will be running logistics on your behalf between the varied professionals who will comprise your team.
All egg donor agencies, regardless of size, build their reputations on what we in the business refer to as their ability to “manage the cycle.” The process is intensely time-sensitive. One misstep and a scheduled retrieval could be thrown off-track. So you want to make sure that the coordinator(s) with whom you will be working are people you can build a relationship with and who will have your back if things should get bumpy.
Another issue which may or may not be important to you is whether the agency has a brick-and-mortar presence, a.k.a. an office. The reality is that technology has evolved to the point that an entire cycle can be successfully executed remotely from where the IP’s home is based. Indeed, as third party reproduction becomes more geographically mainstreamed, it is not unusual for the Intended Parents to never meet face-to-face with an agency representative. Yet, for some, it might be reassuring to know that there is a tangible office location for them to visit should they ever want to. In either case we do recommend that you either Skype or meet face-to-face with an agency rep. before you commit to working with them so at the very least you can put a name to a face.