Egg donation is a complex but beautiful and altruistic collaborative effort by which recipient parents rely on the harvested oocytes of a donor to conceive and hopefully, successfully build a family. The American Society of Reproductive Medicine describes egg donation as the process by which “an egg from a fertile woman is donated to an infertile woman to be used in an assisted reproductive technology procedure such as IVF. The woman receiving the egg will not be biologically related to the child but will be the birth mother on record. The process of fertilizing eggs from a donor and transferring the resulting embryos to the recipient’s uterus or, if necessary, a gestational carrier.”
Who are egg donor recipients?
Candidates for egg donation may include patients of either advanced maternal age, patients diagnosed with premature menopause, patients with a history of failed in-vitro fertilization using the recipient mother’s own eggs, patients experiencing poor ovarian hyperstimulation response as well as women with non-functioning ovaries resulting from chemotherapy, surgery or congenital factors. Also, gay men hoping to parent will rely on egg donation for conception (in addition to the use of a gestational carrier).
Egg donation recipients must be in good health. Recipient mothers over the age of 45 must have medical clearance stating that they are capable of carrying a pregnancy to term without compromising her health and well-being. Medical clearance may be required for younger recipient mothers if indicated by her medical history. Surrogates or gestational carriers will be required to satisfy the clinic’s surrogacy qualification standards.
Who are egg donors?
Egg donors are typically young healthy women who have met clinical as well as FDA criteria for appropriateness to donate. The typical age for an egg donor is between 21 and 32 although in some clinical programs the acceptable age for a known donor may be older out of regard for an interest by the recipients to work with a donor with whom there is a genetic connection (sibling, cousin) or a compelling social relationship. The upper-age limit for qualified egg donors varies from clinic-to-clinic and recipients should inquire about the age limits at their program particularly if considering a known donor.
How much does egg donation cost?
A considerable factor in deciding if egg donation is a reasonable family building option will be cost.
Typically, costs for Egg Donation will include:
Agency or Donor Selection Fees (if selected donor is not identified through the fertility clinic)
Donor Travel Expenses (if selected donor is not local to the fertility clinic)
Recipient parents must consider that anonymous donors are expecting to be compensated for their time, effort and inconvenience of undergoing in-vitro fertilization on their behalf. While the rate of egg donor compensation varies from program to program and is often reflective of regional factors, the American Society of Reproductive Medicine suggests the following: “Total payments to donors in excess of $5,000 require justification and sums above $10,000 are not appropriate.” Certainly, there are programs that compensate donors below $5,000 but recipients should inquire about excess compensation, relative to the American Society of Reproductive Medicine’s recommendations, if they are presented a donor (typically through an agency) who is asking to be compensated greater than $10,000. Recipients should not expect that donor compensation will be covered by medical insurance.
In planning for sound financial management of your family building efforts, recipients should inquire at their fertility clinic about the average rate of donor compensation in their area and, if working with an agency, should instruct the agency about expectations regarding maximum fee the recipient is able/willing to pay the donor.
Costs related to Donor Identification:
Some recipient parents work with their clinical donor team for donor identification chosen from a donor pool overseen by the clinic. If recipients have the option of working with an “in-house” donor program, typically fees related to donor identification will be minimal, if any at all. For many recipient parents working with a clinic that does not offer “in-house” donor selection and for others who may wish to work with third-party service providers (typically because greater control over donor selection is desired by the recipient and/or the recipient wants to access greater information, often including photos of donor candidates), the recipient can engage a third-party service provider (known as an agency or matching service) and should expect to pay a service fee in the range of $3500-$8,000 to the agency or matching service. This fee is paid directly to the agency or matching service. Recipient parents should not expect that the “agency fee” will be covered by medical insurance.
Recipients should inquire with their fertility clinic about the clinical fee for an egg donation. Typically, the clinic fee includes that cost charged for an in-vitro fertilization, the fee charged for preparing the recipient (or gestational carrier) for embryo transfer and the fees charged for donor and recipient screening practices as required by clinic and/or the FDA. Recipient parents may expect that the donor egg clinic fee will be covered by medical insurance, if recipients have such coverage, although each recipient should discuss their policy allowances with the financial team at the clinic.
In addition to the donor egg clinic fee, recipient parents will also pay for donor medications as well as those prescribed to prepare the recipient (or gestational carrier) for embryo transfer. Some clinics incorporate fees for medications into their quoted donor egg clinical fee. Recipient parents may expect that the medications will be covered by medical insurance, if recipients have such coverage, although each recipient should discuss their policy allowances with the financial team at the clinic.
Donor Travel Costs:
Some recipients may choose to work with an agency or matching service that offers the option of cycling with donor candidates who are not local to the recipient’s fertility clinic. Recipient parents should expect that all travel related costs incurred by the donor (including the cost of having a companion travel with her for the egg retrieval) will be paid by the recipient. These costs often include air and/or ground travel, hotel accommodations, per-diem allowances for meals/expenses as well as costs related to any clinical services provided by a fertility center close to where the donor lives. Recipient parents should not expect that donor travel costs will be covered by medical insurance.
The Ethical Committee for the American Society for Reproductive Medicine recommends that: “programs….respect the rights of donors to be fully informed about legal, medical, and emotional issues involved in gamete donation. Donors must be given clear notice that they can obtain independent legal counsel at any point during the donation process.” It is also imperative that the recipient parent receive independent legal counsel. Often, reproductive attorneys will recommend that the recipient and the donor enter into an “Egg Donation Agreement” outlining promises and obligations of the parties relative to each other, including and most critically, with respect to donor relinquishment of all rights to the eggs, embryos and any children resulting from the egg donation. Donor compensation and expectation of her compliant performance is also addressed in the contract.
It is standard industry practice that recipient parents pay for the donor’s legal counsel in addition to their own attorney. Recipients should expect a total legal cost to be in the range of $1,000-$1500 (although this, too, varies from region to region and will be higher for international recipients). If recipients are being discouraged from seeking independent legal counsel for themselves and/or their donor, the recipients should contact the American Bar Association’s Assisted Reproductive Law Committee to discuss the benefits of having an Egg Donor Agreement in place and in having independent legal counsel for both the donor and themselves. Recipient parents should not expect that attorney fees will be covered by medical insurance.
Other fees: Recipients should inquire with the fertility clinic or the agency or matching service if any additional fees will be incurred. Additional fees may include, for example, administrative fees, escrow fees and donor insurance premiums.
This article was published on June, 2010.
Article was written by Amy Demma, a New York State licensed attorney specializing on Reproductive Law.