Egg donation is the process by which a woman donates eggs for purposes of assisted reproduction or biomedical research. For assisted reproduction purposes, egg donation typically involves IVF technology, with the eggs being fertilized in the laboratory; more rarely, unfertilized eggs may be frozen and stored for later use. Egg donation is a third party reproduction as part of ART.

Egg donor may have several reasons for donate her eggs:

  • Unrelated donors to the recipients – they do it for altruistic and/or monetary reasons. The European Union limits any financial compensation for donors to at most $1500. In some countries, most notably Spain and Cyprus, this has limited donors to the poorest segments of society. In US, donors are paid regardless of how many egg she produces. In most countries (excluding the US and the UK), the law requires such type of donors to be anonymous.
  • Egg sharing – the woman decides to provide unused egg from her own IVF for another patient.
  • Designated donors – couple bring their friend or the donor specifically to help them.


First step is choosing the egg donor by a recipient from the profiles on or clinic databases (or, in countries where donors are required to remain anonymous, they are chosen by the recipient's doctor based on recipient woman’s desired trait). This is due to the fact that all of the mentioned examinations are expensive and the agencies/clinics must first confirm that a match is possible or guaranteed before investing in the process. 

Each egg donor is first referred to a psychologist who will evaluate if she is mentally prepared to undertake and complete the donation process. These evaluations are necessary to ensure that the donor is fully prepared and capable of completing the donation cycle in safe and success manner. The donor is then required to undergo a thorough medical examination, including a pelvic exam, blood tests to check hormone levels and to test for infectious diseases, Rh factor, blood type, and drugs and an ultrasound to examine her ovaries, uterus and other pelvic organs. A family history of approximately the past three generations is also required, meaning that adoptees are usually not accepted because of the lack of past health knowledge. Genetic testing is also usually done on donors to ensure that they do not carry mutations (e.g., cystic fibrosis) that could harm the resulting children; however, not all clinics automatically perform such testing and thus recipients must clarify with their clinics whether such testing will be done. During the process, which usually takes several months, the donor must abstain from alcohol, sexual intercourse, cigarettes, and drugs, both prescription and non-prescription.

Once the screening is complete and a legal contract signed, the donor will begin the donation cycle, which typically takes between three and six weeks. An egg retrieval procedure comprises both the egg donor's cycle and the recipient's cycle. Birth control pills are administered during the first few weeks of the egg donation process to synchronize the donor's cycle with her recipient's, followed by a series of injections which halt the normal functioning of the donor's ovaries. These injections may be self-administered on a daily basis for a period of one to three weeks. Next, FSH is given to the donor to stimulate egg production and increases the number of mature eggs produced by the ovaries. Throughout the cycle the donor is monitored often by a physician using blood tests and ultrasound exams to determine the donor's reaction to the hormones and the progress of follicle growth.

Once the doctor decides the follicles are mature, the doctor will establish the date and time for the egg retrieval procedure. Approximately 36 hours before retrieval, the donor must administer one last injection of hCG to ensure that her eggs are ready to be harvested. The egg retrieval itself is a minimally invasive surgical procedure lasting 20-30 minutes, performed under sedation (but sometimes without any). A small ultrasound-guided needle is inserted through the vagina to aspirate the follicles in both ovaries, which extracts the eggs. After resting in a recovery room for an hour or two, the donor is released. Most donors resume regular activities by the next day.

Laws by state

The legal status and compensation of egg donation has several models across states with examples:

  • Totally illegal procedure (Italy, Germany, Austria, Costa Rica, Sunni Muslim countries, Bahrain, Egypt, Hong Kong, Lebanon, Lithuania, Maldives, Norway, Oman, Pakistan, Philippines, Qatar, Saudi Arabia, Syria, Tajikistan, Turkey, Yemen),
  • Legal, no compensation, anonymous donor (France),
  • Legal, no compensation, non-anonymous donor (Canada),
  • Legal, possible compensation, anonymous donor (Spain, Czech Republic, South Africa),
  • Legal, possible compensation, non-anonymous donor (the UK),
  • Legal, possible compensation, anonymous or non-anonymous (the US).

Egg donation could have a number of reasons. Infertile couples may resort to egg donation when the female partner cannot have genetic children because her own eggs cannot generate a viable pregnancy, or because they could generate a viable pregnancy but the chances are so low that it is not advisable or not financially feasible to do IVF with her own eggs. This situation is often, but not always based on advanced reproductive age. It can also be due to early onset of menopause, which can occur as early as their 20s. In addition, some women are born without ovaries, while some women's reproductive organs have been damaged or surgically removed due to disease or other circumstances. Another indication would be a genetic disorder on part of the woman that either renders her infertile or would be dangerous for any offspring, problems that can be circumvented by using eggs from another woman. Many women have none of these issues, but continue to be unsuccessful using their own eggs in a case when they have undiagnosed infertility - and thus turn to donor eggs or donor embryos. Egg donation is also helpful for gay male couples using surrogacy which allows them to have their “own” children.

Egg donation is recommended in these cases:

Congenital absence of eggs

  • Turner syndrome,
  • Gonadal dysgenesis,

Acquired reduced egg quantity / quality

  • Oophorectomy,
  • Premature menopause,
  • Chemotherapy,
  • Radiation therapy,
  • Autoimmunity,
  • Advanced maternal age,
  • Compromised ovarian reserve.


  • Diseases of X-Sex linkage,
  • Repetitive fertilization or pregnancy failure,
  • Genetic diseases present in their pedigree,
  • Ovaries inaccessible for egg retrieval.

Maternofetal immune tolerance is essential to maintain pregnancy. It has been reported that maternal morbidity during egg donation pregnancies is higher as compared with spontaneous or IVF pregnancies. If the recipient is less genetically similar to the fetus than a biological mother, pregnancies are associated with a higher incidence of pregnancy-induced hypertension and placental pathology. The local and systemic immunologic changes are also more pronounced than in normal pregnancies, so it has been suggested that the higher frequency of some conditions in egg donation may be caused by reduced immune tolerance from the mother.

In donors:

Egg donors place themselves at risk for developing a number of complications: from the relatively minor side-effects of fertility drugs (i.e., bloating, weight gain, and irritability), to potentially serious conditions, including ovarian hyperstimulation syndrome, future infertility, blood clots, and liver or kidney failure. This list does not mention the risks of the surgical egg extraction itself, which requires a needle to be inserted into the vagina, and which carries a risk of infection, bleeding, adverse reaction to anesthesia, and the accidental puncture of an organ.

The long-term impact of egg donation on donors has not been well studied, but because the same medications and procedures are used, it should be essentially the same as the long-term impact (if any) of IVF on patients using their own eggs. The evidence of increased cancer risk is equivocal; some studies have pointed to a slightly increased risk while other studies have found no such risk or even a slightly reduced risk in most patients (women with a family history of breast cancer, however, may have a higher risk). 1 in 5 women report psychological effects—which may be positive or negative—from donating their eggs, and two-thirds of egg donors were happy with the decision to donate their eggs. In accordance with the American Society for Reproductive Medicine guidelines, female donors are given a limit of 6 cycles that they may donate in order to minimize the possible health risks.

However, it appears that repetitive oocyte donation cycles does not cause accelerated ovarian aging, evidenced by absence of decreased AMH hormone in such women.

In recipients:

There appears to be a slightly higher risk of pregnancy-induced hypertension and first trimester bleeding in pregnancies of egg donation. Pregnancies after oocyte donation represent a unique group of pregnancies because they are achieved with an immunologically foreign embryo. This may underlie the observed increased obstetrical and perinatal risk associated with these pregnancies. However, obstetrical risk factors such as advanced maternal age, primiparity and multiple pregnancies tend to be more common in this population. Moreover, there is a higher incidence of potential obstetrical risk factors that necessitate oocyte donation treatment, such as previous pelvic radiation, immunologic disorders or severe endometriosis.

The success rate of egg donor cycles is over 60% in US. When a "fresh cycle" is followed by a "frozen cycle", the success rate with donor eggs is approximately 80%. Pregnancies with egg donation are associated with a slightly increased risk of placental pathology. The local and systemic immunologic changes are also more pronounced than in natural pregnancies, so it has been suggested that the association is caused by reduced maternal immune tolerance towards the fetus, as the genetic similarity between the carrier and fetus from an egg donation is less than in a natural pregnancy. In contrast, the incidence of other perinatal complications, such as intrauterine growth restriction, preterm birth and congenital malformations, is comparable to conventional IVF without egg donation.

Find more about related issues


Egg donation ―sourced from Wikipedia licensed under CC BY-SA 3.0
Donor conceived people ―sourced from Wikipedia licensed under CC BY-SA 3.0
Egg donation compensation: ethical and legal challenges ―by Kenney and McGowan licensed under CC BY-NC 3.0
Donor registration ―sourced from Wikipedia licensed under CC BY-SA 3.0
Immune tolerance in pregnancy ―sourced from Wikipedia licensed under CC BY-SA 3.0
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