All donors, both anonymous and known, should be screened per the most recent guidelines of the U.S. Food and Drug Administration (FDA) and American Society for Reproductive Medicine (ASRM). Donors should be legal adults in their state and preferably between the ages of 21 and 34. The reason for the age minimum is to ensure that the donor is mature enough to understand and provide true informed consent. The reason for the upper limit is that younger women typically respond favorably to ovarian stimulation, produce more eggs and high-quality embryos with greater chance of implantation, and have higher pregnancy rates than older women. If the donor is over the age of 35, recipients should be informed about the increased risk of having a child with a chromosomal abnormality such as Down syndrome and the impact of donor age on pregnancy rates.
Both anonymous and known donors should complete an extensive medical questionnaire about their personal and family medical history. Included in this questionnaire should be a detailed sexual history, substance use/abuse history, history of family disease, and psychological history. In the United States, the FDA requires that all egg donors be screened for risk factors for, and clinical evidence of, infections and diseases that can be passed to either the recipients or the offspring. A donor is not eligible if these are found. A medical professional will review this history with the donor and conducts a comprehensive physical exam.
For anonymous donors, screening should assess the donor’s motivation for donating her eggs and provide insight into the donor’s personality, hobbies, educational background, and life goals. This is typically performed by a Mental health professional (MHP). Generally, each donor completes a written psychometric test result prior to meeting with an MHP. In addition to reviewing the psychometric test, the MHP has the opportunity to evaluate the donor further, discuss the many complex ethical and psychosocial issues she may encounter, and confirm that the donor truly is able to provide informed consent for egg donation.
The minimum laboratory testing of all donors should include screening and testing for syphilis, hepatitis B and C, human immunodeficiency virus (HIV)-1 and HIV-2, gonorrhea, and chlamydia, as well as screening for human transmissible spongiform encephalopathy and testing when risk factors for it exist. Outbreaks of other infectious diseases may become a concern. For instance, with the emergence of Zika virus, it is recommended that egg donor candidates be screened for risk factors. Risk factors for Zika virus infection include medical diagnosis of Zika virus within the last six months; residence in or travel to an area with a documented high rate of Zika virus infections; and intimate sexual relations with a man with risk factors for Zika virus infection. The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) can provide additional recommended testing. All infectious disease testing must be done and noted to be negative within 30 days before egg donation.
Donors should have documentation of their blood type and Rh status, complete blood count, and rubella titer. All donors should have genetic-carrier screening to identify if they are carriers of any heritable diseases. All donors should be tested for the presence of a cystic fibrosis (CF) mutation and spinal muscular atrophy.
Additional testing can be performed based on the ethnicity of the donors. Donors of Asian, African, and Mediterranean descent should undergo a hemoglobin electrophoresis as a screen for sickle-cell trait and thalassemia. If the donor is of Ashkenazi Jewish origin, CF mutation analysis and screening for Tay-Sachs disease, Canavan disease, familial dysautonomia, Gaucher disease, and other genetic diseases are indicated. Donors who are of French-Canadian descent should be screened for CF mutation as well as Tay-Sachs disease. Further screening of a wider panel of genetic diseases is available and may be performed based on the standard procedures of individual fertility clinics. Additional genetic testing such as Fragile X premutation screening and karyotyping of the donor is not required but may be offered by individual programs as part of their standard procedure or upon the request of the recipient(s).
At Egg Donation Inc., we are proud to play a small role in helping you accomplish your reproductive goals; whether you are looking to start or grow your family. As the largest and oldest egg donation program in Southern California, we have worked with only the best and most seasoned IVF Clinics as well as belonging to the industry’s top organizations. Having helped more than 15,000 families in our 30+ years in business, we assist all our donors and recipients through every step of the process. Contact us today to learn more!