This blog addresses various emotional aspects of experiencing infertility. It is written by a clinical psychologist who specializes in infertility counseling. Thank you for reading, and best of luck with your journey!

Monday, February 23, 2015

Anonymous egg donor selection: a few tips

 Choosing an anonymous egg donor can seem like a very daunting task.  Usually, people don't arrive at choosing an egg donor without having experienced some emotional turmoil already, so they are already likely be stressed and upset.  Thus, when faced with the job of selecting maternal genetic material for their family, many people understandably become overwhelmed!  I've been fortunate to work with many couples and individuals who have gone through this process, and the amazing thing is that they all seem to find donors that they connected with and felt good about--so I think that although it can be quite intimidating at first, it usually has a positive outcome!

Here are few tips about choosing an egg donor.

--Don't try to replace yourself.

Some women begin the process of choosing an egg donor with a very specific list of qualities they would like in their donor, only to find that very few women can match all of these criteria.  Often, this stems from a wish to "replace" the woman with a copy of herself.  It is very difficult to mourn the loss of a genetic connection to a child, and perhaps the fantasy of a nearly identical donor seems like it might soften the blow.  This type of defensive strategy can be problematic for a couple of reasons.  First, it can make it very difficult, if not impossible, to find an available egg donor.  Secondly, even if such a donor exists and is available, it may delay a woman's grieving process about her reproductive misfortune.  In my experience, there is really no way to avoid dealing with such feelings of loss, and I think it's probably better to do that at the front end of the egg donation process rather than after a pregnancy is achieved or children are born.

--There is an illusion of choice.

Looking through an egg donor database for the first time can be an overwhelming, overstimulating experience.  It can appear as though there are hundreds or even thousands of possibilities.  However, that is somewhat of an illusion.  In many egg donation databases, women have applied to be egg donors but have not been screened medically or psychologically.  Thus, a certain percentage of them will be eliminated as possible donors because they won't pass one of these screenings.  In addition, potential donors are usually listed on databases months or even years after they apply to be an egg donor.  Thus, by the time they are selected, their life circumstances may be very different and they may no longer be available to be egg donors.  Further, they may be available to be egg donors in general, but not for the specific time window, or clinic location that you require.  By the time unavailable donors are eliminated, the selection pool becomes much smaller (and perhaps more manageable).

--No matter which donor you choose, epigenetics and random chance may be big factors in the characteristics of your children.

Just as their really aren't any genetic guarantees in a typical baby-making situation, random chance plays a role in the egg donation process as well.  Selecting a donor with specific characteristics doesn't give any guarantee that your child or children will also have those characteristics.  Further, science is just beginning to understand the role epigenetics plays in turning on or off different traits.  It is theorized that different uterine environments turn on or off different genetic traits present in the DNA.  A fetus with identical DNA that develops in one woman's uterus may end up being in some way different than if he or she developed in another woman's uterus.  At this point, we don't fully understand the extent of the uterine environment's influence on genetic traits.

--Find a donor with whom you feel some sort of connection.

Given all the unpredictability in the situation, both in terms of donor availability and genetic factors, my best advice is to find a donor with whom you feel some sort of emotional connection.  Perhaps she excels at the same sport that you do, or her favorite book is the same as yours.  Ideally, she should be someone that you feel you would like if you actually met her, and about whom you have very positive feelings.  After all, you are going to be having thoughts and feelings about your donor for the rest of your life, as a parent and in regards to your own infertility.  It helps to feel positively about her from the beginning.

--Don't forget the pragmatic issues!

I think one of the main criteria on which to evaluate a potential egg donor is on her ability to follow through with the many demands of the process.  For an egg donor to successfully complete a cycle, she must be able to be consistently on-time to appointments, be able to follow complicated instructions, be able to inject herself with the correct medications at the correct times, and be alert to any medical problems or side effects she might experience.  To do all of this, she needs to be responsible, organized and consistent.  When looking at a donor profile, look for evidence of the donor candidate's level of organization, follow-through, and responsibility.  For instance, if she has a consistent work history, or was able to complete a higher education degree or a vocational training program, chances are she has utilized these skills in her life.  If a written statement is included in the profile, you might be able to glean further evidence of her level of responsibility and her understanding of how important her role in the process is to intended parents.

Finally, perhaps it goes without saying, but I do find myself saying it to clients quite a bit anyway:   proven donors may have a better chance of ensuring a successful cycle.  Not only do proven donors have an established history of fertility, they are also more experienced with the  appointments and injections.  They know what the process entails, and may be less likely to drop out of a cycle.  However, the most important thing is to feel positively about the donor, and that might be a more important variable than prior experience.  Every donor has to have a first cycle!

At the end of the day, there's always a risk that things aren't going to go well, no matter what donor you might pick.  However, if you try to find a responsible, available donor with whom you feel some sort of commonality or connection, you've pretty much covered your bases in terms of the variables you can control.

Thanks for reading, and please let me know if you have other tips for choosing an egg donor.  Suggestions and comments are always welcome!


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