Egg donor agencies are all about matching families with qualified egg donor candidates. And at Cofertility, we want to make sure we’re upfront about what might disqualify someone from egg donation.
Through our Split program, if you qualify, you can freeze your eggs for free if you donate half of the eggs to a family who can’t otherwise conceive. But some factors may limit eligibility (for Split and egg donation in general). Some of these are official disqualifiers based on regulations by the FDA. Others are discretionary disqualifications based on recommendations by governing bodies like the American Society for Reproductive Medicine (ASRM). Read on to get the full picture.
Unfortunately, most doctors and agencies will turn a donor away if she’s over age 33. At Cofertility, we take a similar approach for our Split program.
The reason for this age limitation is because data shows that, on average, those over 33 tend not to respond to fertility medication as well and therefore may not produce as many eggs. Also, research shows that, unfortunately, egg quality declines with age.
If you are 34-39, you are still eligible to participate in our Keep program, where you can freeze your eggs and keep 100% of them for yourself. Also, if you are over 33 and donating for a family member or friend, a doctor may approve you for egg donation on a case-by-case basis.
Please note, per ASRM guidelines, we also do not accept Split members who are under 21. If you’re younger than this and you’d like to participate, please reach out and we’ll get back in touch after you turn 21.
As a preliminary step in the process, we will review several health-related factors before you can be approved for egg donation.
For starters, you’ll need to have two ovaries and you cannot have taken a Depo Provera shot, which can interfere with hormonal medications, within the past 6 months.
Due to these hormonal medications you’ll need to take during egg freezing, you also cannot be currently pregnant or breastfeeding. However, if you plan to stop breastfeeding within the next six months, you can still go through with your Split application. You’d just need to hold off on your actual freezing cycle until then, and this situation would be communicated to potential match families.
Additionally, you’ll need to have a BMI of 18-29. Those outside of this range are at increased risk of complications, negative outcomes, and negative side effects from hormonal medications or an egg retrieval.
You will not qualify if you’ve had a sexually transmitted disease within the past 12 months (but can apply after 12 months of treatment). You also will be disqualified if you’ve been refused as a blood donor due to other infectious disease or medical conditions. Same goes if you’ve ever had a blood transfusion.
Medical and family history
Agencies will also review your and your family’s medical history. Unfortunately, this means that if you are adopted and cannot confirm your biological family’s medical history, you will not qualify.
Though not an exhaustive list of every condition that may disqualify a member, when reviewing your personal and family medical history, agencies look for personal and/or family history of:
- Heart/blood disease
- Neurological diseases
- Mental health disorders
- Genetic disease
- Reproductive disease
- Autoimmune disease
- Respiratory disease
- Metabolic disease
- Gastrointestinal disease
- Kidney disease
- Birth defects
We review your personal and family medical history as a whole with our medical advisors. When reviewing, we consider the severity of the disease/conditions, number of relatives with the disease/condition, age of diagnosis, as well as that relative’s relation to you.
Following this, there will be some psychological questions you’ll have to answer. We don’t expect you to be perfect. But some psychological factors may be more likely to disqualify you than others.
For example, a history of physical, sexual or substance abuse or having family members with psychiatric disorders that could be passed down, may make it more difficult to be approved than, for example, having had some mild depression or anxiety. Per ASRM guidance, agencies - including our own - will, however, exclude those with a personal or first-degree (parents, siblings, offspring) family history of:
- Bipolar disorder
- Schizoaffective disorder
- Severe depression
- History of alcoholism or drug abuse
In addition to genetic screening, you will have to undergo a physical screening to ensure you are physically healthy and producing a good number of eggs.
Some disqualifications are set in stone by the Food and Drug Administration (FDA). They, understandably, want to ensure that egg donor tissue doesn't spread contagious diseases. If evidence of any of these conditions arises, you will be considered ineligible for the Split program. These are considered to be non-negotiable:
- Hepatitis B
- Hepatitis C
- Human transmissible spongiform encephalopathy
- Treponema pallidum
The following could also be deal breakers:
- Issues with your ovaries, such as only having one ovary
- Hormone levels outside of recommended limits with concerns about your ability to produce sufficient eggs
- Any issues that would make the egg freezing and donation process risky for your health
- Evidence that you are at high risk of getting a sexually transmitted disease or could already have one. Doctors will look for discharge or ulcerative lesions for this purpose
- Indicators of possible drug use (needle tracks, for example) or exposure to needles in non-sterile conditions—including recent piercings or tattoos within the past 12 months
Anti-Mullerian hormone (ovarian reserve) levels
As you likely know, women have a set egg quantity present at birth. Your eggs mature in ovarian follicles, and each of these follicles produces the anti-Mullerian hormone (AMH). Over time, this hormone level drops, and eventually, women naturally develop what's known as a diminished ovarian reserve (DOR).
Your AMH level can help predict how well medication may work to stimulate your ovaries to produce eggs. It also tells doctors what dosage of drugs may be needed to do so. The higher the AMH level, the more eggs generally produced.
At Cofertility, if you appear to have low ovarian reserve at the time of screening, you will be ineligible for our Split program. We only accept Split Members with a higher AMH level as it helps mitigate the possibility of a second cycle to obtain enough eggs that could result in a live birth down the line (for yourself and for intended parents). Nevertheless, it is important to note that, even with high AMH levels, there is always a chance of having to do another cycle to improve the odds of a live birth. In the Split Program, once you are matched with intended parents, you’ll undergo your physical screening, which will include AMH-reading bloodwork.
If you’d rather get a sense of your AMH ahead of matching, talk to us about helping you set up an initial egg freezing consultation at a local fertility clinic. While it’s not required until this later phase of the screening process, it can help you better understand your fertility outlook. We may offer discounted consult options in your area, and this could give you upfront peace of mind about your choice to pursue Split, Keep, or neither.
As part of the evaluation process, you will also be required to do genetic testing via blood test or saliva sample. This helps ensure that embryos resulting from your eggs will lead to a viable pregnancy and that a child won't be born with severe disease.
But even for serious diseases, not all disease-related genes are deal breakers. For example, if your tests reveal that you have a copy of a gene that can lead to cystic fibrosis, spinal muscular atrophy, or thalassemia, this may disqualify you depending on the clinic. Even if two copies of the gene are needed in order for the condition to occur, clinics and agencies handle this differently.
In line with ASRM guidance, in most cases where carrying one copy of a particular gene won't impact the child themselves, you can still donate.
Agencies often screen for Fragile X syndrome. However, since this is an X-linked condition, just one copy of the gene can cause health issues. While most agencies will disqualify you if the X-linked health issues are severe, they may allow you to participate if you carry genes for milder conditions, such as red-green color blindness. Note that agencies will still inform potential parents that you carry this gene.
Some states do maintain their own specific requirements for women who are donating eggs. These requirements will extend to those in our Split program and would be determined by the location of the clinic at which you would be conducting the retrieval.
Any state-specific egg donation qualifications will be evaluated at the time of your physical examination.
Additional disqualifying factors
In addition to the above, there are several factors that, unfortunately, would disqualify you from our Split program (and in many cases, per ASRM and/or FDA guidance, egg donation in general). These include if you:
- Are not a U.S. citizen
- Have served jail time for more than two days
- Have undergone body piercing and/or tattooing within the past twelve months in which sterile procedures may not have been used
- Have the highest education level of GED
- Have Indigenous American ancestry and are associated with a tribe—this is due to the Indian Welfare Act
If one or more of the above applies to you and you’d still like to participate in our Split program, reach out to us. We’d be happy to chat with you about your fertility options, including your ability to re-apply in the future.
The net net
We know this sounds like a lot, but these disqualifiers are in place to respect the health and wellbeing of our Split members and intended parents. If you have any questions about Split—including the factors outlined here—don’t hesitate to connect with us.
You have tons to offer, and whether you qualify for the Split program is in no way reflective of your value. The most important thing is that you feel one hundred percent comfortable in any decision you make. This is a big one, and we’re with you every step of the way.