Disqualifications for Egg Donation: an Overview

Becoming an egg donor can be a meaningful and empowering experience, but unfortunately, not everyone who wants to become an egg donor will qualify. That’s because the process is highly regulated to ensure the health and safety of the donor, the success of the donation cycle, and the long-term well-being of any future children. Medical organizations and regulatory agencies set clear guidelines around who can donate based on age, health history, genetic background, and more.

If you’re thinking about egg donation—especially through Cofertility’s Split program, where you can freeze your eggs for free when you donate half to a family who can’t otherwise conceive—it’s helpful to understand what might stand in the way.

Some disqualifications are set in stone, like those enforced by the FDA. Others are recommended by professional groups like the American Society for Reproductive Medicine (ASRM) or based on clinic-specific rules. Here, we’ll walk through the most common reasons someone might be disqualified from egg donation, what they mean, and what your options might be if you don’t meet certain criteria right now.

Age

Unfortunately, most doctors will turn away an egg donor over age 33. 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 enough eggs to donate. Also, research shows that, unfortunately, egg quality declines with age. 

If you are over 34, 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. 

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.

General health

As a preliminary step in the process, we will review several health-related factors before you can be approved for egg donation. Any issues that would make the egg freezing and donation process risky for your health is a disqualification. 

A few health-related factors can disqualify someone from egg donation, including certain heart problems, chronic diseases, HIV, hepatitis B or C, and certain transmissible diseases. 

Also, and this sounds random, but if you lived in Europe for over five years, or in England for over three months between 1980-1996, the FDA has determined that your risk of mad cow disease would also disqualify you.

These requirements help protect your health and ensure a safe donation process for all involved.

Reproductive and sexual health

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.

As part of the process, you will get your hormones tested. If your hormone levels are outside of recommended limits or the doctor has concerns about your ability to produce sufficient eggs, you would not qualify (more on AMH below).

You will also not qualify for egg donation if you’ve had a sexually transmitted disease within the past 12 months (but you 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 diseases or medical conditions. Same goes if you’ve ever had a blood transfusion.

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 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. 

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 that meet a threshold AMH level as it increases the chance of success for you and the intended parents.

Read more in AMH 101: Everything You Need to Know

BMI

Body mass index, or BMI, is one of the criteria used during egg donor screening—and we understand that this can be a sensitive and sometimes controversial topic. Most clinics require a BMI between 18 and 29 to be eligible for egg donation, and we follow these clinic requirements at Cofertility.

This range is largely based on concerns about procedural risk and egg retrieval outcomes. People with a higher BMI may face increased risks during anesthesia or complications related to egg retrieval. On the flip side, very low BMI can raise the risk of ovarian hyperstimulation syndrome (OHSS) and may affect hormone levels or cycle response.

That said, BMI alone is not a full picture of someone’s health. It doesn’t account for muscle mass, body composition, bone density, or ethnic and genetic differences. For athletes, for example, BMI can be especially misleading. And since BMI calculations were originally based on white, male body types, their use across populations can perpetuate racial inequities—especially among women of color, who are already disproportionately affected by both infertility and barriers to care.

If your BMI is currently outside this range, you’re welcome to reapply in the future. And regardless of your eligibility, we’re here to support you in exploring all your fertility options.

Read more about BMI and egg freezing here.

Medical and family history

Because donor-conceived children share your genetics, your personal and family medical history matters. If you’re adopted and can’t access your biological family’s health history, that’s unfortunately considered a disqualifier.

Though not an exhaustive list of every condition that may disqualify a member, when reviewing your personal and family medical history, doctors look for personal and/or family history of:

• Cancer
• Heart/blood disease
• Neurological diseases 
• Some mental health disorders
• ‍Genetic disease
• Reproductive disease
• Autoimmune disease
• Respiratory disease
• Metabolic disease
• Gastrointestinal disease
• Kidney disease
• Birth defects

Our medical team  reviews your personal and family medical history as a whole. 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. 

Psychological screening

Mental and emotional wellbeing are also part of the screening process. You’ll complete a psychological evaluation, and while a history of manageable anxiety or depression doesn’t automatically disqualify you, more severe conditions might.

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
• Schizophrenia
• Schizoaffective disorder
• Severe depression
• History of alcoholism or drug abuse

Learn more in What Happens During Psychological Screening to be an Egg Donor

Genetic screening

As part of the evaluation process, you will also be required to do genetic testing via blood test or saliva sample. This helps increase the chance that embryos resulting from your eggs 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 each 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.

State-specific qualifications

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:

• 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
• Do not have a high school diploma 
• Have Indigenous American ancestry and are associated with a tribe—this is due to the Indian Welfare Act 
• Show indicators of possible drug use (needle tracks, for example) or exposure to needles in non-sterile conditions

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.

Click here to learn more about Cofertility's programs and see if you qualify.