Our goal at Cofertility is to match intended parents with Split members who can help them achieve their goal of parenthood. Because of that, we want to make sure we’re upfront about what might disqualify someone from our Split program.
Through this program, you can freeze your eggs for free if you donate half to a family who can’t otherwise conceive. But, importantly, several factors may limit your eligibility. Some of these are official disqualifiers based on regulations by the Food and Drug Administration (FDA). Others are discretionary disqualifications based on recommendations by governing bodies like the American Society for Reproductive Medicine (ASRM).
While it’s not possible to create an exhaustive list of every reason someone may not qualify for our Split program, this guide outlines some of the most common reasons for disqualification.
To apply to be a part of the Split Program, you must be between the ages of 21-33. This is because you’ll need to complete your retrieval before you turn 35, so because the process can take some time, we don’t accept applicants who are 34 or older.
The reason for this age limitation is because data shows that, on average, those over 35 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. Various factors may affect your cycle timing (application paperwork, time to match with a family, and more) and you will need to cycle before you turn 35. We’d hate for someone to apply, get accepted, and then when the time comes for the cycle itself, potentially age out.
If you are 34-39, you are still eligible to participate in our Keep program. With this program, you can freeze your eggs and keep 100% of them for yourself.
If you are under 21 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’ll review several health-related factors.
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
We 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, we look for personal and/or family history of:
- Heart/blood disease
- Neurological diseases
- Mental health disorders
- Thyroid 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.
There are also some psychological questions you’ll have to answer. We don’t expect you to be perfect. But note that certain 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, we will 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
As part of the process, you’ll 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 we find that you have a copy of a gene that can lead to cystic fibrosis, spinal muscular atrophy, or thalassemia, this may or may not disqualify you; it can depend on the clinic and genes of the intended parents.
In line with ASRM guidance, in most conditions where carrying one copy of a particular gene won't impact the child themselves, you can still qualify for the Split program.
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 here are set in stone by the Food and Drug Administration (FDA). If evidence of any of these conditions arises, you will be considered ineligible for the 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 having only 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; eventually, it drops so low that 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 your AMH < 2, you are ineligible for our Split program. We only accept Split Members with these higher AMH levels 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’s important to note that, even with a high AMH level, there is always a chance that you need to do another cycle to improve the odds of a live birth. In the Split Program, you will receive AMH-reading bloodwork prior to being activated on our platform.
If it turns out that your AMH levels are below the required minimum threshold, you would unfortunately be ineligible to move forward with egg donation. However, we can still help you freeze your eggs for your own future use through our Keep program.
Some states do maintain their own 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
Lastly, there are a few additional factors that, unfortunately, would disqualify you from our Split program. 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
- 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
- Currently use any nicotine products regularly, since the ASRM has confirmed an association between smoking and decreased fertility — if you engage in vaping, you will need to quit for 2-3 months before re-applying for Split, but if you only vape occasionally/socially, you will need to quit for one month prior to your retrieval date
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.