Split

If you're participating in Cofertility’s Split Program, where you freeze your eggs for free when donating half to another family that can't otherwise conceive, a necessary step in the process is carrier screening. Carrier screening is a type of genetic test that can tell you whether you carry a gene for certain genetic disorders. This critical step ensures the best possible outcomes for both you and the recipient family.

You may have some questions or find yourself wondering about its necessity, what it involves, and how the results could affect you and the intended parents. This article aims to clarify the process and provide you with essential information to help you feel informed and confident.

By understanding the role of genetic testing, you'll be better equipped to make informed decisions and communicate effectively with healthcare providers, genetic counselors, and anyone else.

Why is genetic testing required for egg donors?

The American Society for Reproductive Medicine (ASRM) has developed guidance for the screening of egg donors that most clinics and egg donation agencies (like ours) follow. This  guidance includes genetic risk assessment, and specifically carrier screening. Why is carrier screening important?

Carrier screening plays an important role in ensuring the health of any potential children resulting from the donation. Many genetic conditions are recessive, meaning a person can carry the gene without showing symptoms. By screening egg donors, we can identify these genetic variants and minimize the risk of passing on inherited disorders.

Importantly, this genetic information is also valuable for you as the donor. It provides insights into your own genetic makeup, which can be beneficial for your future family planning. If you discover you're a carrier for a particular condition, you can make informed decisions about your own reproductive health and discuss potential risks with your healthcare provider.

Additionally, genetic testing helps in the matching process between donors and intended parents. By understanding the genetic profiles of both parties, we can ensure compatibility and reduce the risk of passing on inherited disorders. This contributes to the overall success and safety of the egg donation process.

What is carrier screening?

Carrier screening is a type of DNA test that looks for variants (mutations or DNA changes) in certain genes. These genes are associated with "recessive" conditions, which means a person needs to inherit two copies of the variant gene - one from each parent - to develop the condition.

Understanding autosomal recessive inheritance

We inherit two copies of every gene - one from the egg provider and one from the sperm provider. Autosomal recessive diseases occur when someone has a gene variant in both copies of a certain gene. Individuals who carry only one variant for a recessive disease are called "carriers" and generally don't have any symptoms of the disease.

X-linked inheritance

Some conditions are linked to genes on the X chromosome. Females typically have two X chromosomes, while males have one X and one Y chromosome. For X-linked conditions, males who have a variant are usually affected, while females are typically carriers. This is important in egg donation because a female carrier has a chance of passing the condition to male offspring.

The testing process

Genetic testing for egg donors typically involves the following steps:

1. Sample collection: Either a blood draw, saliva, or cheek swab sample is taken.
2. Laboratory analysis: The sample is sent to a specialized genetics laboratory for analysis.
3. Waiting period: Results usually come back within 2-3 weeks.
4. Result interpretation: A healthcare provider or genetic counselor will interpret the results for you, at no cost to you.

Today’s carrier screening tests often examine more than 100 genes associated with various inherited conditions. This comprehensive approach has replaced older methods that only tested for conditions common in specific ethnic groups.

What can you learn from genetic testing?

Genetic testing, particularly carrier screening, can provide you with a wealth of information about your genetic makeup. Primarily, you'll learn about your carrier status for the genetic conditions included in the panel. Being a carrier means you have one copy of a gene variant associated with a particular condition, but you don't have the condition yourself. This information is helpful for understanding potential reproductive risks, both for your role as an egg donor and for your own future family planning.

In addition to carrier status, genetic testing can sometimes offer insights into your ethnic background. Certain genetic variants are more common in specific populations, which can provide clues about your genetic ancestry. While this isn't the primary purpose of the screening, it can be an interesting secondary finding for some individuals.

Occasionally, carrier screening might reveal unexpected information about your own health. For instance, being a carrier for certain conditions might be associated with an increased risk of developing related health issues. While rare, these findings can be valuable for your long-term health management.

Furthermore, genetic testing results can sometimes shed light on your family health history. You might gain a better understanding of why certain conditions run in your family or discover previously unknown genetic factors that could be relevant to your relatives.

While genetic testing provides valuable information, it doesn't predict everything about your health or your potential offspring. Many factors beyond genetics contribute to overall health and development. Nonetheless, the insights gained from genetic testing can be a powerful tool for making informed decisions about your health and your participation in the egg donation process.

Types of conditions included in carrier screening

Carrier screening generally tests for genes associated with:

• Moderate to severe childhood diseases
• Conditions that lead to a shorter life expectancy
• Disorders causing disability
• Diseases with limited or no treatment options

Some examples of conditions often included in carrier screening are:

• Cystic fibrosis
• Spinal muscular atrophy
• Thalassemia/hemoglobinopathy
• Fragile X syndrome
• Tay-Sachs disease
• Sickle cell anemia

Specific conditions tested can vary depending on the screening panel used.

How genetic test results affect your donor status

In most cases, being a carrier for a genetic condition won't prevent you from being an egg donor. The key is ensuring that your genetic profile doesn't match with any variants carried by the intended parents or sperm provider.

However, there are some rare situations where a positive carrier screen might affect your eligibility, like if you're a carrier for a serious X-linked condition, like Fragile X.

What does a negative carrier screen mean?

A negative or normal screen means that no changes were found in any of the genes on the panel tested by the lab. While this is good news, it's important to remember that no test is perfect. Carrier screening doesn't test for all recessive diseases and can't identify all carriers for the diseases that were tested.

What does a positive carrier screen mean?

A positive carrier screen means that you have been identified as a carrier for one or more genetic conditions tested in the screening. Being a carrier doesn't mean you have the condition yourself. Instead, it means you have one copy of a gene variant associated with a particular condition.

Being a carrier is actually quite common. Most people are carriers for at least one genetic condition, and this usually doesn't affect their health. However, it can have implications for reproductive planning, both for egg donation and your own future family planning.

If you receive a positive result on your carrier screen, there's no need to worry. We cover the cost of talking to a genetic counselor to help you understand what your test results mean. The genetic counselor can explain your results in detail, discuss any potential implications, and answer any questions you may have. This ensures that you have a clear understanding of your genetic status and can make informed decisions moving forward.

Remember, a positive carrier screen doesn't necessarily disqualify you from being an egg donor. The implications depend on the specific condition and the genetic status of the intended parents or sperm provider. The genetic counselor and your Cofertility Member Advocate will guide you through what your results mean for your participation in the egg donation program.

Summing it up

Genetic testing is a required part of the egg donation process. It is a tool to ensure the best possible outcomes for all involved. The information you gain can be valuable not only for your role as an egg donor but also for your own future family planning.

As you go through this process, it's normal to have questions or concerns. Don't hesitate to ask your fertility doctor, genetic counselor, or your Cofertility Member Advocate for clarification or support. They're there to guide you through this important step in your egg donation journey.

Remember, being a carrier for a genetic condition is common and doesn't necessarily impact your overall health or ability to be an egg donor. By participating in genetic testing, you're contributing to informed decision-making and potentially helping create families while gaining valuable insight into your own genetic makeup.

You may not be ready to have kids quite yet, but perhaps you’re starting to think about your future. If you’re exploring fertility preservation or assisted reproductive technologies, you might be considering whether egg freezing and embryo banking is right for you. 

Both options offer unique advantages and considerations, and understanding their differences is important for making an informed choice that aligns with your goals and values. In this guide, we'll dive into both egg freezing vs. embryo banking, empowering you to navigate this important decision with confidence.

How does egg freezing and embryo banking differ?

Both egg freezing and embryo banking begin with the same medical procedure: about 10-14 days of fertility medications and monitoring appointments, followed by an egg retrieval. 

The fertility medications encourage the development of multiple mature eggs, followed by a minimally invasive procedure to retrieve those eggs. The medical process, medications, and monitoring are identical whether you ultimately choose to freeze your eggs or create embryos.

The key difference between egg freezing and embryo banking lies in what happens after your eggs are retrieved.

• Egg Freezing: The retrieved eggs are immediately frozen using vitrification technology and stored until you're ready to use them. In the future, when you decide to pursue pregnancy, these eggs will be thawed, fertilized with sperm, and the resulting embryos will be transferred to your uterus.
• Embryo Banking: The retrieved eggs are fertilized with sperm in the laboratory, creating embryos. These embryos are then cultured for a few days and the healthiest ones are selected and frozen. When you're ready for pregnancy, the embryos are thawed and transferred to your uterus.

In essence, the medical journey up to the point of retrieval is the same for both options. The decision point comes after retrieval, where you choose whether to freeze the eggs unfertilized or to fertilize them and freeze the resulting embryos. Which option is right for you may depend on factors like whether you have a partner or access to sperm at the time of retrieval, or your personal preferences around timing and future family planning.

Egg freezing: increasing your options down the line

Egg freezing, also known as oocyte cryopreservation, is a process where your eggs are retrieved, frozen, and stored for future use. This technology has revolutionized fertility preservation, providing women with the opportunity to delay childbearing and increase their chances of having a biological child later in life.  

Pros of egg freezing

• Flexibility and autonomy: Egg freezing offers women greater control over their reproductive timeline. It allows them to focus on career goals, personal development, or finding the right partner before starting a family.  
• Medical reasons: Women facing medical conditions that may impact their fertility, such as cancer treatment or certain surgeries, can benefit from egg freezing as a way to preserve their options.  
• Technological advancements: Advances in vitrification (flash-freezing) technology have significantly improved the success rates of egg freezing, making it a more reliable option.  

Cons of egg freezing

• Age-related factors: While egg freezing can preserve fertility, the age at which eggs are frozen plays a critical role in their viability and potential for successful pregnancy.  
• Additional procedures: If you decide to use your frozen eggs, you'll need to undergo in vitro fertilization (IVF) to fertilize them and transfer the resulting embryos.  
• Cost: Egg freezing and subsequent IVF can be expensive, and insurance coverage may vary.  

Embryo banking: a step closer to parenthood

Embryo banking, or embryo cryopreservation, involves creating embryos through IVF using a woman's eggs and a partner's or a donor's sperm. These embryos are then frozen and stored for future use.  

Pros of embryo banking

• Known fertility potential: With embryo banking, you have a better understanding of the fertility potential of the embryos, as they have already undergone fertilization and, if you choose, can undergo preimplantation genetic testing (PGT). This allows you to understand the genetic makeup of your embryos sooner and determine whether additional egg retrievals might be needed.
• Higher success rates: Embryos have slightly higher survival rates after thawing compared to eggs, potentially increasing the chances of a successful pregnancy.
• Gender selection: With embryo banking, you have the possibility of learning the sex of the embryos sooner through preimplantation genetic testing), whereas with egg freezing, you would need to wait until fertilization and further testing at a later stage.

Cons of embryo banking

• Requires sperm: Embryo banking requires the use of sperm, which may not be ideal fo r those without access to sperm or those who haven't found a partner yet.  
• Ethical and legal considerations: Embryo banking could raise ethical and legal questions regarding ownership, disposition, and potential future use of the embryos, particularly in cases of divorce or death.
• Can’t be undone: Once embryos are created with someone’s sperm, they can’t be turned back into eggs, meaning you can’t change your mind on the biological father for those fertilized eggs down the line.

Questions to ask yourself

Choosing between egg freezing and embryo banking is a deeply personal decision, and will depend on your individual circumstances, goals, and values. To help you navigate this choice, here are some good questions to ask yourself:

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• What are my current relationship goals and family plans? Are you planning to have children with your partner? Or are you unsure about your future plans?
• What is my financial situation, and can I afford the associated costs? Both egg freezing and embryo banking can be expensive. Does your insurance cover the costs? Does your employer, or a partner’s employer, offer any fertility benefits?
• What are my thoughts regarding embryo creation and storage? Embryo banking involves creating and potentially storing embryos that may not be used. Would you be okay with that?
• Am I comfortable with the potential outcomes and uncertainties associated with each option? Both egg freezing and embryo banking have varying success rates, and there's no guarantee of a successful pregnancy. 
• Have I discussed my options with my partner and/or a fertility doctor? Open communication with your partner and seeking guidance from a fertility doctor will help you make an informed decision that aligns with your goals and values.

Remember, knowledge is power. Understanding the processes and considerations involved will help you make the choice that best suits your individual needs and aspirations.

Summing it up

Choosing between egg freezing and embryo banking is a big decision with long-term implications. You’ll want to carefully consider your individual circumstances, goals, and values before moving forward. 

Remember, you can always turn eggs into embryos but the opposite is not true. So if you have any doubt, freezing eggs may provide more flexibility for future decisions.

Egg freezing and embryo banking with Cofertility

We’d love the opportunity to support you on your egg freezing or embryo banking journey.

Through our Split program, qualified applicants can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.

Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep and Split members also get access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help individuals overcome the biological constraints of their reproductive timeline, giving egg freezers greater control of their career goals and family planning while promoting social justice and advancing gender equality.

Read more:

• Should I Freeze Eggs or Embryos?
• We Asked Four Women: Did You Freeze Eggs or Embryos?
• How Much It Costs to Freeze Your Eggs
• Should Your Partner Help Pay For Your Egg Freezing?

If you just started researching egg freezing, you might feel like you’ve been introduced to a whole new language. Whether clinical in nature or just shortened slang, with egg freezing comes its own terminology. And even if you’ve already educated yourself on what’s involved with egg freezing, chances are, you’ll come across an acronym you’ve never heard of. 

Fear not. Below, you’ll find a comprehensive list of acronyms, abbreviations, and terms you should know when diving into an egg freezing cycle. Read this, and soon you’ll rattle off egg freezing lingo like a pro. 

Hormones and general fertility 

• AMH: One of the first hormones your reproductive endocrinologist will investigate, Anti-Müllerian Hormone is measured early in a woman’s cycle to determine her ovarian reserve. A higher AMH level correlates to a higher ovarian reserve, or in other words, more eggs.
• CD: "Cycle day"—or the day of one's menstrual cycle, with CD1 = the first day of a period. Understanding your cycle length is super important, as it may indicate your most fertile window of dates. It will also help you determine any irregularities to consider as you embark on an egg freezing cycle. 
• DPO: "Days past ovulation." In a typical menstrual cycle, women can expect their period at 14DPO.
• Dx: Diagnosis, the medical identification of a condition or issue affecting fertility, which may impact decisions regarding egg freezing and related treatments.
• E2: Estradiol, a female hormone that's produced by ovarian follicles and determines how well a woman is responding to controlled ovarian hyperstimulation with fertility drugs. If you're freezing your eggs, you’ll have several routine monitoring appointments that include ultrasounds and bloodwork that measures estradiol levels. The higher the estradiol, the more follicles that are likely developing and (fingers crossed) the more eggs that may be retrieved.
• FSH: Follicle stimulating hormone, a hormone released from the pituitary gland to stimulate the ovaries or testicles. When getting an initial fertility workup, you'll get tested for your existing FSH. If you're taking FSH as a drug as part of your egg freezing protocol, it's also known in the United States as Follistim, Gonal-F or Bravelle.
• hCG: Human Chorionic gonadotropin, a hormone produced by an implanting embryo. If this hormone is present in a woman's blood, it indicates a possible pregnancy. It can also be given to women undergoing an egg freezing cycle to trigger ovulation right before a retrieval procedure.
• LH: Luteinising Hormone, a hormone released by the pituitary gland to stimulate the gonads (ovaries and testicles). If you're freezing your eggs, you'll have levels of this hormone measured often via bloodwork in order to determine ovulation timing.
• LMP: "Last menstrual period," or the start date of a woman's last menstrual period.
• MII: Metaphase II, the stage of egg maturation where the egg is ready for (hypothetical) fertilization, with chromosome alignment necessary for successful embryo development.
• PCOS: "Polycystic ovarian syndrome," a condition where the ovaries develop many small cysts, which results in irregular periods and ovulation. It can contribute to future infertility, so if you know you have PCOS, regardless of whether you’re freezing your eggs or not, chat with a reproductive endocrinologist to ensure a safe and healthy plan.
• TSH: Thyroid stimulating hormone, a hormone produced by the pituitary gland meant to stimulate the release of thyroid hormone by the thyroid gland. Recent research has suggested that slightly low TSH may associate with fertility challenges.

Egg freezing 

• AFC: “Antral follicle count,” a count of the number of small follicles in a woman's ovaries, seen via ultrasound early on in her cycle. Used to measure ovarian reserve, you'll have a lot of these if you're freezing your eggs to monitor how you're responding to ovary-stimulating medication.
• ART: “Assisted reproductive technology,” including any procedure involving egg retrievals and manipulating eggs and sperm outside the body. It includes things like egg freezing, gamete intrafallopian transfer (GIFT), in vitro fertilization (IVF), and zygote intrafallopian transfer/tubal embryo transfer (ZIFT/TET). 
• BCP: Birth control pills. If you’re freezing your eggs, your doctor may prescribe these as part of a medicated cycle in order to regulate the timing
• COH: “Controlled ovarian hyperstimulation,” when several follicles mature simultaneously in response to fertility drug treatment. The key word here is controlled. Your follicle growth will be carefully monitored by your doctor, who will adjust your medication protocol accordingly to stimulate or halt further growth.
• ER: "Egg retrieval" — not "emergency room!" An ER will be performed as part of an egg freezing cycle, and may also be referred to as a VOR (“Vaginal Oocyte Retrieval”).
• IM: Intramuscular, a method of injecting medication directly into a muscle. This method is often used for hormone treatments during the egg freezing process.
• OC: “Oocyte Cryopreservation,” which is another term for egg freezing. 
• OHSS: “Ovarian hyperstimulation syndrome,” a condition where the ovaries become excessively swollen and painful due to the overproduction of eggs from fertility medications. This is very rare, but can happen.
• REI: "Reproductive endocrinologist," or a doctor who specializes in treating male and female fertility.
• SD1: “Stimulation Day 1,” or the first day of medication administered to stimulate the ovaries for egg production during the egg freezing process.
• SQ: Subcutaneous (also abbreviated as SC), a method of injecting medication into the fatty tissue just under the skin, commonly used for administering fertility hormones during an egg freezing cycle.
• TVUS: “Transvaginal Ultrasound,” an imaging technique used to visualize the ovaries and follicles internally, providing information about egg development and ovarian health. If you’re undergoing an egg freezing cycle, you’ll have a lot of these, but they are quick and painless. 

Egg donation

• DE: “Donor eggs,” or eggs provided by another woman to be fertilized with sperm and transferred to the uterus of an intended parent or gestational carrier.
• IP: “Intended parent,” which is a person who becomes the legal parent of a child born through third party reproduction.

If you’re feeling totally overwhelmed by all that’s involved with egg freezing, we’ve got you covered. Take our quiz to see how you may qualify for our more accessible egg freezing opportunities, including our Split program, through which you can freeze your eggs for free when you donate half to another family who can’t conceive. 

We’re wishing you the best of luck on your egg freezing journey! 

Egg donation plays a crucial role in helping many individuals and couples achieve their dreams of parenthood. At Cofertility, we recognize the significance of this decision for our donors and are committed to ensuring that every aspect of the donation process is conducted with the utmost care, transparency, and respect for our donors' autonomy.

This article provides a comprehensive overview of how informed consent works at Cofertility, where women can freeze their eggs for free when donating half to a family that could not otherwise conceive. 

We'll explore the various aspects of informed consent, including its definition, its specific application to egg donation, and the medical, psychological, genetic, and legal considerations involved. By the end of this article, you'll have a clearer understanding of our commitment to ethical practices and donor well-being throughout the egg donation journey.

What is informed consent?

Informed consent is a fundamental ethical and legal principle in healthcare and medical research. It refers to the process by which a fully informed patient or participant can participate in choices about their healthcare or involvement in research. For consent to be considered "informed," several key elements must be present:

1. Disclosure: The healthcare provider or researcher must provide all relevant information about the proposed treatment, procedure, or study. This includes potential risks, benefits, alternatives, and the option to refuse or withdraw.
2. Understanding: The patient or participant must comprehend the information provided. This may involve explaining complex medical terms in plain language or using visual aids to ensure clarity.
3. Voluntariness: The decision to consent must be made freely, without coercion, undue influence, or pressure from healthcare providers, researchers, family members, or others.
4. Competence: The individual must have the mental capacity to make the decision. This means they must be of legal age and sound mind to understand the implications of their choice.
5. Consent: The patient or participant must explicitly agree to the treatment, procedure, or participation in the study, usually by signing a consent form.

Informed consent in egg donation

At Cofertility, we take donor consent very seriously. In the context of egg donation, informed consent ensures that donors fully understand all aspects of the donation process, including medical procedures, potential risks, psychological implications, and legal considerations. It empowers donors to make autonomous decisions about their bodies and genetic material, protecting their rights and well-being throughout the donation process.

To ensure that an egg donor is making a knowledgeable and autonomous decision about becoming an egg donor through our Split program, the potential donor is required to be fully educated about all aspects of the donation process. This includes:

• Medical implications: Understanding the procedures involved and potential health risks.
• Psychological considerations: Exploring the emotional aspects of egg donation.
• Genetic implications: Comprehending the long-term genetic connections created through donation.
• Legal aspects: Understanding the rights and responsibilities of egg donors.
• Egg sharing vs. financial implications: Grasping the differences between our Split program and traditional financial compensation models.

It is crucial that the donor demonstrates she understands all the information provided and has ample opportunity to ask questions before deciding to move forward. Another important aspect of informed consent is that it must be given voluntarily, without coercion or undue influence. The egg donor must understand that she has the right to withdraw from the process at any time before the egg retrieval.

This process of informed consent is just one aspect of how we work to educate each member through various aspects of the process— on top of providing support and guidance— all in the name of supporting our donors in making the best decision for themselves.

Medical risks and side effects

Just like any other medical procedure, egg donation has medical risks and side effects. Understanding the medical side effects of egg donation is vital for ensuring that donors can give informed consent, prepare for and manage potential risks, and safeguard their physical well-being. It also empowers donors to make confident, informed decisions about their participation in the donation process.

Typically, during the menstrual cycle only one egg is released. So when donating eggs,  medications are given to help produce multiple eggs at one time. Sometimes ovaries over respond to these medications and cause side effects. Ovarian Hyperstimulation Syndrome (OHSS) is one possible side effect. The ovaries swell because they are producing more than what is typical and can become painful. Symptoms can range from mild bloating and nausea to severe symptoms such as shortness of breath, blood clots, and even kidney failure. According to the Cleveland Clinic, OHSS occurs in less than 5% of women undergoing retrieval. And severe cases are less than 1%.

Because a needle is involved to remove eggs from the ovaries, an infection is possible. However, according to the American Society for Reproductive Medicine (ASRM), pelvic infections after egg retrieval are pretty rare. Severe infections may require hospitalization and/or treatment with intravenous antibiotics. Rarely, surgery may be required to remove one or both of the ovaries, tubes, and/or uterus. Light vaginal bleeding or spotting for 1–2 days after an egg retrieval procedure is also very normal. Since the retrieval involves puncturing and aspirating ovarian follicles, it can lead to varying degrees of bleeding.

These and other potential side effects will be fully discussed and covered in detail before any procedure begins. The donor will have ample opportunity to learn about all the possible side effects and opportunity to ask questions until she feels fully informed and comfortable with moving forward. We believe that being aware of the medical side effects empowers donors to take an active role in their healthcare. This knowledge allows them to advocate for themselves, ask the right questions, and make decisions that are in their best interest.

Psychological and emotional considerations

The decision to donate eggs involves a lot of personal considerations as well, not just medical. And donors must be counseled on the potential emotional and psychological impacts of donation, including the potential for regret. Donors may experience stress related to the medical procedures, the hormones used, and the overall commitment required. But the emotional and psychological impacts can impact a donor well past the donation phase and into the future. The knowledge that their genetic material may result in the birth of a child can create a sense of connection or identity-related concerns. Donors may wonder about their genetic offspring and may feel a sense of loss or confusion regarding their role in the child's life. Donors may find that their decision affects their relationships with partners, family members, or friends, particularly if those around them have differing views on egg donation. 

This and other psychologically complex reasons are why donors undergo an extensive psychological screening to assess their emotional readiness and understanding of the potential psychological impacts of egg donation. Understanding the potential mental health implications ensures that they are prepared for the emotional journey ahead. By being aware of these potential effects, donors can make more informed decisions, seek appropriate support, and manage their mental health throughout and after the donation process. We provide access to professional mental health support that can help donors process their emotions and manage any psychological challenges that arise.

Over time, a donor's feelings about their decision might evolve. What seemed like a straightforward decision at one point in life might be reconsidered as the donor’s circumstances or perspective changes, potentially leading to feelings of regret or doubt.  So before proceeding with the donation, we discuss this with our donors to reduce the likelihood of misunderstandings or regrets later in life. This is where we spend time discussing the genetic implications of egg donation. 

Genetic implications of egg donation

The egg provided by the donor contains half of the genetic material that will combine with sperm to form an embryo. This means that the donors and recipients' family tree will be tied forever. We want our donors to understand the significance of this implication. Being informed about potential future impacts allows donors to develop coping strategies and seek support networks, whether through professional counseling, support groups, or trusted individuals in their lives.

At Cofertility, we offer potential egg donors the choice of how, if at all, they want to be connected to the family they help. Two broad options for the the relationship include: 

• Disclosed, you exchange contact information and can communicate directly. The scope and degree of communication (both during and post-match) is what both parties make of it. 
• Undisclosed, you do not exchange contact information and only communicate through Cofertility. With an undisclosed donation, you and the family can choose to allow the donor-conceived child to receive your contact information when they turn a certain age (usually 18). This is called Open ID, an increasingly popular option.

Some egg donation agencies promise the opportunity to be anonymous. However, with the rise of direct-to-consumer genetic testing services, we know that anonymity is simply not possible. It has become easier for children conceived through egg donation to discover their genetic origins and potentially locate the egg donor and other biological relatives. It’s important for donors to carefully consider this implication and discuss them with medical, psychological, and legal professionals before proceeding with the donation. 

Legal rights and responsibilities

Before the donation process begins, the donor must sign legal contracts that outline their rights, responsibilities, and the terms of the donation. The legal rights and responsibilities of an egg donor are carefully defined in a legal contract to protect both the donor and the recipients. These rights and responsibilities involve issues of parental rights, disclosure, and confidentiality and are legally binding. 

In the contract it will be explicitly directed that the egg donor relinquish all parental rights to any children born as a result of their donation. This means they have no legal responsibilities or rights regarding the child. So the donor has no legal claim to the child, no right to contact or visitation, and no responsibility for the child's upbringing. Although research and guidelines encourage transparency, suggesting that children should be informed about their genetic origins, it is up to the recipient parents to decide if and when they will disclose the egg donation to their child. 

At Cofertility donors are required to have independent legal counsel to review these contracts and ensure they fully understand their rights and obligations. There is no cost to the donor. 

Egg sharing vs. financial compensation

Egg sharing is a program in which a woman shares some of her eggs with another individual or couple who need donor eggs. In the case of Cofertility, the donor gives half of her retrieved eggs to a family who cannot conceive otherwise and keeps the rest for herself. Every expense associated - medications, supplement, travel, insurance, freezing, legal etc - are completely free of charge.

Egg sharing and financial compensation are two very different models used in the context of egg donation. Both involve women donating their eggs, but the motivations, benefits, and processes differ. 

Egg sharing is a program in which a woman shares some of her eggs with another individual or couple who need donor eggs. In the case of Cofertility, the donor gives half of her retrieved eggs to a family who cannot conceive otherwise and keeps the rest for herself. Every expense associated— medications, supplement, travel, insurance, freezing, legal, and 10 years of storage— are completely free of charge. What’s beautiful about egg sharing is that both the donor / egg sharer and the recipient benefit from the process. The donor gains access to free egg freezing, while the recipient receives donor eggs that increase their chances of conception. 

In a financial based model of egg donation, a woman donates her eggs in exchange for a direct financial payment. This compensation is for her time, effort, and the physical and emotional demands of the donation process. Donors receive a pre-agreed sum of money as compensation for the donation. This payment is not for the eggs themselves but for the donor’s participation in the process, covering time, discomfort, and any associated risks. 

With cash compensation, ethical issues can arise regarding the commodification of human eggs, the motivations of donors (financial need versus altruism), and the potential for exploitation, especially in economically disadvantaged populations. Plus, a 2021 Harvard study found that 62% of donor-conceived adults felt the exchange of money for donor gametes was wrong, and 41% were troubled by the fact that money was exchanged around their conception. 

The bottom line

Egg donation is a complex process, and it is important for potential donors to receive comprehensive information before giving their consent. This includes information regarding medical, psychological, genetic, legal, and egg sharing vs financial implications, before voluntarily agreeing to participate. They have the right to ask questions and receive clear, unbiased answers to ensure that they are making fully informed decisions at every stage of the donation process. This right is crucial for safeguarding their health, legal rights, emotional well-being, and autonomy. It also upholds ethical standards by ensuring transparency, trust, and the protection of donors from exploitation or coercion.

Egg freezing, also known as oocyte cryopreservation, is a process where a woman's eggs are retrieved, frozen, and stored for later use. This allows women to preserve their eggs at their current age, potentially increasing their chances of having a biological child in the future.

Egg freezing is becoming more and more common, with a 30% increase in egg-freezing cycles from 2021 to 2022 alone! 

I’m Dr. Meera Shah, a double-board certified OBGYN and Reproductive Endocrinologist (REI). I have helped countless women freeze their eggs as a fertility doctor and as a Medical Advisor to Cofertility. This article is a guide to everything you need to know to make a confident, informed decision about egg freezing.

Why people choose to freeze their eggs

There are many reasons why women opt for egg freezing. Here are some of the most common reasons we hear:

• Focusing on other priorities: Women focusing on career or personal goals can freeze their eggs until they're ready to start a family.
• Waiting for the right partner: As the average age of first marriage continues to rise, some women choose to freeze their eggs instead of rushing into a marriage.
• Medical reasons: Women facing medical conditions or treatments that could impact fertility, such as chemotherapy or radiation, can freeze their eggs before undergoing these treatments.
• Genetic predisposition: Women with a family history of early menopause may choose to freeze their eggs to ensure they have viable eggs for future use.
• Peace of mind: Some women simply want the peace of mind knowing they have a backup plan for their fertility.

At what age should you freeze your eggs?

There is no perfect age at which to freeze your eggs. However, the younger you can do it, the better. According to the American Society for Reproductive Medicine (ASRM), an optimal time to freeze your eggs is in your 20s and early 30s, while you have a higher ovarian reserve and eggs are healthier. 

A large 2020 study at a fertility clinic that specializes in this area looked at egg freezing cycles for over 1,200 people. It compared the average number of eggs people of different ages were able to freeze versus the “optimal” or goal number of eggs they should freeze. This goal number was based on how many eggs would give them a 70% live birth rate after doing 1 or 2 egg freezing cycles (this rate is calculated using some other numbers and it typically goes up as we age to make up for the lower number of healthy eggs). 

The study found that younger people, unsurprisingly, have an easier time freezing the goal number of eggs in one cycle. As people aged, they needed multiple egg freezing cycles to reach that goal number.

Read more in What’s the Best Age to Freeze My Eggs?

Is it worth freezing eggs after age 35?

The findings from the study above bring up a common question–is it worth freezing eggs after age 35? Well, it depends. The ASRM does not recommend egg freezing for people older than 38, but this isn’t a strict cutoff. 

Your biological clock is not a cliff. Everyone’s fertility decreases down at a different rate. Having your fertility hormones checked can sometimes help you and your doctor get a general idea of your ovarian reserve and chance of a future pregnancy. This can better help you decide if egg freezing is right for you.

Egg freezing success rates by age

Success rates with egg freezing depend on a lot of factors: your health, your ovarian reserve, your response to egg freezing medication, and the quality of the clinic. That being said, generally, younger women have higher success rates due to better egg quantity and quality. 

A study of 1,241 women found that the average number of eggs retrieved on the first egg freezing round was:

• 21 eggs for women under 35
• 17 eggs for women 35-37
• 14 eggs for women 38-40

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Because women in their 30s tend to produce less eggs, at this age you may end up having to either settle for fewer eggs for freezing or undergo multiple rounds to collect enough eggs to have on hand for later implantation. As you can imagine, those costs can creep higher and higher the more rounds you endure. 

Now, you might be thinking: isn’t 14 eggs a lot?  It’s true that eggs retrieved from women under the age of 36 will have a 95 percent survival rate after being thawed.  But, not all thawed eggs will become viable embryos and lead to a live birth. The probability of a live birth varies with the age of the woman trying to conceive and the number of mature eggs available. In short, the older the woman, the more eggs required to achieve a high probability of a live birth. 

A study in the Journal of Assisted Reproduction and Genetics further supports this point. For example, a woman under 35 will need nine eggs to achieve a 70% chance of having at least one live birth. If you’re trying to conceive in your mid to late 30s, you may need double as many eggs to achieve that same 70% success rate. 

The right number of eggs to freeze for your age

Different folks have different reasons for freezing their eggs. Some may be thinking about prolonging their fertility into the future. Others may be freezing some eggs but also hoping to donate some eggs to help others grow a family — something that’s done via our Split program, where you freeze for free when donating half of the eggs to a family that can’t otherwise conceive. 

Either way, studies have found that the optimal number of eggs to freeze really comes down to your age. That’s because the number of eggs in the body isn’t the only thing to decrease as you get older — egg quality decreases too, and egg quality is the number one factor in determining whether an egg can eventually result in a live birth. 

Here are the number of eggs you’ll want to freeze based on your age in order to obtain an optimal live birth rate:

Should I do multiple egg retrievals?

What happens if you don’t get as many eggs as you had hoped during your egg retrieval cycle? 

If you’ve undergone one round of egg freezing and the number of eggs your reproductive endocrinologist retrieved from your ovaries wasn’t as high as you’d hoped, you may want to talk to them about trying again. A fertility specialist can help you talk through all of your options.

There is technically no limit to the number of egg freezing rounds a person can undergo, but it’s not recommended that egg donors undergo more than six cycles. If you’re hoping to split your eggs with intended parents (donating half of the eggs retrieved) as part of our Split Program, you may find that additional retrievals help you provide the optimal amount of eggs for a live birth for you and for the intentend parents too. 

The right number of eggs to freeze to have multiple children

If you’re planning to have a big family one day, you may want to look at the number of eggs it’s recommended you freeze to achieve one live birth and talk to your Reproductive Endocrinologist (REI) about freezing more eggs. 

As we shared above, a woman under age 35 will need to freeze about nine eggs to achieve a 70% chance of a successful pregnancy and live birth. If you’re under age 35 now and thinking you might want to use frozen eggs to conceive twice in your future, you will want to freeze closer to 18 eggs.

The number of eggs necessary will increase with your age at time of the retrieval, and the number of children you hope to have via those eggs. 

Can frozen eggs guarantee a successful pregnancy in the future?

When trying to decide if you should freeze your eggs, it’s important to know that egg freezing is not an “insurance policy” for your fertility. While egg freezing can take some of the stress of having a baby right now off your shoulders, it is not a guarantee that you’ll have a baby in the future. 

Why not? Well, for one, not all the eggs that get frozen will actually be viable. It’s expected that some eggs will not survive the warming process when it comes time to use the eggs. In addition, the chances of the eggs that do survive being successfully fertilized depends on a variety of factors, including how old you were when you froze them (more on this later). 

This is not to sway your decision one way or another. Ultimately, only you and your doctor can decide if egg freezing is the right decision for you. But it's important to go in knowing that it’s not meant to be a done deal. As egg freezing has gotten more popular, many companies will gloss over this fact. We don't think that's right and want to be straight with you from the outset.

Freezing your eggs when you’re unsure if you want kids

Perhaps the biggest benefit of egg freezing is that it puts the decision-making power entirely in your hands. Whether you’re freezing your eggs because you want to focus on your career or you’re about to undergo medical treatment that may affect your fertility later on, or you’re waiting to find the right partner, freezing your eggs allows you to preserve some of your fertility independently. 

While you might not be sure about having kids today, if you do decide you want kids down the road, especially if you’re in your mid- to late-thirties, having eggs on ice will increase the chances that you’re able to do so.

Know this: most people do not regret their egg retrieval procedure. We looked at five studies on egg freezing. The rates of regret reported in these studies varied, likely due to the sample size, study design, and the follow-up period. However, taken together, these studies suggest that the vast majority of those who freeze their eggs have zero regrets.

There also appear to be factors that reduce the chances of regret, including feeling fully informed beforehand, and getting adequate support during the egg freezing process. In other words, if you take the time to think things through and feel supported throughout the journey, you’re less likely to regret making this decision for yourself.

The egg freezing process: step-by-step

The egg freezing process is about a two-week journey. You will work closely with a Reproductive Endocrinologist (fertility doctor) and the clinic team throughout the process. 

Here's a detailed breakdown of what you can expect from start to finish, and beyond:

1. Ovarian stimulation: You'll take hormone medications to stimulate your ovaries to produce multiple eggs, and have multiple monitoring appointments and blood tests to see how the eggs are maturing.
2. Egg retrieval: Your eggs will be retrieved through a minor surgical procedure using ultrasound guidance.
3. Vitrification: Your eggs will be rapidly frozen using a technique called vitrification, which helps preserve their quality.
4. Storage: Your frozen eggs will be stored in a secure facility until you're ready to use them.
5. Thawing and fertilization: When you're ready to conceive, your eggs will be thawed, fertilized with sperm (either your partner's or a donor's), and transferred to your uterus.

Will egg freezing hurt my future fertility?

Egg freezing actually rescues all the other eggs that your body would otherwise allow to die during a normal menstrual cycle. So the process of egg freezing doesn’t take anything away from your egg reserve, it actually helps you save some extra eggs! And since during each cycle, your body goes through the ovulation process again with a new set of competing eggs, your chances of getting pregnant unassisted in the future also aren’t affected by egg freezing. 

What egg freezing does do is give you additional options for if and when you’re ready to start growing your family.

Is egg freezing safe?

Like any other procedure, there are risks and side effects when freezing eggs, including risks of anesthesia, bleeding, pain, and infection. Thankfully, the majority of people who go through with it deal with side effects for a few days at most. When it comes to the ovaries themselves, they generally recover quickly. The overall data indicate that the potential risks of surgical complications from egg retrieval are generally very small. However, in people with a history of endometriosis, pelvic inflammatory disease, pelvic adhesions or previous pelvic surgery, the risks are slightly increased so make sure to speak to your doctor about your medical history if you fall into any of these categories.

Egg freezing vs embryo freezing 

There’s one major difference between freezing eggs and freezing embryos. When you freeze your eggs, they stay unfertilized. We all know that to make a baby, you need an egg and a sperm because each of them provides half of the material needed. On its own, an egg can’t function (and neither can a sperm).

An embryo, on the other hand, is an egg that has already been fertilized by a sperm. Once they combine, the egg and sperm become a single cell. Over the next three to four days, the embryo divides several times, going from one to two to four to eight cells, and so on until it reaches the blastocyst stage and is ready to be frozen. Once an embryo has developed, there’s no going back– that is, there’s no way to turn that embryo back into a separate egg and sperm. 

If you don’t know who you want to have children with, then freezing your eggs may be the best approach. This option gives you the freedom to hold off on thinking about having a baby until you’ve met someone or are ready to choose a sperm donor. 

On the other hand, if you are currently with a partner who you know you’d like to have children with but now isn’t the right time, then frozen embryos might be the way to go with the goal of a future embryo transfer. The caveat here is to be 100% certain—stars like Sofia Vergara and more recently, Anna Kendrick, have run into trouble after freezing embryos with partners they didn’t end up with. 

Read more in Should I Freeze Eggs or Embryos?

Cost of egg freezing

The question of how much does it cost to freeze your eggs will come down to a few factors. These include the number of cycles you undergo to retrieve eggs and how long you keep the eggs in storage. Overall, the typical egg freezing can cost anywhere from $10,000 to $20,000 for one cycle plus the cost of storage fees.

Another option? Freeze by Co offers women a chance to freeze their eggs for free when they donate half of the retrieved eggs to a family that can’t otherwise conceive. The cost of the entire process, including 10 years of cryopreservation, is fully covered — we think it’s a win-win. 

Or, if you want to freeze and store your eggs for your own future use without donating, Freeze by Co offers lower prices on things like consultations and storage, along with access to our community of freezers. ‍We partner with lenders, like Sunfish, to offer you fertility financial resources.

Learn more about egg sharing

Egg sharing programs exist worldwide to help make fertility care more accessible. Egg sharing is when a woman undergoes an egg retrieval, and some of the resulting eggs are donated to a family that can’t otherwise conceive.

In Cofertility’s Split program, women can freeze their eggs for free when they donate half of the retrieved eggs to a family who can’t otherwise conceive. 

Ask us anything

If you’d like help figuring out when to freeze your eggs, you can contact us for more information. While every woman’s fertility preservation path differs, we can connect you with reputable clinics who can offer basic guidance about when the time is right for you to freeze your eggs during a consultation or dig into specifics by going through a preliminary exam in a provider’s office.

We understand that the timing may not be right for you to start a family right now, but that doesn’t mean it’s too early to start thinking about what choices will be available to you when that time comes. As you can see, a lot goes into preparing for an egg retrieval process.  The earlier you consider your fertility, the more options you’ll have. 

Whether you decide to freeze or not, we’re here for you to answer any questions or talk through any concerns. 

The demands of medical school can make it seem like there's never a good time to focus on personal goals like proactive family planning. But if egg freezing is on your mind, understanding the best timing can make the process much smoother. Medical school actually offers some unique advantages. You are better positioned to understand everything involved in the medical procedure.

When it comes to egg freezing, your age is the most important factor influencing future success rates with frozen eggs, so acting while you're younger (under 35) gives you the best possible options. Additionally, certain phases of med school might have slightly more flexibility than the intensity of residency.

So, when should you consider freezing your eggs during medical school? Optimal windows include summer breaks (most time available), fall/spring breaks (if you're a meticulous planner), or potentially elective periods (depending on your choices). Let’s dive in to learn more.

A quick overview of egg freezing

The egg freezing process itself typically takes a few weeks. It begins with ovarian reserve and fertility testing along with a consultation with a fertility doctor where you map out the plan. Once you’re ready to go, you'll take hormonal medications for about 10-12 days to encourage the development of multiple mature eggs. During this time, you'll have regular monitoring appointments to track your progress.  Once the eggs are ready, they'll be retrieved in a short, outpatient procedure under sedation.  After retrieval, your eggs are frozen and stored for future use.

A guide to the ideal timing during medical school

Here's the essential timeline to keep in mind:

2-3 months before your egg freezing cycle:

• Initial consult: Discuss your goals, the process, and costs with a fertility doctor.
• Baseline testing: Bloodwork and ultrasound to assess ovarian reserve.
• Stop birth control: Depending on the type of birth control you are taking, you may need to stop taking it ahead of the egg freezing cycle. 

The egg freezing cycle:

• Medications and monitoring: Begin ovarian stimulation with daily hormone injections for 10-12 days. This phase requires several monitoring appointments (ultrasounds and blood tests) at your fertility clinic or a local remote monitoring clinic. If you work with Cofertility in our Split program, we can work with you and your program to find the most convenient place for these appointments, including at your hospital.   
• Egg retrieval: Short, outpatient procedure under sedation where eggs are retrieved and frozen.
• Recovery: Expect a few days of cramping and/or bloating. Most people can return to light activities soon after.

Expect about 3 to 6 monitoring appointments (which last no more than an hour) and one day for the retrieval.  Ideally, you'll want to align the cycle with a break in your medical school schedule– such as spring break, summer break, or otherwise– to ensure you have the flexibility you need for appointments.

The key is being proactive! Don't wait to start the conversation with a fertility clinic. The earlier you plan, the less stressful it will be. Since medical schools publish their calendar in advance, use one of the week-long breaks as a target for the egg retrieval. You can then work backwards from that date to start the cycle. 

Be your own advocate with your school's administration about needing some flexibility for medical appointments. If you work with Cofertility, we can help you map out the egg freezing schedule and find a cycle start date that works with your schedule. 

If you join our Split program, you will be assigned a Member Advocate who will take the extra steps to understand your busy schedule and help schedule appointments in the most convenient way possible. In some cases this means reaching out to the hospital(s) connected to your medical school program for availability to perform labs and ultrasounds.

Freeze your eggs with Cofertility

Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:

1. Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
2. Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

The benefits of working with Cofertility include:

• Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
• Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
• Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
• Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
• Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.

Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.

Egg donation is a medical procedure where a woman donates her eggs to individuals or couples who are unable to have children using their own eggs. The egg donor undergoes a series of medical and psychological screenings and hormonal treatments to stimulate egg production. Once the eggs are mature, they are retrieved through a short surgical procedure done on an out-patient basis. The eggs are then fertilized with sperm (either from the intended father or sperm donor) and the resulting embryos are either transferred to the recipient's uterus (intended mother or gestational carrier) or frozen for later use. 

Many times donors have seen first hand their own friends or family struggling with infertility. Witnessing this creates a desire to help and motivates them to donate their eggs. This act of giving can be deeply fulfilling on a personal level knowing that they are creating family trees or relationships (parents, grandparents, aunts, uncles, etc.) that might otherwise have never existed. 

Anonymity is often a primary question for potential donors as they may believe that anonymity to be a way to protect themselves from the emotional complexity that is egg donation. They may believe that by remaining anonymous they can avoid forming any type of relationship with the child or recipients thereby also potentially avoiding feelings of guilt, responsibility, or attachment. Or they may not want it to interfere with future relationships or their own family dynamics. While anonymity is no longer realistic, disclosed and undisclosed egg donation offers benefits and the chance for meaningful future connections.

Donor anonymity

The traditional concept of anonymous donation prioritizes privacy and confidentiality for donors, the intended parents, and any resulting children. In traditional anonymous donation, there is no exchange of identifying information between the egg donor and the intended parents. If there is contact, it is very limited and is facilitated by the fertility clinic or agency.

But in recent years, DNA testing services, like 23andMe, have had a profound impact on egg donor anonymity. The ability to uncover genetic connections through these tests undermines the anonymity promised in traditional egg donation arrangements. Even if donors and recipients agreed to anonymity, individuals who were conceived using donor eggs may take one of these tests and uncover genetic connections to relatives, including their egg donor.

In the past, when anonymity was promised in egg donation arrangements, it was often based on the understanding that the identities of both the donor and the recipient would remain confidential and undisclosed to each other. However, as mentioned above, with the increasing popularity of direct-to-consumer genetic testing services, maintaining complete anonymity in egg donation is basically impossible. If an egg donation agency or egg bank promises anonymity, be very weary. They are not able to guarantee it due to DNA testing.

There is an increasing trend towards greater openness in egg donation arrangements in many countries, with increasing recognition of the importance of providing donors and offspring with the option for contact. For example, the United Kingdom has a regulated system for egg donation overseen by the Human Fertilisation and Embryology Authority (HFEA). Donors are required to provide non-identifying information that may be shared with offspring at the age of 18.

Disclosed and undisclosed donation

At Cofertility, we offer donors and the families they match with two general types of relationships.

In a disclosed relationship, the egg donor and recipient exchange contact information and can communicate directly. So, both the donor and the recipients are aware of each other's identities. The scope and degree of communication (both during and post-match) is what both parties make of it. This can range from occasional updates to ongoing relationships and involvement in each other's lives.

In an undisclosed relationship, identifying information is not exchanged and communication is facilitated through Cofertility. With an undisclosed donation, the donor and the family can choose to allow the donor-conceived child to receive the donor’s contact information when they turn a certain age (usually 18). This is called Open ID, an increasingly popular option.

Benefits of non-anonymous donation

Non-anonymous donation offers a more personalized approach. It provides donors and intended parents the opportunity to establish meaningful relationships and make informed choices based on mutual understanding and respect. This openness can offer opportunities for building positive relationships and can enable donors and intended parents to provide emotional support to one another throughout the donation process. This support network can be valuable in navigating the emotional complexities and challenges associated with egg donation. 

Considerations for potential egg donors

The level of desired openness in egg donation is a personal choice and can vary significantly from individual to individual.  Some individuals may prioritize transparency and openness in all aspects of their lives, including reproductive choices, while others may prefer privacy and discretion. Some may feel comfortable with potential future contact whereas others do not. Both are completely acceptable.  

Summing it up

The concept of egg donor anonymity has evolved over time, with increasing recognition about the benefits of disclosure in egg donation. Initially, anonymity was commonly practiced to protect the privacy of all involved. However, as attitudes towards third party reproduction in general have shifted and advancements in technology have made maintaining anonymity difficult, there has been a growing trend towards disclosure and openness in egg donation. Every donor needs to prioritize their own comfort and values while understanding the positive possibilities of connection. It's essential for individuals considering egg donation to be aware of the potential risks and limitations regarding anonymity and to carefully consider the implications before proceeding with the donation process.

Read more:

• Disclosed vs Undisclosed Egg Donation: How Do I Choose?
• Decoding the Lexicon of Egg Donation: A Guide for Donors on the Continuum of Disclosure
• The Ultimate Guide to Egg Donation

Thanks to advancement in reproductive technology, egg freezing can offer women the opportunity to preserve their fertility while they focus on other aspects of their lives. But what if they have pursued their education, advanced in their careers, and are happily settled with their forever person, when life takes a left turn? Significant life changes such as divorce may also prompt women to consider egg freezing as a way to preserve their fertility for future family-building purposes. This option may allow them the time needed to heal without feeling pressured to rush into finding a new partner and give them the space to make informed decisions about their future.

The emotional impact of divorce

Divorce or a breakup can be an incredibly challenging and emotionally taxing life event. The end of a relationship can bring about feelings of loss, grief, loneliness, and uncertainty. Divorce can impact various aspects of one's life, including future plans— plans that may have included children. A divorce or breakup can raise concerns about future fertility issues, especially for women over the age of 35. 

How egg freezing works, and how much it costs

The process of egg freezing typically begins with ovarian stimulation where the woman undergoes hormonal treatments to stimulate the ovaries. The goal is to produce multiple eggs in one cycle as typically only one egg is produced in a cycle. Once the eggs have reached maturity, they are retrieved via an out-patient procedure where a thin needle is inserted into each follicle, and the eggs are retrieved. Once retrieved, the eggs are cryopreserved using vitrification, a rapid cooling technique. The frozen eggs are then stored in cryogenic tanks until they are ready to be used.

There are a few factors that determine success rates. By success rates we are referring to a live birth outcome using the frozen eggs. Generally, women under 35 have better outcomes and the more eggs retrieved, the higher the likelihood of success. A recent study found that irrespective of age at freezing, a significantly high live birth rate was achieved when the number of eggs frozen per patient was 15 or more. 

The process of freezing eggs can cost anywhere from $10,000 to $20,000 and above. Costs include things like the initial consultation and testing, ovarian stimulation and egg retrieval, the egg freezing procedure, medication, and storage fees. Once the eggs are ready to be used, there are costs involved for thawing and then fertilizing to create embryos. After that there are fees for embryo testing and the transfer. If a sperm donor is used, there are various costs involved with that as well.

Learn more about our Split program, where qualified women can freeze their eggs for free when donating half to a family that couldn’t otherwise conceive. 

Navigating the decision-making process

Egg freezing allows women to take control of their fertility and help them make informed decisions about their reproductive future, with or without a partner.  However, there is still some concern about whether those who choose this option will regret their decision, especially given the costs involved. This article looks at several studies that explore this idea of regret. Overall, it was surmised that the only regret most had was they wished they had done it sooner.

Deciding to freeze eggs after a breakup or divorce can be a complex and personal decision. So it is important to feel and process emotions, seek support when needed, and make decisions that feel right for you and your future goals. It is understandable that following a breakup or divorce, there may be uncertainty about future relationships. So the decision to freeze eggs may involve deciding how to move forward with one's fertility independent of a partner. 

It’s also normal to have mixed feelings about the decision to freeze eggs, including relief at having a plan in place for the future but also sadness about the circumstances that led to the decision, and anxiety about the unknowns ahead. So it is very important to find healthy ways to manage stress and anxiety during this time. Which includes self-care, self-compassion, and leaning on support systems.

As important as it is to plan for the future, it is also important to keep in mind that plans always evolve over time. So I encourage you to remain flexible. Be prepared to adjust plans as  circumstances change. For example, at what point will you consider a sperm donor? If you find a new partner will you use frozen eggs or will you try to get pregnant on your own? If you do  get pregnant without using the frozen eggs,  what happens to the frozen eggs? Do they remain stored for a certain period of time? Are they donated? Or are they disposed?

Summing it up

Divorce or a break up brings about significant life changes, including changes in family planning. Freezing eggs provides a way to preserve fertility options for the future, allowing individuals to take time to decide on family planning when they're ready, whether it's with a future partner or as a single parent. It also allows individuals to focus on their emotional healing without feeling rushed into making decisions. By offering a way to preserve fertility and extend the window for family planning, egg freezing has become a valuable option for women navigating life changes.

Read more

• Amanda Goetz on Egg Freezing After Divorce
• We Asked Four Women: Did You Freeze Eggs or Embryos?
• A Breakdown of Egg Freezing Success Rates by Age

Freeze your eggs with Cofertility

Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:

1. Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
2. Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

The benefits of working with Cofertility include:

• Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
• Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
• Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
• Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
• Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.

Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.

At Cofertility, we’re big believers in destigmatizing mental health conditions — whether it’s depression, anxiety, ADHD, substance abuse, or anything else. If you’re treating or working through a mental health condition, we support you and your strength, and we know that recognizing a mental health condition can actually be pretty empowering.  But if you are thinking about donating your eggs, there are a few considerations you should take into account before starting the process. Read on for everything you need to know about egg donation if you have a mental health condition.  

Do antidepressants or anti-anxiety medications impact cycle outcomes? 

If you’re currently on medication for depression or anxiety, the short answer is — most likely — no. Most commonly used SSRI antidepressants and anti-anxiety medications (benzodiazepines) have not been shown to have clear long-term effects upon egg freezing cycles. That includes both egg quantity and quality, as well as hormone levels and the ability to ovulate. There is concern that the use of SSRIs and other antidepressants during fertility treatments could interfere with the effectiveness of hormonal medications used in treatments, potentially by altering the body's response to these hormones or affecting hormone levels directly. This interaction could theoretically exacerbate symptoms of depression due to the added stress of fertility treatments and the hormonal fluctuations they cause

If you’re planning on freezing your eggs — regardless of whether you’re also donating any — you’ll need to provide your doctor’s office with your current medications. As for official guidance, the CDC and the American Society for Reproductive Medicine (ASRM) consider antidepressant usage safe during fertility treatments. That said, you can never be too proactive, so we definitely recommend bringing this question up with your doctor and discussing your medication, specifically.

When it comes to egg donation, however, things get a little bit more complicated. The ASRM (yes, the same organization that stated antidepressants are safe to take during fertility treatments) considers the current use of SSRIs or other antidepressants a “relative exclusion criteria”' for egg donation. So, not an automatic disqualification, but something that should be reviewed by the doctor on a case-by-case basis. All clinics may view this guidance differently, and different intended parents may feel differently about the issue. Again, we recommend discussing your usage of these medications with your fertility clinic and your psychiatrist. Two people may take the same medication for very different reasons, and context is important here.

Cofertility’s eligibility decisions are rooted in adherence to ASRM guidelines, which fertility clinics follow within comprehensive screenings. Many clinics may have their own eligibility policies on top of the guidelines dictated by ASRM – we ultimately defer to the discretion of the clinic and overseeing physician.

Risks of inheritability — and what they mean for your cycle

Even though the usage of SSRIs or antidepressants may not impact your egg freezing cycle outcome or automatically disqualify you from egg donation, it’s still important to understand the inheritability risk of your mental health condition to potential future offspring. When you are undergoing medical screening for egg donation in a specific match, it involves more than just meeting the general requirements for egg donation. This process also includes eligibility to donate for a particular family. Since sperm contributes the other half of the genetic material in an embryo, it is essential to evaluate the genetic carrier status of both you, the egg donor, and the sperm provider collectively.

Depending on your condition, your reproductive endocrinologist (REI, otherwise known as your fertility doctor) may ask your psychiatrist if you are able to safely go off of your medication if needed. And during your psychological evaluation, the psychiatrist will want to verify that you aren’t under excessive stress or experiencing any instability when providing consent. 

If, based on your condition and psychiatric history, you are still cleared for egg donation, it’s likely that you will be matched with intended parents who don’t maintain a shared history of your condition or related ones. This will be discussed with a genetic counselor as part of the process to mitigate risk of inheritability to future offspring as a result of your egg donation. 

What criteria is required for egg donation? 

In order to mitigate the risk of inheritability of mental health issues to offspring, the ASRM has the following criteria in place that would deem someone ineligible to donate:

• Presence of significant psychopathology 
• Positive family history of psychiatric disorders 
• Current use of psychoactive medication 
• Substance use disorders 
• Two or more first-degree relatives with substance use disorders 
• History of emotional, sexual, or physical abuse without professional treatment 
• Excessive stress 
• Relationship instability 
• Inadequate cognitive functioning to support informed consent 
• High-risk sexual practices 
• Risks/concerns for the donor for future contact with donor-conceived offspring

Each of these factors would be evaluated as part of your initial egg donation application and/or your psychological screening later in the process. 

What’s the rationale for psychological screening for egg donation? 

As part of the egg donation application process, mental health screening checkpoints exist at two key points: 

• The initial (written) application, including a detailed medical history screening, as some conditions are more heritable than others
• The psychological evaluation that takes place once you’ve already passed bloodwork and physical evaluation portions of the process

These screenings take place for several reasons, but the two primary ones are egg donation preparedness and reducing inheritable risks of the mental health conditions to any resulting offspring. 

Preparedness for egg donation

Egg donation isn’t *not* a big deal. You’re helping grow another family who otherwise can’t conceive — and, if you’re donating your eggs through Cofertility’s Split program, you’re also freezing half of the eggs retrieved for your own fertility future. This process is definitely manageable (and actually, empowering?), but someone should only go through with it if they are truly one-hundred-and-fifty-percent ready. 

There are many emotional implications involved with egg donation, both for you and the intended parents. Implications like, what degree of communication with intended parents or any future offspring are you comfortable with, if any? We review every single Split program application to ensure that every member feels not only prepared, but excited, about the prospect of matching with another family and donating half of their retrieved eggs. 

Reducing inheritable risks to offspring

The second, more clinical reason for psychological screening is ultimately to reduce the risk of any potential future offspring inheriting any serious mental health issues. We (and maybe you, if you’re reading this) know first-hand the struggles mental health conditions can bring, not only to the affected individual but also their loved ones. Depending on the severity of the conditions, it’s important to get ahead of any potential risks to families that may be created as a result of egg donation. 

The net-net

Ultimately, if you have a mental health condition, your likelihood of getting approved for egg donation is totally case-by-case. It depends on the specific condition, the severity, medication (if applicable), possible input from your psychologist/psychiatrist, and the evaluation of your readiness for donation. Checks and balances and standardizations within the process exist to ensure you (a) feel great about consenting to the procedure, and (b) that there is not a high risk of passing along a severe condition to potential offspring. 

Egg donation with Cofertility

If you’re curious to learn more about egg donation through Cofertility, take our quiz here to see if you may qualify for our Split program. Through Split, donors are supported throughout the process and get to keep half of the eggs retrieved for their own future use. 

With our innovative approach, you’ll also get:

• Free storage of your own eggs in cryopreservation for up to 10 years
• Coverage of all medical costs throughout the egg freezing and donation processes
• Connection to the Cofertility community for support all along the way (and after, too!)
• The ability to work with intended parents to decide together what your relationship will look like

We hope to support you on your egg freezing and donation journey! 

Egg freezing is, undoubtedly, one of the most empowering journeys anyone with a uterus can embark on. One of the biggest reasons you’ll feel like you can conquer the world after an egg freezing cycle is also one of the least fun parts about it: the injections.

If you’ve already begun to explore freezing your eggs, you know that the process requires administering injectable medication shots. So a thorough understanding of how they work — and how to get through them all (mentally, emotionally, and physically) — is essential. This article aims to provide clinically-sourced tips to guide you through this crucial aspect of egg freezing.

Types of egg freezing shots and medications

At its core, egg freezing involves the use of injectable medications to stimulate the ovaries, promote egg development through maturity, and enhance the chances of a successful egg retrieval. What doctors — and you — are looking for is strong egg volume and quality, and certain medications are used to help you on the road to get there.

These medications fall into a few categories:

Follicle-Stimulating Hormone (FSH)

FSH medications stimulate the ovaries to produce multiple eggs.

Luteinizing Hormone (LH)

LH medications support the final maturation of eggs within the ovaries.

Gonadotropin-Releasing Hormone Agonists/Antagonists

These medications prevent premature ovulation, ensuring that eggs are retrieved at the optimal time.

Human Chorionic Gonadotropin (hCG)

hCG triggers the final maturation of the eggs, preparing them for retrieval. Otherwise known as a “trigger shot,” this shot is timed right before your retrieval so they are at peak maturity (without ovulating, of course!).

The number of shots required varies among individuals, but it typically ranges from 10 to 20 injections over a period of 8 to 14 days. While the idea of injections may seem daunting, many individuals find the process totally manageable with proper guidance.

At Cofertility, all Freeze by Co members gain access to our free member community portal, where we share tons of egg freezing tutorial videos that walk you through the whole thing, step-by-step. You can also ask a partner, friend, or family member to help!

Do egg-freezing shots hurt?

The pain associated with egg freezing shots is subjective and varies among individuals. Most commonly, individuals report feeling a mild discomfort or a slight pinch during the injection. Here are some tips on managing egg freezing injections and making the process more comfortable, but you can dive into more here.

Tips for making injections painless

Utilize the right technique

Proper injection technique is crucial for minimizing pain. The angle and speed at which the needle is inserted, as well as the depth of injection, can impact the level of discomfort. Our videos in our community member portal provide a good, close look at the right technique and method of injection. If you have extra syringes, you can also practice injecting water on a peach or another fruit!

Ice the injection site

Applying an ice pack to the injection site for a few minutes before the injection can numb the area, making the process more comfortable.

Let medications reach room temperature

Allowing the medications to reach room temperature before injection can reduce the sensation of cold, making the process more comfortable. (Of course, you’ll want to read the packaging or talk to your doctor to make sure this is okay for your specific medication).

Take deep breaths

Practicing deep breathing exercises before and during the injection can help relax the muscles, making the process less painful.

Troubleshooting egg-freezing shots

Despite careful planning and execution, you may encounter some issues with egg freezing injections. It’s essential to be aware of potential challenges and know when to call your clinic.

Missed or incorrect dosages

Missing or administering an incorrect dosage can impact the efficacy of the egg freezing process. In case of a missed or potentially incorrect or missed dosage, it is crucial to contact your doctor immediately for guidance on the appropriate course of action. Most fertility clinics have on-call support that you can contact after hours if needed.

Injection site reactions

Some individuals may experience redness, swelling, or bruising at the injection site. These reactions are generally mild and temporary. However, persistent or severe reactions should be reported to your doctor for evaluation.

Ovarian Hyperstimulation Syndrome (OHSS) risks

OHSS is a potential (though low) risk of egg freezing, during which your ovaries can become overstimulated as a reaction to the fertility medication. If you experience symptoms such as severe abdominal pain, nausea, or shortness of breath, it is crucial to seek immediate medical attention.

If you’re afraid of needles

We get it. Sometimes, even with the most support and the best resources, you just might not be able to get yourself there when it comes to needles — even if you really want to freeze your eggs. If this is the case, talk to your doctor about a protocol known as “mini IVF”.

Mini IVF is a newer, needle-free alternative to fertility injections, where fertility medication is given via capsule form instead. Often, mini IVF candidates include those who are at higher risk of developing OHSS or those who actually have lower ovarian reserves that may not be able to be helped much with injectable medications anyway.

If this is you, chat with your doctor to see if you’re a candidate for mini IVF and what kinds of results to expect.

Summing it up

Mastering the art of egg freezing involves meticulous attention to ordering, organizing, and administering injectable medication shots. We’ve got your back with tons more educational content and egg-freezing tips.

If this article’s got you feeling like you can conquer the world (10-14 days of egg-freezing injections? No sweat!), check out our Split program, where you can freeze your eggs for *free* when you donate half to another family who can’t conceive. By donating half of their frozen eggs to LGBTQ+ parents, those with infertility, or cancer survivors, participants in our Split program can make a meaningful impact for themselves and others. Apply for our Split program today.

Maybe you already know the ins and outs of egg freezing, or maybe not — but (especially if you’re a med student), the question remains: how can you afford it? Or, better yet, could your school possibly even offer egg freezing as an insurance benefit? 

The answer? It depends, and it may differ whether you’re a student or faculty member. In this article, we’ll share an overview of egg freezing and the costs involved, why egg freezing is especially important to consider as a female in medicine, and what kind of egg freezing benefits universities may offer medical students and faculty. 

Why you should care about egg freezing

First things first: what even is egg freezing, and why should we talk about it? Egg freezing is a procedure where your eggs are extracted, frozen, and stored for later use. While you may not end up needing them, if you do end up facing fertility challenges or decide to pursue donor sperm to grow your family, you can thaw your previously frozen eggs and fertilize them with sperm. This will, hopefully, lead to those eggs becoming embryos that can then be transferred to your uterus and ideally, result in a pregnancy. 

Data tells us that the younger eggs are, the healthier and higher quality they are. Our egg quantity also declines with age, so if you’re going to freeze your eggs, freezing at an earlier age is ideal and increases the likelihood of conceiving a biological child in the future. 

Female physicians face infertility at a higher rate

We hate to report this, but a recent study indicated that roughly 25% of female doctors trying to conceive face fertility challenges — just about double the rate of the general public. The rate of pregnancy loss among female surgeons is equally concerning; at 42%, this compares to the rate among the general public of 1 in 4 pregnancies ending in some sort of loss.

“Roughly 25% of female doctors trying to conceive face fertility challenges — just about double the rate of the general public.”

There are many factors that contribute to these statistics. For starters, female physicians are more likely to delay family building due to pursuing their medical education and residency. Depending on the specialty, many doctors will be well into their 30s before beginning to try for their first child. And, as previously explained, age can impact egg quality and quantity down the line. Combine this with the strain caused by the grueling lifestyle of residency, and the impact of a medical track upon a female physician’s fertility becomes even clearer.

Egg freezing coverage for med students and faculty

Before jumping into specifics around egg freezing coverage, it’s important to understand the concept of university healthcare insurance, especially for students.  

How university healthcare coverage works

Many higher education institutions offer health insurance plans to their students, either through the university itself or by facilitating access to external plans. These plans typically cover essential medical services, preventive care, and, in some cases, mental health services.

University health insurance plans usually operate on an annual basis. Students are required to enroll in or waive coverage at the beginning of each academic year. The cost of coverage is often included in tuition and fees, and coverage extends throughout the academic year, including breaks. Some plans also cover services rendered off-campus, providing flexibility for students studying abroad or residing off-campus.

However, the extent and details of coverage vary widely among university health insurance plans, and there are even various state-by-state regulations that govern what’s allowed. 

Egg freezing coverage for med students

So, if we know that medical professionals are more likely to experience fertility challenges, surely there must be sweeping, extensive egg freezing coverage to help them get ahead of it, right? These individuals are sacrificing their time, their livelihoods, their sleep, and their bank accounts to take care of us — so of course they’re being taken care of too, yes? 

For students, unfortunately, the answer is no. 

Typically, as part of university healthcare plans, elective procedures (chosen by the patient vs. being deemed “medically necessary”) such as proactive egg freezing are not covered. And, while many university healthcare institutions do have their own in-house fertility clinics with reproductive endocrinologists on staff conducting assisted reproductive technology (ART) procedures daily, these services are not subsidized for students. 

Non-elective procedures that may be covered, on the other hand, might include things like egg freezing as a result of a cancer diagnosis. Some schools may even include infertility treatment as part of their student healthcare coverage. It’s essential for students to review their specific plan details to understand the scope of coverage and any potential gaps in benefits. 

One 2022 study found that only one medical school provides coverage for elective fertility preservation. Unfortunately, however, at the time of writing, we were not able to confirm which school is referenced (if this is your school — we want to hear about it!).

It is worth noting that some private fertility clinics will subsidize costs for med students, residents, or fellows, in recognition of the unique additional hardships that they face when it comes to family building. At the time of writing this, Massachusetts-based Boston IVF, for example, currently offers 25% off one egg freezing cycle plus 15% off medication through VFP Pharmacy Group for those individuals. With many locations nationwide, Shady Grove also offers a discount on egg freezing cycles (including monitoring, retrieval, and freezing) for surgical residents across various specialties. Their site is not clear on the exact discount, but you may contact ResidentEggFreezing@USFertility.com for the most up-to-date information. 

Egg freezing coverage for med school faculty

Like many employers, to entice the best and brightest minds, medical universities often tout the benefits that come along with working on staff. This includes healthcare coverage, and those plans may include some degree of fertility and family-building coverage. Johns Hopkins, the University of Maryland, and the University of Michigan (to name a few) all provide faculty with the option of enrolling in their insurance plans that include fertility treatment coverage.

That being said, for egg freezing in particular, even for med school faculty it still has to be deemed “medically necessary” vs. “elective” in order to be covered within these plans. Instead, the healthcare coverage that’s usually provided tends to focus primarily on services for those trying to conceive — hormonal, IUI, or IVF treatment and medication. 

How to freeze your eggs more affordably

Given that elective egg freezing coverage — even for med students and faculty — tends to remain an out of pocket expense, you’re probably wondering how to afford the costs. Depending on where you’re located, your clinic, and your medication protocol, average egg freezing cycle costs can range anywhere from $10,000 - $20,000, plus annual storage fees. 

That being said, there are various ways to lighten the load of egg freezing costs, including financing, using money from your flexible spending account (FSA) or health savings account (HSA), crowdfunding, and more. 

With Cofertility, though, you may be able to freeze your eggs completely for free if you donate half of the eggs retrieved to another family who can’t conceive through our Split program. This may include LGBTQ+ intended parents, those with infertility, or cancer survivors who want to grow their family. 

If you’re interested in learning more about our Split program, take our one-minute quiz to see if you’re eligible and get started. 

Read more:

• Why Do Female Physicians Face Higher Rates of Infertility?
• Everything You Need To Know About Egg Freezing Medication
• Do’s and Don’ts for Egg Freezing: Alcohol, Baths, Exercise, and More

So, you’re considering freezing and donating your eggs with Cofertility. This is exciting! Donating a portion of your eggs to another family who needs them in order to have children is an incredible decision. But it’s certainly not one to be taken lightly, so you’re doing the right thing by researching the process and considering all factors (and perspectives) involved. 

One of the most important aspects of egg donation is having a clear understanding of what happens to your eggs once donated, and what kinds of families you’ll help. Here, we outline several types of families that you may help when you choose to participate in our Split program. 

How does the Split program work? 

Cofertility was founded on the principles of making egg freezing more accessible and empowering, while also helping grow families via egg donation. With our Split program, those who qualify are able to freeze their eggs completely for free (including up to 10 years of frozen egg storage!) when they donate half of the eggs retrieved to another family who can’t conceive. We consider our unique model a win for everyone involved, and a more human approach to egg donation.

Through the Cofertility Split program, once you’ve qualified, signed your program agreement, and undergone initial fertility testing, your profile will become available to match with intended parents on our Family by Co platform. These intended parents will be able to view your profile and hopefully connect with you, your values, and your motivations for donating a portion of your eggs — in which case, they’ll move forward with a match! 

What is “egg sharing,” anyway?

Once you have matched with intended parents and undergone some additional screening for clearance purposes and industry guideline compliance, you’ll kick off your egg freezing cycle. Within this cycle, you’ll take 10-14 days of injectable medication that will stimulate your ovaries to mature as many eggs as possible. When the eggs have reached peak maturity, you will undergo a retrieval procedure under light anesthesia where the doctor will use a vaginal ultrasound to remove the eggs. 

As part of our egg sharing model, once their eggs are retrieved, our Split members will have half of those eggs immediately frozen and stored for free for up to 10 years (they can be removed from storage any time). The other half of the retrieved eggs will go to the intended parents and can be fertilized with their sperm of choice. If an odd number of mature eggs is retrieved, the additional mature egg will go to the intended parents. 

Types of families you help when donating eggs with Cofertility

There are many types of intended parents who require egg donation in order to conceive and grow their families. 

LGBTQ+ families

As the world has become more tolerant of diverse sexual identity and orientation, so too has it become more tolerant of the evolution of what a “family” looks like. For LGBTQ+ families, this acceptance has been incredibly meaningful in being able to live and grow their families freely. According to 2021 U.S. Census Bureau data, there are 1.2 million same-sex couple households in the US, and about 15% of these couples have children. 

For gay dads in particular, egg donation plays a vital role in providing the ability for them to have biological children. Eggs shared via donation can be fertilized with sperm from one of the intended fathers, with a subsequent pregnancy carried via gestational carrier. Remember, children of gay dads don’t happen by accident; they are the result of lots of effort, motivation, and desire to become fathers. We’re proud to support this growing population of parents. 

People struggling with infertility

Did you know that, according to the World Health Organization, 1 in 6 people worldwide face some sort of fertility challenge? With 1 in 4 pregnancies ending in a loss and 12% of women experiencing difficulties becoming pregnant or carrying a child to term, the prevalence of infertility has increased over time. 

This not only indicates why the best time to freeze your eggs is now (like, right now), it also provides some context as to how (and why) some people may eventually decide to pursue egg donation. It may provide their only option for conception, or perhaps their timeline doesn’t allow trial-and-error of other fertility treatments and they’d like to save themselves the heartache and financial strain of pursuing other options. These intended parents are always incredibly grateful for help from egg donors in growing their families, because it often comes at the end of a long, winding road that involves lots of disappointment and false starts. Growing their family via egg donation is often filled with lots of hope. 

Cancer survivors

Sadly, when a woman undergoes medical treatment as part of a cancer-fighting protocol, this can impact her fertility and family-building options down the line. And unfortunately, only in recent years have fertility preservation options become part of the standard conversation that cancer patients in their fertile years have with their doctors. Even today, this is something many cancer patients with ovaries may need to proactively bring up to protect their options for the future. 

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As a result, many female cancer patients have undergone treatment that, while lifesaving, has caused various forms of infertility. This may be due to resulting hormonal changes, or damage to eggs, ovaries, or uterus. In cases where these hopeful moms cannot use their own eggs to conceive, they need the help of an egg donor to create embryos that they themselves or a gestational carrier may carry.

Single dads by choice

At Cofertility, we support all types of families — and we pride ourselves on the fact that more than 10% of our intended parents are single men, regardless of sexuality. These intended parents have decided to pursue fatherhood on their own, but will need the help of an egg donor as well as gestational carrier in order to make that happen. To us, any person pursuing the option of taking on sole responsibility for a child is someone who really wants (and deserves) to be a parent. And they’re forever grateful to everyone who can help make that dream come true. 

How to get started

If you’d like to move forward with participating in Cofertility’s Split program, where you can freeze your eggs for free when you donate half of the eggs retrieved to another family who can’t conceive, fill out this quick quiz to learn more about your options and see if you qualify. It only takes one minute! 

As a fertility psychologist with training and education in third-party reproduction and 10+ years of experience screening egg donors, I wanted to share a little more about the rigorous psychological evaluation that takes place for potential egg donors.

Whether you are someone who is thinking about donating your eggs or someone pursuing donor egg IVF, this article is for you. Understanding the process and its importance can ensure a smooth and ethical egg donation process. 

What is screening like for a potential egg donor?

Psychological screening of a potential egg donor starts with the initial application. This application digs deep into the donor’s physical, medical, and emotional history. It also digs deep into her first and second degree. The reason we need to look into family history is because certain disorders are heritable and the receiving parties need to know and fully understand a donor's complete medical picture before deciding to move forward with her. 

Once a donor matches with a family, she then undergoes a psychological evaluation with a fertility psychologist. The American Society for Reproductive Medicine has set forth guidelines for Psychologists to follow when assessing potential egg donors. These guidelines are a way to ensure informed consent, to ascertain that she does not have any psychological contraindications to donating, and that she will be able to be committed and fulfill her responsibilities for the cycle.  

The evaluation is an interview which will review many of the things found in the application but will delve deeper. For example, the interview will include, but is not limited to, conversations about family, work, education, medical, and psychological history. Potential emotional and social risks, understanding disclosed vs. undisclosed relationships will also be discussed. The evaluation will also include a standardized, empirically-validated test designed for the assessment and/or screening of mental and behavioral disorders. Typically, these are conducted on the same day and can be done in-persons or through a telehealth consultation.

Why would someone fail a psychological screening?

Unfortunately, not everyone is suitable for egg donation, and a psychological evaluation can make this apparent. When someone does not clear psychological screening, it can lead to disappointment for the family and woman alike. 

But, psychological screening of an egg donor comes down to ethical responsibility. We need to ensure the donor’s psychological stability, informed consent, and emotional readiness which includes her understanding of the short and long term consequences of the donation process. 

Further, as a clinician my job does not only include the potential donor and her well-being. It also includes the recipient family, which also includes the future human(s) that will result from the donation. This donation isn’t just a one and done type of deal. So psychological screening is not just a formality, it is a necessity. 

What if I’ve donated my eggs before? Do I have to go through psychological screening again?

Things change. Life happens. Who you were and what you were doing during a previous donation cycle may no longer be the same. So just because you have successfully donated before does not always mean that you will be eligible to donate again. If you are wanting to donate again, I want to know why you want to do this again? I want to know what has changed since your last donation. You will once again complete a full clinical interview along with the standardized assessment. For donors who undergo additional cycles, ASRM recommends that a new full evaluation be conducted if more than 24 months have elapsed since the previous evaluation. 

Summing it up

The American Society for Reproductive Medicine (ASRM) has clear guidelines for who is and is not eligible to donate. These guidelines are there to protect everyone involved. Remember, you are creating an entire new branch of a family tree using your DNA. So it is important that no stone is left unturned. As a therapist, our job is to ensure informed consent (meaning, prospective donors fully understand the process); that the assessment is fair regardless of race, gender, or socio-economic status; and to protect personal and sensitive information as we will be asking for a lot of personal information. 

A psychologically prepared donor is essential for successful egg donation. So it is important to do your research. Understand the process and ask a lot of questions.

Egg donation with Cofertility

At Cofertility, we are striving to be the best place to be an egg donor (or what we call, a Split Member). We offer a supportive and transparent process that empowers donors to make informed decisions about their egg donation journey.

With our innovative approach, donors get to keep half of the eggs retrieved, plus:

• Free storage of their own eggs in cryopreservation for up to 10 years
• Coverage of all medical costs for the egg donation process
• Connection to the Cofertility community for support all along the way and after too
• The ability to work with the intended parents to decide together what your relationship will look like

If giving your eggs to intended parents sounds like something you would like to do, you may be able to qualify for the free egg freezing process and have your donation process covered too.

Find out more about Cofertility, and take our quiz to see if you qualify for Split!

We believe that every donor deserves to have a positive and empowering experience, and we are committed to making that a reality. That’s why Cofertility was named one of the Best Egg Donor Programs by Egg Donor Connect.

When you're freezing your eggs, it can feel like you're navigating a maze of unfamiliar terms and unfamiliar people. Who are all these people? What do they do? And when should you see them? 

Here, we'll break down the different members of your fertility team and what services they provide, to help you understand who you'll be working with on your egg freezing journey.

Your Primary Care Physician (PCP)

For some, the dialogue about fertility begins with a conversation with their Primary Care Physician (PCP). This medical generalist can provide an overview of the fertility landscape and may guide you towards specialized care if your situation calls for it.

Obstetrician-Gynecologist (OBGYN)

As a specialist in women's reproductive health, an Obstetrician-Gynecologist (OBGYN) can offer nuanced insight into fertility and hormonal health. Although not directly involved in the egg freezing process, their counsel is often a valuable stepping stone to more specialized care.

Reproductive Endocrinologist (REI)

An OBGYN with additional training in reproductive endocrinology, your REI is the main person overseeing your egg freezing journey. Specializing in the hormonal and medical intricacies of fertility, they oversee and perform the egg retrieval process. Many people start their egg freezing/donation journeys with an REI consultation. 

Nurse Coordinator

An RN serving as a lynchpin in patient care, the Nurse Coordinator organizes patient education, scheduling, and medication management. Their role varies by clinic but invariably serves to harmonize the efforts of the entire fertility team.

Embryologist

The Embryologist also works at the fertility clinic and is the scientist who helps fertilize and grow your embryos! They are in charge of making sure your eggs get safely frozen. 

Egg Freezing Agency, such as Cofertility

For those seeking an additional layer of service and support, Cofertility helps streamline your journey. We help you find a clinic, connect with others freezing their eggs at the same time, and fill the gaps not covered by a standard fertility clinic.

Financial Counselor

Navigating the costs of egg freezing can be daunting. A Financial Counselor specializes in demystifying this aspect, helping you explore insurance coverage and financing options.

Fertility Courier

Responsible for the logistical challenge of safely transporting your frozen eggs, the Fertility Courier is a specialized service provider you may never meet but will trust implicitly.

Cryostorage Facility

A cryostorage facility serves as the vault for your frozen tissue. Specializing in the preservation of biological material, these facilities are where your eggs will reside until you decide to use them. We have a partnership with TMRW where we have negotiated discounted rates for our members. 

Genetic counselor

Being a carrier doesn't mean you have the condition, but it can still be concerning when your genetic testing reveals you have a genetic predispositions to certain conditions. Your genetic counselor helps you understand the implications of your carrier status. They can explain the risks, potential impacts on future children, and provide guidance on family planning.

Third-party reproductive (TPR) care coordinator

A clinic employee who works in the field of assisted reproductive technology (ART) and reproductive medicine. Their primary role is to facilitate and coordinate various aspects of third-party reproduction, which involves using donated eggs, sperm, or embryos, as well as gestational surrogacy.

If you participate in our Split program, there are even more people you will work with along the way 

Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.

Member Advocate 

At Cofertility, the Member Advocate serves as your personalized concierge, easing communication among all the parties above and ensuring a smooth journey  from start to finish. A Member Advocate plays a crucial role in supporting you through the complex and highly regulated process of egg freezing and donation, helping you navigate the medical, emotional, and logistical aspects of preserving your fertility with compassion, evidence-based research and trustworthy guidance.

Fertility Psychologist 

Emotional support is invaluable. We have a Fertility Psychologist on our team to support the psychological and emotional aspects of your journey, offering screening and therapeutic support.

Third-party Reproduction Lawyer

When you match with a family, you will work with a Fertility Lawyer to ensure that all agreements, from donor agreements to future use contracts, are conducted within the bounds of the law. We can help you find a lawyer with expertise in this space, which is entirely free to you. 

It's important to note that not everyone needs the same team or the same services. Your path will be as unique as you are; tailored to meet your specific needs and circumstances. Never hesitate to ask questions or advocate for yourself; after all, this is your journey, and you deserve a team that not only supports but champions your reproductive goals. The most important person on your fertility team is you. 

At Cofertility, we have a preferred network of partners across the country that can help with every aspect of your egg donation journey, from the legal contracts to the embryo storage. While reading this list can feel overwhelming, if you work with us, know that we can handle most every interaction.

Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Split program allows women to freeze their eggs at no cost, when they donate half to a family that could not otherwise conceive. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.

Today, I have the privilege of sitting down with one of our Split members to delve into her personal journey—why she chose to freeze her eggs through our program, how she navigated the emotional toll, and the future she envisages for herself and her family. By peeling back the layers, we seek to understand not just the practicalities but also the emotional and psychological nuances of this choice.

Why did you decide to freeze your eggs through Cofertility’s Split program? What were the factors that led to this decision?

I had considered donating my eggs a few times before I had heard of Cofertility, but it had never moved beyond it being an idea in my head because it never felt right. Most of the marketing I saw about egg donation focused on the monetary benefits, which I understood because it is an invasive procedure, but they never talked about where your eggs were going. It felt very impersonal and that I would have no control or say in where these eggs would go. 

I had not considered it again until I heard about Cofertility on Instagram. When I first learned about the idea of helping a couple to conceive while also protecting your own fertility I thought it was genius and wondered why this wasn't an option already. My company does not have egg freezing benefits so egg freezing wasn't something I had been planning to do. 

Cofertility's split option gave me an opportunity I hadn't even considered - egg donation that didn't feel as yucky and a chance to preserve my own fertility without a huge price tag. It really felt surreal that I would be able to freeze my eggs and not worry so much about a timeline to decide on kids. 

What was the hardest part of the process?

Overall, I really felt that Cofertility made this process quite easy for me. Having a Member Advocate throughout the entire process was incredible, and not having that person switch or change made it really easy to build up the trust. 

At the clinic I went to I saw various nurses and doctors, but my Cofertility Member Advocate stayed the same and that consistency was extremely impactful to my mental health throughout the process.

At the clinic I went to I saw various nurses and doctors, but my Cofertility Member Advocate stayed the same and that consistency was extremely impactful to my mental health throughout the process. Out of the entire process, I would say the number of appointments and the amount of time needed during the two-week hormone cycle was probably the hardest. Getting blood drawn multiple times a week, followed by doctors appointments, and all the waiting that comes with both does require time investment. I would try to make my appointments as early in the morning as possible to not interfere with my work, but giving yourself grace and flexibility for those two weeks is necessary. I am fortunate to have the flexibility at my job and work with a group of people that were extremely supportive of what I was going through, but if you are someone who is not used to the process it can feel like a lot of time out of your control.

Was there anything that you were nervous about, but ended up not being as bad as you thought?

I was most nervous about the shots going into it, but they ended up not being as bad as I had expected them to be. For the most part, the needles were much shorter and thinner than I expected and I was able to do all of the shots myself. 

In fact, once I did my first one I felt a sense of pride and accomplishment for being able to do it. Cofertility had given me a goody bag when I started my cycle and the little ice pack was wonderful for any post-shot discomfort. I also tried to pair the shots with a treat for myself as a little reward... give myself a shot and have some chocolate, give myself a shot and watch a show I love, give myself a shot and do a little online shopping. This process was all new and different for my body so I tried to give myself grace and love throughout it!

Read about egg freezing shots in I'm Afraid of Needles; Can I Still Freeze My Eggs?

Did freezing your eggs affect your relationships or dating life in any way? How did you navigate these aspects during the process?

When thinking about the people I know who have gone through the egg freezing journey, they were all in different stages of their dating / relationship journey. Some were casually dating and not looking for anything serious, some had a new partner that they hoped would turn into something serious, and some were with a long-term partner but not ready to build their family further than that yet. I fall into that last category. When I decided to freeze my eggs with Cofertility, my husband and I had been together for 9 years and married for one. While we were very serious about each other, we weren't sure if or when we wanted kids, but we knew we didn't want them now. My husband was very supportive of the idea of freezing my eggs for our own future use, but I was curious how he would feel about me donating eggs to another family. When I brought it up to him he truly had less hesitation than I even had. His perspective from day one has been that it is my body and if I feel comfortable with the choice then he is here to support me. That position did not change throughout the process, and if anything he (similar to myself) felt more confident each day with the decision to "split" once we met the intended parents and got to know them more. 

I feel very lucky to have had a supportive partner to go through this with and someone who trusted my choices 100%. I know this route is something that may take some partners time to digest and understand, but I think in the end the most important thing is that you, as the person freezing and donating your eggs, feel that this is right for you. 

Read more in Want to Donate Your Eggs? Tips on Talking It Over with Your Partner

How did you manage the emotional and psychological aspects of freezing and donating your eggs? 

Looking back, the opportunity to know the parents who I was donating the eggs to played a huge role in managing the donation emotionally and psychologically. When I first learned about Cofertility I wasn't sure if I would want to have a disclosed donation. I was worried about what that would mean and what that relationship would look like. 

After learning more about egg donation, it was clear that there is no such thing as an anonymous donor due to the genetic testing that exists today. If I wanted to donate my eggs, I needed to be okay that the child(ren) that they created would be able to know who I am at some point in their life. This was something that I thought over for a while and researched how DCP (Donor Conceived People) felt about. I wanted to know that I was doing the right thing for the possible children that came from these eggs - my own and the intended parents'.

In the end I felt really good about my decision to have a disclosed donation. Knowing that both the intended parents and myself were on the same page on this built a foundation of care and immense respect for the other party.

In the end I felt really good about my decision to have a disclosed donation. Knowing that both the intended parents and myself were on the same page on this built a foundation of care and immense respect for the other party. I have always shared with them that I want to follow their lead on what feels right throughout the process and the years to come and they have been great communicators of what they want while respecting my choices as well. This relationship, along with the huge support from Cofertility, made the process really supportive of my mental health. I went into it wondering if the combination of doing something totally new, medications / hormones, and other life stress would be hard to handle, but I think the peace of mind that comes with preserving your fertility hugely outweighed any weight from those factors. 

What are your plans for the future regarding your frozen eggs? How do you envision incorporating them into your family-building journey, if applicable?

Right now, my husband and I haven't decided when we will start to build our family. In a perfect and easy world, we would have no trouble conceiving and the eggs I have frozen wouldn't need to be used, but I have seen for so many people I love this is not always the case. Whether we use the eggs to conceive all of our future children, conceive naturally at first then need to use the eggs for later children, or not use the eggs at all, it gives me so much peace of mind to know that they are there and we took this step to preserve my fertility. It is not an insurance plan, but it feels good to know that Cofertility opened a door for me that otherwise I likely would not have opened on my own.

Lastly, what advice would you give to someone who is considering freezing and donating their eggs? Are there any important factors they should keep in mind?

The biggest advice I would have is to really understand if you want your egg freezing journey to be something that happens and you are done with it or if you are open to something that will be a little part of you for your life. 

What I mean by this is that if you freeze your eggs without donating you go through the process, the injections, and the retrieval and then you are done unless you one day need to use those eggs. When you freeze your eggs and donate half you go through that same process, but in the future there may be a DCP that reaches out to you once they are 18 to try to make a connection, or intended parents that reach out when they need additional family medical history, or maybe you have a closer relationship with the intended parents and you get annual cards with updates of the DCP. 

No matter the case, there is a possibility that your involvement with egg donation does not end entirely when the eggs are physically donated. This was something I really thought hard about and found a lot of peace with. The process that Cofertility leads you through with speaking to a fertility counselor both alone and with the intended parents helped with that as well. 

On top of the counseling, having a clear contract and great legal support (Cofertility also helps with recommending representation) gave me peace of mind that I knew and agreed to all boundaries in the donation.

I truly think egg donation is such a meaningful thing to do, helping someone who wants to be a parent so badly conceive is truly life changing and I am so grateful to Cofertility for giving me the opportunity to help out an amazing couple and also preserve my own fertility in the process.

Read more:

• The Ultimate Guide to the Split Program
• 8 Questions to Ask Yourself Before Donating Your Eggs
• Will I Regret Donating My Eggs?