Donor Egg Guide: Using donor egg in Canada
An interview with Stefanie, Donor and Surrogacy Program at Markham Fertility Centre
What is an egg donor?
An egg donor is a person who provides their eggs to assist individuals or couples in achieving pregnancy through assisted reproductive techniques. Egg donation is commonly used when intended parents are unable to use their own eggs due to medical conditions, advanced maternal age, or other fertility challenges or in the case of same-sex male couples.
The eggs are retrieved from the donor through a medical procedure after hormonal stimulation of the ovaries. These eggs can then be fertilized with sperm in a laboratory to create embryos, which are subsequently transferred into the intended parent’s uterus or a gestational carrier.
Egg donation is a vital part of third-party reproduction and involves thorough screening of donors to ensure their physical and emotional suitability for the process.
On EP25 of My Fertility Podcast we dive deep into the world of donor eggs with Stefanie, a seasoned donor and surrogacy nurse and program lead at Markham Fertility Centre (MFC). Stefanie has over five years of experience working with patients navigating the complexities of donor eggs, donor sperm and surrogacy. In this interview, Stefanie provides an in-depth look into everything from regulatory considerations to choosing the right donor.
The Importance of Donor and Surrogacy Programs
Stefanie, why is a donor and surrogacy program essential in fertility clinics, and what makes Markham Fertility Centre (MFC) stand out?
Stefanie McGlynn: Infertility or family building can be incredibly challenging. The baseline process is complex, and adding a third party—whether it’s a donor, surrogate, or embryo donation—quadruples that complexity. That’s where a dedicated donor and surrogacy program becomes invaluable.
At MFC, we recognized the growing need for this type of program and established a specialized team in late 2020. Initially, it was just me, but it has since expanded to include additional coordinators, administrative support, and a genetics team. Our role is to guide patients from the very beginning of their journey, through the logistics of donor selection, and right through the first trimester of pregnancy.
The continuity we provide is one of the most unique aspects of our program. Patients work with the same team throughout, which helps build trust and ensures we fully understand the nuances of their journey. This consistency can lighten the emotional and logistical burden for families as they navigate what can be an overwhelming process.
Why a Dedicated Team Matters
How do you build relationships with patients, and why is that connection so crucial?
Stefanie: The bonds we form with patients are one of the most rewarding aspects of my role. Navigating third-party reproduction is deeply personal and often emotionally vulnerable. Having a consistent team helps patients feel supported and understood.
What’s especially exciting for me is seeing all the pieces come together—working with the intended parents, the donors, and, in some cases, gestational carriers. It’s incredible to watch how these unique journeys unfold and to hear updates, especially when family members donate or act as surrogates for one another. Those long-term connections make this work truly fulfilling.
Why Third-Party Reproduction Can Be Complex
Can you discuss the challenges involved in third-party reproduction and how the regulations in Canada impact these processes?
Stefanie: The regulatory landscape adds a layer of complexity to what is already a challenging process. For instance, Health Canada’s “Safety of Sperm and Ova Regulations,” introduced in February 2020, significantly changed how third-party reproduction operates in Canada. These regulations include stringent testing requirements and specific timelines, which can feel restrictive for patients.
Access to donors and surrogates can also be a hurdle. Canada’s restrictions on compensating donors often limit the donor pool, making it harder to find matches that align with patients’ cultural, ethnic, or personal preferences. At MFC, we try to mitigate this by building strong relationships with agencies and egg banks, ensuring our patients have as many options as possible while adhering to regulations.
Choosing an Egg Donor: The First Steps
Let’s say I’m a patient just starting this process. What should I expect?
Stefanie: The first major decision is whether to pursue a fresh egg donor or a frozen egg donor. Here’s a breakdown:
- Fresh Egg Donors:
- This could be someone you know (e.g., a family member or friend) or a donor you’re matched with through an agency. These donors are stimulated specifically for your cycle.
- While fresh donations require more coordination and effort, they yield higher success rates. On average, we see 3-6 embryos from a fresh cycle.
- Frozen Egg Donors:
- These donors have already completed their stimulation cycles, and their eggs are stored in egg banks, often located in the U.S.
- While frozen eggs might seem faster, the actual timeline—from purchasing the eggs to embryo creation—is usually comparable to fresh eggs, taking about 2.5 to 3 months.
- Frozen eggs yield fewer embryos on average—typically 1 or 2 per lot—and often require multiple lots to achieve a viable pregnancy.
Cost-wise, both fresh and frozen options are comparable, with total expenses typically ranging from $40,000 to $45,000. The exception would be known donors, where agency fees might not apply.
Understanding Donor Profiles
The idea of choosing a donor feels overwhelming. How do patients navigate the information in donor profiles?
Stefanie: Choosing a donor can feel a bit like online shopping or dating—it’s an unusual experience. Donor profiles include:
- Photos: Childhood and adult photos, sometimes including their children’s photos if applicable.
- Medical Information: Reported health history, family history, and genetic screening results.
- Personal Details: Education, hobbies, cultural background, religion, and motivations for donating.
When reviewing profiles, I advise patients to focus on a few key factors:
- Proven Fertility: This means the donor has successfully conceived herself or has donated successfully before.
- Age: Ideally under 32, though exceptions can be made for known donors.
- AMH Levels: For fresh donors, an AMH of 15 pmol/L or higher is recommended.
- Location: Donors local to the Greater Toronto Area can help reduce costs, while donors from farther afield may require travel-related expenses.
Patients often share profiles with us for feedback. While we rarely give a definitive “yes” or “no,” we help weigh the pros and cons to ensure informed decisions.
Counseling: A Cornerstone of the Process
Why is psychological counseling mandatory for intended parents, and what should they expect?
Stefanie: Psychological counseling, or implications counseling, is an essential step, mandated by organizations like CFAS and ASRM. While some patients initially view it as an unnecessary hurdle, the feedback we receive is overwhelmingly positive. Counseling provides a space to:
- Discuss how to talk to children about their donor-conceived origins.
- Explore emotional dynamics with donors, especially if they’re known.
- Identify priorities when choosing a donor.
The goal is to equip parents with the tools and resources they need to navigate this journey confidently.
Genetic Counseling: Understanding Compatibility
Can you explain the role of genetic counseling in this process?
Stefanie: Genetic counselling is especially critical in third-party reproduction. At MFC, we perform Expanded Carrier Screening (ECS) for all donors and often recommend it for the intended parents. This testing identifies hundreds of recessive conditions that neither the donor nor the parent may know they carry. If both carry the same condition, the risk of passing it to the child increases.
Genetic counseling helps patients interpret these results and understand their implications. While the decision to proceed with a particular donor is always up to the intended parents, having this information ensures they’re making informed choices.
The cost of ECS is approximately $500 per person, and results take about three weeks. For same-sex couples using sperm from both partners, testing both individuals can ensure compatibility with the chosen donor from the start.
Legal Considerations in Egg Donation
What legal aspects should patients be aware of?
Stefanie: Legal agreements are mandatory for fresh egg donations at MFC, regardless of whether the donor is known or anonymous. These agreements clarify the donor’s and intended parents’ rights, ensuring both parties are protected. For frozen eggs, while not legally required, we recommend having a lawyer review the contract with the egg bank.
Common Concerns and Advice for Intended Parents
What do you wish intended parents knew before starting this process?
Stefanie:
- Don’t Be Afraid to Ask Questions: Many people hesitate to even start the conversation about egg donation. But we’re here to help—no pressure, just information.
- Prepare to Be Flexible: While it’s great to have a vision of your ideal donor, flexibility is often necessary.
- Document the Journey: I encourage parents to save donor profiles and write notes explaining why they chose that donor. It can be a meaningful way to connect with future children about their origins.
Finally, I’d emphasize that donor conception is a beautiful way to build a family. While it’s natural to grieve the loss of a genetic connection, most parents find immense joy in the journey and the family they create.
The Emotional Journey of Egg Donation
Some patients initially resist the idea of using an egg donor. What’s your advice for them?
Stefanie: It’s perfectly okay to feel hesitant or even resistant. This is a big decision that takes time to process. Many patients start by saying, “I don’t want an egg donor,” and that’s valid. Over time, as they gather information and explore their options, they often reach a place of acceptance.
Patients should know they can pursue multiple paths simultaneously—continuing cycles with their own eggs while exploring donor options. It’s not an either/or situation, and there’s no judgment from us. We’re here to support you, whatever route you take.
Timelines and Next Steps
Once someone decides to proceed with donor eggs, what’s the timeline like?
Stefanie: Here’s a general timeline:
- Initial Consultation: Patients meet with our team to discuss options, costs, and timelines.
2. Counseling and Genetic Testing: Psychological and genetic counseling are completed.
3. Donor Selection: Patients review profiles and select their donor.
4. Screening and Legal Agreements: The donor undergoes medical screening, and legal agreements are finalized.
5. Cycle Coordination: The donor’s stimulation and egg retrieval are scheduled, leading to embryo creation.
Each step is tailored to the patient’s unique situation, ensuring they feel supported throughout.
Final Thoughts
What parting advice do you have for intended parents?
Stefanie: Remember, this journey is about creating a child who will be loved and cherished. Take the time to gather information, lean on your support network, and trust the process. And don’t forget to preserve pieces of this journey for your future child—they’ll appreciate knowing how much love and thought went into bringing them into the world.
Egg donation is a path filled with challenges, emotions, and ultimately, immense rewards. Stefanie and the team at Markham Fertility Centre are dedicated to making this journey as smooth and supported as possible. Whether you’re just starting to explore your options or are ready to take the next step, know that resources and experts are here to help you every step of the way.