Choosing an egg donor is an exciting and important decision. Intended parents consider many attributes before coming to a final decision, and among them are a donor’s thoughts and feelings about future contact with any offspring created from their donation.

An openness to future contact most often stems from a parent’s desire to provide their child with access to current medical and family history information. In addition, many intended parents are interested in making sure their child has access to information that will allow them to understand who they are and where they came from.

Growing Generations has created our donor profiles with this in mind—to help supplement the need for future contact as the only way by which donor-conceived people can understand who they are and where they came from. It's why we offer extensive photo galleries and videos of each donor.

However, some intended parents have a strong desire for their donor to be open to future contact from offspring in addition to the profile they’ll have. Many donors are comfortable with the concept, but like intended parents, they want to understand how future contact is managed.

Thanks to The Donor Sibling Registry (DSR), we’re able to refer our intended parents and egg donors to an independent registry where future contact can be initiated without revealing full contact details for any party. DSR is a website facilitating safe, direct contact with an egg or sperm donor. It was created to bridge the gap between seeking information and forming genetic connections for those conceived via assisted reproduction.

Not only does DSR give people the potential to ask questions about where they come from or characteristics they’ve inherited, but it can also serve as a tool for those desiring information about family medical history. Modern-day DNA tests can only supply a limited amount of information. Obtaining answers to donor-specific questions can be reassuring, especially when the questions are so personal and details may feel unattainable.

Using DSR is simple. Users create a profile they use to post to the database or search for potential connections. There is also a search engine where people can look for connections using keywords, donor information, and facility information. If a connection occurs among the 78,000+ registered members, users have the option to upgrade their membership. Paid members can interact and communicate with connections they've made. The best part? All parties can do this without sacrificing personal privacy, because DSR works like a virtual post office box. It’s a non-intrusive option for those looking for answers to interpersonal questions.

If intended parents and their chosen egg donor agree to future contact, most often a provision will be added to their legal contract.

In 2021, Growing Generations announced its partnership with Mitera, a group of California-based maternal-fetal subspecialist and reproductive health counselors operating via telehealth. Dr. Kathy Salari, co-founder and Chief Medical Officer of Mitera, kindly answered some commonly asked questions on surrogacy. She is a maternal-fetal medicine subspecialist, specializing in caring for high-risk pregnancies. Reproductive genetics and fetal imaging are the primary focus of her clinical work.

WHAT IS MATERNAL-FETAL MEDICINE (MFM)? HOW DOES IT HELP WITH THE SURROGACY PROCESS?

Maternal-Fetal Medicine is a subspecialty of Obstetrics & Gynecology that focuses on the complications of pregnancy. As the expert in conditions that can negatively affect the fetus and the pregnant individual, an MFM physician is uniquely qualified to assess the medical profile of a surrogacy candidate. Furthermore, involvement of an MFM in the surrogacy process allows for a more robust dialogue and an educational opportunity for all those involved in third party reproduction.

AS A FIRST-TIME INTENDED PARENT, WHAT SHOULD I LOOK FOR IN A SURROGACY AGENCY? WHAT QUESTIONS SHOULD I ASK WHEN TALKING TO EACH AGENCY?

First-time intended parents are likely to feel overwhelmed when searching for a surrogacy agency. An agency that is transparent and forthcoming about their surrogacy selection and matching process is more likely to exercise prudence in ensuring appropriate candidates are selected to serve as surrogates. Intended parents should inquire about specifics regarding the medical and psychological clearance process and what type of healthcare professionals are involved in determining a candidate’s health profile. Furthermore, intended parents should inquire as to the nature of medical oversight provided for their pregnancy and to what medical experts, they will have access should complications arise.

WHAT ARE SOME OF THE MOST COMMON MISCONCEPTIONS ABOUT SURROGACY?

When starting their surrogacy journey, many intended parents assume that surrogates have undergone extensive medical and obstetrical screening and are considered good candidates with a low risk for pregnancy complications.

WHAT RECOMMENDATIONS CAN YOU SHARE WITH FIRST TIME SURROGATES?

As advocates of women’s health, we generally encourage surrogates to ask questions about pregnancy, the IVF process, and to have any concerns about their own medical history addressed. We also encourage surrogates to have open discussions with their intended family regarding their expectation for the surrogacy journey.

WHAT ARE FACTORS THAT CAN DISQUALIFY YOU FROM BEING A SURROGATE?

Factors that can disqualify an individual from surrogacy are varied but may include current or past health conditions that may impact the health of the pregnancy as well as a prior history of obstetrical complications.

HOW DOES EARLY GENETIC SCREENING HELP IN THE SURROGACY PROCESS?

Early genetic screening, either at the time of embryo formation or early in the pregnancy provides early information regarding the health of the fetus. Genetic screening of embryos (also known as preimplantation genetic testing) allows for identification of chromosomally normal embryos; therefore, ensures that the healthiest embryos are transferred to the surrogate. However, genetic screening of embryos is not universally recommended, and it is best for intended parents to discuss pros/cons with their fertility specialist. It is recommended that intended parents have a discussion regarding genetic screening and testing early in their pregnancy. Genetic testing modalities have significantly evolved over the last decade and intended parents should consider what information they value knowing early in their pregnancy.

WHAT ARE SOME CHALLENGES SURROGATES AND INTENDED PARENTS FACE DURING THE SURROGACY PROCESS?

Meeting expectations of both parties in third party reproduction can be challenging. A transparent matching process that promotes open dialogue and discussion among surrogate candidates, intended parents, and healthcare providers helps ensure that a relationship based on mutual trust and respect continues to build as the pregnancy progresses. Unforeseen challenges including medical complications and changes to delivery planning may cause frustration or anxiety for either or both parties involved. In such circumstances, it is best for both surrogates and intended parents to turn to their medical experts for guidance..

WHAT SUCCESSES HAVE YOU SEEN?

The most successful surrogacy journeys we have seen are among well-screened and prepared surrogates who are matched with well-informed intended parents where the mutual goal is to achieve a healthy singleton pregnancy. Agencies with dedicated case workers that are available and attendant to the concerns of both parties usually ensure that the surrogacy journey meets the medical and emotional expectations of all those involved.

WHAT ARE SOME COMMON MISCONCEPTIONS ABOUT EGG DONATION?

Many intended parents believe that because egg donors are young, there is no risk for a genetic abnormality in the fetus and that egg donors have all undergone extensive medical and genetic screening. Prior to an egg retrieval cycle, egg donors undergo intensive medical screening.

WHAT ARE THE RISKS INVOLVED IN BECOMING AN EGG DONOR?

Egg donation is generally considered very safe. However, it does have small procedure-related risks for the egg donor including a small risk of infection, bleeding, and ovarian hyperstimulation. Risks of using an egg donor are largely related to inheriting the genetic health burden of another individual.

HOW DOES A SURROGACY AGENCY GET CERTIFIED BY MITERA? WHAT ARE THE REQUIREMENTS?

Certification by Mitera is a commitment to medical transparency and responsibility in third-party reproduction. Becoming a Mitera certified agency provides intended parents with the assurance that their surrogate has undergone a comprehensive medical evaluation by a Mitera Maternal-Fetal Medicine subspecialist and that the pregnancy will continue to be under Mitera’s obstetrical surveillance as it progresses. Mitera certification requires that an agency commit to pre-match medical screening of all surrogate candidates with Mitera and that Mitera’s determination of suitability for surrogacy or stipulations for surrogacy be acknowledged and upheld by the agency.

It’s important during this phase of your process to establish the foundation of your relationship with your surrogate.  Here’s what I hear from surrogates about what they are looking for.

Surrogates are not looking for a new best friend. Their goal is to help you create your family and the pay-off for them is seeing you gazing at your newborn for the first time. During the process, however there are things that can help make your relationship smooth and pleasant. I always tell surrogates and intended parents that there are four things that make a surrogacy relationship work. They are trust, communication, appropriate boundaries and flexibility.

The most important ingredient in any surrogacy relationship is trust. Trust is the foundation of surrogacy and should be at the core of your relationship with your surrogate. This is not total, unconditional, blind trust, but trust as a mutual gift that you give one another. Surrogates want to feel that you trust them and that you know that your baby is in good hands. They don't want or need to be managed by you (although of course it's understandable that you want lots of details). If you have a solid foundation of trust in your surrogate and she in you, you will be able to relax and enjoy your surrogacy journey.

The next important ingredient in your surrogacy relationship is communication. While you and your surrogate will have a team of professionals that you can talk to throughout your journey being able to communicate with each other about your relationship and about the pregnancy will help you feel that you are really participating and it will help your surrogate feel that you really care. At the core of good communication is having clear and articulated expectations. It is totally appropriate to ask your surrogate how much and what kind of communication she wants. It is also important for you to be clear about how much communication you want. The best way to keep open lines of communication with your surrogate is to be interested in her and her life, but you can keep it light and let the relationship develop naturally.

Boundaries are an essential part of any relationship and the surrogacy relationship is no different. You can always open a boundary as the process progresses, but once you open a boundary up it is very hard to close it again. Be careful not to make promises that you can't keep--remember your surrogacy relationship exists for one goal: to help you create your family. Intended parents sometimes make the mistake of "falling in love at first sight" with their surrogate when they meet her and realize that she is the woman who will help them fulfill their dream of parenthood. In that honeymoon phase they may reveal things or promise things that they later regret. The rule of thumb is: take it slow, be warm and authentic and have good boundaries.

The final ingredient in the surrogacy relationship is flexibility. Surrogacy is not a linear process and there are many points in the journey where flexibility will be essential. Remember that your surrogate probably has a very full life outside of the surrogacy and although your journey to parenthood may be first and foremost on your mind, she also has to think about her kids, her partner, and her job, and the surrogacy may not always be first in line for her attention. So, be flexible in your expectations of her. She doesn't need to return your call instantly to be taking good care of her body and your baby!

Overall, your surrogate's primary goal is to succeed at having your baby--the relationship that you have along the way is the backdrop for that unfolding story and the beginning chapter in your child's life. When you trust each other, have good, open communication, live inside of appropriate and fluid boundaries and bring flexibility to all of your expectations you set the stage for a wonderful journey together!

Stories have always been a powerful communication tool, and that’s no different when we’re talking to little ones about about how they were created. Whether you’re an egg donor, surrogate, or intended parent, you likely will be excited and proud to tell your current and future children about your decision. However, finding a way to explain something so scientific to young minds can feel challenging. Children are full of curiosity, even at a young age. 

As a parent, you can educate your child on the subject of their birth story or the birth story of another child without it being an uncomfortable topic of conversation. One way to broach the subject, especially with younger children, is through topical books. As assisted reproduction grows in popularity, more and more authors are penning books for children about egg donation that explore the topics in an age-appropriate way. 

Here are a few books to consider, including those that can open the door to discussion with slightly older kids. 

EXPLAINING EGG DONATION TO YOUR CHILDREN

Stories to Share

• You Began as a Wish by Dr. Kim Bergman: This wonderful children's book written by Dr. Kim Bergman, author of Your Future Family: The Essential Guide to Assisted Reproduction, and beautifully illustrated by Irit Pollack, answers those questions in simple, easy-to-understand language. Use this book to help your children understand all the parts that came together to make them who they are, beginning with a wish!

• “A Tiny Itsy Bitsy Gift of Life, An Egg Donor Story for Boys” by Carmen Martinez Jover: Egg donation is explained through the context of a family of rabbits in this touching story.

• “One Little Egg” by Kimberly F. DeMeo: Readers follow the journey of an egg all the way from the “Donor Egg Academy.”

• “The Pea That Was Me: An Egg-Donation Story” by Kimberly Kluger-Bell: This is one of many books in a series that helps parents explain birth stories.

• “A Very Special Lady: A Story about IVF, an Egg Donor and a Little Girl” by Nell Carswell: Discover a beautifully illustrated story about “a very special lady.”

• “Mommy, Was Your Tummy Big?” by Caroline Nadel: Great for small children, this book explains egg donation through a mom and baby elephant.

• “A Part Was Given and an Angel was Born” by Rozanne Nathalie: With phrases that lift the heaviness of the topic, this is a sweet story about egg donation.

• “How We Became a Family” (Version Egg Donor — Twins) by Teresa Villegas: Find a combination of science and a love story in this helpful book for parents.

• “Hope & Will Have A Baby: The Gift of Egg Donation” by Irene Celcer: This is part of a series addressing various topics with subtitles such as “The Gift of Sperm Donation” and “The Gift of Surrogacy.”

If you want to keep the conversation going with your kids, we also list helpful children's books about surrogacy in a related blog post.

Our Growing Generations team delights in helping you navigate the wonders of egg donation and surrogacy. If you're considering becoming an egg donor or surrogate or you want to build your family through surrogacy, get started by completing our online application form.

By the time an egg donor or IM reaches her retrieval day she very fertile and ready to have upwards of 30 eggs extracted! The idea of something coded as a minor surgical procedure can sound a little scary, but the truth is that this is a very routine in office process that is generally pain free. The donor or IM will be typically scheduled for a morning appointment at the clinic. It is usually a good idea to arrive a bit early in order to fill out any paperwork and have time to ask any questions you may have. As you will be placed under light sedation for the procedure, you should not consume food after midnight on the day of the retrieval. When it is time for the procedure you will be put under light sedation for comfort. The doctor will then use a very small needle, guided by an ultrasound, to retrieve the eggs. The needle is inserted through the vagina where it will pass into the follicles and ovaries. The needle then extracts the eggs with a gentle suction action. The fluid surrounding the eggs is also extracted. After the eggs have been safely captured the needle and ultrasound wand are removed. The entire procedure takes between 15-30 minutes to complete. 

Despite the quick procedure you should plan on spending another two to three hours at the office. The doctor will want you to come out of the light sedation state and monitor you for a while before releasing you. Plan on having someone at the clinic with you in order to drive you home. Once you’re home you are encouraged to spend the rest of the day resting and recovering. You can expect to feel menstrual cramping and to see some light blood spotting when you wipe. If the pain or bleeding become extreme you should call your nurse to let her know what you’re experiencing.  Painful urination, a temperature above 101.0 degrees, fainting or vomiting are all highly unlikely but should also be reported if experienced. Normal activities can typically resume the day following the retrieval. Occasionally the doctor will ask to see you in office one final time following your next period. This is just a precaution to make sure you’ve healed properly.

Another bit of jargon you may encounter on your way to transfer day includes the terms “mock cycle” and “dropped cycle.” Both are IVF terms used when a surrogate takes medications as directed but does not transfer an embryo at the end of the cycle. Here’s a look at what each term means and how they differ.

WHAT IS A MOCK CYCLE?

A mock cycle is when a doctor puts a surrogate on full or partial medicines and monitors her as if she was planning to transfer with the clear intent that she will not transfer an embryo. This can be ordered for a number of reasons with the most common being that the doctor wants to observe how the surrogate’s body responds to a certain medication. 

An IVF mock cycle allows the doctor to ensure that the surrogate's body, most specifically the endometrium lining, is capable of reaching levels that will support pregnancy and make implantation likely—without the cost of preparing an egg that could potentially be lost to unfavorable conditions. At the conclusion of the mock cycle, medicines or dosages may be changed or fine-tuned in order to create optimum results in the real cycle.

You can learn more about embryo transfer preparation on our Surrogacy Process page. 

WHAT IS A DROPPPED CYCLE?

A dropped cycle is when a surrogate is taking all prescribed IVF medications with the intent of transferring an embryo at the end of the med-cycle, but the transfer is canceled. This can be ordered because of many factors, including:.

• The egg donor or intended mother’s response to medicines

• A mistake in properly following protocol

• The quality of the eggs retrieved

• Having eggs lost to the thawing process 

However, a surrogate with a thin lining can also cause a transfer to be canceled or “dropped.” If you experience a dropped cycle in your journey, you will most likely consult with your IVF doctor, make changes to the medical plan and try again in the next month.

Growing Generations is here to support surrogates throughout the process. If you or someone you know is interested in becoming a surrogate, you can fill out an application or contact us online for questions or more information.