Choosing a Donation Center

Your Choices:

Choosing to build your family by way of embryo can work amazingly well. The steps required to find just the right embryo donation facility, however, can get a little complicated. Contradictory claims from various centers may make the task of comparing facilities difficult. To help you select the best facility to receive your embryos, we ask that you please consider some of the questions presented here.

Remember that you should be comfortable asking any of the questions below of any clinician or practice. By being well prepared, your chances of finding just the right program will increase. Become the most informed patient you can be.

Questions to Ask When Deciding


 

Can I have Embryo Donation Performed at my Nearby IVF Facility?

Many IVF facilities claim to offer embryo donation but you may find that they rarely, if ever, perform the procedure. The U.S. Center for Disease Control & Prevention government is responsible for collecting all IVF data in the United States each year, but it fails to collect embryo donation statistics. Without this data, you will have to ask your local IVF program to furnish detailed statistics regarding their embryo donation program to discover out how often they actually perform the procedure and what their success rates are.

As with any medical procedure, you want to have it performed by  a competent and experienced practice Your goal should be to find the most experienced facility with the highest success rates combined with the largest number of embryos available to choose from.

Does the Facility Offer a Full Range of Embryo Donation Options?

For the few programs that perform embryo donation on a regular basis, some are very limited in the options for both the donor and recipient. Anonymous embryo donation is the most common option and has numerous advantages to both parties. That stated, some donors want to know more about the recipients and yet are unsure if they really want a totally open relationship. An intermediate process that maintains anonymity is ideal for these cases. Lastly, some donors and recipients feel most comfortable with a totally open process. Ideally, your embryo donation program should offer all of these alternatives.

Seek the embryo donation facility that provides the greatest number of options. If you already know what option you want, then certainly seek the program that will meet your specific needs.

Do They Force You To Undergo an “Embryo Adoption” Process?

Some of the facilities only offer anonymous embryo donation. Others use the phrase "embryo adoption"
requiring the donors and recipients to undergo the type of evaluation seen in cases of the adoption of a live child. This issue is covered in detail elsewhere on the site (click here) but it is not ideal that anyone be forced into this process. If the donors and recipients both want an open embryo donation process (similar to “embryo adoption”) then this should be available. Programs that require “embryo adoption” often don’t give the participants enough options to make decisions that are truly right for them.

Do They Discriminate With Regard To Those That Donate and Those That Receive Embryos?

From the donation side, most programs do not discriminate against those providing embryos. Since donated embryos are such a valuable commodity, most are simply grateful to receive them.

Regarding recipients, there are a greater number of differences between the programs. Some of the programs will do the following:

  • Mandate that embryo recipients be married no matter how long they have been together.
  • Mandate the embryo recipients be married for a certain period of time before qualifying for the program.
  • Refuse to care for the single patient.
  • Refuse to care for lesbian or gay couples.
  • Require the embryo recipients ascribe to a specific religion.


The staff here at EDI finds somewhat inconsistent that certain facilities will accept embryos from single patients but often not allow the same category of patients to receive donated embryos.

If you are not a member of the above groups, it probably doesn’t matter which program you seek with respect to discrimination issues. That stated, some recipients do not feel comfortable supporting organizations that would otherwise exclude friends and family members should the situation arise.

How Long Have They Been Performing Embryo Donation?

Without getting into the history of embryo donation, clearly it is best to try to find an experienced program. Experience can be measured by how long the program has been functioning as well as the shear number of embryo donation procedures taking place. While a new “kid on the block” might do a very good job, the greater the experience, the smoother the process for both the donors and recipients.

Are There Any Hidden Fees?

As with any expenditure, it is important that you grasp the full costs before committing yourself to the process. Some embryo donation programs list only the bare essential costs. While not purposefully being misleading, no one likes getting started only to find out there are additional fees.

Just as a few examples, we are aware of programs that charge for the following:

  • Open Agreement Facilitation Fees
  • Home Study Review Fees
  • Communication Exchange Facilitation Service fees
  • Shipping Fees
  • Past Storage Fees
  • Matching/Re-matching Fees
  • Openness Planning and Services


Some fees may appear excessive, so see if they are negotiable especially when you do not see other programs charging the same fee.

Seek a program that does their best to realistically estimate the costs to you. Be complimentary when they are accurate but patient if they miss the mark only slightly. Taking care of human beings can get tricky with the unexpected sometimes the rule.

While still a cliché, if the price really seems too good to be true, then it probably is. Examining the other side of the coin, if the provider’s fees are so much above others, it doesn’t necessarily mean they have a more valuable program.

Can I Simply Find Donated  Embryos Through The Internet via Forums?

There are matching sites out there and they certainly do perform a service. These sites essentially play the roll of an “embryo broker”. Should you find yourself seeking embryos on a forum, please remember to consider the level of security you are seeking and the potential motives behind the embryo donation posting. If you do find the embryos you want, you will still have to find a facility that will accept the donated embryos and transfer them to you. Do your homework and find the facility first before getting started in such a venture.

Be cautious if money is transacted between you and the embryo donors. This is illegal in many states and you don’t want to be participating in a criminal act. We encourage you to obtain the assistance of a skilled attorney who understands the reproductive law in your state protecting you under these sets of circumstances. Legal contracts should be the norm in these types of donation procedures.

Also, be sure to protect your anonymity on these sites unless you are certain you want an open process.

Do I Have to Travel There For Procedures That Could be Done Close to Home?

Many steps of the evaluation of the embryo recipient may be able to take place at home. Seeing Mental Health Professionals, laboratory evaluation and monitoring during the actual embryo transfer cycle may be able to be done close to home assuming that there is a skilled provider available to assist. If your embryo donation facility requires that all of the evaluation and monitoring take place in their facility, this may not be terribly convenient or cost-effective for you.

Whenever possible, the embryo recipient should be allowed to stay close to home. Please understand, however, the quality of the evaluation and fees involved may be less predictable than those provided by the embryo donation facility itself.

Does The Program Match The Embryos For You?

Some embryo donation programs match the embryos to you. Ideally, the recipients should make this personal decision and not the embryo donation program. Seek a facility that gives you the ability to choose your own embryos. If they don’t, do not settle for embryos that do not match your basic requirements. It is better to be placed on a waiting list for embryos then choosing embryos out of desperation rather than true desire.

Do They Routinely Mix Embryos From Different Couples During The Transfer?

It is important to have enough embryos to transfer understanding that not all embryos survive the thaw and that only a minority of the embryos that are transferred implant and grow. While your success rates certainly depend on a number of issues, one basic concern is simply the number of donated embryos that will be thawed. We have to start with enough frozen embryos to make it to the finish line.

It is ideal that all the embryos come from one embryo donor. If we don’t have enough embryos from a single donor, more than one set of donated embryos may be needed. Some programs, however, routinely mix sets of donor embryos rather than doing it only when absolutely necessary. While the overall goal is to build families from donated embryos, mixing sets of embryos can cause some problems.

First, if there are multiple sets of embryos, the recipient may be responsible for the fees involved in the laboratory rescreening of multiple donors.

Now, this gets a bit complicated. Under the rare circumstance, here may be newly discovered genetic issues in the donor family or the offspring of the embryo donation process itself. If a new genetic issue is identified, it is our responsibility to notify others to be on the look out for medical illness. If more than one set of donated embryos were used, it will become very difficult to notify the correct individuals. For example, if a mild genetic disease was discovered in the donor embryo offspring, which donor parent form the multiple sets would be contacted and notified of the concern? Likewise, if one of the donor parents had a new genetic disease identified in their family, would we really have to notify the donor recipients and suggest testing of their child, who may actually have come from different parents, be tested for genetic disease?

One embryo donor set of embryos for one embryo recipient is ideal and routine mixing of sets of embryos should be discouraged.

Do The Statistics Seem Realistic or Too Good To Be True?

Embryo donation success rates are a complex issue and are discussed elsewhere on this website (click here). In general, frozen embryo transfer success rates will reflect embryo donation success rates since the process is essentially the same. In 2008, the CDC reported there were 25,261 frozen embryo transfers performed in the U.S. with the average delivery rate of 31% resulting in 7,123 live births. There were 5,861 frozen embryo transfers using embryos created from donor eggs resulted in slightly higher delivery rates of 33% resulting in approximately 1,946 live births. Understand that these are not donor embryo success rates but the embryos donated have to come from the very same patients included in these numbers.

If your embryo donation facility claimed success rates are far above the U.S. averages, you will need to ask as to how they succeeded. If the success rates are too good to be true, a detailed explanation will be needed.

What Are Their Educational Materials Like?

Does the practice offer a tremendous amount of educational materials? Are they written in such a way that you can understand the issues without a medical degree? Do you feel like you understand the issues after reviewing them once or twice? Well-written materials for patients reflect a tremendous sensitivity from the practice and again, reflects an excellent attention to details.

Does The Facility Answer Your Questions Adequately; Return Your Phone Calls Quickly And Is Sensitive To Your Emotional Needs?

Even in the busiest of embryo donor programs, they should still have enough time to answer important questions and attend to your needs. Understand that they will often triage your questions, so the urgent patients get attention first, but all of your concerns should eventually be addressed. Please do try to limit questions that don’t really pertain to your situation. The Internet is rampant with misinformation and busy practices that have to answer a long list of questions derived from the Internet that have little to do with your care challenges even the most patient of programs. Keep your list trimmed and efficient asking those questions that truly involve your medical care but be sure to ask away when you need the answers.

Nearly all programs will have access to Mental Health Counselors (MHC) if you feel you need some assistance beyond what is provided by family and friends. Some programs mandate that you see a MHC, which irritates those that feel it unnecessary, while other programs have it available to those that request.

Do They Perform Research in the Field of Embryo Donation?

There are still many unanswered questions in the field of embryo donation. Finding a program that is actively performing research in embryo donation to answer questions for the medical community and patients alike is ideal. Look for a facility that is preparing, performing or has published in the field of embryo donation.

What is Their Reputation Amongst Their Peers?

This may be hard to gauge but you can try to find out what other Reproductive Endocrinologists think of the facility. If they have time, they may be able to research the program and give you feedback. While not always available, positive feedback by a physician you know and trust may be very helpful. Negative feedback also needs to be listened to carefully.

Should I Look For A Faith-Based Program?

This is a very personal question and a very personal decision. If the program supports your faith strongly, you may feel more comfortable there.

Most medical practices are not faith based, especially in the field of reproduction, so religiously neutral practices are the norm and have fulfilled the needs of patients for many years.

Remember that not being faith-based doesn’t mean against any faith. In fact, a faith-neutral medical practice welcomes all faiths without exclusion making all feel equally welcome. Health care providers in faith-neutral practices may be very religious, or perhaps quite spiritual, but they choose to make this separate from their professional lives.

Does The Facility Receive Federal Money?

Embryo donation facilities may receive federal funds though their research or basic programs. If research is funded, this can be very helpful in supporting studies that whose results will have merit to the medical community and the public as a whole.

If the embryo donation facility becomes dependent on Federal funds, should these be pulled back due to budget constraints, the program may have difficult being self-sustaining and patient care be interrupted.

Are Embryos Created Fresh From Donated Sperm and Donated Embryos The Same as Donated Embryos?

There are times when patients request donor eggs and donor sperm. They do so to choose what they feel are the ideal genetic traits of each. All the embryos created from such a union are the property of the intended parent/couple. These are not, however, donor embryos.

Donor embryos are embryos that were previously created and cryopreserved for future use. The owner of these embryos is the intended parent until they are donated. These embryos always belong to an individual or couple but not the reproductive endocrine practice.

A new entity has been discovered where embryo recipients are having donated eggs and donated sperm joined with live embryos transferred. The issue, however, is who owns the remaining excess embryos? No embryos are ever to be created without an intended parent. Such an action could result in thousands of embryos created without a destination and without a true owner other than the reproductive practice. If these embryos are left waiting for someone to choose them, this is a clear violation of ethical guidelines and such activities should be avoided.

Did They Review Your Records Prior To Your First Visit?

There is something special when you walk into a physician’s office and they have already reviewed your case in detail even before meeting you. This shows diligence and attention to detail that is uncommon these days. These programs should be given the accolades they deserve and should be sought out.

Are Insurance Codes Accurately and Ethically Chosen for Insurance Reimbursement?

Embryo Donation may or may not be covered by your insurance company. The facility performing the procedure may or may not participate in your insurance. Whenever possible, it is most helpful to you to have the embryo donation facility code imaginatively, but always ethically, to maximize your reimbursement from your insurance carrier. Seasoned programs do this routinely.

Do You Have A Feeling of Transparency for the Practice?

Is the practice upfront with your chances for success? Are they clear about the costs involved? Will they allow you to visit the laboratory? Do they carefully explain the chances for failure as well as the chances of success? Do they offer the less expensive option when available? Seek a facility that feels transparent to you.

UPDATED: 04/06/2013
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