Your welcome packet.

Nothing medical happens until a family has chosen you, and every fee along the way is paid by that family. This is the order it goes in.

1. 1

   A few questions

   The short screening on our site. We read every one ourselves and write back to the women we would like to hear more from.

2. 2

   Your profile, in your own words

   The longer form, with your family medical history and a mix of photographs from childhood to now. Only parents we have approved will ever see it.

3. 3

   A conversation

   Face to face on video. We get to know you, and you ask us everything you want to.

4. 4

   Being chosen

   We show your profile to parents who might want to work with you. Some donors are chosen within a week. Some wait a year. Some are never matched, and we cannot predict which.

5. 5

   Screening

   Once a family chooses you: a psychological assessment, a genetic screening, a consultation with an attorney to go through the contract, and a medical screening at the clinic.

6. 6

   Cleared

   When the doctor clears you, the clinic sets up your cycle with a nurse coordinator, and about a month of appointments and injections begins.

Every clinic has its own protocol and yours will give you a calendar. This is the shape most cycles take, so nothing on that calendar is a surprise.

1. 1

   The pill

   After a day three ultrasound and blood test, you start a birth control pill. It holds your hormones steady so your cycle can be lined up with the intended mother's.

2. 2

   Suppression

   Daily injections of a medication such as Lupron quieten your ovaries so the clinic can control the timing. About a week to ten days in, you get a period. A check confirms you are ready.

3. 3

   Stimulation

   Injections of follicle stimulating hormone, once or twice a day for around ten days, grow many eggs at once. Some clinics use a newer medication like Ganirelix or Cetrotide instead of Lupron for the last few days. Expect eight to ten early morning visits for blood work and ultrasound, and a call each afternoon with your next dose.

4. 4

   The trigger shot

   When the follicles are the right size, one injection of HCG ripens the eggs. It has to be given at a precise time, usually late at night, about thirty five hours before retrieval. Nothing to eat or drink after midnight the night before.

5. 5

   Retrieval

   Under IV sedation, about thirty minutes, and you feel nothing while it happens. Somebody has to drive you home and stay with you for twenty four hours. Rest that day and do not drive.

6. 6

   Afterwards

   Some bloating and cramping is normal and passes anywhere from the next day to your next period, which should come within ten days or so. Call the clinic on the first day of it. Heavy bleeding or sharp pain is unusual and means calling straight away.

You will not need all of these. Your clinic decides which, and the nurses show you how. Knowing the names helps.

• Lupron

  One injection a day for around twelve days, then alongside the stimulation for about twenty two days in all. It lowers your own hormone signals so your response to the other medications is even and predictable, and it stops eggs releasing early.

• Ganirelix or Cetrotide

  Sometimes used instead of Lupron. Added after four or five days of stimulation and taken for five or six days, it does the same job of holding the eggs back, with fewer days of injections.

• Follicle stimulating hormone

  Sold as Gonal F, Follistim, Menopur and others. It is the same hormone your body makes to mature one egg a month, given so that many follicles grow at once. About ten days of daily injections.

• The trigger shot

  HCG, sold as Ovidrel, Pregnyl and others. One injection about thirty four to thirty six hours before retrieval that ripens the eggs. Without it the eggs are not usable. It will make a pregnancy test read positive for ten days or so afterwards.

• An antibiotic after retrieval

  Often doxycycline, taken by mouth for a few days to lower the small risk of infection.

The chance of a problem is low, but egg donation is a medical procedure and every medical procedure has risks. You should know them before you decide.

• Anaesthesia

  The chance of a serious complication from the sedation, such as a stroke or death, has been put at around one in twenty thousand. Short term effects like nausea and sleepiness are more common and pass within the day.

• Infection and injury

  Retrieval is guided by ultrasound, but there is a slight risk the needle touches nearby tissue and causes bleeding or injury. Infection after retrieval has been reported at about one in a thousand.

• Over response, called OHSS

  In about one in a hundred cycles the ovaries over respond to the medication and retain fluid. Mild cases mean pressure, pain and swelling that go after your next period. Moderate cases need rest, monitoring and pain relief. Severe cases are rare and serious, with clots, kidney trouble, fluid in the lungs or shock, and can need hospital. If signs appear before retrieval, the doctor may stop the medication and cancel the cycle.

• Allergic reactions

  Rash, fever, itching or breathing trouble are possible and rare.

• Longer term

  There is no evidence so far of a link to breast or ovarian cancer, but donation has only been studied since 1989. A large study sponsored by the National Institutes of Health is looking at exactly this, and the results so far are reassuring. Nobody can say for certain yet, and we will not pretend to.

Can I donate if I just had a baby?

Not while you are breastfeeding, and you need at least three regular periods before a cycle.

Can I donate if I have had my tubes tied?

Yes. The eggs are collected before they would reach the fallopian tubes.

Will donating affect my own fertility later?

Everything known so far says no. A normal retrieval does not reduce your ability to get pregnant afterwards. In the month after donating you are more fertile than usual, then back to normal.

Am I responsible for a child born from my eggs?

No. The intended parents take on every responsibility.

Do I need health insurance?

No. The intended parents cover your medical costs and extra insurance for any complication directly related to the retrieval.

How much time off will I need?

Usually a day for the retrieval itself. The first screening takes about half a day, and monitoring visits are under an hour, early in the morning. If your clinic is far away, plan for three to ten days near it around retrieval, with travel paid by the family. The doctor can say more precisely after your first visit.

How long until I am matched?

We cannot predict it. Some donors are matched within a week. Some take a year. Some are never matched.

How old do I have to be?

Between 18 and 29. Now and then we make an exception for a woman a little older who has children or has donated before.

How long does the whole cycle take?

About a month from the first medication to retrieval. The retrieval itself takes minutes.

Will I be put to sleep?

You are given IV sedation by a nurse anaesthetist. You will not feel the procedure. Somebody collects you afterwards, and you do not drive for twenty four hours.

When will I feel normal again?

Expect a period within about ten days of the retrieval. After the following one, your body should be back to normal.

Alexis Fuller, Director, Golden Egg Donation, Inc.