If intending parents decide to be matched with a donor, in some countries they’ll face a decision of which third parties to work with. In that case, there are often one of three options:
The reality is the options aren’t always this cut-and-dry, and some clinics will have preferences (or restrictions) from where they’ll take donors or donor eggs.
In counties like the United States, there is exceptionally little regulatory oversight over any of these options, and so intending parents need to be discerning, ask respectful-but-pointed questions, and be prepared to self-advocate.
Some clinics have an in-house agency that recruits local donors and pre-screens them physically and emotionally. The positives are expediency, less coordination hassle, and greater accountability: if the cycle goes poorly, there will be no finger pointing between your clinic and another entity. Clinics will also charge less money than a freestanding agency because they expect to make money on the IVF cycle itself. To the negative, the “donor pools” available are often small.
Some entities will recruit donors, do all the necessary screening, and freeze the donor's retrieved eggs. Thereafter, intending parents can buy eggs in 6–8 egg “lots” and have them shipped to their local clinic to be warmed and fertilized. These entities often started at a single clinic but over the years have coordinated with other clinics to recruit a broader sample of patients. If a patient is fearful about their clinic’s ability to receive, handle, and warm eggs from another clinic, the patient can send frozen sperm to the egg bank itself whereupon the egg bank will thaw the eggs, perform fertilization and then ship (the much more stable) embryo(s) to your clinic.
As we alluded to earlier, donor egg banks often offer a broader selection, expediency, and a lower up-front price. However, they provide fewer eggs, are more costly on a per-embryo basis, and if the acquired eggs don’t achieve their result, you, the clinic, and the egg bank may disagree on who’s accountable and what should happen next.
These are organizations that recruit donors, provide high-level screening, help facilitate a match and help shepard the process. Unlike an in-house program or “egg bank,” they don’t retrieve eggs or provide any medical services. They are simply a facilitator.
Many agencies are of a “mom-and-pop” nature and some have a focus on recruiting donors of a specific heritage or religion who are otherwise hard-to-find in donor pools. For agencies, providing a match is their only source of income and so they tend to collect more money for their services than a clinic’s in-house donor program. We recommend ensuring your clinic has worked with an agency in the past, that there is a clear cash refund program if the matched donor does not reach her retrieval, and that whatever money you provide remains in ESCROW until the terms of the contract have been met.