For hopeful LGBTQ+ parents-to-be pursuing biological family-building options, the process of choosing a sperm donor or an egg donor can be overwhelming and costly. Do you choose an anonymous donor? Or go with someone you know? And what’s the difference in cost—and how will the choice impact your family’s future? As a fertility doctor and the medical director of Illume Fertility in Norwalk, CT and founder of Gay Parents To Be, I’m sharing seven key factors I help my patients keep in mind when choosing a donor.

Considering a sperm donor or egg donor? Here are 7 things to keep in mind

1. What is a known donor?

Many parents-to-be consider using a known donor to help grow their family, like a relative (their partner’s brother or sister) or even a close friend. This person is typically a family member or someone already important in the intended parents’ lives long before they decided to start their family-building journey.

If you’re a dad-to-be, one of your friends could choose to donate her eggs, and then one or both partners’ sperm (if applicable) could be used to fertilize those eggs and create embryos.

In another scenario for same-sex male couples, if one of you has a sibling or cousin willing to be your egg donor, then the other partner’s sperm could be used to create embryos. This is a beautiful way to have both partners’ family trees represented in the genetic makeup of your future child.

If you’re a mom-to-be, you could similarly use known donor sperm to fertilize eggs via intrauterine insemination (IUI) or complete an in-vitro fertilization cycle (IVF). It’s important to note that if the known sperm donor is biologically related to one of the partners (for example, a brother or cousin), then we would counsel you to move forward with IUI or IVF utilizing the unrelated partner’s eggs to avoid increasing any risk of familial diseases.

2. What is an anonymous donor?

An anonymous donor may be found through an egg donor agency or a sperm bank. You will typically have access to information about this person’s physical characteristics, family history, genetic background, academics, and potentially, their hobbies and interests. Many anonymous donors have already been pre-screened, and have been counseled on their release of parental rights. You can choose anonymous donors that are open to future disclosure or willing to meet you prior to their donation.

3. Choosing a known donor: expectation vs. reality

For many LGBTQ+ parents-to-be, choosing a known donor over an anonymous donor seems to be the easier option. But the choice is complex and requires an extensive screening process, so it’s important to consider the time it takes, as well as the relationships you are creating for your future child.

The process of using a sperm or egg donor is subject to oversight by the FDA, and all U.S. fertility practices must abide by the same rules and regulations. Additionally, most clinics follow the guidelines for gamete (sperm and eggs) donation from the American Society for Reproductive Medicine. All gamete donors undergo infectious disease screening, drug screening, medical screening, mental health screening and genetic testing. Your known donor would have to come in and actually become a patient at your fertility clinic in order to have those tests done.

Your known donor would meet with a mental health provider privately, and then you, your partner (if applicable) and your donor would meet with that counselor together. This is both for screening and to establish how you will navigate your own relationship with the donor and your donor’s relationship with your future child before starting fertility treatment or attempting pregnancy.

How much contact will your donor have with your child? What will you tell your child about their donor? How will you refer to your donor? All of these questions are important things to consider before you think about using a known donor. Right now they are that special person offering their sperm or egg, but raising a child and educating them about how they came to your family is a lifelong discussion for the LGBTQ+ community.

4. Known vs. anonymous donor costs

Cost considerations are a major factor for many intended parents considering asking a friend or family member to be a known donor.

For donated sperm

Using an anonymous sperm donor from a sperm bank can cost anywhere from $500 to a few thousand dollars, depending on how many vials you purchase. Using a known donor who is not asking for compensation may seem less expensive, but you will be responsible for screening costs and legal fees for a known donor agreement. (For anonymous donors, sperm banks assume some of the responsibility of pre-screening and testing.)

For donated eggs

For dads-to-be, reproductive agencies typically charge between $8,000 to $15,000 for egg donor fees, but this does not typically include the donor’s screening, travel to the clinic and medication, or the cost of IVF or IUI.

Depending on whether you opt for fresh or frozen eggs, the process can cost on average between $10,000 and $35,000 (frozen eggs are less expensive). This, of course, does not include the costs associated with IVF and surrogacy.

5. Legal aspects of using a known donor

Using a known donor doesn’t just involve reproductive clinics and medical screenings. There is also a good amount of legal work that goes into a known donor agreement.

Many fertility clinics require that all intended parents and donors engage separate reproductive attorneys to put in place agreements for all parties. This not only protects you and your parental rights, but your donor as well. These agreements are focused on the parental responsibilities for your future child.

The attorneys will lay out certain parameters, including:

How often will your donor have contact with your future child?
What if your child has a medical or family history question down the line? Is your donor comfortable providing that information, and staying in touch for the next 18-25 years in order to be available to answer questions?
Issues of parental rights and responsibilities such as visitation and child support.
What information will you share with your future child about the donor’s contribution to their genetics?

All of these questions are things that your mental health provider and reproductive attorney will help you navigate in order to protect you and your future family.

6. Anonymity & genetic testing

Many intended parents make their choice to use an unknown versus a known donor based on the concept of anonymity.

Some parents-to-be worry that if they use a donor from an agency or a sperm bank, they will never have full access to their child’s genetic information or their donor’s family history. On the other side of the spectrum, some intended parents are happy to grow their families using an unknown donor because they want the person to be truly anonymous and separate from the new family that they are creating. They worry about that donor being looked upon as a parent or somehow inserting themselves into the family unit.

But we’ve all heard those stories of children conceived with the help of egg and sperm donors connecting with members of their biological families through different genetic testing websites like ancestry.com and 23andme.com. This new technology means you can likely find your donor (and they can find you) if anyone related to them has shared their genetic information with one of the companies that helps build family trees.

So, while neither anonymous or known donor relationships are objectively good or bad, the growing popularity of mainstream DNA testing is an important thing to consider when making your donor choice.

7. Your child’s creation story

Perhaps one of the most important things to consider when choosing your donor? Your child’s conception story. In other words, what you are comfortable telling your future child when they ask where they came from.

Research shows that donor-conceived children do far better if they have more information about their biological (donor) parent. So take your time and be thoughtful about this process. Rather than simply saying, “We picked your donor because they were tall and good-looking,” perhaps you can tell your child that you had a personal connection to your donor and they offered you a great gift by choosing to be your known donor. Or maybe you and your partner use a donor from an agency or sperm bank and connected with the traits or hobbies listed in your donor’s profile. Collect the pieces of your story together so you can talk with ease to your child about it in the future.

A note from Motherly: Choosing an egg donor or sperm donor

Each LGBTQ+ family-building journey is unique, and every path to parenthood has its own pace. But the more you know about the donor process, the better informed you’ll be when it comes to making important decisions.

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