The Disadvantages of Egg Donation Every Donor Should Know 

The main disadvantages of egg donation are the medical risks for donors (above all Ovarian Hyperstimulation Syndrome) , the emotional and financial costs for intended parents, gaps in long-term health data, and the identity questions that donor-conceived children may face later in life. Clinics tend to present egg donation as straightforward and low-risk; the reality, as recent research shows, is more complicated.

However, when it comes to infertility treatments, there is a tendency to ignore the negative aspects of the procedures.

In 2024, Eggonomics: The Global Market in Human Eggs and the Donors Who Supply Them by medical anthropologist Dr. Diane M. Tober (Routledge, 2024) was published – a groundbreaking book that analyzed data on almost 1,000 egg donors from the USA and Spain within 10 years and revealed significantly higher complication rates than those usually reported by fertility clinics. As Dr. Tober and other fertility researchers have noted, most studies of infertility treatments analyze IVF patients, so that if a clinic claims that “there are no known long-term risks,” it simply means that no one bothered looking. 

If you are planning to donate your eggs, consider donor eggs as a fertility treatment method yourself, or research it for someone else’s sake. Our guide contains all of the facts, both positive and not-so-positive.

Part 1: Disadvantages of Egg Donation & Risks (for Egg Donors)

While egg donation is generally considered safe, it still carries risks and potential side effects. Donors need to consider both their short- and long-term effects.

1. Ovarian Hyperstimulation Syndrome (OHSS)

The main medical risk associated with egg donation is called Ovarian Hyperstimulation Syndrome (OHSS). OHSS happens as an adverse reaction to hormone injections intended to stimulate the ovaries for multiple ovulations.

What clinics often say: OHSS affects less than 5% of all donors and is always mild.

What studies show: According to self-reported survey data from Dr. Tober’s research (reported by Think Global Health, Council on Foreign Relations, 2024), 10.3% (64 out of 617) of U.S. donor respondents reported severe OHSS symptoms. In addition, 1.62% required hospitalization due to critically severe symptoms such as kidney failure and cardiovascular collapse. Furthermore, 19 of the surveyed individuals experienced ovarian torsion, a complication involving twisting of the ovaries, which cuts off their blood flow. A separate peer-reviewed study (Tober et al., Journal of Assisted Reproduction and Genetics, 2023), covering 289 donors across 801 cycles, similarly found that close to 1 in 10 cycles involved severe OHSS symptoms.

For context, the American Society for Reproductive Medicine (ASRM) puts the risk of severe OHSS at 1–2% per stimulation cycle, rising to a cumulative 8–13% risk of serious complications across the six-cycle lifetime maximum it recommends. Because Tober’s figures are self-reported and subject to selection and recall bias, they are best read as raising concerns that warrant further research rather than as settled clinic-wide rates.

In extreme cases, the ovaries may grow up to five times their regular size and lead to:

1. Severe pain and swelling in the abdomen
2. Collection of fluid in the abdomen or lungs
3. Clotting of blood (deep vein thrombosis)
4. Renal failure (rare but critical cases)
5. Ovarian bursting (extremely rare cases)

Canadian Note: According to specialists from the Canadian Fertility and Andrology Society (CFAS), young egg donors are more likely to develop ovarian hyperstimulation syndrome (OHSS) due to their heightened ovarian sensitivity. This sensitivity is considered a positive trait, making them ideal candidates for donation. Skilled professionals in fertility clinics should handle the risks associated with OHSS.

2. Surgical Risks of the Egg Retrieval Procedure

Egg retrieval is a small-scale surgery done under sedation, taking about 10-20 minutes. This procedure is generally safe, but it still involves risks.

• Bleeding: Sometimes, a large-scale internal bleeding occurs, which may be treated surgically.
• Infections: Pelvic infection after egg retrieval is very rare.
• Injury to surrounding structures:  Bowel, bladder, or blood vessel injury is possible (though rare).
• Anesthesia: Some adverse reactions to anesthesia medication may occur.
• Unintended pregnancy: Since donors are off birth control at the time and produce lots of eggs, having unprotected sex during their cycle leads to a real pregnancy threat if all the eggs cannot be collected.

It usually takes 1-2 days to recover from the egg retrieval. In case complications occur, they may need more care than expected, up to hospital admission and even emergency surgery.

3. Side Effects of Fertility Medications

Before the procedure, donors take hormonal drugs daily for about 10-14 days to promote egg production. Some common side effects include:

• Bloating and pressure in the abdomen
• Hormonal mood changes and sensitivity (caused by high levels of estrogen)
• Nausea and headaches
• Temporary pain and bruises from injections
• Changes in weight until the next period
• Changes in menstrual cycles

The side effects mentioned above are valid and can disrupt daily activities and work routines.

4. The Long-Term Risk Gap: What We Don’t Know

Perhaps this is one of the most underreported disadvantages in the entire field.

The documents signed by most donors read that there are “no known long-term risks.” However, as fertility experts have argued on numerous occasions, “no known risks” does not mean there are no risks, but rather that long-term research on the issue is nonexistent or that donors are not part of the study subjects.

The ASRM committee guidance advises against more than six lifetime donations, an acknowledgment that cumulative risk is real even if its full extent is not yet quantified 

Some of the long-term issues that are not sufficiently researched include:

• Cancer risk: Specifically, ovarian and breast cancer due to high hormone exposure.
• Future fertility: While there is generally no cause for concern, some donors struggle with conceiving in the future.
• Endometriosis and PCOS development: Self-reported rates are higher in donor surveys than anticipated.
• Hormonal disruption: Chronic effects from repeated stimulation cycles.

5. Significant Time and Life Disruption

Donating an egg is neither fast nor easy. An egg donation cycle usually takes between 4 and 6 weeks and involves:

• Medical and psychological screenings at the beginning of the procedure
• Several visits to the clinic, where blood samples are collected and ultrasounds taken
• Daily injections of hormones into oneself
• Travel limitations (as the donor needs to stay within reach of the clinic)
• Taking one entire day off for the egg retrieval procedure
• Avoiding strenuous physical activities, alcohol, and sexual intercourse

For many egg donors, especially those who are students or hourly employees, this can be quite a burden.

6. Psychological and Emotional Impact on Donors

This topic tends to be entirely overlooked in the course of clinical consultations, but it is receiving attention in 2025 research studies.

The emotional impact of egg donation on donors can include:

• Grief/loss: Feelings related to the unexpected emotional reactions regarding using genetic material for the creation of a baby they will never have themselves.
• Anxiety about anonymity: With consumer DNA testing now common, anonymous egg donations cannot guarantee anonymity anymore.
• Regret about consent for anonymity: Many donors later regret choosing to remain anonymous rather than revealing their identity.
• Moral complexity: Questions about how the child may be raised, or whether multiple donor-conceived half-siblings exist.

A 2025 mixed-methods study (Doyle et al., Fertility and Sterility, January 2025) found that most donors reported a positive overall experience. However, 94% received no follow-up contact from their clinic after donation. Depression rates among donors were above the national average, and regret was most commonly linked to having chosen anonymous donation.

Individuals who suffer from depression and/or anxiety should not be banned from donating, but they do need an in-depth psychological examination and support after donating.

Part 2: Disadvantages for Intended Parents (Recipients)

Egg donation is a highly effective fertility treatment, but it is not without disadvantages for intended parents. Factors such as financial costs, emotional adjustment, potential pregnancy complications, and decisions regarding genetic connections should all be considered before pursuing donor egg IVF. 

7. No Genetic Connection to the Child

For some intended mothers, the lack of a genetic link to their child may be the most psychologically impactful disadvantage of egg donation.

The child conceived using donor eggs possesses the genetic material of the donor – and not the birth mother. Although the birth mother does have an impact on her baby in terms of the prenatal environment, epigenetics, and ultimately in everything to do with parenting her child, the fact of the genetic discrepancy leads to what reproductive psychologists refer to as genetic grief.

This grief is a legitimate one, and usually revolves around:

• Grieving the loss of the biological legacy of the family
• Struggles with the decision on disclosure – including timing
• Social pressure to provide genetic parenthood
• Inconsistencies in the level of acceptance by both partners

Longitudinal research on donor-conceived families (e.g., the studies led by Professor Susan Golombok at the University of Cambridge’s Centre for Family Research) shows that donor-conceived children usually have positive psychological adjustment; however, this is more likely when children are told about their origins early on.

8. Elevated Risk of Preeclampsia and Pregnancy Complications

Pregnancies resulting from egg donations present a greater chance of complications compared to pregnancies conceived using the recipient’s own eggs. One of the reasons for the increased incidence rate is the immune reaction against genetically foreign material in the pregnancy – “transplantation without immunosuppression” describes a donor egg pregnancy.

Some of the increased risks include:

• Preeclampsia: A peer-reviewed systematic review (Schwarze et al., Jornal Brasileiro de Reprodução Assistida, 2018) covering studies from 1995 to 2016 found preeclampsia in 11.5% of donor-egg pregnancies versus 3.9% in autologous IVF pregnancies.
• Premature births
• Delivery by cesarean
• Small for gestational age newborns

Such risks can be managed with proper pregnancy monitoring.

9. Unknown or Incomplete Genetic History

Despite thorough screenings, donor eggs may still carry undetected genetic risks.

• Undiscovered hereditary conditions: Donors who are unaware of any hereditary problems within their relatives.
• Incomplete family history disclosure:  Due either to their own ignorance or, in extremely rare cases, deliberate deception for monetary gain.
• Conditions that emerge with age: Some genetic predispositions become visible later in life and thus escape early detection.

As required by the FDA, donors must undergo testing for STDs within 30 days of donating eggs, while reliable organizations carry out extensive genetic carrier screening, yet no testing procedure can cover all contingencies.

10. Cycle Delays, Cancellations, and Success Rates

The procedure of egg donation does not automatically result in having a child:

• Donor cycle cancellations: There can be many reasons for this, including illness, poor response to medication, or even personal matters.
• Frozen vs. fresh donor eggs: The advantage of using frozen donor eggs is shorter wait times; however, slight variations in success rates may exist compared to fresh eggs.
• Multiple cycles may be required: The success rate per cycle for donor egg IVF typically ranges from 40% to 60%, which means repeated attempts are often necessary.
• Financial cost accumulates: Every individual cycle will cost money – in the USA, a single donor egg IVF cycle can cost from $25,000 to over $50,000.

In Canada, since the Assisted Human Reproduction Act strictly forbids any payment to the egg donor (and only permits reimbursement of expenses), couples usually seek help abroad, in American clinics and elsewhere.

11. Legal Complexity Across US States and Canada

Egg donation laws around the world are different in various aspects:

• USA: Egg donor rights, recipient parentage rights, and egg donor-conceived persons’ access to identifying details are defined differently from one state to another. Some states provide better legal certainty in this regard.
• Canada: The Assisted Human Reproduction Act (2004) bans any commercial egg donation activities. Egg donors cannot be paid compensation; only reimbursement of expenses is allowed. The situation leads to shortages, driving many Canadians to look for donors abroad and in the USA.
• Identity-release vs. anonymous donation: Many locations are considering adopting a mandatory egg donor identity disclosure law, which would affect existing agreements between egg donors and recipients.
• Multiple donor-conceived siblings: In the absence of a centralized registry system, it is possible that donor-conceived children run into their half-siblings in real life, this ethical question is becoming increasingly important.

Part 3: Impact on Donor-Conceived Children

While egg donation has enabled many families to bring children into the world, certain challenges can arise with this experience for some donor-conceived children. Matters such as genetic identity, medical background information, and emotional health could impact how donor-conceived children process their own identities as they get older.

12. Identity and Disclosure Challenges

There is overwhelming evidence to indicate that the manner in which and timing of disclosure of donor conception impacts the well-being of the children.

• Children who were told the truth at an early age adjust easily and demonstrate good psychological growth.
• Children who learn about their background during their teenage years or adulthood, especially through genetic screening, may experience issues such as identity disruption, betrayal, and lack of trust.
• Some adults conceive via anonymous sperm donors and face issues related to their genetic identities.

The common use of commercial genetic screening has made anonymity in egg donations nearly nonexistent.

In short, disclosure is not a question of if but when; and the evidence consistently points to earlier being better for the child’s long-term wellbeing.

Conclusion: 

Many happy parents owe their parenthood to egg donations; egg donations continue to bless many others. This fact alone is worth celebrating. However, informed consent, true informed consent, mandates a complete list of all the negatives, ranging from the health risks involved to the emotional aspects to consider to potential questions regarding identity that children born through egg donation will ask one day.

The most sensible approach in the future involves:

• Donors are being evaluated medically and psychologically, informed of the risks, and given post-procedure counselling.
• Recipients who know the medical risks of carrying donor eggs, know what the emotional road ahead looks like, and inform their child of it as soon as possible.
• Donor-conceived people being informed of their origin.

If you’re exploring egg donation, as a donor or a recipient, connect with our community of surrogates, intended parents, and egg donors who can share their lived experience alongside the clinical facts.

Egg Donation FAQs

Sources

• Tober, D. M. Eggonomics: The Global Market in Human Eggs and the Donors Who Supply Them. Routledge, 2024.
• Tober, D. M., Richter, K., Zubizarreta, D., & Daneshmand, S. “Egg donor self-reports of ovarian hyperstimulation syndrome: severity by trigger type, oocytes retrieved, and prior history.” Journal of Assisted Reproduction and Genetics, 2023.
• Think Global Health (Council on Foreign Relations). “The Money and Risks Behind Human Egg Donation,” 2024.
• American Society for Reproductive Medicine (ASRM) — committee guidance on repeated oocyte donation and OHSS risk.
• Schwarze, J. E., et al. “Is the risk of preeclampsia higher in donor oocyte pregnancies? A systematic review and meta-analysis.” Jornal Brasileiro de Reprodução Assistida, 2018. PubMed: PMC5844654.
• Doyle, M., et al. “Oocyte donors’ physical outcomes and psychosocial experiences: a mixed-methods study.” Fertility and Sterility, January 2025.
• Golombok, S., et al. — longitudinal studies of donor-conceived families, Centre for Family Research, University of Cambridge.