By Jill Colvin

According to the New York State Task Force on Life and the Law’s Advisory Group on Assisted Reproductive Technologies, egg donors begin “controlled hyperstimulation” by injecting themselves daily for about 10 days with fertility drugs that stimulate egg production so that multiple eggs are released during a single cycle. During this phase, women are advised to abstain from sexual intercourse due to heightened fertility.

In addition to intense PMS-like symptoms—such as mood swings and fluid retention—in some cases, the hormones can trigger Ovarian Hyperstimulation Syndrome (OHSS), which causes the ovaries to swell, resulting in intense pressure and pain. In very rare cases, OHSS can cause serious, life-threatening medical complications—including blood clots, kidney failure, fluid build-up in the lungs and shock—requiring hospitalization. One or both ovaries could have to be removed. According to the task force, “the long-term risks of fertility drugs are unknown.” Some studies have suggested an increased risk of ovarian cancer, although others have not. Additionally, if women choose not to undergo egg retrieval after taking the fertility drugs, they may put themselves at risk for a very rare but serious condition where one of the ovaries twists, cutting off its blood supply. This requires immediate surgery and could lead to the loss of an ovary.

During the hyperstimulation period, women are given frequent (often daily) blood tests and ultrasounds (using vaginal probes) to monitor egg development. When the eggs have developed sufficiently, the donor will undergo transvaginal ovarian aspiration surgery. During the procedure, an ultrasound probe equipped with a thin needle is inserted into the vagina. Using suction power, anywhere from one to several dozen eggs are removed from the donor’s ovaries. In rare cases, the needle may damage the pelvic organs or nearby blood vessels, requiring surgery. The procedure lasts about 30 minutes, and women are typically sedated or anesthetized. Recovery time lasts anywhere from an afternoon to several days. Women are given antibiotics to prevent infection. However, if infection does occur, it could affect later fertility.

Egg donors should expect to commit about 60 hours over 5 to 7 weeks to complete the entire process, complete with screenings and medical appointments.