1 in 40 online egg donor applicants is accepted at a US commercial bank
An analysis of the outcome of 2,443 women applying to be donors at a commercial egg bank in the USA. (Pacey, 2026)
Pacey, A. A., Lassen, E., Pennings, G., Kasiri, S., & Skytte, A.-B. (2026). An analysis of the outcome of 2,443 women applying to be donors at a commercial egg bank in the USA. Reproductive Biology and Endocrinology, 24, 69. https://doi.org/10.1186/s12958-026-01578-1
Geographic Region: United States (Florida)
Research Question: What proportion of women who apply to become egg donors at a commercial US egg bank are ultimately accepted, at what stage(s) do most applicants exit the process, does initial identity-release (ID-release) preference influence acceptance rates, and how do these patterns compare to sperm donor recruitment at the same institution during the same period?
Design: Retrospective analysis of anonymized records from Cryos International’s commercial egg bank in Florida. Data were drawn from every egg donor applicant during 2018 and 2019. The recruitment process moved through six stages: (1) an online initial application assessing basic eligibility; (2) a detailed medical questionnaire covering personal and family health history; (3) a nurse consultation with STI testing and AMH level measurement; (4) a medical evaluation including physical examination and expanded genetic screening; (5) a clinical interview with a certified mental health counselor; and (6) final consent and ovarian stimulation leading to egg collection and cryopreservation. All donors who were accepted received a fee per donation of 5,000 USD (for non-ID release) or 5,500 USD (for ID-release) donations.
Sample: 2,443 women who submitted online applications to Cryos International’s Florida clinic between January 1, 2018 and December 31, 2019. No demographic characteristics (age, ethnicity, BMI, education, socioeconomic status) are reported for the sample, as only anonymized summary data were made available to the research team.
Key Findings
61 of 2,443 applicants (2.5%) successfully passed all stages, had eggs collected, and had viable eggs cryopreserved and certified for use in treatment.
The acceptance rate did not differ statistically by initial ID-release preference: 2.9% of women who initially chose ID-release were accepted vs. 2.1% of those who did not. This finding contrasts with sperm donor recruitment at the same clinic, where ID-release preference was significantly associated with higher acceptance rates.
51.2% of all applicants did not meet initial eligibility criteria (age, BMI, height, willingness to screen) and were rejected at the first step.
26.7% withdrew, failed to respond, missed an appointment, or did not return a questionnaire at some point during the process. This dropout rate was substantially lower than the 61.2% dropout rate seen for sperm donor applicants at the same clinic during the same period, despite both groups reporting similar motivations for donating in a related survey.
19.7% of applicants reported a disqualifying health condition or failed a medical or genetic screening test, a rate similar to sperm donors at the same clinic (17.4%).
Only 5 of the 61 accepted donors did not ultimately donate: 2 due to poor ovarian response, 2 for other medical reasons, and 1 due to poor egg quality.
18 of the 61 accepted donors (30%) changed their ID-release preference before final consent forms were signed. Changes from non-ID-release to ID-release were significantly more common (53.6%) than changes in the opposite direction (9.1%).
Editor’s Note: The finding that 51% of all applicants are screened out at the very first step is presented as a recruitment challenge, but it can also be read as a selection system that produces a highly constrained and non-representative donor pool. The initial eligibility criteria established by Cryos are treated by the authors as fixed and neutral, but they are not. The BMI range of 18–27 kg/m² and minimum height of 152 cm reflect commercial standards that embed historical and racialized biases in reproductive medicine. Because no demographic data were included in the dataset provided to the researchers, this study cannot assess whether these criteria disproportionately exclude women of color or women from lower-income backgrounds — even though the authors’ own literature (Sachs et al., 2010) suggests this is likely.
Limitations: Because only anonymized summary data were made available, no individual-level demographic characteristics (age, ethnicity, BMI, lifestyle, medical history, socioeconimic status) could be analyzed. The study is limited to a single commercial egg bank in Florida and may not generalize to other egg donation settings. The data period (2018–2019) predates recent changes in screening standards, continued expansion of global commercial egg banking, and awareness-building efforts by donor-conceived people. No power calculation is reported. With only 61 accepted donors, the comparisons by ID-release status have limited statistical power.
Applications: The largest single source of exclusion being eligibility criteria defined by the egg bank itself. Future studies of egg donor recruitment should include demographic data to assess whether dropout and disqualification rates differ by age, ethnicity, and socioeconomic status. The authors also conclude that more research is needed, with an end goal of cost reduction for recipients. The study suggests that initial ID-Release preference at enrollment is not a reliable indicator of final preference at donation, and donors’ initial anonymity selection might not be fixed. The authors attribute the shift from non-release to release to counseling, but it may also be financial.
Funding Source: None declared. However, three of five authors are Cryos International employees and two are members of Cryos’s External Scientific Advisory Committee.
Lead Author: Allan Pacey is Professor of Andrology in the School of Medical Sciences, Faculty of Biology, Medicine and Health, at the University of Manchester, UK. His research focuses on male reproductive health, sperm biology, and gamete donation. He is a member of the Cryos International External Scientific Advisory Committee. No person connection to donor conception was disclosed.
Regulatory Context
The United States has no comprehensive federal legislation governing donor conception, with regulation primarily occurring at state level, creating a patchwork of laws across the country. The Food and Drug Administration (FDA) provides minimal federal oversight, mainly focused on screening requirements for disease prevention.
There are no federally mandated limits on the number of children conceived from a single donor. The American Society for Reproductive Medicine (ASRM) recommends limiting donors to 25 live births per population area of 850,000, but this is voluntary and not enforced. Colorado became the first state to establish a statutory limit in 2022, capping donor use at 25 families per donor, regardless of location, effective January 2025.
No centralized national registry exists to track donor-conceived births OR donors, making it difficult to enforce any limits in practice.
Commercial donation is permitted throughout most of the United States. Donors can be compensated for their gametes.
Access to donor conception is generally open to a wide range of individuals regardless of marital status, sexual orientation, or gender identity. Most major medical organizations support the position that fertility treatments should be available to any individual who is fit to parent.
The U.S. does not have national laws prohibiting anonymous donations, but this practice is gradually changing. Colorado’s 2022 “Donor-Conceived Persons Protection Act” (effective January 2025) bans anonymous donation and gives donor-conceived individuals the right to access their donor’s identity upon reaching age 18. In January 2024, the Uniform Law Commission amended the Uniform Parentage Act to require disclosure of donor identifying information to adult donor-conceived persons upon request, though states must adopt this amendment for it to become law in their jurisdictions.
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