When intended parents review an egg donor profile, they typically see a photograph, a short biography, and a list of educational or personal attributes. What they rarely see in full is the clinical and psychological assessment that sits behind that profile. Understanding what that assessment covers — and, crucially, what it does not — is one of the most important steps you can take before committing to a donor and a programme.
Screening standards vary considerably between countries, between clinics, and even between donor agencies operating within the same jurisdiction. There is no single global protocol. What follows is a guide to the categories of testing that are commonly applied, the areas where gaps frequently appear, and the questions you should put in writing before you proceed. This article does not constitute medical or legal advice; its purpose is to help you ask better questions of the professionals who will be advising you.
Almost every reputable programme will test donors for a standard panel of infectious diseases. This typically includes HIV (types 1 and 2), hepatitis B surface antigen and core antibody, hepatitis C antibody, syphilis, chlamydia, and gonorrhoea. Many clinics also screen for cytomegalovirus (CMV) status, which is relevant if the intended mother or gestational carrier is CMV-negative, as primary infection during pregnancy carries clinical risks.
These tests are generally repeated close to the start of a stimulation cycle, because initial screening results can become outdated if several months pass between assessment and retrieval. Ask your clinic or programme coordinator to confirm the retesting interval in writing.
A donor's likely response to stimulation is assessed through a combination of antral follicle count (AFC) via transvaginal ultrasound and serum anti-Müllerian hormone (AMH) measurement. These are predictive markers, not guarantees of yield; individual responses to the same protocol can differ substantially. Programmes typically apply minimum thresholds for both AFC and AMH before accepting a donor, though those thresholds vary.
Standard karyotyping examines the gross structure and number of chromosomes (46,XX for a typical female). It identifies large structural abnormalities such as translocations or inversions that could affect embryo development or implantation. Karyotyping is considered standard practice in most European and North American programmes; its inclusion elsewhere is less consistent. Confirm whether it is performed before donation begins or only if a problem is suspected.
This is the area of greatest variation across programmes, and the one that most frequently surprises intended parents. A basic panel might test for cystic fibrosis, spinal muscular atrophy, and fragile X premutation status. An expanded carrier screen, by contrast, can cover several hundred recessive conditions simultaneously. The clinical significance of identifying a carrier is that if both the donor and the sperm source carry a pathogenic variant for the same recessive condition, each embryo has a one-in-four chance of being affected.
Expanded carrier screening is not universally offered as standard. Some programmes include it as a default; others offer it as an add-on at additional cost; others do not offer it at all. If the sperm source has already been carrier-screened, the results should be shared with the clinic so that matching — selecting a donor whose carrier status does not conflict — can be considered. If the sperm source has not been screened, this is the moment to arrange it.
A psychological assessment, typically conducted by a licensed psychologist or counsellor with relevant specialism, explores a donor's motivations, understanding of the process, capacity to provide informed consent, and emotional readiness. Most accredited programmes in the United Kingdom, United States, Australia, and Spain require this as a condition of acceptance. The depth of the evaluation, however, varies: some are structured clinical interviews lasting several hours; others are briefer. Ask whether the evaluating clinician is independent of the agency or clinic, and request confirmation that the evaluation followed published professional guidelines such as those of the ESHRE (European Society of Human Reproduction and Embryology) or the ASRM (American Society for Reproductive Medicine).
A full medical history, including family history to at least two generations, is standard. Blood group and Rhesus factor typing are included. Body mass index, blood pressure, and a general physical examination are routinely performed. Drug and alcohol screening and tobacco use history are also typically assessed, though the method of verification differs between programmes.
Even in programmes with thorough protocols, certain areas fall outside the scope of routine screening.
Some of these questions may meet with resistance, particularly in markets where donor anonymity is legally protected. As of writing, the legal framework governing disclosure of donor screening information to intended parents differs significantly between jurisdictions. In some countries, intended parents have a statutory right to receive full screening documentation; in others, only summary information is provided. Confirming the position in your specific destination country with local legal counsel is strongly advisable before you proceed. Our guide to destination countries gives an overview of the regulatory landscape in the most common programme locations.
When you receive a donor's screening summary, treat it as a starting point for questions rather than a certificate of assurance. If a programme is unable or unwilling to answer the questions listed above, that itself is useful information. Reputable clinics and agencies welcome rigorous enquiry; it reflects due diligence on your part and is consistent with the informed consent process they are obliged to support.
If you are comparing programmes across different countries, our costs guide outlines what is typically included in programme fees and what is charged separately, including genetic testing. Expanded carrier screening, for example, is sometimes included in a quoted package price and sometimes billed as an additional item at a cost that, in typical ranges, falls between several hundred and a few thousand pounds or euros depending on panel size and laboratory.
For a broader explanation of how a donation cycle is structured from matching through to embryo transfer, see how it works.
Thorough screening reduces risk; it does not eliminate it. Every programme, however rigorous, operates within the limits of current medical knowledge. Approaching the process with accurate expectations — neither unrealistic confidence nor unnecessary alarm — places you in the best position to make considered decisions alongside your medical and legal advisers.
This article is provided for informational purposes only. It does not constitute medical or legal advice. You should consult qualified medical professionals and independent legal counsel in the relevant jurisdiction before making any decisions regarding egg donation or assisted reproduction.