Egg donation programs screen for a long list of factors, and most applicants don’t make it through. Disqualifications fall into several categories: age, body composition, genetics, mental health, lifestyle habits, infectious disease risk, and even your ability to commit to the process. Some are absolute deal-breakers, while others are evaluated on a case-by-case basis.
Age and BMI Requirements
Most programs require donors to be between 21 and 32, though some clinics extend the upper limit to 35. The lower cutoff exists partly because the American Society for Reproductive Medicine (ASRM) considers 21 the minimum age at which someone can give fully informed consent for this kind of procedure. The upper limit reflects the natural decline in egg quality that begins in the early thirties.
Your BMI also matters. Fairfax EggBank, one of the larger programs, requires a BMI between 18 and 29. A BMI outside that range can affect how your body responds to the hormone medications used during the donation cycle, increasing the risk of complications for you and reducing the chances of success for the recipient. If your BMI is slightly outside the window, losing or gaining a small amount of weight could make you eligible later.
Genetic and Family Medical History
Clinics take a close look at your biological family’s health history, and this is where many applicants are screened out. Doctors evaluate your personal and family history of cancer, heart disease, neurological diseases, autoimmune conditions, thyroid disorders, birth defects, kidney disease, respiratory disease, metabolic disorders, and genetic conditions. They consider how severe the condition is, how many relatives have had it, how closely related those relatives are to you, and at what age they were diagnosed.
If you can’t confirm your biological family’s health history, perhaps because you were adopted and don’t have access to medical records, that alone is typically considered a disqualifier.
You’ll also undergo genetic carrier screening through blood tests. If your results show you carry a gene for conditions like cystic fibrosis, spinal muscular atrophy, or thalassemia, that may disqualify you depending on the program. Carrier status doesn’t mean you have the disease yourself, but it means there’s a chance of passing it to a child, especially if the intended father also carries the same gene.
Mental Health and Psychological Screening
Mental health history is one of the more nuanced areas of screening. The ASRM has established several psychological criteria that can make someone ineligible:
- Significant psychiatric disorders in you or your close family members
- Current use of psychoactive medications, including antidepressants
- Substance use disorders, or two or more first-degree relatives (parents, siblings) with substance use disorders
- History of emotional, sexual, or physical abuse that hasn’t been addressed with professional treatment
- Excessive stress or relationship instability at the time of donation
- High-risk sexual practices
Antidepressant use is a common concern for applicants. The ASRM classifies current use of SSRIs or other antidepressants as a “relative exclusion,” meaning it’s not an automatic disqualification but something the medical team reviews individually. If you recently stopped taking antidepressants, or if your condition is well-managed, some programs may still consider you.
The psychological evaluation also assesses whether you fully understand what you’re agreeing to, including the possibility that a biological child will exist in the world and may someday want to contact you. If the evaluator has concerns about your ability to handle that reality, it can be grounds for exclusion.
Smoking, Drugs, and Substance Use
Any current use of nicotine, tobacco, marijuana, vaping products, or recreational drugs will disqualify you. Smoking and smokeless tobacco damage the genetic material in eggs, and vaping liquids contain many of the same harmful chemicals as cigarettes. Marijuana use is also disqualifying, even in states where it’s legal recreationally.
If you’ve recently quit, you may not need to wait long. Many agencies allow you to apply after three months of being completely tobacco and nicotine-free. You’ll be drug tested during the screening process and again during the donation cycle, so abstinence needs to be genuine, not just declared.
Injecting drugs for nonmedical reasons at any point in the past five years is an automatic disqualification under both FDA and ASRM guidelines.
Infectious Disease and Sexual History
Every potential donor undergoes blood testing for HIV, hepatitis B, hepatitis C, syphilis, gonorrhea, and chlamydia, among other infections. Any positive result on these screening tests will exclude you from anonymous donation. The one partial exception: if you’ve had gonorrhea or chlamydia in the past but completed treatment and tested negative afterward, you can become eligible again after a 12-month waiting period.
Your social and sexual history also factors in. Under FDA and ASRM guidelines, the following will disqualify you:
- Having exchanged sex for money or drugs in the past five years
- Being incarcerated for more than 72 consecutive hours in the past 12 months
- Having close contact with someone who has HIV or viral hepatitis in the past 12 months
- Getting a tattoo, piercing, or acupuncture in the past 12 months where sterile procedures weren’t clearly used
- Having a sexual partner in the past 12 months who falls into any of the above categories
These rules aren’t moral judgments. They exist because certain infections have window periods where they won’t show up on tests, and egg donation bypasses the body’s usual barriers to transmission.
Prior Donation Cycles
The ASRM recommends a lifetime limit of six stimulated egg donation cycles per donor. This cap exists because of the possible cumulative risks of repeated hormone stimulation, including the long-term effects on your own fertility and ovarian health. If you’ve already completed six cycles, most reputable programs will not accept you for a seventh, regardless of how well your previous donations went.
Practical and Logistical Factors
Beyond the medical and genetic criteria, clinics screen for your ability to actually follow through. Egg donation is a time-intensive process. During a donation cycle, you’ll take medications for roughly three weeks, give yourself daily injections, and make multiple clinic visits for blood tests and ultrasounds. If your work or school schedule doesn’t allow that flexibility, or if you live too far from the clinic to attend frequent monitoring appointments, you may be turned away.
Reliability matters more than you might expect. Failure to follow the medication protocol precisely can endanger your health and ruin the cycle for the recipient. If the screening team has doubts about your ability to stick to the schedule and instructions, that’s enough to disqualify you. Some programs also prefer donors who have already given birth or completed a successful donation cycle, since those donors have a track record of fertility and have already had time to consider how they feel about having genetic offspring raised by someone else.