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About 10,000 babies are born every year via egg donation: a process in which a woman agrees (typically for a fee) to have her eggs retrieved and used by another family to conceive a child. Some hopeful parents (“recipients”) choose known donors, that is, family members or friends to serve as their donors. But the vast majority are unknown, found through donor pools at IVF clinics, independent agencies, or frozen egg banks.

For medical purposes, doctors and the FDA make clear black-and-white distinctions between known and unknown donors. But the growing reality among recipients and donors is that “known” has many shades of gray.
Twenty or so years ago when clinics were the only source for egg donors, complete mutual anonymity between donors and recipients was the standard. Anonymity was one of the factors that allowed egg donation, then still new and unfamiliar, to flourish in the US. [In countries where anonymity is not allowed (such as Great Britain), egg donation is very limited (compensation is restricted there, too).] Guaranteed privacy and confidentiality encouraged women to participate.

Basic medical information was presented to recipients, but not current photos. Photos were off limits not only because they could theoretically breach confidentiality, but they could also “irrationally” sway the recipients’ preferences beyond the criterion of medical eligibility, the primary concern of their doctors. From a clinical point of view, any kind of openness, even photos, could threaten the whole arrangement. Anonymity kept clinics in control of the process.