about to undergo, she is not fully able to give informed consent, and she will be excluded from being a donor on that basis. Furthermore, a women who has suffered from mental illness or who has a family history of mental illness will also generally be excluded. In this case, the reason is not so much a medical or ethical one but rather that very few women undergoing IVF with donated eggs will select a donor with such a history.

One other exclusionary factor is what Dr. Klock referred to as excessive current life stress. “This is kind of a global term,” she explained. “If a woman is in the midst of a divorce, or if a woman has just been a victim of a violent crime, this is not a great time for her to be an egg donor.”

Studies show that between 2 and 27 percent of potential donors are excluded for psychological reasons, and it is this exclusion that offers the major psychological risk in the screening process. If an applicant is excluded for a psychological reason, the interviewer must explain to her what psychological issues have been discovered and then provide appropriate referrals if there is a problem that needs to be dealt with.

“So the potential risk here,” Dr. Klock explained, “is uncovering a previously undetected or undiagnosed psychological problem. That is a very jarring thing for a woman to experience. Sitting in the office with her, talking with her about that, she can tend to feel rejected, inferior. It can be a huge blow to her self-esteem. ‘Why? You don’t even want my eggs. Oh, I feel terrible.’ And that’s a very real concern for women from a psychological perspective.”

Another potential risk is the possibility of uncovering something in the medical screening that the applicant didn’t know about, particularly something that could affect her future fertility. That can also affect a woman psychologically.

POTENTIAL PSYCHOLOGICAL RISKS OF THE DONATION PROCEDURE

The donation procedure itself carries certain potential psychological risks as well, but these tend to be less threatening. They are also temporary, not lasting much past the procedure itself.

One issue is the effect of the hormone injections that the donors give themselves to prepare their ovaries to produce as many eggs as possible. Dr. Klock described a study performed by a pair of doctors who surveyed a group of donors after they had completed a donation cycle. The study found that fully half the donors reported mood swings and irritabil-



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