Repeat Donors Are a Fertility Clinic's Most Undervalued Asset

I have a long and broad experience as an egg donor. There are a few clinics I returned to over and over. One clinic I would never work with again after my first cycle was complete.

The clinics I returned to were not necessarily the most prestigious, or the closest to me, or the highest-paying. They were the ones where I always knew what was happening, where my questions were answered before I thought to ask them, and where I felt, at every monitoring appointment and in every email, that the people managing my cycle actually wanted it to go well for me—not just for the recipient.

The clinic I didn't return to taught me what the absence of that feels like.

It was my first donation. Communication happened almost entirely over the phone, which meant I had no record to refer back to, no way to re-read an instruction I wasn't sure I'd caught correctly. The calls themselves were rushed. Several days before my retrieval, my coordinator called to check in. I told her I was feeling full and bloated (as to be expected) but otherwise fine, and that I'd been doing some light walking and yoga to manage the discomfort.

She reprimanded me. She said I shouldn't be doing any physical activity, that it could jeopardize the cycle.

No one had told me this. Not in any call, not in any document I'd been given. Suddenly I was a first-time donor, days away from a medical procedure I'd never been through before, being told I had been doing something wrong without knowing it. The anxiety that followed was immediate and, for several days, hard to shake.

What I know now, after many more donations, is that what I described to her was not dangerous. What I was doing was well within the range of what experienced donors do in the days before retrieval. Her reaction was a gross overreaction to what I told her — but I had no way of knowing that. She was the expert. I was the first-timer. So I believed her, and I carried that anxiety into my retrieval.

I completed the cycle. I didn't go back.

The clinical experience and the donor experience are not the same thing. A cycle can be medically flawless and still leave a donor with no desire to return. What brings donors back is something the clinical team alone can't fully control: the feeling of being in capable, organized, communicative hands. The feeling that the people managing the process have thought about what it's like to be on the receiving end of it.

That feeling is built or destroyed in the small moments — the call that leaves a first-time donor feeling chastened instead of supported, the email that contradicts what the coordinator said yesterday, the instruction that never came and whose absence only becomes apparent when something goes wrong.

A repeat donor costs a fraction of what a new donor costs. She already knows the process, which means less hand-holding, fewer anxiety-driven calls to the coordinator, more reliable protocol adherence because she's done it before. She is, in almost every measurable way, lower risk and lower overhead than someone going through it for the first time.

Clinics that retain donors don't do it through compensation alone. They do it by making the experience of working with them smooth and organized enough, and human enough, that a donor who has options — and experienced donors always have options — keeps choosing them.

That's not a clinical outcome. It's an operational one. And it's well within reach for any program willing to look honestly at what the experience actually feels like from the other side of it.