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Though thousands of women in the United States step forward to donate their eggs each year, startling new led by The University of Manchester in the UK reveals only a tiny fraction ever make it through the rigorous selection process.

Egg donation is a lifeline for families, offering hope to women with conditions like early menopause, older mothers, and men without a female partner pursuing surrogacy.

Across Europe, around 8 per cent of fertility treatment cycles rely on donated eggs, underlining just how crucial donors are to modern family-building.

Yet behind the scenes, the research team 鈥� which is also from Cryos International and The University of Ghent - show the path to becoming an egg donor is far tougher than many realise.

In their study of 2,443 women applying to be egg donors at Cryos, a commercial US egg bank, just 2.5 per cent were accepted and went on to have their eggs frozen and banked ready for donation.

This shows that recruiting egg donors is far more challenging than it might seem, with roughly only one in 40 women making it through what the authors describe as an exceptionally thorough recruitment process.

More than half of all applicants (51 %) were rejected almost instantly for failing to meet strict enrolment criteria such as age or body mass index.

A further 26.36 % dropped out during the process, missing appointments or simply failing to respond to the clinic.

Nearly one in five (19.69 %) were later ruled out after health problems were uncovered in their family history or they failed medical screening tests.

鈥淲hile there is clearly strong interest in donating eggs, only a very small proportion of applicants ultimately meet the requirements, which has important implications for the availability of donor eggs in fertility treatment,鈥� said lead author from The University of Manchester.

鈥淎dvances in egg freezing have enabled global egg banks to emerge, allowing frozen donor eggs to be shipped worldwide.

鈥淗owever, from initial eligibility checks through to detailed medical screening, the process is designed to ensure that only donors who meet very specific safety and quality standards are accepted.

鈥淚t is striking that more than half of applicants are excluded at the very first step, and that a significant number also withdraw or disengage before completing the process, presumably as they find out more about it and realise it鈥檚 not for them鈥�.

In a previous study investigating the recruitment of sperm donors at the same sperm and egg bank during the same time-period, the team found that only 1.03% of men who initially applied to be sperm donors were finally accepted.

Interestingly whether men applying to be a sperm donor chose to be ID-release or not had an impact on his likelihood of being recruited, this was not seen in the study of egg donor applicants.

The researchers say this contrast cannot be explained by motivation, as a previous surveys at the same clinic show sperm and egg donors report remarkably similar reasons for volunteering.

Co-author Anne-Bine Skytte, Medical Director at Cryos International who ran the egg bank where the study took place commented: 鈥淒espite similar motivations between sperm and egg donors, the recruitment pathways function quite differently. Egg donation involves a surgical procedure, whereas sperm donation typically requires repeated visits over an extended period. Therefore, whilst egg donation is more medically invasive, our findings show more success in recruiting egg donors suggesting that the surgical procedures do not necessarily put women off from donating.鈥�

鈥淲e also saw that many women became more open to becoming ID-release as they progressed through the screening, with more than half switching from anonymous to ID-release.鈥�

The authors suggest that counselling during the recruitment process may help donors feel more comfortable with the idea of future openness and contact

• The paper An analysis of the outcome of 2,443 women applying to be donors at a commercial egg bank in the US, is published in DOI https://doi.org/10.1186/s12958-026-01578-1