INTERESTED IN BECOMING AN EGG DONOR?
Scott Roseff, MD, FACOG, Director
Palm Beach Center for Reproductive Medicine
Wellington, FL
CALL US AT: 561-333-8232  ·  doc@reproendo.com

Would you like to help another woman achieve the miracle of pregnancy by donating your eggs?

Unfortunately, many women are not able to become pregnant using their own eggs.  Reasons for this may include a prior illness that caused their eggs to be depleted or of poor quality, gynecologic or other cancers, cancer treatments such as chemotherapy or radiation therapy, past surgeries for disorders such as endometriosis, and premature ovarian failure.  Fortunately, most of those women have the option to achieve a pregnancy by going through a process called in-vitro fertilization (IVF) using eggs donated from another woman.

Our program in South Florida has rapidly become renowned for offering HIGHLY successful and advanced reproductive technologies while maintaining a personalized and caring approach in a warm, home-like setting.  Our patients thank us for taking all the time they need to discuss their concerns and reproductive problems with them.  We treat our egg donors and their recipients with respect in a private practice setting.  If you would like to consider being an egg donor, please call us at 561-333-8232, or complete our screening questionnaire, below.  In order to be considered, you must:

If you meet the above criteria, please complete our preliminary questionnaire, below.  We will review your responses and contact you soon thereafter for a possible interview.  If you fulfill the criteria for egg donation based on a preliminary interview, you will undergo further testing at no expense to you.  Accepted donors will need to comply with a fertility medication treatment protocol and give us a two week commitment during treatment and testing.  Donors will receive generous compensation for their time and efforts.

We're looking forward to hearing from you!

PLEASE COMPLETE OUR PRELIMINARY QUESTIONNAIRE.  ONCE WE RECEIVE IT, WE WILL REVIEW IT AND CONTACT YOU AS SOON AS POSSIBLE:

First Name:   

Last Name:  

Street Address:  

City:  

State:  

Zip Code:  

Age:  

E-mail Address (***We can only reply to a valid address; check your spelling***):  

Contact Phone Number:  

Have you been an egg donor before?  

Height:  

Weight:  

Ethnic background:  

Religion:  

Marital status:  

Do you currently smoke? If yes, how much/often?  

Do you currently drink alcohol?  If yes, how much/often?  
 

List of current prescription medications:   
 

 

List of current over the counter medications:  
 

 

List of current "alternative" or "complimentary" medications:  
 

 

List of current medical conditions:      

Do you have any genetic abnormalities?  

Have you ever:
  
Had a medical disorder?  If so, please describe:  
 

Had surgery or been hospitalized?  
 

Had surgery on your ovaries? If so, please describe:  
 

Smoked?   

Used drugs?          

Been told you had a sexually transmitted disease (STD)?     

Been pregnant? If so, please list dates and tell if pregnancy was delivered, aborted, miscarried, or ectopic:   
 

Is there anything else you think we should know in considering you as a candidate for egg donation?  

  

E-mail: doc@reproendo.com

If you've spoken with one of our nurses, and ONLY IF you were told to complete the more comprehensive donor questionnaire packet, please print and complete that packet (and bring it with you to your interview).  You can access the questionnaire by clicking HERE.  If you have trouble viewing the document, please e-mail or call us.

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