This retrospective cohort study examined the egg donor recruitment pipeline at a commercial US egg bank (Cryos International, Florida) using anonymised records of all 2,443 applicants in 2018–2019, tracking attrition at each stage and comparing outcomes by initial ID-release preference (identity-release vs. non-identity-release).
Only 2.50% of applicants (61/2,443) had eggs frozen and approved for use. The acceptance rate did not differ by initial ID-release choice (ID-release: 2.94% vs. non-ID-release: 2.12%; p = 0.195). The top reasons for dropout were: failing initial eligibility criteria (51.17%), voluntary withdrawal or non-response (26.36%), and disqualifying health issues or failed screening (19.69%). Among accepted donors who changed ID preference, switching from non-ID-release to ID-release was far more common (53.57%) than the reverse (9.09%; p < 0.0001).
- Only anonymised summary data were available; no demographic details (age, ethnicity, BMI) were recorded, limiting sub-group analysis. - Single US clinic (Florida), limiting generalisability to other settings or countries. - No commercial egg banking existed in Denmark, so a USA/Denmark comparison—done for sperm donors in a companion study—was not possible here.
Clinicians and egg bank administrators should expect that fewer than 3% of initial applicants will ultimately donate, with the majority lost before any clinical screening begins. Initial donor anonymity preference does not predict recruitment success and should not be used as a triage tool.
