A sperm donor is needed when the male partner has complete testicular failure or a chromosomal abnormality in the sperm. If there is a blockage but he is still making sperm, the sperm can be obtained via a procedure such a PESA. A sperm donor is also the only way a same sex female couple can have a baby together.
An egg donor is needed, again, for abnormal genetic conditions with the eggs, as well as same sex male couples seeking to start a family, as well as for couples where the female partner cannot produce enough eggs for an IVF cycle, mostly likely due to age.
Donor embryos are usually for couples who cannot conceive a child of their own but desire the experience of pregnancy and birth when starting their family. They are also an option for single females who want to have a child on their own, and have not had or would not have any success with a sperm donor IUI (Intrauterine Insemination).
Gestational carriers (or "surrogates") are usually for couples who can conceive their own embryos but the female's uterus is unable to carry the child to full term.
Access to donors depends on the clinic and the country you live in. You may have to go out of country for an egg donor if you live in Canada for example, and some couples go out of country for a gestational carrier, as the costs can be considerably lower.
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