By donor-egg IVF we refer to the conventional IVF process, but with the difference that donor eggs instead of the patient’s own eggs are used. The success rates with egg donation are usually higher, as egg donors are young women who produce healthy oocytes.
However, failure can also occur for a number of reasons linked to the recipient, which we will explain hereunder.The calendar followed in a donor-egg IVF cycle is different for the donor and the recipient.
The various sections of this article are assembled in the following table of contents.
Process of IVF with donor eggs
In the process of donor-egg in vitro fertilization (IVF), we use donor eggs instead of the patient’s own eggs to create embryos after fertilizing them with either partner-donated sperm or donor sperm. The new embryos are transferred to the recipient’s uterus in order for her to get pregnant.
Even though this post focuses on the donor-egg IVF journey, in which the sperm used has been donated by the recipient’s partner, there are cases in which poor sperm quality is another factor leading to infertility in the couple. In these cases, double-donor IVF—i.e. to use both donor eggs and donor sperm—may be an option to have a baby.
What is the recipient protocol?
The primary indication for donor-egg IVF is for women with premature ovarian failure (POF), a condition that is defined as having menopause earlier than the age of 40 years. POF indicates the cessation of ovarian function, and therefore the depletion of a woman’s ovarian reserve.
The process should start with a fertility evaluation. The presence of elevated FSH (follicle-stimulating hormone) and/or estradiol levels can be detected by taking a blood sample on cycle days 2 or 3. It helps uncover evidence of POF even in women younger than 40.
Other reasons why women may need donor eggs are:
- Previous IVF failure
- Poor egg quality
- Presence of genetic abnormalities that could affect offspring
Medical evaluations should include a complete history and physical examination to make sure pregnancy will not affect the woman’s overall state of health. It is important to seek factors which could have a negative impact on fertilization, embryo implantation and/or pregnancy.
Some IVF clinics around the world perform what is known as “mock cycles” or “prep cycles” prior to the actual treatment cycle. As the name suggests, it is a preparatory cycle of programmed hormone replacement that helps ensure the prescribed hormone medications will help achieve endometrial receptivity and thus the desired results.
Recipients with premature menopause require uterine preparation by means of estrogen and progesterone, as they lack ovarian function. When fresh donor eggs are used, patients with intact ovarian function may be prescribed this treatment or birth control pills for synchronizing their menstrual cycle with that of the donor.
It is important for recipients to pay attention to their blood type and Rh factor. For example, if the patient has a Rh-negative blood type, there exist some indications if the donor is Rh positive of her partner/husband is Rh-positive.
Frozen donor-egg cycles are simpler because there is no need for synchronization. This reduces the cost of donor-egg IVF cycles due to the lack of individual synchronization. Furthermore, cancellations occur in less than 5% of cycles.
Success rates and statistics
The woman’s age affects the chances for pregnancy with any fertility treatment. This is the reason why, in women over 40, the success rates of IUI are generally less than 5% per cycle. As far as IVF, although it is normally more effective, the statistics show that women aged 40 or older reach less than 20% per cycle.
In these cases, and especially in women over 42 who have not succeeded in previous IVF cycles using their own eggs, egg donation may offer them the opportunity to experience pregnancy, birth and motherhood, as it involves using the eggs of another woman who is in her 20s or 30s.
The following statistics should be taken into account when deciding whether to use donor eggs:
- By age 30, around 30% of the eggs a woman releases are chromosomally abnormal, while by ages 40-44, this figure rises to 60-90%.
- Donor eggs are normally used until about age 49, although some egg donation programs may accept 50-year-old patients.
- By age 43, the chances of achieving a successful pregnancy through IVF are less than 5%, and by age 45 egg donation turns out to be the only reasonable alternative.
- Clinical pregnancy rates and live birth rates are lower in recipients 45-50 years old, while the miscarriage rates are higher.
Some countries have established an upper age limit to receive donor eggs somewhere between 42 and 50 years of age. In some European countries such as Spain, this limit is set up by law, and therefore fertility clinics will not accept women older than 50. The law in the United States, however, does not address this aspect, though most IVF clinics have established their own age limit as well.
How much does it cost?
In general, the price of IVF with donor eggs is substantially higher than normal IVF programs using the patient’s own eggs. However, it depends on the country where the donation is done, the type of egg donor chosen (anonymous or known), and the need for additional techniques such as the following:
- Intracytoplasmic sperm injection (ICSI)
- Preimplantation genetic diagnosis (PGD)
- Sperm cryopreservation
- Embryo vitrification
The legal status and the financial compensation of egg donors vary by country. They depend mainly on the types of donation permitted, whether both anonymous and known egg donors or just anonymous oocyte donation, commercial or altruistic donations, etc. This, at the same time, influences the cost of egg donation.
There exists an alternative method that may reduce the overall cost of donor-egg IVF. It is called shared egg donation or just egg sharing and differs from donor-IVF cycles, where single donors are used, because the eggs produced are shared with other recipient couples.
Both the egg donor and the recipient benefit from this alternative procedure. On the one hand, the donor receives medication and the IVF cycles for free after completing the egg donation process. On the other hand, the recipient avoids waiting too long for being matched with a donor and is given a second chance if the first cycle fails.
Also, the use of fresh or frozen donor eggs should be kept in mind when calculating the cost of donor-egg IVF. With fresh donor eggs, it is necessary to synchronize the menstrual cycles of the donor and the recipient, thereby increasing the cost and number of visits to the clinic. If frozen donor eggs are used, the treatment becomes cheaper, as the process becomes shorter and simpler.
Fertility clinics may offer different financing options. Full money back guarantee programs are a common example in which the cost of egg donation is more expensive, but covers up to 3 or 4 donor cycles. If a live birth is not achieved, the 100% of the total fee is refunded. Shared-risk plans and pregnancy-on-the-first-attempt programs are further examples.
FAQs from users
Is donor-egg IVF with PGD for gender selection an option?
Sex or gender selection is not allowed in every country. Thus, the availability of IVF with PGD for gender selection depends on the location of your fertility clinic. Most patients who wish to select the gender of their baby-to-be travel to the United States to do so, as the majority of laws by state are favorable to its performance.
Embryos can be genetically biopsied with PGD prior to fertilization with IVF. Once one cell of the embryo is removed, its chromosomes can be analyzed to detect potential genetic defects and determine the embryo’s gender. Then, only the embryos of the desired gender are selected for the transfer.
What is the difference between egg donation and IVF?
Broadly speaking, by in vitro fertilization (IVF) we mean the process of fusing artificially the eggs and the sperms of the intended parents, with the purpose of creating new embryos and achieve a pregnancy after transferring them to the patient’s uterus.
On the other hand, egg donation is a procedure that is part of the IVF process when the patient’s own eggs are unable to be used. In these cases, donor eggs are fertilized exactly as explained in the previous paragraph. To sum up, egg donation is all about receiving donated eggs in order for the patient to get pregnant through IVF.
Donor-egg IVF vs. adoption, what is the best option?
It is not that one option is better than another, but a question of preference. In both cases, intended parents are addressing childlessness, and in this sense both options have their pros and cons, although there is some asymmetry between them, including embryo adoption.
While in adoption neither parent has a genetic connection to the child, donor-egg IVF gives the chance for one parent to have a genetic link with the baby-to-be. This, however, may create in the non-genetic parent a feeling of “exclusion”, while with adoption both share the same status.
For some, the level of privacy of assisted conception is appealing, and for others adoption is the best option because it is a more established system that gives a child the opportunity to have a home. Be it as it may, our advice is that you consider both the advantages and disadvantages carefully.
What are the chances of getting pregnant with twins using donor eggs?
The side effects of egg donation for recipients are minimal, being the most common the risk of getting pregnant with multiples. It depends on the number of embryos to transfer.
If multiple embryos are transferred, the rates of having a multiple pregnancy shoot up overnight. It should be taken into account that donor eggs have high implantation rates, given the young age of egg donors, which translates into healthier eggs.
On average, the rate of having twins with egg donation is at 36.6%. To reduce this risk, the general recommendation is to bet on single embryo transfers (SET). Two-embryo transfers are advisable only in cases of repeated implantation failure (RIF) or poor embryo quality.
Why does IVF fail with donor eggs?
On average, the chances of success with donor-egg IVF are as high as 60% per transfer, since egg donors are young and healthy women with a high reproductive potential.
But egg quality is not the only factor influencing the outcome of this treatment. The patient’s uterine conditions and sperm quality, among others, are also key factors when trying to get pregnant with donor eggs.
In some cases, however, in spite of transferring high-quality embryos and having a good endometrial receptivity, the embryos are still unable to implant for no apparent reason.
If you have gone through multiple failed IVF with donor eggs, the likelihood or risk for RIF or recurrent miscarriage with donor eggs depends on the cause behind your previous miscarriages. When it is caused by uterine abnormalities, using donor eggs will not change the situation to a large extent.
Down syndrome runs in my family, can I pass it to my offspring despite using donor eggs?
If you use donor eggs, preimplantation genetic diagnosis (PGD) is not required, as the hereditary factor disappears when donor eggs are used. Also, it should be taken into account that donors are young women, so the chances for their eggs to carry a genetic abnormality associated with advanced maternal age are very low.