By Andrea Rodrigo BSc, MSc (embryologist), Cristina Mestre Ferrer BSc, MSc (embryologist), Rebeca Reus BSc, MSc (embryologist) and Mark P. Trolice MD, FACOG, FACS, FACE (reproductive endocrinologist).
Last Update: 09/21/2018

When it comes to using donor eggs, several doubts and questions arise, either related to making the decision, getting started with the treatment, or issues related to genetics. The purpose of this article is to answer the most frequently asked questions (FAQs) and queries raised by egg donor recipients either before, during, or after the treatment.

Contents

FAQs from users

How many IVF cycles should you do before using donor eggs?

By Mark P. Trolice MD, FACOG, FACS, FACE (reproductive endocrinologist).

This is an extremely difficult question to answer because Fertility is a physical, emotional, and financial investment. Unless a woman is in menopause, one can never definitively provide a 0% chance for pregnancy using her eggs. However, as a woman ages, particularly above age 39 along with very poor ovarian age testing (ultra low AMH and/or elevated FSH), the prognosis for success with IVF becomes very poor.

So, there is no absolute number of IVF cycles to recommend undergoing before moving to egg donation. Nevertheless, one should consider egg donation if her IVF cycle was cancelled due to a poor response or a low number of eggs were retrieved despite a high dose of stimulation with poor embryo development.

What is the difference between egg donation and IVF?

By Cristina Mestre Ferrer BSc, MSc (embryologist).

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.

How much does IVF with egg donation cost?

By Rebeca Reus BSc, MSc (embryologist).

The cost of egg donation depends widely on the country where the patient undergoes treatment.

While in European countries such as Spain, Cyprus, the Czech Republic, Portugal, or Greece it ranges from €3,800 to €5,500 approximately, in others such as Ukraine and Russia, it can be as high as €8,500-11,000. In the UK, however, egg donation costs about £9,500.

As for the USA, it is the most expensive destination, but at the same time the one that offers the possibility of choosing between a known, a semi-known, or an anonymous donor, which is an advantage for many egg donor recipients. On average, the price there reaches $20,000-40,000.

Other popular egg donation destinations around the world are Barbados and South Africa, where the price range is €4,500-5,900.

Read more in the following post: Cost of IVF with donor eggs.

What are a woman’s chances of getting pregnant with a donor egg?

By Andrea Rodrigo BSc, MSc (embryologist).

One should keep in mind that the egg cells used have been donated by young, healthy egg donors, which makes them high-quality eggs. For this reason, the average success rates of donor-egg IVF are high. However, as stated earlier, it may depend on significant factors such as sperm quality, endometrial receptivity, the profile of the donor-egg recipient, etc.

For further information, we recommend that you read the following post: Pregnancy success rates with donor eggs.

What are the most common symptoms after embryo transfer with donor eggs?

By Sara Salgado BSc, MSc (embryologist).

When a woman conceives with donor eggs, the symptoms she is expected to feel in case of a successful outcome are those of any other natural pregnancy. The only difference may be due to the side effects derived from the fertility drugs recipients should take for endometrial preparation.

The following post may provide you with further information: Early pregnancy signs after donor-egg IVF.

Does using frozen donor eggs impact the success of IVF?

By Rebeca Reus BSc, MSc (embryologist).

The truth is, the success rates with frozen donor eggs can vary greatly from clinic to clinic. Sometimes, the chances of success are not altered by using frozen oocytes at all, while in other cases, if the clinic does not master the egg vitrification technique, egg quality can be lower.

Why does implantation failure occur with donor eggs?

By Zaira Salvador BSc, MSc (embryologist).

In spite of having high-quality embryos with a normal development rate, unfortunately some egg donor cycles fail when the uterus is not receptive. Implantation will never take place in a non-receptive uterus.

Does a donor egg have my DNA?

By Rebeca Reus BSc, MSc (embryologist).

No, donated eggs contain the DNA of the donor. The fact that it is later fertilized in the laboratory and transferred to the recipient’s uterus does not modify the original genetic code of the egg. The embryo, therefore, contains the donor’s genetic material.

How can I prepare for IVF with donor eggs?

By Rebeca Reus BSc, MSc (embryologist).

From the medical point of view, the recipient has to get her body ready to receive the embryo that has been created using donor eggs in order to maximize the chances of implantation.

If fresh donor eggs are used, then synchronization between the cycles of the donor and the recipient is required. Inversely, this step is not needed when frozen donor eggs are used.

The recipient has to prepare her body for donor-egg IVF by means of endometrial preparation, which makes the uterus to grow its lining so that it is prepared for the embryo to implant successfully after the transfer (ET). To this end, the patient has to follow a strict drug protocol.

Do babies from egg donation share genes with the birth mother?

By Rebeca Reus BSc, MSc (embryologist).

Egg donor babies do not share the genetic load of the birth mother, but that of the egg donor, who is in fact the biological mother.

Nevertheless, recent studies have shown that recipients of donor eggs still pass some traits of their DNA through a phenomenon called epigenetics, a branch of Biology that studies the influence of a person’s lifestyle on who he or she is, regardless of the gene expression.

So, factors such as the mother’s diet during pregnancy could affect the development of the baby-to-be’s gene expression.

Who will the baby look like in cases of egg donation?

By Rebeca Reus BSc, MSc (embryologist).

Fertility clinics make sure that egg donors share similar physical characteristics with the recipient, so that they resemble the future child in spite of not sharing their DNA with him or her, and the same applies in cases where donor sperm is used. If the baby is conceived using your partner’s or husband’s sperm, then he or she will resemble him as well.

How likely am I to get pregnant with twins from donor eggs?

By Andrea Rodrigo BSc, MSc (embryologist).

This factor depends on the number of embryos to transfer. If two embryos are transferred, the chances of getting pregnant with twins increase. If, however, a single embryo transfer (SET) is done, it is highly unlikely that a multiple pregnancy occurs.

What are the success rates of egg sharing if compared to IVF with an exclusive donor?

By Andrea Rodrigo BSc, MSc (embryologist).

The odds of success with infertility treatments are not calculated baed on the number of eggs per cycle. For them to be properly analyzed, the average between all the cycles performed during a year is calculated. This means its pregnancy and live birth success rates are the same as those obtained with conventional IVF with donor egg cycles.

You can see the success rates of egg and sperm donation programs here: Pregnancy success rates with donor eggs and sperm.

Is it possible to do IVF with both donor eggs and sperm?

By Andrea Rodrigo BSc, MSc (embryologist).

Yes, it is. This technique is known as double-donor IVF and is indicated in the following cases: problems in the ovaries (either because of age or other unknown causes), sperm problems (zero or low sperm count, or poor motility), and single females.

For further information, we recommend you to visit the following post: What is double-donor IVF?

Donor-egg IVF vs. adoption, what is the best option?

By Cristina Mestre Ferrer BSc, MSc (embryologist).

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.

If I use donor eggs, will the baby be mine?

By Rebeca Reus BSc, MSc (embryologist).

Absolutely. Having a child is not only about sharing your DNA with him or her, but about educating, bringing up and enjoying life together as a family. Women who become mothers via egg donation love the baby exactly as any other female who got pregnant naturally with her own eggs would do. Having a child, no matter how you do it, is one of the most gratifying and rewarding experiences in life.

So, those women who are afraid of developing feelings of regrets once pregnant or after the birth of the child should know that this idea will disappear eventually.

How successful is IVF with donor eggs?

By Rebeca Reus BSc, MSc (embryologist).

In general, the use of donor eggs makes an IVF treatment more likely to succeed, as the oocytes have been donated by young, healthy girls who enjoy a good ovarian reserve, features that make the quality of the eggs they produce optimal.

In comparison, if the normal pregnancy rate of IVF with own eggs stands at 35-34% on average, with donor eggs it increases to up to 55-63% approximately. These figures, however, depend on the uterine receptivity of the patient.

Visit the following article to learn more: Pregnancy success rates with donor eggs.

How many embryos should be transferred with donor eggs?

By Rebeca Reus BSc, MSc (embryologist).

Specialists do recommend everyone undergoing IVF, whether it is done using own or donated eggs, to transfer one embryo in order for a multiple pregnancy to be prevented. There exist certain cases where transferring two embryos would be justified, including poor embryo quality and previous failed IVF attempts with a single embryo.

Also, given that the final decision is in the hands of the patient, sometimes younger patients who wish to have twins request a 2-embryo transfer from the beginning. The older the woman is, the higher the number of risks associated with a multiple pregnancy.

Can you get pregnant with donor eggs after menopause?

By Rebeca Reus BSc, MSc (embryologist).

Yes, it is possible to have a baby after menopause, a phenomenon known as postmenopausal pregnancy. Menopause is defined as the cessation of menstruation, which means the loss of ovarian activity. However, this does not affect the uterus, which is still functional, and able to carry a pregnancy. This is perfectly possible with either donor eggs from a young girl, the woman’s own previously frozen eggs, or the couple’s frozen embryos, if any.

What are the miscarriage rates with donor eggs?

By Rebeca Reus BSc, MSc (embryologist).

While in women younger than 45, the implantation rate is 45% on average, it drops to 35% in women from the 45-50 age group. Subsequently, the miscarriage rates increase with age in spite of using donor eggs: while they are less than 10% when the woman is 45 or less, they stand at 16% on average for women over 45. As explained above, a decline in endometrial receptivity is usually the reason behind this.

What are the risks of egg donation for recipients?

By Rebeca Reus BSc, MSc (embryologist).

The main risk of egg donation for recipients is becoming pregnant with multiples if more than one embryo is transferred. To avoid this, recipients are encouraged to bet on a single embryo transfer (SET), as the high quality of the eggs used guarantees a high success rate even with a SET. As for the side effects derived from the medications for endometrial preparation, these are considerably lower than those associated with the medical process for egg donors.

What are the best success rates for donor-egg IVF abroad?

By Rebeca Reus BSc, MSc (embryologist).

Success rates vary by country, but also from clinic to clinic, so choosing a single destination as the best according to general statistical data is difficult. We recommend you to take a look at this map: Egg donation rates worldwide.

Additionally, our advice is that you choose the clinic that best fits your needs, in accordance with factors such as your particular fertility issue, budget, etc.

How can recipients cope with feelings of regret after using donor eggs?

By Rebeca Reus BSc, MSc (embryologist).

The loss of one’s own genetics is a dramatic step in many women’s lives. The good news is that grieving the use of one’s own egg cells is a normal part of the process, and many women understand that parenting is not 100% about genetics after a few months.

Remember that the donor may be the genetic DNA source, but she is not the mother. You are the one who is going to be a mom, regardless of whether it is a donor-conceived or biological child.

More info here: Telling children about their conception by gamete or embryo donation.

If IVF does not work with my own eggs, is egg donation the only option left for me?

By Andrea Rodrigo BSc, MSc (embryologist).

In case of repeated IVF failure with own eggs, women have two alternatives: double-donor IVF (sperm donation + egg donation) or embryo adoption.

Using both donor eggs and donor sperm is more expensive than IVF with just donor sperm, as the egg donor fees (treatment for oocyte retrieval, gamete cryopreservation and storage, etc.) should be added to the total cost. However, the main benefit is that both gametes will be of optimal quality and therefore the embryos will be more likely to implant.

What is the relationship between epigenetics and egg donation?

By Rebeca Reus BSc, MSc (embryologist).

Epigenetics is the study of physiological phenotypic characteristics in babies that result from environmental factors. Such variations have an influence on how cells express genes.

In this sense, women who regret having used donor eggs because they do not share their genetic expression with the baby should know that, during pregnancy, the metabolism of the pregnant woman may have an influence on the baby’s future behavioral patterns.

How can I calculate my due date after donor-egg IVF?

By Andrea Rodrigo BSc, MSc (embryologist).

In general, when donor eggs have been used, pregnancy due date calculators work by adding two more weeks to the date of the embryo transfer. It allows us to copy the process followed in natural pregnancies, where we start counting from the first day of last menstrual period. In principle, embryo implantation occurs around 2-3 weeks before the last menstrual period.

Why does IVF fail with donor eggs?

By Cristina Mestre Ferrer BSc, MSc (embryologist).

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.

What are the donor-egg success rates over 40?

By Rebeca Reus BSc, MSc (embryologist).

With donor eggs, the chances of getting pregnant with donor eggs at age 40-45 reach about 50% in most cases, while with non-donor eggs, they are as low as 19%.

Donor embryo vs. donor egg, what is better?

By Andrea Rodrigo BSc, MSc (embryologist).

No technique is better than the other; it just depends on the characteristics of each patient and what is causing infertility. For instance, in cases where the male partner produces good-quality sperm, egg donation would be the most advisable treatment, as this allows for at least one of the intended parents to share his DNA with future offspring.

On the other hand, if both partners are infertile, double-donor IVF or embryo adoption would be the options of choice. In the former, the eggs and the sperms are of an excellent quality, as they both have been created using donor gametes. As for the latter, it involves using the spare embryos from the IVF cycle of another couple; although it is more affordable from the financial point of view, its success depends on the quality of the adopted embryos. Conversely, outcomes obtained by donation are usually satisfactory, but are dependent on the uterine conditions of the recipient.

As can be seen, several factors have an influence on such decision, so examining each case individually to determine what may be the most suitable option according to medical, economical and psychological aspects is crucial.

Down syndrome runs in my family, can I pass it to my offspring despite using donor eggs?

By Cristina Mestre Ferrer BSc, MSc (embryologist).

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.

What is the average number of eggs retrieved from donors?

By Andrea Rodrigo BSc, MSc (embryologist).

Currently, the average number of eggs retrieved is 10.5 per donor. You should keep in mind that not all eggs collected may be suitable for fertilization, though.

With donor eggs, the rate of mature oocytes is high, as they are collected from young (25 years old on average) and healthy women.

Is donor-egg IVF with PGD for gender selection an option?

By Cristina Mestre Ferrer BSc, MSc (embryologist).

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.

I used donor eggs, when should I tell my child?

By Rebeca Reus BSc, MSc (embryologist).

Deciding when to tell your child depends on your preferences, though experts are in favor of disclosure at some point in the child’s life. Telling earlier may help them absorb the information more easily over time.

Authors and contributors

 Andrea Rodrigo
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia along with the Valencian Infertility Institute (IVI). Postgraduate course in Medical Genetics. More information
 Cristina Mestre Ferrer
BSc, MSc
Embryologist
Bachelor's Degree in Biological Sciences, Genetics & Human Reproduction from the University of Valencia (UV). Master's Degree in Biotechnology of Human Assisted Reproduction from the UV and the Valencian Infertility Institute (IVI). Embryologist at IVI Barcelona. More information
 Rebeca Reus
BSc, MSc
Embryologist
Degree in Human Biology (Biochemistry) from the Pompeu Fabra University (UPF). Official Master's Degree in Clinical Analysis Laboratory from the UPF and Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). More information
 Mark P. Trolice
MD, FACOG, FACS, FACE
Reproductive Endocrinologist
Mark P. Trolice is the Director of Fertility CARE – The IVF Center and Clinical Associate Professor in the Department of Obstetrics & Gynecology (OB/GYN) at the University of Central Florida College of Medicine. He is Board-certified in REI and OB/GYN, and maintains annual recertification. His colleagues select him as Top Doctor in America® annually, one among the top 5% of doctors in the U.S. More information
License: ME 78893