What is IVF with egg donation and how much does treatment cost?

By (embryologist), (gynecologist), (embryologist), (gynecologist), (expert in health management), (gynaecologist), (gynecologist), (gynecologist), (embryologist), (embryologist), (embryologist) and (biochemist).
Last Update: 08/07/2022

Donor-egg IVF is a fertility treatment in assisted reproduction that allows a recipient woman to achieve pregnancy using the oocytes of an anonymous donor.

Egg donation is indicated for women who cannot have children with their own eggs, either because they are too old, or because they suffer from some genetic alteration or any other problem with their gametes.

One advantage of donor-egg IVF, whether with partner sperm or donor sperm, is that it has a high probability of success and as such more and more women are turning to it to become mothers.

Provided below is an index with the 11 points we are going to expand on in this article.

Indications

IVF with egg donation is not usually the first choice treatment when a woman or couple goes to a fertility clinic, as patients usually want to try for pregnancy with their own gametes.

Nevertheless, these are the following situations in which egg donation is explicitly indicated:

  • Patients with no ovarian function, either due to primary ovarian failure, premature ovarian failure, absence of ovaries or menopause.
  • Patients with ovarian function but who cannot use their eggs because of transmissible genetic abnormalities, repeated failures in previous IVF cycles or because they are over 40 years old.

This last cause is the most frequent. The quality of the eggs decreases with age increasing the probability that the embryos obtained have chromosomal abnormalities that compromise their viability and cause miscarriage. The chances of having a child with Down Syndrome are also significantly increased.

Chosing the egg donor

Egg donation is a very controlled process. In order for it to be performed, the egg donation candidate must meet a series of legal, medical, and ethical requirements.

A selection process is carried out to assess her suitability to be a donor, in which both her physical condition and psychological aspects are studied.

To be eligible for the egg donation program, the future donor must be between 18 and 35 years old, in good psychophysical condition, and not a carrier of genetic, hereditary, or infectious diseases that can be transmitted to the offspring.

It should be noted that this is an altruistic, voluntary and totally anonymous process: the identity of the egg donor will always remain confidential. Related Article: How can I become an egg donor?

Types of Egg donation

Depending on the origin of the eggs, there are two main types of egg donation: fresh egg donation or vitrified egg donation.

Nowadays, we can also include two other types of egg donations in this classification: eggs from egg banks and mini-egg donation, or shared egg donation, which is also referred as to egg sharing or split egg donor cycle.

In the following section, we will discuss each of them:

Fresh donor egg IVF

In these cases, the donor and the recipient of the eggs must have the hormonal cycle synchronized, so the donor is stimulated while the recipient prepares her endometrium.

In other words, in the same cycle, the donor's eggs are extracted and, after 3 or 5 days, the embryos are transferred to the uterus of the recipient.

The disadvantage of this technique is that if the donor does not respond well to ovarian stimulation, the recipient may have to wait until the next cycle to perform the transfer, which involves more hormonal medication and greater emotional distress.

Frozen donor egg IVF

This treatment doesn’t require the synchronization of donor and recipient. First of all, the donor's oocytes are extracted and the mature ones are frozen by using the vitrification technique.

Once a compatible recipient has been found, these eggs are thawed and fertilized with the partner’s sperm or with the sperm of a compatible donor in the case of a double donation.

As in the previous case, the egg recipient will also have to perform an endometrial preparation treatment prior to the embryo transfer. In this case it will not be coordinated with the donor.

The disadvantage of this method is that the number of eggs available for fertilization may decrease because not all of them survive the thawing process. The current survival rates are still very good thanks to the optimization of the oocyte vitrification technique.

Eggs from egg banks

As we have mentioned in the previous sections, donor eggs can be used either fresh or frozen. In case of fresh egg donation it will be necessary to synchronize the cycles of the donor and the recipient. Otherwise, after harvesting the eggs, they will be frozen until the moment of fertilization, at which point the eggs will be thawed.

For the latter option, the fertility clinic can either have its own donors (its own egg bank) or, on the contrary, work in coordination with an external egg bank.

Health management expert Javier Suarez comments on the advantages of external egg banks:

Having an external egg bank for egg donation treatments offers multiple advantages, such as their expertise in cryopreservation and thawing, removing the need for the synchronoisation of donor and recipient cycles. Perhaps more important is the variety of phenotypes they can offer to help match the babies appearance to that of the mother.

An egg bank is a department in charge of obtaining, evaluating and then distributing donor eggs. Due to their activity, the egg banks have a wide and varied database of donors. For this reason, they can respond to almost any demand from clinics.

This allows fertility centers to offer egg donation treatments almost immediately, as it is rare not to find a compatible donor in the egg bank.

Mini egg donation

Mini egg donation consists of the donation of a smaller number of eggs. While in a complete egg donation the recipient receives all the eggs recovered from the donor, which may be between 8 and 10, in the mini egg donation only 4 or 5 are donated.

Medical Director of FIV Valencia, Dr Miguel Dolz, comments on the two purposes of mini egg donation:

Financial aspect
the cost is significantly lower and thus more women and couples are able to access this treatment.
No surplus embryos are generated
Especially in women or couples who only want to have one child through egg donation. Thus, no surplus embryos are created that must later be donated or vitrified, with the consequent storage costs.

Dr. Miguel Dolz also assures that:

The pregnancy rate per cycle performed in a mini egg donation is the same as with a complete egg donation.

Mini egg donation is also known as shared egg donation, since the eggs extracted from one donor can be used for two or more recipients, always in compliance with current legislation which states that no more than 6 children can be born from the same donor, including their own children.

Egg donation procedure step by step

Once the egg donor has been accepted, it is possible to start the egg donation cycle. The process takes the following steps:

Ovarian stimulation of donor

The donor undergoes hormonal ovarian stimulation treatment to ensure that more eggs develop than in a natural cycle, in which only one would mature. Having more eggs available increases the chances of success.

Then, by means of follicular puncture, the developed eggs are extracted. The mature ones are fertilized in the laboratory with sperm from the recipient's partner or from an anonymous sperm donor which depends on the characteristics of each couple.

The resulting embryos are kept in culture and their development will continuously be evaluated until the day in which the embryo transfer to the recipient takes place.

Endometrial preparation of the recipient

Before the embryo transfer, the recipient needs to get her endometrium prepared so that the embryos can implant in the uterus.

For this purpose, estrogen and progesterone must be administered either orally, vaginally, or in patches so that the endometrium reaches the appropriate thickness (7-10 mm) and becomes receptive.

The embryo transfer to the recipient's uterine cavity will take place between 3 and 6 days after fertilization. The best quality embryo or embryos will be chosen for transfer and the rest will be vitrified for use in subsequent cycles, either for another attempt in case pregnancy is not achieved in this one, or to have another child later.

About 10-12 days after the embryo transfer, the levels of the hormone β-hCG are analyzed to find out whether or not pregnancy has been achieved.

Clinical results of egg donation

Because good quality eggs from young, healthy women are used, the success rates of egg donation are higher than those of IVF with own eggs.

Embryologist Rocio Diaz comments on the success rates:

In older patients, we increase the pregnancy rate when they undergo a fertility treatment with young donor eggs.

According to the statistical report published by the Spanish Fertility Society in 2017 (National Registry of Activity 2017-Registration SEF), in the case of fresh donation the percentage of pregnancy by transfer in an egg donation cycle is 54.7% and the birth rate by transfer at 40.6%.

In the case of the donation of frozen eggs, these percentages decreased somewhat, being 40.6% and 28.4%, respectively.

Read more here: Success rates with egg donation.

Costs

Performing Egg donor IVF makes the fertility treatment more expensive since the medication to stimulate the donor and financial compensation for the discomfort caused must be paid for.

While an IVF/ICSI treatment with own eggs costs between $10,000 and $15,000, when you add in the donation of eggs, the price can range between $14,000 and $20,000 depending on the fertility clinic and the type of egg donation.

The advantage of egg donation IVF is that high-quality eggs are used and the patient usually achieves pregnancy at the first intent. Therefore, it is possible to save the cost of accumulated cycles that would have to be performed if own eggs were used.

IVF with donor eggs is probably the most confusing of all fertility treatments, and oftentimes, a misleading one. Transparency is one of our strict selection criteria when it comes to recommending fertility clinics to our readers. You can create your Fertility Report now to filter clinics based on our selection criteria and get an individual report based on your preferences with answers to your queries and most importantly, to prevent potential frauds.

Interview with Dr. Maria Arqué

In the following video, Dr. Maria Arqué tells us what IVF with donor eggs is and how the selection process works.

FAQs from users

Is a genetic study performed on the partner's semen in an ovodonation?

By Marta Zermiani M.D., Ph.D. (gynecologist).

Before an ovodonation, the male partner is usually asked to undergo a karyotype blood test. The karyotype test examines the size, shape and number of chromosomes. Chromosomes are the parts of cells that contain genes.

At the seminal level, the sperm DNA fragmentation test can be ordered. Thanks to the analysis performed by this test, either of the two types of fragmentation (single or double stranded) can be revealed. If sperm fragmentation is altered in the ejaculate, depending on the predominant type, the proposed treatment will be different.
Read more

By Elena Santiago Romero M.D. (gynecologist).

Those women who are going to undergo IVF treatment with oocyte donation should undergo several tests, regardless of age. Each of them is listed below:

  • CBC with blood count, biochemistry and coagulation.
  • blood group + Rh and indirect coombs.
  • Thyroid study with TSH, T4L and if possible anti-TPO and anti-TG antibodies.
  • Vitamin D.
  • Serology for Syphilis, Hepatitis B and C, HIV, Rubella, Toxoplasma and Cytomegalovirus.
  • Cytology of the last year if possible (at least negative of the last 3 years if same sexual partner).

In addition to these tests, depending on the patient's age, other complementary studies may be requested.
Read more

Fresh egg donation vs. Frozen egg donation- which is one is better?

By Blanca Paraíso M.D., Ph.D., M.Sc. (gynecologist).

Egg donation with vitrified eggs has pregnancy rates very similar to those with fresh eggs. The only difference may be in the number of eggs harvested. In addition, it is also vitally important to have the survival rate of egg devitrification.
Read more

What are the risks of egg donation?

By Rebeca Reus BSc, MSc (embryologist).

Many donors, before getting involved in the process of oocyte donation, are afraid of the consequences that this technique may have, since it is believed to be a dangerous procedure that can even cause cancer.

However, oocyte donation is a safe process with very few side effects, of which the donor is informed before starting it in any clinic. One of them is ovarian hyperstimulation syndrome, which is increasingly rare.

In the following link there is more detailed information about this: Health risks and side effects for donors.

Can egg and sperm donation be done at the same time?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

Yes, it is what is known as double donation. It involves performing an IVF process using both eggs and sperm from donors and not from the furture parents.

You can read more about this in the following article: Double-donor IVF.

What is the number of attempts to achieve success with ovodonation?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

There is no fixed number of ovodonation attempts recommended. It will depend on the characteristics of each infertility situation. There are couples who try numerous times and those who throw in the towel after two or three ovodonation processes.

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, IVF with 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.

If I use donor eggs, will the baby look like me?

By Rebeca Reus BSc, MSc (embryologist).

When matching an egg donor to a recipient, fertility clinics take into account that there is compatibility between them and that they share as many phenotype and immunological characteristics as possible. So, theoretically, yes, a baby conceived with donor eggs is likely to look like the birth mother.

However, it is important to note that the biological mother of the baby will be the egg donor, so in terms of genetic inheritance, the answer to this questions is no, the baby will not look like the recipient, since he or she does not share the genetic load with her.

How does epigenetics affect egg donation?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

Epigenetics refers to the changes that can occur in gene expression caused by environmental factors. Therefore, although in cases of ovodonation the genetic endowment of the embryo comes from the egg donor. During gestation, the maternal environment can influence the expression of these genes.

The experiences I have read of mothers through ovodonation coincide in that they tell their children about the process, but I have doubts, do experts recommend telling their children about it?

By Rebeca Reus BSc, MSc (embryologist).

The decision to tell your children is a very personal one. However, it is a controversial topic and in general, experts recommend telling your children.

In the following link there is more information related to this decision: Pregnancy by ovodonation

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

By Cristina Mestre Ferrer B.Sc., M.Sc. (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 permit it.

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.

In this article, we have discussed the more general aspects of egg donation. If you are interested in this treatment and want to go into more detail, we recommend you read the following article: Egg donation treatment step by step.

There is also another type of egg donation in which donor sperm is used in addition to eggs. This is what is known as double donation IVF. Find out more about it here: IVF with donor eggs and sperm.

We make a great effort to provide you with the highest quality information.

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References

Bjuresten K, Landgren BM, Hovatta O, Stavreus-Evers A. Luteal phase progesterone increases live birth rate after frozen embryo transfer. Fertil Steril 2011;95:534–7.

Eftekhar M, Rahsepar M, Rahmani E. Effect of progesterone supplementation on natural frozen-thawed embryo transfer cycles: a randomized controlled trial. Int J Fertil Steril 2013;7:13–20.

Glujovsky D, Pesce R, Fiszbajn, G, Sueldo C, Hart RJ, Ciapponi A. Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes. Cochrane Gynaecology and Fertility Group 2010.

Groenewoud ER, Cantineau AE, Kollen BJ, Macklon NS, Cohlen BJ. What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis. Hum Reprod Update 2013;19:458–70.

Mounce G, McVeigh E, Turner K, Child TJ. Randomized, controlled pilot trial of natural versus hormone replacement therapy cycles in frozen embryo replacement in vitro fertilization. Fertil Steril 2015;104:915–20.e1.

Ortega I, Garcia Velasco JA. Progesterone supplementation in the frozen embryo transfer cycle. Curr Opin Obstet Gynecol 2015;27:253–7

Robert F, Casper MD, Elena H, Yanushpolsky MD. Optimal endometrial preparation for frozen embryo transfer cycles: window of implantation and progesterone support. Fertil Steril 2016;105:867–72.

Tomás C, Tikkinen K, Tuomivaara L, Tapanainen JS, Martikainen H. (2002). The degree of difficulty of embryo transfer is an independent factor for predicting pregnancy. Hum Reprod; 17:2632–5.

William B. Schoolcraft, M.D., for the ASRM American Society for Reproductive Medicine (April 2016). Importance of embryo transfer technique in maximizing assisted reproductive outcomes. Vol. 105, No. 4. Colorado Center for Reproductive Medicine, Lone Tree, Colorado

FAQs from users: 'Is a genetic study performed on the partner's semen in an ovodonation?', 'What tests are recommended for recipients in an egg donation?', 'Fresh egg donation vs. Frozen egg donation- which is one is better?', 'What are the risks of egg donation?', 'Can egg and sperm donation be done at the same time?', 'What is the number of attempts to achieve success with ovodonation?', 'How much does IVF with egg donation cost?', 'If I use donor eggs, will the baby look like me?', 'How does epigenetics affect egg donation?', 'The experiences I have read of mothers through ovodonation coincide in that they tell their children about the process, but I have doubts, do experts recommend telling their children about it?' and 'Is donor-egg IVF with PGD for gender selection an option?'.

Read more

Authors and contributors

 Andrea Rodrigo
Andrea Rodrigo
B.Sc., M.Sc.
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 about Andrea Rodrigo
 Blanca Paraíso
Blanca Paraíso
M.D., Ph.D., M.Sc.
Gynecologist
Bachelor's Degree in Medicine and Ph.D from the Complutense University of Madrid (UCM). Postgraduate Course in Statistics of Health Sciences. Doctor specialized in Obstetrics & Gynecology, and Assisted Procreation. More information about Blanca Paraíso
License: 454505579
 Cristina Mestre Ferrer
Cristina Mestre Ferrer
B.Sc., M.Sc.
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 about Cristina Mestre Ferrer
 Elena Santiago Romero
Elena Santiago Romero
M.D.
Gynecologist
Bachelor's Degree in Medicine and Surgery from the Autonomous University of Madrid. Master's Degree in Human Reproduction from the King Juan Carlos University and the Valencian Infertility Institute (IVI). Several years of experience as a gynecologist specializing in Reproductive Medicine. More information about Elena Santiago Romero
License: 282864218
 Javier Suárez
Javier Suárez
Expert in Health Management
Bachelor's Degree in Business Sciences by the University of Seville, with Executive Master in International Business Management by the Industrial Organization School and Master in Public Health-Epidemiology by the Pompeu Fabra University. Senior Management of Social Institutions by the San Telmo International Institute. More than 10 years experience in the area of Health Management. More information about Javier Suárez
 María Arqué
María Arqué
M.D., Ph.D.
Gynaecologist
Doctorate in Reproductive Medicine at the Autonomous University of Barcelona, specializing in Obstetrics and Gynecology. Dr. María Arqué has many years of experience as a Reproductive Medicine and Gynecologist Consultant and currently works as Medical Director at Fertty International. More information about María Arqué
Licence number: 080845753
 Marta Zermiani
Marta Zermiani
M.D., Ph.D.
Gynecologist
Graduated in Medicine and Surgery from the Università degli Studi di Padova in Italy, specializing in Gynecology and Obstetrics at the Hospital Universitario de Bellvitge in Barcelona. Specialist in Assisted Reproduction with 4 years experience and currently a gynecologist at Clinica Tambre in Madrid. More information about Marta Zermiani
Licence number: 280847526
 Miguel Dolz Arroyo
Miguel Dolz Arroyo
M.D., Ph.D.
Gynecologist
Bachelor's Degree in Medicine and Surgery from the Medicine Faculty of the University of Valencia (UV) and Doctor in Medicine, finished in 1988 and 1995, respectively. Physician specialized in Obstetrics & Gynecology. Expert in Reproductive Medicine, with more than 20 years' experience in the field. He is the Medical Director and founder of FIV Valencia. More information about Miguel Dolz Arroyo
License: 464614458
 Rebeca Reus
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 about Rebeca Reus
 Rocío Díaz Giraldez
Rocío Díaz Giraldez
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biology and embryologist specialized in Reproductive Medicine. Several years of experience working in embryology laboratories. Currently, she is the lab director of YES! Reproducción in Seville, Spain. More information about Rocío Díaz Giraldez
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Michelle Lorraine Embleton
Michelle Lorraine Embleton
B.Sc. Ph.D.
Biochemist
PhD in Biochemistry, University of Bristol, UK, specialising in DNA : protein intereactions. BSc honours degree in Molecular Biology, Univerisity of Bristol. Translation and editing of scientific and medical literature.
More information about Michelle Lorraine Embleton

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