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.
Provided below is an index with the 11 points we are going to expand on in this article.
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 2021 (National Registry of Activity 2021-Registration SEF), in the case of fresh donation the percentage of pregnancy by transfer in an egg donation cycle is 58.7% and the birth rate by transfer at 44.2%.
In the case of the donation of frozen eggs, these percentages decreased somewhat, being 52% and 39.3%, respectively.
Read more here: Success rates with egg donation.
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?
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.
What tests are recommended for recipients in an egg donation?
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.
Fresh egg donation vs. Frozen egg donation- which is one is better?
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.
What are the risks of egg donation?
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?
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?
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?
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?
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?
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?
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?
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.
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Braga DP, Setti AS, Figueira RC, Azevedo Mde C, Iaconelli A Jr, Lo Turco EG, Borges E Jr. Freeze-all, oocyte vitrification, or fresh embryo transfer? Lessons from an egg-sharing donation program. Fertil Steril. 2016 Sep 1;106(3):615-22 (View)
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.
Kushnir VA, Gleicher N. Fresh versus cryopreserved oocyte donation. Curr Opin Endocrinol Diabetes Obes. 2016 Dec;23(6):451-457.
Ley 14/2006, de 26 de mayo, sobre técnicas de reproducción humana asistida. Jefatura del Estado «BOE» núm. 126, de 27 de mayo de 2006 Referencia: BOE-A-2006-9292 (Ver)
Ovodonante.com, 2017, FIV con ovodonación: pasos del tratamiento para las receptoras, Rebeca Reus, https://ovodonante.com/donacion-de-ovulos/
Sociedad Española de Fertilidad. Registro Nacional de Actividad 2021-Registro SEF. (View)
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?'.
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