The procedure of egg donation is an alternative option to IVF with own eggs. In this case, a woman becomes an egg donor for an infertile intended mother that cannot use her own oocytes. The success rates of donor-egg IVF are lower in women over 40. The donor baby will not have the genes of the birth mother but those of the donor, i.e. the biological mother.
The pros and cons of using donor eggs to get pregnant, whether fresh or frozen, should be weighed before making a hasty decision. Factors such as the cost, which is higher than a normal IVF procedure, and the risks involved are of outmost importance. The following is a comprehensive guide to this fertility option.
The various sections of this article are assembled in the following table of contents.
What is egg donation?
Egg donation is an option for infertile women willing to have a baby. It involves the presence of two main parties: the recipient or intended mother, and the egg donor. When using donated oocytes, in vitro fertilization (IVF) is the only treatment of choice.
Broadly speaking, the following are the main pros and cons of egg donation:
- Advantages: the woman can go through all the stages of pregnancy, have a baby and give birth as if it was a natural pregnancy. Also, the baby has a genetic connection to the male partner.
- Disadvantages: the first one is that the child will not have any biological connection to the mother. Secondly, egg donation cycles are expensive, although it depends on the country.
The history of this treatment goes back to 1984, and was specially aimed to those women who have fertility problems due to early menopause, surgery for ovarian cysts, or malignant diseases, and until then saw themselves with the impossibility of becoming pregnant.
Process of donating eggs
Generally, egg donors act altruistically. Nevertheless, it is allowed that egg donors are rewarded with an economic compensation for the potential risks and inconveniences that might arise from the treatment.
While in some countries the minimum egg donor compensation is addressed on the regulations governing this field, others leave flexibility regarding how much money should be paid to the donor.
Regarding the donor profile, policies vary from country to country. For example, while some have egg programs where the donor must remain completely anonymous, others allow that it is the recipient who chooses the donor profile or even gets to know her in person.
Who is a good candidate?
In the case of single women, lesbian couples, and heterosexual couples, egg donation may become necessary due to many reasons. The following are the most common causes why women become egg recipients:
- Poor or zero ovarian reserve
- Genetic alterations or diseases
- Advanced maternal age
- Risk of transmitting a hereditary disease to offspring
Out of the causes mentioned above, low ovarian reserve is the most common one, either of natural origin or as a consequence of a medical treatment such as especial medication or cancer treatments, or a surgical intervention (having one or both ovaries removed).
As a woman ages, the quality of her eggs becomes poorer, and her ovarian reserve keeps on diminishing. Today, the phenomenon known as delayed motherhood is a major reason leading to an increase in the demand for IVF with donor eggs among women over 35-40.
Donor-egg IVF process step by step
Using an egg donor may seem complicated, but the process every receiving woman should follow is almost the same to that followed in IVF. The following is a guide to the donor egg IVF process step-by-step:
Finding a fertility specialist
Single parents and infertile couples who decide to travel abroad for IVF with donor eggs should look for the clinic that best fits their personal needs. And the same applies in case they wish to undergo this treatment in their home country.
Do seek experienced doctors, nurses, and counselors willing to guide you through this procedure. Choosing the right fertility clinic is a key step to make the most out of your donor egg experience.
Make sure the center has good quality control, strong ethics, and ask them for their live birth success rates. Pay attention to the location, search for the testimonials of previous patients on different egg donation websites and/or forums, etc.
Evaluating your fertility
The next step is all about cycle preparation. You may be ordered several tests to identify any potential abnormalities that may reduce your chances of success (e.g. fertilization and/or implantation failure).
Women in their 40s or even 50s may be required additional testing in order to ensure they are able to get pregnant in optimal conditions. Thanks to it, high-risk pregnancies can be prevented.
Ask your fertility clinic for the costs of your donor egg IVF cycle, what’s included and what’s not, what are the donor fees, etc. The cost of oocyte donation varies from country to country.
Choosing an egg donor
Choosing a donor is crucial, as well as a uniquely personal decision. In some cases, consulting with an experienced psychologist may be helpful in order for patients to make up their minds.
Although in most European countries, egg and sperm donors must remain anonymous (Spain, Cyprus, Greece, Czech Republic, France…), there are countries such as the USA where non-anonymous donors are acceptable as well.
Once you choose a donor, she will have to undergo extensive genetic and mental screening. It is not until your donor coordinator confirms she is healthy to go through the egg donation process when the cycle begins.
Deciding between fresh or frozen eggs
In case you prefer to use fresh donor eggs, then your cycles must be synchronized. This step is crucial, as it allows the recipient’s uterine lining (endometrium) to be prepared for implantation right after the retrieval of the donor’s eggs.
The hormone therapy for recipients can be administered either orally, vaginally or using patches. The aim is to reach the ideal endometrial thickness, which is the mucosal layer of the uterus where embryo implantation takes place.
The donor has to take stimulation of ovarian function medications that trigger the growth and maturation of a number of eggs. For 10 to 14 days, she will be monitored until the eggs are ready to be harvested.
Frozen cycles are easier from a procedural point of view. In this case, the patient works with an egg bank, from which she gets a certain amount of unfertilized eggs. After being fertilized with the husband’s or donor’s sperm, an embryo transfer is carried out.
Pregnancy test after donor-egg transfer
Once the donor’s eggs are retrieved, your partner or sperm donor has to provide a semen sample on the day of the ovum pick-up, so that the eggs are inseminated for the creation of human embryos.
The embryos are left in culture until they reach the proper stage for transfer, usually on day 3. That is the moment when recipients have to return to the clinic for transfer to the uterus.
Patients have to decide how many embryos to transfer in this very moment. Although experts typically recommend single embryo transfer (SET) to reduce the chances of multiple births, it is a topic for discussion with your doctor.
Once the endometrium acquires the ideal thickness, that is, trilaminar appearance and a 8 mm lining, the embryos will be transferred and their implantation awaited.
Embryo transfer (ET) is a simple, painless procedure after which the only thing left to do is waiting for embryo implantation. In other words, pregnancy is what every woman expects after performing an ET. You can find out whether you are pregnant within 10 days by means of a beta-hCG pregnancy test.
Risks to the recipient
The number of side effects recipients may experience during and after undergoing an IVF cycle with donor eggs is considerably lower than that expected for donors.
Having a multiple pregnancy is the principal risk of egg donation for the recipient. This may occur when multiple embryo transfers are carried out, because the fact that donors are young women increases the pregnancy success rate.
It should be kept in mind that the age of the recipient does not have an influence on the final outcome, even if she is 40 or over. Inversely, being pregnant with multiples increases the chances of:
- Premature birth
- Gestational diabetes
- Heart problems
- Placenta previa
- Iron deficiency anemia
For this reason, experts do recommend to limit the number of embryos to transfer, generally to no more than 2 or 3 for day 2-3 transfers. If the embryo is transferred on day 5 (blastocyst stage), a single or two embryo transfer.
Donor eggs are from the highest quality, since they have been delivered from young, healthy women who do not suffer from any fertility problem. Besides, to be accepted as donors, they must undergo a series of thorough medical tests to ensure their optimum state of health.
Bearing this in mind, it is only logical that IVF cycles using donor eggs usually present higher success rates than those cycles that are performed using the patient’s own eggs.
The following statistical data should be taken into account when deciding to use donor eggs:
- Recipient age: women over 40 have lower implantation rates, live birth rates, and clinical pregnancy rates. Subsequently, the miscarriage rate is higher.
- Uterine receptivity: it declines with advanced maternal age, especially if there is history of pathological conditions in the uterus such as myomas or polyps.
- Hypertension: along with other systemic disorders, it is more common in older women, something that might contribute to reduce the implantation potential.
Also, chances of getting pregnant with donor eggs may vary depending on other factors such as the recipient’s anatomy of the uterus, using frozen versus fresh eggs, the ages of the donor and the recipient, what is causing infertility on the recipient, etc.
If you want to find detailed information about success rates, you can read the following article: Pregnancy success rates with donor eggs.
Egg donation and surrogacy
Host, full or gestational surrogacy is the name given to the process of using an egg donor and a gestational carrier to have a baby. It is often the treatment of choice for single men and gay couples.
Because of their own anatomy, it is obvious that single men or gay couples are unable to naturally conceive a biological child without a female partner. This is the reason why they have no choice but to start a surrogacy treatment using their own genetic material (sperms) in combination with donor eggs.
Although it is considerably more expensive than traditional or straight surrogacy, in which the surrogate’s own eggs are used, this type of surrogacy is usually the preferred one, as it is less legally complex and become harder emotionally.
To make the dream of being a father come true, men can start an IVF cycle using their own sperm with donor eggs (either from an anonymous or known donor). Thus, the surrogate mother is genetically unrelated to the baby-to-be.
If conception occurs and the embryos develop, only those of the highest quality will implant into the gestational carrier’s uterus. It should be clear that the role of the surrogate is to rent her womb for the gestation of a child, but she won’t act as the child’s legal parent.
Should you need any further information, please visit the following post: Egg donation and surrogacy.
FAQs from users
Donor-egg IVF vs. adoption, which one is better?
Both donor assistance and adoption offer the pleasures of parenting, so it is up to you. Prospective parents should focus on long-term aspects such as how this decision could affect their family life.
I used donor eggs, when should I tell my child?
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.
How can recipients cope with grief and regret after using donor eggs?
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.
What is the relationship between epigenetics and egg donation?
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.
Does a baby conceived via donor eggs resemble birth mom?
Keeping in mind that egg donors should be compatible with recipients, so that they share certain characteristics such as the hair, eye, and skin color, ethnicity, height, etc., the donor-conceived baby will share certain physical traits with her.
Suggested for you
In order to use donor eggs, in vitro fertilization (IVF) is the only technique of choice, as we have seen throughout this post. If you want to learn more about the entire process, do not miss this specific article: What is donor-egg IVF?
How can a woman become an egg donor? Whether you are a woman considering donating your ova or a patient willing to know how are potential donors screened, the following post will enlighten you and clear any doubt you may have: How to become an egg donor.
Should you need a gestational carrier (GC) in addition to an oocyte donor, you should know the IVF process in these cases is almost the same, with the difference that the embryos are transferred to the GC’s uterus instead of the intended mother’s. Learn about the process here: Gestational surrogacy.