In IVF treatments with donor eggs and/or sperm, success rates are higher if compared to cycles where own gametes (eggs and sperm) are used. This is due to the fact that donors are young persons who lead a healthy lifestyle, and are free from genetic abnormalities or diseases affecting their fertility.
A great number of factors have an influence when it comes to achieving a pregnancy, yet the gametes play a major role. Hence the greater number of success stories when donor egg and sperm cells are used.
The various sections of this article are assembled in the following table of contents.
How are statistical data gathered?
Calculating the statistics of each assisted reproductive treatment is a very useful tool to find out what may be your chances of getting pregnant using a particular fertility treatment.
Although these rates should be taken into account, relying on them too much when it comes to choosing one fertility clinic or another is not recommendable. This is due to the fact that basing our decisions only on statistics may easily lead to mistake.
The first aspect to consider when comparing between clinics is whether they are talking about the same results. There are various rates that may translate into success such as:
- The pregnancy rate, in which case we should distinguish between a positive HPT result or if pregnancy development till week 8-12 is taken into account.
- The birth rate
- The live birth rate, which clearly is the most important one.
Unluckily, the reality is that not every pregnancy is carried to term, that is, childbirth does not always occur; that is the reason why attention should be paid to the rates of miscarriage and embryonic arrest during development as well.
Another point to be borne in mind is how many fertility treatments does this clinic perform, since the data they are showing may not be representative. What we mean is the following: if, for instance, a clinic makes a treatment to a single patient per year and she becomes pregnant, the success rate will be 100%; however, it is only obvious that such rate has no value, since it is showing data obtained from a single case.
IVF with own eggs vs. IVF with donor eggs
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.
Success rates of donor-egg IVF by age
By reproductive success we refer to a baby being born, and not to the pregnancy rate. However, more often than not, the success of fertility treatments is measured in accordance with the latter parameter instead of the former.
Odds of getting pregnant are higher if donor eggs are used instead of the woman’s own eggs, since donor eggs come from healthy, young women with a good ovarian reserve; therefore, donated eggs are of optimal quality.
When a woman uses donor eggs to get pregnant, the treatment of choice is in vitro fertilization (IVF), either through conventional IVF or an advanced technique called ICSI (intracytoplasmic sperm injection).
Thus, while the pregnancy success rates obtained in IVF cycles using the woman’s own eggs stand at 35-43% on average, the rates of donor-egg IVF cycles may increase to 55-63% approximately. They depend on uterine receptivity, a factor which has been examined by several authors.
There is evidence that implantation and clinical pregnancy rates are lower in women aged 45-50 than those younger. At the same time, the miscarriage rate increases if compared to women under 45. On average, the clinical pregnancy rate with donor eggs is 69% in patients under 45, while it reaches 63% when the recipient is 45-50 years old.
The above listed results apply only to fresh egg donor cycles. Should it be a frozen donor egg cycle, that is, the embryos are created from donor oocytes after embryo thawing, the success rates are slightly different:
- Pregnancy rate per transfer: 39.7%
- Birth rate per transfer: 24.7%
Nevertheless, these are just general figures and can vary depending on whether partner-donated or donor sperm is used, as well as in cases of double-donor IVF (egg donation + sperm donation). Also, we should keep in mind that these are just average rates, but they may vary from clinic to clinic by country.
Embryo quality is also a major factor. Evidence shows that day-5 blastocyst transfers allow patients to reach higher pregnancy rates as compared to day-3 transfers. Even though it relies on age, embryo quality has a greater impact on the outcomes as well.
The following are the live birth rates per embryo transfer of day-5 fresh embryos by female age:
- Under 35: 68.1%
- Age 35-37: 52.7%
- Age 38-40: 52.0%
- Age 41-42: 37.0%
The greater the number of attempts with donor-egg IVF, the higher the odds of success. Broadly speaking, most women achieve pregnancy after 3 or 4 cycles.
Pregnancy via IVF or IUI with donor sperm
With donor sperm, two different infertility treatments can be used:
- Artificial insemination by donor (AID): The semen is inserted manually through the vagina and placed in the uterus by cannula transfer. Should this be the technique of choice, the eggs used are necessarily from the intended mother.
- Donor-sperm IVF: Donor eggs (double-donor IVF) or own eggs can be used, obtained prior to fertilization by means of ovum pick-up (OPU). Egg insemination can be done following the conventional IVF or the ICSI method.
As for in vitro fertilization using donated sperm, no difference is observed when compared to the average patients, since only a low amount of sperm is used and the male gamete intervenes to a lesser extent in treatments such as ICSI.
On the other hand, a big difference can be seen in artificial insemination treatments if we compare between using the own gametes and donor reproductive cells. While chances of getting pregnant reach 12-15% in cases of artificial insemination by husband (AIH), those of artificial insemination by donor (AID) may rise to 18-25%.
The pregnancy rate per cycle in women under 40 is 22% approximately, while it reaches only 13% when the patient is older than 40. Age plays a major role when determining IUI outcomes, as egg egg quality diminishes dramatically over time.
Out of all pregnancies achieved by AID, 88.5% are singletons, while 11.5% of women get pregnant with multiples. Out of all the multiple pregnancies, 10.1% were twins, 1.2% triplets and 0.2% will carry more than three sacs.
After several IUI attempts, the odds for pregnancy increase, which means it is a cumulative rate. In other words, if a pregnancy is not achieved on the first cycle, the chances for it to occur on a second, third, or fourth insemination are higher.
After 4 IUI cycles, women become pregnant in 60-70% of the cases. Should the treatment still be unsuccessful, experts will recommend you to move on to IVF, as it is a more complex infertility treatment, which improves the success rates to a large extent.
In cases of double-donor IVF, embryo quality is better, since the eggs and the sperm used are more “powerful”, which increases the success rate a bit. However, this depends on other factors such as female age, endometrial receptivity, the characteristics of the uterus, embryo development, etc.
IVF results by country
Many foreign countries count on databases where information regarding the success rates of each fertility treatment is made public, including those obtained after using donated eggs or sperm.
Getting an overall picture of how do fertility treatments work on a particular country is possible thanks to the creation of this sort of reports.
Nevertheless, taking into account a series of aspects is crucial in order to compare between countries:
- Enabling these databases may be optional rather than compulsory, which means that not every fertility clinic will make their data public despite being located in the same country.
- Shown rates can be different; that’s why the pregnancy rate is not to be confused with the rates of birth and live birth.
- Regulations on this field have an influence on the results, given that not all techniques are allowed in the same ways worldwide.
An example of the impact that legislation may have on IVF results, either using own eggs and sperm or from a donor, is related to the amount of embryos to transfer permitted by law. Within the US or India, the maximum number of embryos that can be transferred is not enforced by law. Thus, it is not uncommon to perform 4-embryo o more transfers among clinics located in these countries.
Conversely, in Spain or Italy, a 3-embryo transfer is the legally marked limit for every embryo transfer. Obviously, this automatically translates into slightly lower pregnancy success rates. However, it also means the risk of having a multiple birth diminishes, which means that a lower amount of health complications both for the mother and the fetus will occur, including gestational diabetes, high blood pressure, pre-eclampsia, risk of miscarriage or even fetal death.
In the UK, there is an average 25-40% rate for each cycle if donated oocytes are used, according to data provided by the HFEA (Human Fertilisation & Embryology Authority). Again, this rate is higher than that reached in conventional IVF cycles with own eggs across all age groups.
As for Cyprus, success rates are handled differently depending on the region where the clinic is located. In the North (Northern Cyprus), there is no law which forces clinics to submit their results to a governing body, so there is no verification of them even if they were made public. In the South, there exists a governing body with regulates the results provided by each clinic.
FAQs from users
How successful is IVF with donor eggs?
The success rates of IVF treatments with donor eggs are generally high. However, the ultimate goal may not always be achieved, either because the embryos are unable to implant, or due to a miscarriage. This may happen as a consequence of:
- Uterine abnormalities: Polyps, endometriosis, an intrauterine adhesion or septum, among others. As they may prevent or hinder implantation, surgery may be required before getting started with the treatment.
- Immune disorders: The immune system should be working properly for implantation and a successful pregnancy to occur, as the mother’s body should be capable of “accepting” the embryo.
- Blood clotting disorders (hypercoagulability): Clotting properly is essential for the chances for embryo implantation to rise, and therefore for a term pregnancy to take place.
- Genetic disorders: The sperms may carry a genetic abnormality that prevents the embryo from developing.
- Poor embryo quality: Low-quality spermatozoa may lead to poor-embryo quality. Also, it is possible, though unusual, for donor-egg quality to be low, in which case choosing another donor would be advisable.
How many cycles with donor sperm will I need before success?
The success rates of IUI and IVF, even if donor sperm is used, rely on factors such as age, endometrial thickness and pattern, what is causing infertility and for how long, and the protocol and medications for ovarian stimulation.
In order for the specialist to find out what is leading to failure, every step taken during the process should be examined. If necessary, if the patient’s response to medications was insufficient or inappropriate, the solution may be to just change the stimulation protocol or the meds to take to see whether the results change.
Moving on to another method is another option. For instance, if success has not been achieved after 3-4 attempts with IUI, patients are often recommended to give IVF with own eggs a try. If a successful pregnancy does not occur, moving to donor eggs could give you the chance to become parents.
What are the best success rates for donor-egg IVF abroad?
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.
Can Clomid increase the chances for success of IUI with donor sperm?
Clomiphene citrate, better known as Clomid, is usually prescribed for fertility cycles as a first option, given that it is a low cost fertility drug. The success rates with Clomid are usually high, as it gives patients an 80% chance of ovulating within the first 3 months.
It is an ideal medicine in the following cases: if you are over 35, overweight or underweight. You should keep in mind that dosages have an impact on the success rates. Normally, women start with a 50 mg dosage. If it does not lead to ovulation, your doctor may increase it in subsequent cycles.