This blog post is written by Dr. Lucky Sekhon, reproductive endocrinologist, infertility specialist, board certified OBGYN, at RMA of New York. Dr. Sekhon has particular expertise in fertility...
Egg donation can provide the missing link for those struggling to conceive, who want to avoid passing down a genetic disease, or for singles and gay couples who know they cannot conceive on their own. In this article, we’ll explain in more detail what the egg donation process looks like, how egg donors are screened, the factors to consider in your search for the ideal egg donor and the differences between fresh and frozen donor eggs.
The egg donation process - a quick overview
Through egg donation, a donor chosen by the intended parents provides her eggs to be transferred via IVF. Fertility clinics follow a rigorous screening process when it comes to clearing egg donors. Prior to starting the egg donation process, the egg donor undergoes a thorough medical screening to ensure that she is fit to receive the stimulation medication required (more on this below). Her egg reserve is assessed, and her medical history and family and genetic history evaluated. Blood tests are done to check for undiagnosed medical conditions or infectious diseases.
Once the egg donor is cleared by the clinic, she is prescribed hormone medications to stimulate ovulation and the production of multiple eggs. If it’s a fresh cycle, the intended mother will be prescribed estrogen and progesterone to build up the uterine lining and prepare it for implantation.
The next step is the egg retrieval and fertilization with sperm from the intended father or a sperm donor. The best embryo is transferred to the uterus using a thin catheter, a procedure known as a fresh embryo transfer (FET). The intended mother continues her medication (progesterone). If the transfer is successful, once a heartbeat is confirmed, the pregnancy progresses from there, hopefully making it successfully to term.
While there are various reasons why the use of an egg donor may be recommended, the first step is to understand if egg donation is right for you.
Is egg donation right for you?
Deciding to grow your family via egg donation is not easy, however it may be an ideal solution if conceiving naturally isn’t possible. The first step is to consult a reproductive endocrinologist (RE) or your fertility clinic to go over your options. Egg donation may be recommended in the following scenarios:
- Advanced age: fertility naturally diminishes with age as changes start occurring in the ovaries
- Diminished Ovarian Reserve (DOR): when the ovaries no longer produce quality eggs in adequate numbers. This generally occurs with ageing and menopause, but genetic abnormalities, medical treatments or injury may also lead to an earlier DOR
- Primary Ovarian Insufficiency (POI): women naturally experience reduced fertility around 40 years old but for those with POI, this starts earlier - in some cases even as early as the teenage years
- Absence of the ovaries: due to surgery or a congenital malformation
- Poor oocyte quality: an oocyte is an immature egg cell. During ovulation, the oocyte matures and becomes an egg. The number of oocytes decreases with age, as does their quality
- Poor embryo quality: this could be due to a genetic abnormality in the egg or sperm of the male or female partner, or a genetic abnormality in the embryo
- Prevention of genetic diseases: if the intended parent is aware of a condition that could be inherited by the baby
- Previous IVF failure: when IVF was attempted using one’s own eggs
- Men: who are single or in a same sex relationship need the help of donor eggs to conceive
If a medical issue is keeping you from growing your family, the news that you will need an egg donor can be difficult to take. It’s important that, if necessary, you seek support to come to terms with the news and to discuss the way forward. It’s also completely understandable that you may feel wary of using an egg donor for some time, but chances are the desire to have a baby will help you overcome your reservations and concerns.
So, give yourself the time you need. Remember that, donor eggs or not, you will still 1,000,000% be your child’s parent. And then once you and your partner feel ready, it’s time to start searching for the ideal egg donor, one that matches all of your preferences.
Factors to consider when selecting an egg donor.
Choosing your specific egg donor is one of the most personal and important decisions you’ll make. Many intended parents choose to seek the services of an egg donor agency - however, choosing which agency to work with is a big decision in itself and many intended parents go to multiple agencies before they find their perfect donor. To make the process easier, GoStork provides the largest free online database of over 10,000 egg donors from various egg donor agencies all in one place, allows you to compare egg donors side-by-side, then connect directly with the agencies of your favorites.
Egg donor profiles you review include the donor’s physical attributes, education level, medical history, as well as family history, among other elements such as ethnicity and religion. Undeniably, you are presented with a large amount of information, but in this case, the more information the better! To get started, you’ll want to decide what characteristics matter personally to you. Here is a list of criteria you’ll have to consider:
- Age – Donor must be between the ages of 21 and 30 but if you prefer one on either the younger or older end of that spectrum, that’s a valid decision
- BMI – Donors must have a healthy Body Mass Index (BMI) between 18-27, but as far as the donor’s specific weight - that may be a consideration that’s important to you.
- Medical History – Personal health history (ideally, a non-smoker, non-drug user and non-alcohol dependent, has no STDs, and is not undergoing treatment for depression or anxiety - these elements are pre-vetted and indicated for you to consider), family health history (ie. you would be looking for egg donor profiles with no family history of genetic disorders, and no significant family history of cancer).
- Reproductive history – If applicable, you’ll see information about ‘proven fertility’ in egg donor profiles, ie. a previous successful pregnancy shows that the donor has the potential to provide healthy eggs. You may also learn that the donor has donated eggs prior that resulted in a successful pregnancy.
- Appearance – You’ll see the donor’s photos, (ideally current as well as from childhood) and - when available - videos, natural hair color, eye color, height, and, as already mentioned, you’ll see her weight. Many intended parents are interested in donors with similar physical features to themselves, while others are interested in dissimilar features. Again, these are personal decisions and any preference is valid.
- Personal Background – This can range across heritage, religion, characteristics, education, career, and even criminal record. This is obviously a wide range of criteria - so just to explore one example; a donor with a graduate degree or high test scores may be someone you’re ideally looking for - so you could, as a starting point, filter your options through the lens of your desired standard of education. Also, many intended parents look for egg donors with a similar heritage or religious background as themselves.
- Compensation: Fee can range from $8,000 to $20,000 - donors may charge more when they have proven fertility or a higher level of education, among other factors.
- Location - An egg donor close to your IVF clinic can help save you money in covering her travel costs. That said, this may not be your most important criterion - in which case it’s totally up to you to prioritize other factors over where the donor lives.
Choosing Between Frozen or Fresh Donor Eggs
Both fresh donor eggs and frozen donor eggs have specific pros and cons which you should consider:
Advantages of using fresh donor eggs
- Better odds of live birth – IVF with fresh donor eggs has been widely researched and found effective. A national study published in the journal Obstetrics and Gynecology found that the use of fresh donor eggs in IVF has a small advantage in birth outcomes. According to the study’s lead author, Jennifer L. Eaton, M.D., “the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference.” Data from the Centers for Disease Control and Prevention (CDC) also shows that, overall, 55.3% of embryo transfers from fresh donor eggs resulted in a live birth vs. 46.7% for embryo transfers from frozen donor eggs.
- Larger number of eggs – A fresh egg donation cycle will give intended parents anywhere from ten to twenty eggs. This is ideal if you plan on having more than one child: a fresh donation cycle will likely provide you with a good number of embryos to pursue more than one pregnancy.
- No need for ICSI - with frozen eggs, an extra procedure known as intracytoplasmic sperm injection (ICSI) becomes a must (which also adds to the overall cost). The freezing and thawing process makes the shell surrounding the egg hard for the sperm to penetrate on its own. ICSI bypasses this as a single sperm is injected directly into the egg.
Caveats with fresh donor eggs
- Longer timeline – using fresh donor eggs is a longer process: it takes time to match a donor to the recipient and then to synchronize schedules and cycles.
- Greater cost – fresh donor egg IVF is typically more expensive than the frozen alternative: as noted by what to expect, at an average of $25,000, fresh donor eggs amount to around twice the cost of frozen eggs.
- Potential for cancellation – donation cycles can on occasion get cancelled due to poor medication response or issues, or because of an insufficient amount of eggs obtained. Medical issues more specifically may include uterine cysts or bleeding, which can have a negative impact on implantation, preventing the cycle’s success.
Ultimately, when it comes to choosing between fresh or frozen eggs, it all comes down to your personal situation. There is no easy answer as to which is best. Success rates can depend on each individual’s specific case, as well as the expertise of the clinic you’re working with. A doctor and the clinic can help you assess your options based on your medical history and specific circumstances.
We hope that this helped provide the information you need. And remember - the right decision is whatever feels right for you. All the best on your journey!
About Eran AmirWith more than 20 years of experience, Eran Amir has worked as both a software development and product management executive in Israel and the Greater New York Area. The development of GoStork combines his professional skill set with a personal mission. After undergoing a long, difficult, and costly process to expand his family via surrogacy and egg donation, Amir vowed to help other intended parents avoid the complexity and confusion he experienced. His passion led to the creation of GoStork, which proudly names Amir’s two-year-old daughter as its co-founder.
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