Many women come to my blog to read about pregnancy and in some cases infertility. I am happy to offer a guest post regarding the topic of IVF and donor eggs. I hope this can be helpful to anyone exploring this option.
For families experiencing infertility, the journey to parenthood can be a deeply trying time. This is especially true for those struggling to conceive with their own eggs. Helplessness and despair are commonly felt. However, becoming pregnant is still very possible via egg donors who help women faced with infertility challenges. In Vitro Fertilization (IVF) with eggs from donors is a highly effective treatment and a potential option to explore as you continue on the family building journey.
The Emotions Involved
The decision to use donor eggs is often accompanied with mixed emotions; grief over the lack of genetic connection to the child, uncertainty about choosing the donor, and anxiety surrounding the procedure are all common. While the negative emotions may seem overwhelming, there is respite ahead.
As the possibility of pregnancy becomes more likely through the use of donated eggs, families may find hope. Sometimes this is not immediate, but made possible with the assistance of counselors trained in third-party reproduction. These counselors help sift through the complex emotions and range of feelings that is unique to each couple, helping to build a set of coping skills to navigate through the process. Counseling is quite helpful and often required for those considering treatment with donor eggs.
Selecting the Egg Donor
Deciding which specific egg donor to utilize is a significant part of the process. Some women locate their donor within their network of family or friends and ultimately proceed with a fresh egg donation cycle. Others locate their donor through a clinic, agency or egg bank and continue with either a fresh or frozen donor egg cycle. There are numerous donor egg programs to choose from. These programs provide varying amounts of information about the egg donors, but most include family medical history, physical characteristics of the donor, and a general overview of the donor’s personality and accomplishments. Many programs share childhood photos, and some may share photos of the donor as an adult. This decision can be overwhelming, but you are not alone. A good donor egg program, like the one at Donor Egg Bank, will have a dedicated professional to assist you in finding the right donor and alleviating the anxiety that often accompanies this process.
Choosing Fresh or Frozen Donor Egg
For those deliberating IVF using donated eggs, there are two notable treatment modalities: undergoing a fresh egg donation process or using frozen donor eggs. In examining the two possibilities, it is recommended to look at the method, price, timeline, and success rates of both to help you decide.
The Fresh Donor Egg Process
All egg donors need to meet clinical requirements, as well as FDA requirements, to donate eggs. This screening process is important. It is evaluating the markers for potential success as an egg donor and ensuring the donor is healthy enough to undergo the process. Screening includes an in-depth look at the donor’s family medical history as well screening for infectious diseases, fertility potential, and in most cases meeting with a psychologist. In a fresh donor egg cycle, this occurs after the woman has matched to the egg donor. Therefore, the time needed to complete the screening, and the associated costs, are important points to consider.
Once the screening is complete and the donor is approved, the recipient and the donor begin the treatment plan, commonly referred to as “the cycle.” In a fresh cycle, the goal is to synchronize the donor’s menstrual cycle to the recipient’s. This is most commonly achieved by placing both parties on birth control pills. Once the synchronization has occurred, the recipient and egg donor begin medications. The donor requires injectable medications on a daily basis for about 10 days. During this time, she is seen frequently by the clinic monitoring the donor’s response to the medications. The goal of these medications is to mature multiple eggs within the ovaries. Once the donated eggs are mature, the donor will have her eggs retrieved in an outpatient surgery knows as the Egg Retrieval.
The recipient begins medications to build a thick uterine lining around the same time as the donor begins her medications. The challenge is to build a good endometrial lining by the time the donor’s eggs are retrieved. If the lining looks appropriate, and mature eggs are retrieved from the donor, the process continues. Sperm and egg are introduced in a petri dish, where fertilization will hopefully result. From there, the resulting embryos grow in a special incubator until they are ready for embryo transfer sometime between day 3 and day 6 of embryo development. It is important to note that not all of the eggs will fertilize and not all of the embryos will continue to grow; this is expected.
When the physician is ready for the embryo transfer, the chosen embryo will be placed directly into the recipient’s uterine cavity. (Any remaining embryos that have not been transferred may be cryopreserved for future use.) After the embryo transfer, the recipient will continue medications up until the pregnancy test, which normally occurs two weeks after the egg retrieval. Hopefully pregnancy is confirmed and the recipient will continue the medications until advised by her physician to stop.
Costs can be an important factor to consider in a fresh egg donation cycle. The initial screening can range from $2,000- $4,000. Legal fees for the egg donation are often required, and range from $500-$1,000. Egg donors are generally compensated, at a cost between $5,000-$10,000. The medical treatment fees for the egg donor and the recipient averages $15,000 and does not include the drug cost for the egg donor or recipient, which ranges from $3,800-$6,000. Adding these fees together, one can expect to the total cost for an IVF cycle with fresh eggs from donors to be between 27,000 to $40,000.
In a fresh egg donation cycle, you need to factor in both screening and the treatment timeframes. The screening time can range from 3 weeks to 2 months depending on the donor’s schedule and where she is in her menstrual cycle. Once approved to donate, the synchronization process begins, averaging about three weeks. Finally, the IVF treatment cycle takes an additional three weeks.
It is important to remember that the egg donor has a dynamic life that may interfere with the timing of the process. While egg donors are usually quite committed to the donation cycle, they are also human and may forget to take a medication or have a work/family obligation come up suddenly, all of which can impact timing. They may also not respond to the medication as expected. Please note that about 10% of fresh egg donor cycles are delayed or canceled due to unexpected variables.
The Frozen Donor Egg Process
In a frozen donor egg cycle, the eggs from donors have already been retrieved, cryopreserved, and are ready for use. This means frozen donor eggs offer the opportunity to begin treatment immediately. The screening and cycling times and costs are no longer variables to consider, given that they happened previously. As such, using frozen donor eggs is a faster, more affordable process.
The cryopreserved eggs have been assessed for maturity and are usually offered in an egg lot size of 6 eggs. (Some programs have more or less than 6 egg in the lot.) This number is usually less eggs than the number retrieved from a donor in a fresh cycle, however it is a sufficient number to attempt an embryo transfer successfully.
After the frozen donor egg lot is selected, the eggs are shipped overnight to the recipient’s practice. Since there is no requirement to synchronize the recipient’s cycle, the timing of the procedure is dependent only on the recipient’s schedule. The recipient is given medications to build a thick uterine lining; when the lining looks appropriate, the eggs are warmed. After the egg warming, the process of fertilization, embryo development and embryo transfer mimics the process outlined above in the fresh egg donation section.
The cost of a frozen donor egg IVF cycle is considerably less expensive than fresh donor egg. Donor eggs already retrieved and ready for immediate use cost can cost as little as $13,000. Programs average $18,000-$21,000 for the entire treatment process, which includes the egg thaw, embryo culture, and transfer back into the waiting womb.
The time needed to complete a frozen egg donation cycle is about 5 weeks from start to finish.
IVF with donated eggs is considered one of the most successful treatment options in Assisted Reproduction. The national average for fresh egg donation delivery rate is roughly 50% per transfer, while the national averages for frozen egg delivery rate is around 44%. However, in experienced clinics, the frozen donor egg delivery rates mirror the fresh rates, and sometimes exceed them. In experienced hands, the success rates are the same.
The Donor Egg Path to Parenthood
While the path to becoming parents looks different to each family, fresh and frozen donor eggs are successful methods to explore when conceiving with your own eggs is no longer possible. Finding good programs and experienced clinics to assist you in the process can help make your family building goals a reality.