In-Vitro Fertilization (IVF) with Donor Eggs
If you or your partner are struggling with infertility, in-vitro fertilization (IVF) with donor eggs may be an option.
In this article, we'll cover everything you need to know about IVF with donor eggs, from how it works to its success rates to the emotional challenges it can bring. We'll also talk about how IVF with donor eggs can be a great way for LGBTQ couples to build their families.
We want to be clear that all families are created equal, and we support all couples who are trying to build their families, regardless of their sexual orientation or gender identity.
Why donor eggs may be necessary with IVF
There are several reasons why a person or couple may need to use donor eggs to achieve a pregnancy through IVF. These include:
Premature ovarian failure (POF): Premature ovarian failure (POF) or early menopause is when the ovaries stop working properly before age 40. This can make it hard or impossible to produce healthy eggs. POF causes low estrogen levels and prevents the ovaries from releasing mature oocytes.
Diminished ovarian reserve (DOR): This is when the ovaries have a lower number and quality of eggs. DOR can be caused by age, medical conditions like endometriosis, or previous treatments that damaged the ovaries.
Advanced maternal age: Fertility declines with age, especially after 35, due to decreased egg quality and quantity.
Genetic conditions: People who carry or have certain genetic conditions may use donor eggs to avoid passing them on to their children.
Unsuccessful IVF attempts: People who've had multiple unsuccessful attempts at assisted reproductive technology (ART), such as IVF, intrauterine insemination (IUI), or artificial insemination, or who have other fertility challenges, may choose IVF with donor eggs.
Why LGBTQ couples and individuals may need donor eggs
LGBTQ couples and individuals may need donor eggs for a variety of reasons:
Trans women: Trans women assigned male at birth (AMAB) may not have ovaries or functional eggs.
Lesbian couples: Lesbian couples may choose to use donor eggs if they don't have a male partner who can provide sperm.
Single LGBTQ individuals: Single LGBTQ individuals may use donor eggs to have a child without a partner.
Donor eggs can be a life-changing option for people struggling to conceive. With the help of donor eggs, people can build their families and experience the joy of parenthood.
How donor eggs are used in the IVF process
The IVF process with donor eggs is similar to standard IVF but with a few key differences:
Matching with a donor: Finding a suitable egg donor is the first step in using donor eggs in IVF. Fertility clinics and agencies have databases of donors who meet specific criteria, such as age, health, and personal characteristics. According to the American Society of Reproductive Medicine (ASRM), the ideal donor should be between the ages of 21 and 34, have a healthy medical history, and undergo thorough screening for infectious diseases and genetic disorders.
Synchronizing cycles: Cycle synchronization is critical in IVF with donor eggs. It involves using medications to adjust the recipient's and donor's menstrual cycles so that the recipient's uterus is primed to receive and support the donor-egg embryo at the time of embryo transfer.
Egg retrieval: Once the donor’s eggs have matured, they’re retrieved from the ovaries. This minor surgical procedure is performed under anesthesia in an outpatient setting. During the retrieval, a fertility specialist uses an ultrasound probe to guide a thin needle through the vagina and into the ovaries to remove the eggs. The entire procedure takes about 5-10 minutes.
Fertilization and embryo development: After retrieval, an embryologist fertilizes the donor eggs with the recipient's or donor's sperm in a petri dish using a process called insemination or ICSI.
Embryo transfer: Once the embryos have developed to the blastocyst stage (5-6 days after fertilization), they're transferred to the recipient's uterus using an ultrasound-guided catheter.
Fertility clinics sometimes offer preimplantation genetic testing (PGT) before embryo transfer to check for genetic problems. However, studies show that PGT doesn't improve live birth rates or lower miscarriage risk in donor egg cycles.
Success rates with donor eggs in IVF
IVF with donor eggs is a complex and individualized treatment, so success rates can vary depending on several factors, including the recipient's age, the quality of the donor eggs, and the fertility clinic.
CDC data shows that 41.4% of women of all ages who had an embryo transfer using donor eggs or embryos had a live birth.
Separately, the American College of Obstetricians and Gynecologists (ACOG) found that women who used eggs from healthy, young donors had a live birth rate of 51% per transfer.
It's important to remember that these are averages. Some IVF cycles may have a higher or lower success rate depending on a variety of factors, which we cover below.
Factors that affect egg donor IVF success rates
IVF isn't guaranteed to result in a successful pregnancy, and several factors can influence the success rates of IVF with donor eggs:
Recipient age
Recipients of an advanced maternal age (older than 35) are at an increased risk of certain adverse maternal and fetal outcomes, including gestational diabetes mellitus, hypertension, cesarean delivery, chromosomal abnormalities, miscarriage, and preterm labor.
A 2021 study found that out of 343 completed IVF treatment cycles, the overall clinical pregnancy rate was 40.2%. Of these cycles, 69.4% (238/343) were donor egg cycles. Within the donor egg group, 99 (41.6%) clinical pregnancies were established, resulting in 92 (38.7%) live births.
Recipient medical history
Certain medical conditions, such as endometriosis, polycystic ovary syndrome (PCOS), and uterine abnormalities, can affect IVF success rates, even with donor eggs.
Donor age and egg quality
Egg banks typically have strict age restrictions for donors, with a cutoff of 35 years old. This is because egg quality declines with age, and younger donors tend to have higher success rates regarding egg quality and the likelihood of achieving a successful pregnancy.
Chosen donor
The donor's reproductive health, physical traits, and genetic profile can also play a role in the success of donor egg IVF.
Selecting a donor with a healthy medical history, physical traits similar to the intended parent or parents, and a genetic profile compatible with the recipient's is important.
Couples or recipients who choose a friend or family member as a donor may face additional challenges, including:
Increased risk of genetic disorders and complicated relationships: Known donors may not be screened as thoroughly as anonymous donors, which could increase the risk of genetic disorders in the child and complicate the relationship between the recipient and donor.
Potential impact on psychological and emotional well-being: Using a known donor could have potential psychological and emotional implications for both the recipient and the donor.
Varying laws and regulations: Laws and regulations around known donor IVF vary widely, and there may be ethical considerations to weigh.
Fresh vs. frozen eggs
Fresh donor eggs are eggs that are retrieved from a donor and used immediately for IVF. Frozen donor eggs are eggs that have been cryopreserved (frozen) for later use.
Generally speaking, FET has several advantages over fresh transfer, including higher implantation rates, better obstetrical outcomes, and more optimal timing. FET also allows for a more natural transfer experience because the embryo can be frozen until the recipient's hormone levels return to a more natural state.
FET is a standard of care for all patients undergoing IVF at RMA.
Other factors
Other factors that can affect the success rate of IVF with donor eggs include:
Recipient lifestyle (this includes weight, smoking, and excessive alcohol consumption)
Recipient immune system
Type of fertility medication used
Thickness and quality of the recipient's uterine lining
Recipient stress levels
Fertility clinic expertise and protocols
How are donor egg success rates and IVF success rates different?
According to the Society for Assisted Reproductive Technology (SART), the live birth rate for donor egg IVF cycles in 2020 was 40.5% (for all ages). This is significantly higher than the average live birth rate per fresh and frozen IVF retrieval for women using their own eggs.
It's important to note that these are just averages, and individual success rates may vary.
Should you consider IVF and donor eggs?
Whether or not to consider IVF with donor eggs is a personal decision that depends on each individual's unique circumstances and preferences.
Here are a few factors to consider:
Age: IVF with donor eggs is often recommended for people over 40 or those with other fertility challenges that make it difficult to conceive with their own eggs.
Medical history: People with certain medical conditions, such as premature ovarian failure or genetic disorders, may also benefit from using donor eggs in IVF.
Finances: The cost of IVF with donor eggs can be higher than traditional IVF due to the additional cost of sourcing and screening a donor and the costs associated with the egg retrieval and transfer process.
Emotional readiness: IVF with donor eggs is a complex process that can raise emotional questions about genetic connection and parental identity.
Speak with Our Fertility Specialists
If you're considering IVF with donor eggs, RMA can help you make your dream of parenthood a reality.
Our fertility specialists are here to support you every step of the way. Together, we can create a customized plan that addresses your unique needs and maximizes your chances of success.
Give us a call or schedule a consultation to speak with one of our staff about your options and to learn more about which infertility treatment is best suited for you.