Fertility treatment: Donor eggs and embryos

More than 70 percent of women older than 45 who try assisted reproductive technologies (ART) such as in vitro fertilization (IVF) use donor eggs to try to conceive a child. Over 8,000 babies are born in the United States each year to women of all ages as a result of egg donation and ART. And with advances in egg-freezing technology, using donor eggs for fertility treatment is likely to become even easier.

Egg donation agencies and egg banks are now found throughout the United States. At an egg bank, donor eggs are collected and frozen for purchase, similar to the way a sperm bank operates. Some fertility clinics have even started their own egg banks.

But many clinics still provide ART treatments using “fresh” (nonfrozen) donor eggs, which means the reproductive cycles of both donor and recipient are synced, and eggs are produced and used right away.

Donor embryos – which are always frozen – can also be used with ART. Many fertility clinics and embryo-matching agencies have programs that offer frozen embryos donated by couples who have a surplus after completing ART treatment.

Is fertility treatment with donor eggs or embryos for me?

If you’re older than 40 or unable to become pregnant with your own eggs, donor eggs can help you conceive and deliver a baby. If you and your partner both have fertility problems, or if you’ve had repeated miscarriages because of embryo issues, donor embryos may be an option.

Single women with fertility problems can also conceive using donor eggs or embryos, and men without a female partner can become fathers by using donor eggs or embryos and a gestational carrier. (In certain states, however, there may be laws restricting unmarried people from using gestational carriers. Some embryo donation agencies also require clients to be married.)

If you’re at risk for passing a genetic disease to your child, donor eggs or embryos may be an option, though many couples prefer to try IVF using their own embryos that have been genetically tested to screen for inherited disorders.

How does fertility treatment work with fresh donor eggs?

The timeline for fertility treatment with fresh donor eggs goes something like this:

  • Syncing cycles. If you want to use fresh donor eggs, you and the egg donor take birth control pills and a synthetic hormone (like leuprolide) to get your cycles in sync. Your uterus must be able to support an embryo by the time the donor’s eggs are retrieved and fertilized. The donor takes a gonadotropin – an ovulation-inducing drug – to help her develop multiple mature eggs, while you take estrogen and progesterone to prepare your uterus for pregnancy.
  • Gathering the eggs. Once the donor’s eggs are mature, she gets an anesthetic before having the eggs removed from her ovaries with a needle inserted through the wall of the vagina. The doctor uses ultrasound for guidance.
  • Fertilization. The rest of the procedure is just like IVF. Your partner’s sperm or a donor’s sperm is combined with the donor’s eggs in a laboratory. Three to five days later, each fertilized egg becomes an embryo. The chance of donor eggs resulting in a pregnancy with twins or multiples is about 40 percent, so the doctor is likely to transfer only one or two embryos to the uterus. If the treatment works, an embryo implants in the uterus and grows into a baby. (Any extra embryos can be frozen for future use.)
  • Test for pregnancy. You can take a pregnancy test about two weeks after the embryo transfer.

How does fertility treatment work with frozen donor eggs or embryos?

Fertility treatment with frozen eggs or embryos is similar, but there are a few differences:

  • No cycle syncing. If you receive frozen donor eggs or frozen donor embryos, you take the same types of medications that you would with fresh ones, but the timing is more flexible because you don’t need to sync your reproductive cycle with your donor’s. You start by taking birth control pills and medication to suppress ovulation, followed by estrogen, and later, progesterone. After several weeks, the doctor checks the lining of your uterus to see whether it’s ready for pregnancy.
  • Thawing, fertilizing, and transferring. Frozen donor eggs are thawed and fertilized with your partner’s sperm or a donor’s sperm. Then three to five days after fertilization, the doctor transfers one or two embryos to your uterus. Frozen donor embryos are thawed and transferred after about four weeks of medication. The number of donor embryos transferred ranges from one to five, and generally depends on the female donor’s age at the time the embryos were created.

How long does fertility treatment with donor eggs or embryos take?

It takes four to six weeks to complete an IVF cycle with fresh donor eggs. The donor spends several hours at the clinic having her eggs retrieved. A few days later, the embryos are transferred to your uterus. You can go home that same day.

If you use frozen donor eggs or embryos, the entire treatment cycle takes about six weeks. You need to take medications including estrogen and progesterone for about four weeks before the embryos are transferred to your uterus.

What’s the success rate for donor eggs or embryos?

Here’s what to expect with each option:

  • Donor eggs: Your chance of pregnancy generally depends on embryo quality, the female donor’s age, and the number of embryos transferred. Using fresh donor eggs, you have about a 50 percent chance of giving birth to a child. Frozen donor eggs are a relatively new option, but so far the numbers are encouraging: A recent large study showed a 44 percent chance of having a baby or set of twins after transferring embryos created with thawed donor eggs.
  • Donor embryos: Recent data shows that about 37 percent of frozen donor embryo transfers result in a birth.
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