Egg donation, or ovum donation, is a high-success treatment option that makes family building possible for those facing even the most challenging fertility issues. Dr. Kevin Maas, Reproductive Endocrinology and Infertility Specialist at the Idaho Center for Reproductive Medicine, is intimately familiar with the hope this treatment option can bring as an intended parent.
Dr. Maas and his wife had been attempting pregnancy for five years. In spite of being busy with their careers and not being fully dedicated to the effort, they eventually recognized that this was too long to not have gotten pregnant under normal reproductive health conditions.
They went for a fertility evaluation and learned that Kevin’s wife had a low egg count. They chose to first try in vitro fertilization (IVF) with their own eggs. After six cycles, including two failed embryo transfers and one miscarriage at nine weeks, they began looking at other options.
They chose egg donation, and now, years later, they have no regrets. Through IVF with their selected egg donor, they received five healthy, chromosomally normal embryos, one of whom is now their six-year-old son, Avery, who is “the light of [their] lives.”
Who It’s For
Egg donation, which involves in vitro fertilization (IVF) using the eggs from a patient-selected donor, is a common fertility treatment for individuals or couples who do not naturally have (or have insufficient numbers of) viable eggs or who have had difficulties conceiving with other fertility treatment options
Patients Facing Female Factor Infertility
Many intended parents facing female infertility factors like endometriosis, diminished ovarian reserve, hydrosalpinges/blocked fallopian tubes, or unexplained infertility, may choose to start their journey with IVF using their own eggs. However, patients with ovarian issues, whose own egg supply is insufficient or whose eggs do not properly function, may choose to build their family with the help of an egg donor. Patients who may use an egg donor for this reason include:
- Women in their late 30s and 40s facing age-related infertility, because their supply of eggs and proportion of chromosomally normal embryos has naturally decreased with age
- Women who have undergone chemotherapy or radiation that could have depleted or damaged their eggs
- Women with conditions affecting ovarian function, like Turner’s Syndrome, Fragile X Premutation, and some autoimmune disorders
Fortunately, a woman’s egg supply can be determined prior to treatment through a pelvic ultrasound, called an antral follicle count (AFC), which is usually a component of a standard fertility evaluation. Antral follicles are what develop into mature eggs for fertilization, so by using an ultrasound to see and count the total number of follicles recruited as part of the menstrual cycle, we can get an approximation of the number of mature eggs possible through ovulation.
While a limited ovarian reserve does not make pregnancy (or pregnancy with IVF) impossible, it can make success challenging. For a successful cycle of IVF, the ideal harvest is 15–40 eggs. Starting with less than 10 follicles, the need for multiple rounds of IVF and the possibility of failed IVF becomes more likely.
Patients Who’ve Been Unsuccessful with IVF
For couples who have undergone several cycles of IVF without success, egg donation can be a hopeful next option. Though it can be hard to let go of the possibility for a full genetic relationship, egg donation allows parents multiple points of connection with the baby, including partial biological relation through the sperm, as well as physical connection through carrying the pregnancy.
Single Males & Same-Sex Male Couples
Single males and same-sex male couples are able to start a biological family through a combination of egg donation, gestational carrier, and IVF using their sperm.
The Process
While the precise timeline and inclusion of additional treatments will vary depending on the unique situation and needs of the intended parent(s), this is what you can expect of a typical egg donation cycle:
1) Egg Donor Selection
After securing an egg donor program, you will gain access to a donor database where you will be able to read about and choose an egg donor. Typically, donor profiles include family medical history, personality traits, and physical descriptors. Donors have the option to preserve their anonymity, but many are comfortable providing adult photos and videos; and some are even open to meeting the recipient parents.
For single males and same-sex male couples, this would also be the time to choose a gestational carrier.
2) Egg Retrieval & Sperm Collection
Once they have been confirmed, your egg donor will begin a 10–14-day treatment of gonadotropin injections to stimulate the growth of multiple follicles and the release of as many mature eggs as possible. Once the optimal number of eggs have matured, a trigger injection will be administered to induce ovulation.
Approximately 36 hours from this trigger shot, the egg retrieval procedure will be performed: using a transvaginal needle under ultrasound guidance, fluid will be suctioned out of the mature follicles and the eggs removed from the ovaries. The parent or sperm donor will provide their sperm sample, and the mature eggs will be moved to an embryology lab, where they will be fertilized and cultured for 5–7 days until they reach the blastocyst stage.
On average, in one egg harvest cycle, donors produce 15–40 eggs resulting in 3–10 embryos that can be transferred to the recipient’s uterus.
When you receive more than one viable embryo, you have the option of choosing which one is transferred. Sometimes, parents receive both male and female embryos and have the option to choose the sex.
3) Uterine Preparation and Receptivity Testing
While your egg donor is preparing for ovulation, the recipient parent or gestational carrier will prepare their uterus for embryo implantation. For about 2–3 weeks, they will take estrogen injections to help build up the lining of the uterus, and about five days prior to implantation, they will begin taking progesterone to simulate ovulation and further enhance uterine receptivity.
For patients with a limited number of embryos or for whom an embryo transfer did not work the first time, an endometrial receptivity assay (ERA) can be performed. This molecular level test of the uterine lining can provide information on whether the uterus is ready for implantation, or how progesterone can be adjusted for the next transfer attempt.
4) Embryo Implantation
On the sixth day of progesterone treatment, the embryo is transferred from the lab to the uterus. If extra embryos remain, they can be frozen for later use via cryopreservation.
Benefits & Risks
IVF with an egg donor is a very safe and highly successful method of having a baby. In conjunction with pre-genetic testing, there is a 70–80% success rate after one embryo transfer attempt and a 95% success rate within three transfer attempts.
One of the major benefits of egg donor IVF is that it allows the recipient parent to carry the pregnancy, while also minimizing genetic risks and possible miscarriage through the use of young, healthy eggs.
Risks
- Egg donor IVF is considered a safe procedure, but the egg retrieval comes with a small risk of bleeding, infection, and injury to nearby organs.
- Embryo transfer is also considered a safe procedure. There is a small risk of twins and other high-order multiples (largely dependent on the number of embryos transferred), ectopic pregnancy, and other pregnancy complications.
- The IVF process poses a slightly higher risk of congenital abnormalities; however this risk is so slight that, especially for parents who don’t have existing congenital issues, it is rarely a concern.
- Every method of pregnancy comes with a risk of miscarriage. With IVF, the most common reason for miscarriage is chromosomal abnormality—a risk that can be largely mitigated through pre-genetic testing.
Pre-Genetic Testing & Carrier Screening
Pre-genetic testing of the embryo allows you to test for chromosomal abnormalities prior to implantation by performing a biopsy of the embryo(s) at the blastocyst stage. Known as pre-implantation testing for aneuploidy (PGT-A), this test enables parents to increase the chance of a successful transfer and a healthy pregnancy by selecting the healthiest chromosomally normal embryo for implantation.
Additionally, pre-genetic carrier screening allows you to identify risks in yourself and your donor(s) before proceeding with treatment. This involves a blood test to screen for single-gene mutations associated with genetic diseases. If risks are identified, you can elect to further test the embryo(s) with pre-implantation genetic testing for monogenic disorders (PGT-M) to determine whether the embryo(s) are carriers for the high-risk gene.
Choosing an Egg Donor
Once you’ve decided to have a baby through egg donation, choosing an egg donor can be an exciting process that allows you to find points of connection with your egg-donor baby.
For Dr. Maas and his wife, who is Japanese, preserving cultural ethnic background was important. This became one of their search priorities, and eventually they found their perfect donor: a Japanese engineering student with a quirky personality that mirrored their own.
Alongside physical characteristics and personality traits, it’s recommended that you locate some essential health information. Here are some questions to ask:
- Has your donor been screened for high ovarian reserve?
- Has your donor been tested for infectious diseases?
- Is your donor a carrier for any genetic conditions for which you, your partner, or your sperm donor are also a carrier?
- How much does your donor cost?
- Generally, the cost of different donors will be similar, but it is often slightly higher for those with high success rates or those who live out of the area.
- What are your donor’s previous success rates? Are you open to first-time donors?
- Most young donors respond well to treatment and provide viable eggs, however that cannot be determined before they have gone through a round of IVF, meaning there’s a bit more risk of a failed attempt with a first-time donor.
Preparing for Your Consultation
Decide if You’re Open to a Third Party
Choosing egg donation means letting go of a full genetic relationship with your child, and it’s important that you and your partner discuss your level of comfort with this prospect. Many parents recommend creating an opportunity to process the sense of loss that can accompany this type of decision.
While a period of grief is helpful for many, Dr. Maas reminds parents:
“The genetic relationship is the least important thing. Being there, caring—that’s what makes you a parent. It’s easy to get caught up, but when you’re a parent, you won’t think about that. After egg donation, it’s alway the same: either way, it’s changing diapers and chasing kids around the house.”
Consider Your Readiness
If you’ve already started your infertility journey, you know that committing to a new treatment involves a commitment of time and energy, preparation for uncertain timelines, and readiness for unexpected turns. It’s helpful to prepare by asking yourself and your partner some questions like:
- Are we financially ready? We will have to make some expensive decisions, so what can we afford?
- If attempting to use our own eggs first, how many cycles of IVF are we willing to undergo before using a donor?
- Are we ready to involve an egg donor in our journey?
- How much additional time and energy can we expend if necessary?
Choose Whose Sperm Will Be Used
For same-sex couples, an important decision to make prior to beginning treatment is which partner’s sperm will be used. For some couples, reproductive health or medical family history are the determining factors, in which case a fertility evaluation and pre-genetic screening can aid this decision. Other couples will choose to have their first baby with one partner’s sperm and their next baby with the other partner’s sperm.
Egg Donation With ICRM
At the Idaho Center for Reproductive Medicine, egg donation is one of many options we are proud to offer our patients for starting and building their families.
What makes egg donation particularly successful at our clinic is that treatment and donor facilitation happen under the same roof and under the singular guidance of our team.
Our renowned egg donor program offers a hand-picked selection of high-quality donors, as well as comprehensive navigation of the patient/donor process to both ease the patient experience and ensure top-notch care every step of the way. Having this process managed by ICRM’s clinical team allows parent’s easy access to information about the donor, and removes additional expenses associated with third-party agencies.
Additionally, for patients whose treatment consists of a gestational carrier cycle, ICRM’s team communicates closely with local gestational carrier agencies and reproductive lawyers to provide a smooth experience. We will coordinate both the egg donor and gestational carrier cycles for the best possible outcome.
ICRM’s Egg Donor Database
When you work with ICRM to find an egg donor, we will provide you with our online database which provides a full range of information about our egg donors, including physical characteristics, personality questions and essays, complete medical and family history, and for donors that give permission (the majority), adult photos and videos.
Additionally, all donors—in order to qualify and enter the donor database—have received:
- A serum AMH check and antral follicle count to ensure a high ovarian reserve and strong probability of success
- Infectious disease testing
- Drug screening and health maintenance testing
- A physical exam and psychological evaluation
- Genetic carrier screening
Our database is designed to be easy to use, allowing you to search donors based on:
- Hair color
- Eye color
- Ethnicity
- Education
- Number of embryos produced in previous cycles
And within each donor profile, you will find:
- Additional information on prior IVF cycles (or identification as a first-time donor)
- Personality traits
- Height & weight
- In-depth family medical history & genetic screening results
- Photos, if permitted
While donor profiles are comprehensive and in-depth, our donor coordinators will facilitate your requests for additional information; and if donors and parents both choose to meet, we will help connect you with the donor sibling registry to coordinate these logistics.
Between our team of dedicated physicians, experienced embryologists, and compassionate donor coordinators, we are more than ready to help you navigate successful treatment and to build your own beautiful family through egg donation.
