For a woman who doesn’t have any viable eggs — whether because of primary ovarian insufficiency (POI), also known as premature ovarian failure, or another condition or complication — pregnancy may feel like a dream.
The happy news is that a woman facing these challenges may be able to experience pregnancy and childbirth by using a donated egg that is fertilized by her partner’s sperm and then implanted in her uterus, where it can grow into a healthy pregnancy.
What is a donor egg?
A donor egg is an egg that has been donated by another woman. The egg will have her DNA, and will be fertilized with partner (or donor) sperm.
The embryo is then transferred to your uterus using in vitro fertilization (IVF) in the hopes that it will implant. If it does, you'll carry the pregnancy and experience childbirth in the same way you would in a pregnancy that occurred with your own egg.[1]
More good news: Because most donors are young, their eggs will be healthy, making the rate of successful pregnancies with donor eggs very high — there’s around a 50 percent success rate per cycle.
Who is a candidate for donor eggs?
If you haven't been able to conceive using your own eggs, you may want to try using donor eggs — a process that has been gaining in popularity in recent years.
The number of IVF cycles that have used donor eggs has increased by about 69 percent from 2000 to 2010, according to one study.[2]
The percentage of IVF cycles that use donor eggs also tends to increase with age, especially in women over the age of 40. Here are a few women who may be candidates for donor eggs:
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- Women who don’t have viable eggs. Older women, for example, or women who have reached menopause are good donor egg candidates. The odds of a woman in her mid-to-late 40s conceiving during an IVF cycle with her own 40-plus-year-old-eggs are 1 percent.[3]
- Women born without ovaries.
- Women who have a medical condition or needed medical treatment that damaged their eggs.
- Women who had poor embryo quality with previous IVF attempts.
How do I find an egg donor?
One way to find an egg donor is to use a fertility clinic or egg donor agency, which will allow you to choose an egg from an anonymous donor. This choice can be confidential, since there's a clearly defined relationship with the donor. Some fertility clinics also allow you to see photos of potential donors before choosing an egg.
You can find a fertility clinic in your state — and browse their success rates — using the Centers for Disease Control and Prevention (CDC)'s assisted reproductive technology (ART) locator or using the Society for Assisted Reproductive Technology (SART) IVF clinic locator.
Or you could receive an egg from a close friend or relative — like, for example, your sister, which will give your baby a genetic link to you. The ideal donor will be younger than 35 years old and won't have a history of infertility.
No matter where your donor eggs come from, the donor will need to be screened for genetic disorders, psychological conditions, infectious diseases, blood type and general health.[4]
How does the donor egg process work?
If you're using fresh donor eggs, you and your donor will first have to synchronize your cycles with medications and hormone shots. Then, your donor will have her egg retrieval when your uterus is ready to receive the embryos created from the donor egg and your partner’s sperm.
If you're using frozen eggs from an egg bank, they're ready whenever you are, and there’s no need to synchronize your cycle with your donor’s. You choose when to have the eggs thawed and fertilized and the embryo(s) transferred.
Is choosing between fresh and frozen a toss-up? Not necessarily. Some research shows a slightly higher chance of a live birth from a fresh donor egg compared to a frozen donor egg. According to some studies, fresh eggs result in a live birth around 50 percent of the time while frozen eggs result in a live birth around 40 percent of the time. Most current research suggests success rates are similar for both methods.
One potential benefit of the fresh donor egg process: If you’re planning to have more than one child using the same donor’s eggs, extra eggs from the live donor cycle can be fertilized, and those embryos can be frozen for later use, ensuring that your future babies will be biological siblings.
Next on the baby-making agenda: involving a lawyer. There are plenty of legal issues surrounding egg donation, and your best protection is a formal written contract with your donor and/or the donor egg agency.
The contract should explicitly state that the egg donor waives all parental rights and that any children born from the donated eggs are legally the recipient couple’s children. It may also specify what will be done with all retrieved eggs and any extra embryos that result.
It’s also recommended that you and your partner meet with a therapist experienced in the emotional side of egg donation to help you work through some of the technical and emotional issues that may arise.
Once all those preliminaries are taken care of, it’s time to get ready for a pregnancy. If you’re using fresh eggs, you and your donor may take hormones to coordinate your cycles (although often the eggs are fertilized and embryos are created and frozen to allow for genetic testing, making cycle synchronization unnecessary) — if you do coordinate cycles, she’ll take fertility drugs to stimulate her ovaries to produce multiple eggs and you’ll take estrogen and progesterone to build up your uterine lining to prepare for implantation.
No synchronization is needed with frozen eggs, though you’ll still need to take estrogen and progesterone in preparation for the embryo transfer. Once the eggs are ready for use, they’ll be fertilized with your partner’s sperm, and the best embryo(s) will be transferred to your uterus, just like in a regular IVF cycle.
How much does it cost to use a donor egg?
Fresh donor eggs are, on average, about twice the price of frozen donor eggs. Your cost for fresh eggs can be in the tens of thousands, with the average cost somewhere around $35,000. Then you’ll have to add all the other fees: all those hormone shots for you, ultrasounds, bloodwork, doctor visits, travel fees for the donor, legal fees and so on.
And if you need more than one IVF cycle to achieve pregnancy, those costs multiply. Add that all together and you could be looking at a total price of $35,000 to $65,000.
Frozen eggs are less expensive (though still costly) because all you’re paying for is the cost of the eggs plus shipping, and then the costs associated with IVF for you. However, your cost per egg (or per embryo) is generally less with fresh cycles as so many more eggs are retrieved.
Are donor eggs covered by insurance?
Donor eggs used to not be covered by insurance, but more and more plans with IVF coverage are sometimes including donor eggs. As always, your best bet is to call your insurance plan and ask what is and isn’t covered.[5]
Egg donation gives hope to women facing fertility challenges related to their eggs, enabling them to experience pregnancy and childbirth and the joy that comes with having a baby of their own.