Donor Eggs in Fertility Treatments

If a couple cannot get pregnant using the woman's own eggs for in vitro fertilization, they may want to consider using donor eggs. Donor eggs -- and sometimes donor embryos -- allow an infertile woman to carry a child and give birth. You might be a candidate for donor eggs if you have any of these conditions:

• Premature ovarian failure, a condition in which menopause has started much earlier than usual, typically before age 40
• Diminished ovarian reserve, meaning that the eggs that you have are of low quality; this can often be caused by age, because fertility drops off steeply after 40.
• Genetically transmitted diseases that could be passed on to your child
• A previous history of failure with IVF, especially when your doctor thinks that the quality of your eggs may be the problem

The use of donor eggs is becoming more common, especially among women over 40. In 2018, over 42% of all assisted reproduction techniques using fresh donor eggs resulted in a birth.

Finding and Choosing an Egg Donor

Most egg donation is anonymous, but some couples prefer to know their egg donor and take legal steps to contract for the donation of the eggs. If the donor knows the couple, the donor may wish to receive updates once the child is born or may even request visits. An egg donor contract that explicitly spells out the terms of any future relationship should always be used, even when the donor is a close friend or relative.

If you decide to use donor eggs, ask your fertility clinic if they have available donors that they have already screened. Because some clinics have long waiting lists, you may prefer to find a donor through one of many egg donor agencies and registries. Some people place ads for donors in college newspapers or other publications that young women read.

Finding a donor yourself can be faster than going through a busy clinic, but there is a serious disadvantage: You will have to interview the donor yourself rather than having a professional screen and evaluate them. It's crucial that donors be tested for any genetic disorders or diseases such as HIV. This is also true for women using donor sperm.

Egg donor programs vary in their requirements, but most conduct extensive screening and provide you with detailed information about the medical history, background, and education of the donor. Some programs have strict age limits; they won't accept donors older than their mid-20s. The American Society for Reproductive Medicine recommends that egg donors be under the age of 34.

What to Expect With Egg Donation

The procedure for egg donation and implantation is similar to standard IVF treatment. After a thorough exam, the woman receiving the donor egg will need a course of hormone treatments to prepare them for the fertilized egg/embryo. If they still have functioning ovaries, they'll need estrogen and progesterone treatments in order to make their cycle coincide precisely with the donor's.

Meanwhile, the donor will also be treated with hormones to induce superovulation. Once they are ready, the eggs will then be retrieved and fertilized. A few days later, the embryo or embryos are implanted in the recipient's uterus. They will continue to take hormones for about 10 weeks afterward.

Donor eggs can be frozen for later use, but the chances of success are lower with frozen eggs.

A newly available option is donor embryo implantation. In this technique, you use a previously frozen embryo that was left over from another couple's IVF treatments. That couple may have gotten pregnant, or decided against IVF. Whatever the reason, they've granted the clinic the right to give their leftover embryos to other couples. But keep in mind this one drawback: Donated embryos often come from older couples who were probably coping with infertility problems themselves. Success is less likely than with the eggs of a young and healthy egg donor.

Legal Rights of Egg Donors and Recipients

There are many potential legal issues that arise when egg donors are used by infertile couples. The egg donor contract should explicitly state that the donor waives all parental rights forever, that any children born from the donated eggs are the legitimate children of the prospective parents.

Other Issues With Egg Donation

Couples using donor eggs must usually bear all costs. Still, investigate your insurance company's coverage of these procedures, and ask for a written statement of your benefits. Typically, you'll be paying for your own procedure, as well as for the donor's medical expenses, including any additional expenses due to complications that may arise from the egg retrieval process. These complications can include bleeding, infection, and injury to the bladder or abdominal organs.

The donor usually also receives a fixed fee for their participation. This amount should be carefully spelled out in the contract that the couple and the donor sign. How the payment is made (such as partial payments before and after egg retrieval) depends on the specifics of the contract. The contract should also be clear on what will happen in the event the donor withdraws before their eggs are retrieved.

Because you may not get pregnant with the first treatment, you may want to ask the donor if they will donate eggs a second time and include that requirement in the contract. Networking with other couples who've gone through infertility procedures is also a good idea. They may be able to share helpful tips and hints you won't find elsewhere.

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