Today’s media coverage would have you believe that celebrities giving birth well into their forties is commonplace. What goes unreported is that most often a much younger egg donor was used because of the celebrity’s age and associated reduced fertility. In fact, age-related decline in fertility is the primary reason a woman who is trying to get pregnant might want to use an egg donor. Once the decision has been made to use an assisted reproductive technology (ART) procedure such as in vitro fertilization (IVF) the next decision for an older woman is whether she will use her own eggs or donor eggs.
Women are born with a finite number of eggs and the number declines with age, as does egg quality, especially after age 35. So some women in their late thirties and many in their forties might need to use donor eggs; also, women who have already tried IVF without success or women with multiple miscarriages might find this option helpful. Some younger women may have fewer eggs and greatly diminished ovarian function related to early ovarian failure (early menopause), ovarian insufficiency, or as the result of chemotherapy or ovarian surgery. Donor eggs may also be used for fertility treatment by same sex male couples or single males. Finally, certain rare genetic conditions that may be inherited may call for using donor eggs. You can learn more about egg donation here.
A woman considering using an egg donor should have a complete evaluation with physical examination, medical and genetic history, and appropriate tests, to detect and correct any abnormalities that could affect fertilization, implantation or pregnancy. Pre-treatment counseling should take place to make sure the woman and her partner fully understand the complete process including how the procedure works, risks and likelihood of a successful pregnancy. This can include reviewing options of fresh vs. frozen eggs, whether to use your clinic’s internal donor program, an outside agency or egg bank and other options. Counseling should include discussion about the psychological and social aspects of using a “third party” to help with reproduction, as well as legal and financial aspects.
In an egg donation IVF cycle, eggs from a fertile woman are fertilized in the IVF lab using the partner’s sperm (or sometimes donor sperm, if necessary) and the resulting embryos are transferred to the recipient’s uterus. The woman receiving the embryo will be on record as the legal birth mother but will not be genetically related to the child.
The success rates for an older woman undergoing IVF and using donor eggs are dependent on the age of the egg donor and quality of her eggs, not the age of the recipient. In fact, the live birth rate for a woman using donor eggs in her forties is the same as that of the egg donor, usually a woman in her twenties. However, the overall health of the woman receiving the eggs – including uterine function – is important for a healthy pregnancy.
Single Embryo Transfer is especially recommended when using donor eggs. This approach is important as multiple infant births carry significantly more problems for both mothers and babies, including higher C-Section rates, prematurity, low birth weight, and infant disability or death.
Once you’ve made the decision to use an egg donor, the next decision is deciding what type of arrangement will work best for you. Each choice has different implications including how much information you have about the woman providing the eggs. You should only work with a reputable clinic or agency that follows the rigorous recruiting and screening guidelines established by the American Society for Reproductive Medicine (ASRM) including testing negative for specified infectious diseases. Additionally, counseling from a fertility psychotherapist or psychologist is strongly recommended so that the intended parents and the egg donor are aware of the many issues associated with egg donation and can be helped to make good decisions for themselves.
Donors – known and unknown – should be under the age of 35 but preferably aged 21-33, nonsmokers, with a normal body weight and a healthy medical and genetic history.
The different options for egg donation include:
Working with a donor you know (“known donor”)
In this case, the donor may be a younger sister or niece or a friend. As you know the donor, you may be able to do the egg retrieval procedure sooner and you may or may not compensate your donor. However, there will still be the cost of the donor medications ($3-$5K) and the cost of the ovarian stimulation and egg retrieval ($7-$12K). Additionally, it is important to consider the relationship your donor will have with you, your child and your family in the future.
Working with an unknown donor (“anonymous donor”)
This type of donation can come through your fertility clinic’s in-house program or an outside agency. Donors are usually young women with excellent reproductive potential who are paid for their time, effort and health risks associated with an egg donation cycle. Clinics tend to have a smaller donor pool than an outside agency and the process can take longer depending on the donor’s needs and having to coordinate the donor’s retrieval schedule. You may also meet with a counselor to discuss making your choice; you may or may not have the option of meeting the donor you select, and how much information you have about the donor. It is important to consider the future and how you, your partner and your child will feel about not knowing the identity of the donor. Also, with sophisticated genetic testing and the many online ancestry and genetics websites, future anonymity cannot be guaranteed.
Donor Egg Bank
Donor egg banks usually have a larger pool of donors and the process may move more quickly as eggs are already available and frozen, ready to be shipped to clinics.
Egg Donor Treatment Package Options
ARC Fertility offers a variety of different treatment packages designed to streamline the treatment and procedure process. Our Donor Egg Treatment Package gives patients the option of using donated eggs during their IVF cycle. Most ARC clinics have treatment packages that can either work with an egg donor or use frozen donor eggs from an egg bank. Prices and services vary depending on what type of donor is used (known vs. unknown and proven vs. unproven) and whether frozen eggs from an egg bank are used.
Treatment packages generally do not include all the costs and services related to an egg lot (6-8 frozen eggs) from an egg bank such as donor compensation and egg retrieval. To meet this need, ARC Fertility recently created the ARC Donor Egg Lot that lets you purchase frozen eggs or bundle with your treatment package. This new service – a partnership with California Cryobank/Donor Egg Bank USA – gives patients the ability to select from a large database of screened and qualified donors. The Donor Egg Lot offers a guarantee of at least one blastocyst embryo for transfer; if this is not achieved, the egg bank will ship another lot of eggs to your clinic.
Making treatment decisions is always challenging, so do talk to your fertility doctor. Whether or not to use an egg donor and if so, what type, may be especially hard. The good news is that egg donation is a good option for many fertility-related issues; the better news is that success rates are high. And the best news comes from ARC Network physician Mary Abusief, MD, who says “Though you will not share a genetic relationship, you will most certainly share the joys of carrying that child, delivering that child and of being a mother.”