If you are in your early to late 40s and trying to conceive a child, you are probably considering whether to use the eggs of a younger woman, known as donor eggs. Sometimes the donor is a relative or friend of the patient, but more often the donor is anonymous. In women age 42 or older, fifty-five percent of all assisted reproductive technology (ART) cycles rely on donor eggs. For women older than 48, 91 percent use donor eggs.
While advanced maternal age is the most common reason for using donated eggs, other indications for choosing to use donor eggs include a history of genetic disease and premature ovarian failure. This last condition occurs when a woman experiences menopause before age 40, often as a result of treatment for cancer or another disease. In 2007, 5,692 pregnancies from cycles using fresh embryos from donor eggs resulted in live births.
How do I select an egg donor?
Start by considering the characteristics that are important to you in an egg donor. Would you be more comfortable using eggs from a family member or friend if that were a possibility, or from someone you don't know? Potential egg donors will be screened for:
- Healthy ovarian reserve
- Detailed medical and social histories
- Hereditary diseases
- Physical and psychological health
- Infectious diseases including HIV, hepatitis B and C, and syphilis
Because there's a considerable amount of time, pain, and inconvenience involved in donating eggs, most donors are paid. (Average payments range from $4,000 to $8,000.) Although state laws differ slightly, donors usually sign away the rights to any children born as a result of the use of their eggs.
In some cases, the resulting baby isn't genetically related to either parent. Some people choose to use embryos donated by a couple who also had recourse to ART and produced more embryos than they could use.
How does it work?
Synchronizing the development of your uterine lining with the growth of the donor's follicles and eggs is important to a successful egg donation. In order to get your cycle in sync with that of the donor, you will take a combination of Lupron (a synthetic hormone) and birth control pills. The donor will take a fertility drug to stimulate the maturation of multiple eggs at once. Simultaneously, you will receive estrogen either by mouth, injection, or skin patch for two weeks.
During this time, you'll be monitored via ultrasound and blood tests to ensure that your uterine lining is prepared to support an embryo. You'll then be given the hormone progesterone, which causes changes in your uterine lining that will help the embryo implant. Once the donor's eggs are mature, your doctor will remove the donor's eggs from her ovaries by inserting a needle through her vaginal wall.
From this point on, the procedure is just like that of in vitro fertilization (IVF); your partner -- or a sperm donor -- provides semen, which is then used to fertilize the donated eggs in a laboratory. After a few days, the embryo is placed in your uterus. And after about 14 days you will take a pregnancy test to see if everything worked as planned.
What's the success rate of IVF using donor eggs?
Although the success rate varies depending upon the donor's age, the sperm quality, and the health of the women involved, the chances are better for donor eggs than for many other ART procedures. In 2007, 55 percent of women using donor eggs experienced a live birth.
What are the risks related to egg donation?
The primary risk for the recipient is multiple pregnancy. Most egg donors are young and have healthy eggs, therefore multiple pregnancy rates are high. In 2005, 40 percent of successful egg donations resulted in the births of twins, triplets, or more, according to the Centers for Disease Control and Prevention. The egg donor may be at risk for ovarian hyperstimulation syndrome, which causes the ovaries to become swollen and painful and, in rare cases, can lead to more serious symptoms. If you become pregnant using donor eggs, your risk of having a child with a birth defect is 3 to 5 percent, the same as for any other pregnancy.
Some women find the medications they are required to take have uncomfortable side effects including hot flashes, depression, headaches and insomnia.
The American Surrogacy Center, http://www.surrogacy.com
American Society of Reproductive Medicine, http://www.asmr.org
American Pregnancy Association, http://www.americanpregnancy.org
The American Fertility Association, http://www.theafa.org
Society for Reproductive Endocrinology and Fertility, http://www.socrei.org
American Pregnancy Association, Donor Eggs. July 2007.
RESOLVE. The Medical Aspects of Egg Donation.
American Society for Reproductive Medicine, Assisted Reproductive Technologies, A Guide for Patients.
American Society for Reproductive Medicine. Third Party Reproduction, A Guide for Patients.
The Ethics Committee of the American Society for Reproductive Medicine. Financial incentives in recruitment of oocyte donors. Fertility and Sterility. August 2000, Vol. 74 No. 2.
Society for Assisted Reproductive Technology. Donor Oocyte.
CDC, ART Report. 2007 Assisted Reproductive Technology (ART) Report: Section 4 ART Cycles Using Donor Eggs. Jan. 2010.
Interview with Paul J. Turek, MD. University of San Francisco Center for Reproductive Health.
National Institute of Child Health & Human Development. Fast Facts About Premature Ovarian Failure.
Centers for Disease Control. Figure 4 Types of ART cycles by Age Group -- United States 2006. December 2008.
Centers for Disease Control Figure 44 Percent of ART Cycles Using Donor Eggs by Patient's Age 2006.
American Society for Reproductive Medicine. Financial compensation of oocyte donors. ASRM Fertility and Sterility. Volume 88, Number 2. August 2007.