Making the decision to use donor eggs to achieve a pregnancy is a tremendous step. There are many reasons why women experiencing infertility may come to use donor eggs, such as diminishing quality of their own eggs, premature menopause, or reoccurring miscarriages. It’s a decision that I myself had to make after multiple failed IVF cycles, the adoption of our son, and then by a failed second adoption. It was through donor egg IVF that we were able to conceive our twins and successfully complete our family.
Frozen and Fresh Donor Eggs: What’s the Difference?
There are many things to consider when making the decision to use donor eggs. Not only will recipients need to come to terms with the loss of their own genetics, they will also need to consider budgeting for egg donor costs as well as where they will obtain their eggs. Women can choose between using frozen or fresh donor eggs for a donor egg IVF cycle, and there are advantages and disadvantages to each.
One major consideration in the decision whether to use frozen or fresh donor eggs is cost. Prices vary by clinic, but on average, a fresh donor eggs cycle costs about $25,000. This is because the recipient is responsible for not only her own medical expenses, but all of the donor’s expenses, including medications, doctor appointments and even travel arrangements if necessary. The appeal of a fresh donor eggs cycle is that all eggs retrieved are given to the recipient. If the donor produces twenty-six eggs, the recipient receives them all. The cost for a frozen cycle is about half that of a fresh donor eggs cycle, but the drawback is the recipient only obtains a subset of all the eggs retrieved – six to eight on average. On the other hand, with a frozen cycle you know in advance how many eggs you will receive. If a fresh donor does not respond well to medication and produces few quality eggs, you will only have that many to work with.
The next thing to consider is in the waiting period before a cycle actually starts. Some clinics’ fresh donor egg programs have waiting lists of six months or more, depending the availability of donors at that point in time. If a recipient has a long list of requirements in a donor (e.g., specific hair or eye color) the wait can be even longer. A donor only starts the process to prepare her body for egg retrieval once she is chosen by the recipient. On the other hand, a frozen cycle is more or less instantaneous, since the eggs have already been retrieved. As soon as a recipient chooses a donor from a database and pays the fees, those eggs become hers.
Once a donor is chosen, the next step is to prepare the recipient for her embryo transfer. When using fresh eggs, both the donor and recipients’ menstrual cycles need to be synced up. This means the donor will take medications to produce a lot of follicles at once and will have several ultrasounds to record their growth. When the time is right, she will undergo a surgery to retrieve the eggs to be fertilized in a lab. The recipient will simultaneously take medications to control her own cycle and build her uterine lining up to accept an embryo transfer. This process can take six weeks, or longer if the cycle is canceled due to poor response from the donor, or if an unexpected life event occurs for either party. In contrast, with a frozen egg cycle, the eggs are already frozen and waiting for use. The only preparation for the recipient is now to build up her uterine lining with medication and ultrasound monitoring, a mere few weeks.
Once the embryo transfer takes place, the process for both frozen and fresh donor egg cycles is the same. The embryo needs to grow and divide and implant into the uterus. The recipient will generally have a pregnancy test at her clinic after two weeks to find out if the cycle was successful.
The success rates and the comparison between the two may be surprising. For years, nationally, the use of fresh eggs in IVF cycles was far superior to the use of frozen. However, that gap is narrowing. In the past, eggs and embryos were frozen slowly, resulting in the formation of ice crystals that damage the delicate cells. In recent years, technology has improved dramatically by a process called vitrification. This technique utilizes liquid nitrogen to flash-freeze the egg so that ice crystals cannot form, and therefore better preserves the cells. This in turn leads to a higher survival rate when eggs are thawed and a better chance for embryo development. While fresh donor egg cycles still have slightly higher average pregnancy rates, some fertility clinics are starting to see near equal results with frozen eggs.
There is a lot to consider when choosing between frozen and fresh donor eggs in a donor cycle and each has its own benefits and drawbacks. What is right for some couples will not be the choice for others. No two women struggling with infertility are the same. Luckily, however, there are many ways a family can be created and using donor eggs can be a wonderful way to bring a baby into the world.