For some women egg donation is their only chance to have a baby. Egg donation is a sensitive and often difficult subject to approach. A frequently asked question is “When Should I think of Egg Donation?” a difficult question to answer because every couple has unique characteristics and there is a combination of factors to be considered. Factors that usually affect the egg donation decision are the age of the recipient woman and the ovarian reserve. Women over 40 with IVF failures, low ovarian reserve and low response to medication, should start thinking of the “next step” – which might be the egg donation. Otherwise, there will be exhaustion and tiredness brought about from low success rates of IVF procedures.
No woman should give up the effort to have her own (genetic) child until she has exhausted all potentials. Even after exploring all available options, the egg donation decision will still be difficult to be made. However, this choice could have a higher success rate and could give you the opportunity to create the family you have always been dreaming of.
4 frequent asked questions about egg donation
1. When Should I think of Egg Donation?
- When your egg quality is poor
- If you are suffering from premature menopause
- After having many failed IVF cycles
- If you are undergoing a surgery or chemotherapy
- To avoid transmitting any potential genetic disease to your baby
Egg donation is also recommended as a solution to older women. Even if you feel young, and you look younger than your age, this doesn't mean that your body forgets its age – neither do your ovaries. The egg’s age is the most important and the one that matters. IVF success rates in women over 45 are extremely low. If you approach the age of 45 you should take your time and think about your next steps and alternatives. It’s not necessary for a woman to have a stable menstrual cycle in order to be able to get pregnant. If she has a healthy uterus, her body will be able to support the embryo’s development during the whole pregnancy until the delivery day.
2. What are the success rates of getting pregnant using donor eggs?
The success rates of getting pregnant through egg donation depend on the egg’s age, not from the age of the mother (biological mother: a woman who gives birth to a child, social mother: a woman who raises the baby after birth). The rate of having a successful pregnancy not only increases but additionally the possibility of having a miscarriage decreases significantly. At Gennima IVF, for women aged 40-43 trying to conceive through IVF with their own eggs, the clinical pregnancy (positive fetal heartbeat) rate is 5-25%. On the other hand, trying to conceive using donor eggs, the rate increases significantly, approaching 54%, this happens because the egg donor’s age is up to 35 years (according the relevant law) and has no infertility issues.
3. Is this treatment the right choice for me?
Making the decision is not easy. As an egg recipient, you will be the biological and legal mother of your child, but not the genetic one (genetic mother: a woman whose contribution to the child was the ovum, and hence genes). At Gennima IVF we recommend you discuss the issue not only with the reproduction gynaecologist but also with couples who made the decision to create their family by using donor eggs. Having the mediator role, we’ll bring you in touch with them. From your side, it is important to be completely aware of your decision in order for you to get all the answers you need. It would be also very useful for you (if you wish) to see a psychologist before making the decision and consent to any treatment.
4. Is it easy to find a suitable donor?
It is very important to be aware of what the law defines about the specific treatment. The aforementioned law in Greece is rather progressive allowing all kind of assisted reproduction treatments, of course under conditions and specifications. It is important to be noted that egg donation is totally anonymous and absolutely voluntarily, meaning:
- Anonymity: the couple is not allowed to know the egg donor’s identity, either the donor to meet the recipient couple. Both, the couple and the donor, will sign the appropriate written consents before proceeding with any treatment.
- Voluntarily: egg donation is a precious gift that a woman can offer to another. So, it’s only her decision if she is willing to help another woman to create her family. The law does not allow any financial transaction (the concept of “payment” is not consistent with the notion of “donation”), however, a compensation is provided to the donors in order to cover any travel expenses, loss of earnings during the treatment (e.g. leave of absence) etc.
For the woman who decides to donate eggs, the procedure is similar to an IVF cycle. The law defines that the donor should be up to 35 years. After the mandatory medical check, she will get injectable medication for the ovarian stimulation, blood tests and an ultrasound will follow until the final day of the oocyte retrieval (usually under light sedation). Due to this procedure, but also due to moral and psychological issues that might occur, women who are willing to donate eggs are not many. In Greece, like in many other countries, the couples in need of egg donation in order to have a baby are more than the women who are willing to donate eggs.
Due to the anonymity imposed from the law, the couple interested in finding an egg donor is not allowed to look for one by themselves. The procedure is onto the reproduction gynaecologist who is responsible for the treatment. The doctor is responsible to find the suitable donor for each couple. In practice, that means that you might need to wait until finding the suitable donor.
The need for egg donation treatment of many couples unfortunately is not well known to the general community, like e.g. organ or bone marrow donation. That means that very few women decide to become egg donors. On the other hand, women who needs egg donation in order to have a baby are becoming more and more by the day. There is no doubt, however, that this is a very sensitive matter due to all legal and moral issues might arise.
Proceeding with egg donation - What to expect
Despite the high success rates in IVF with egg donation (Gennima IVF rates: almost 70% positive pregnancy test and 60% clinical pregnancy) there are specific restrictions due to the physiology of reproduction (physiology of fertilization and development of embryos). For the moment, neither science nor technology guarantees 100% IVF success. At Gennima IVF we provide all the needed information about the whole cycle, the expected success rates in order your expectations to remain realistic.
Day 0: the oocyte retrieval In order to increase the possibility of a successful treatment, we expect to collect 10-12 good quality eggs at the day of the oocyte retrieval. The embryologists and the midwife/nurse will update you about the quality of the collected eggs right after the completion of the procedure. In some cases, we might collect more or less eggs during the oocyte retrieval than expected.
Day 1: the day after the oocyte retrieval It is expected that 7-8 eggs will be normally fertilized after the collection of 10-12 eggs (according the international data of reputable embryology labs, like our lab in Gennima IVF. The embryologists confirm the fertilization of the eggs the day after the oocyte retrieval. In most IVF cycles, the fertilization rate is 70-80%. The egg quality as also the sperm quality are very important factors, embryologists will inform you about both these factors.
Day 3: Embryo transfer without blastocyst culture It is expected that up to the 3rd day, 5-6 embryos out of the 7-8 will be developed normally, i.e. that the division rate, the number of cells and their morphology is according to the evaluation criteria of embryologists (international standards). This might be the appropriate day to proceed to the embryo transfer (it’s mainly your doctor’s decision in collaboration with the embryologists). Based on the recent Hellenic legislation, in an IVF cycle with donated eggs, only up to 2 embryos may be transferred. We recommend freezing the additional embryos, as long as the embryologists consider them of good quality.
Day 5: Embryo transfer with blastocyst culture Finally, it might be decided more appropriate to proceed with blastocyst culture, i.e. embryos that are cultured until the 5th day (blastocyst stage) before being transferred into the uterus. From those 5-6 embryos of the third day only 2-3 blastocysts are expected to develop. This happens because not all embryos have the same potential to develop in blastocysts. The embryos reaching the blastocyst stage seem to have higher potential for pregnancy. Blastocyst culture is a criterion of selecting the best embryos: the embryos developing in blastocysts are the best to proceed to embryo transfer.
Blastocyst culture reduces significant the possibility of additional embryos for freezing. So, the question might be “should we proceed to blastocyst or not?” This is actually your doctor’s decision along the embryologists in order to increase your success chances. Each IVF cycle is different, so every time we adjust the procedure according to your individual needs and inform you thoroughly.
- IVF with egg donation statistically has very high success rates, however the results are not always predictable.
- Objectively, an IVF cycle with egg donation is considered successful if there are 2 top quality embryos to transfer (3rd day embryos or blastocysts).
- The possibility of additional embryos for cryopreservation (freezing) is statistically 20-25%.
- During an IVF cycle with egg donation we expect everything to go according as planned, but in rare cases (about 1%) that there are no embryos to be transferred. This might be due to fertilization failure (fail to fertilize) or to possible abnormal fertilization (embryos with 3 pronuclei).