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Fertility 101: egg donor IVF - how it works

Fertility 101: egg donor IVF - how it works

 

 

What is egg donor IVF?

In egg donor treatment, another woman’s eggs are used instead of your own in order to have a child. The eggs are collected from your donor via IVF and are fertilised – either with your partner’s sperm, or sperm from a donor - in the same way as in a regular IVF cycle i.e. in the laboratory [our Fertility 101: IVF – how it works will give you all the basics].

Eggs can be sourced via:

-an altruistic donor.  This refers to someone motivated by kindness to help others and in the UK is anonymous. A suitable match can be found via an egg donor agency or a licensed UK clinic. (See what’s the process?, below)

-an international clinic or egg bank

-an ‘egg share’ IVF cycle – where the eggs collected from your donor are split between the two of you for your own IVF treatment and also theirs

-a ‘known donor’ such as a close friend or relative

Whichever route you choose, you should work with a clinic with a good track record in donor treatment to ensure all the appropriate screening and paperwork is covered off.

Although egg donor IVF is becoming much more common, the decision to use an egg donor is quite a big one and you will need to think your way around some of the wider implications. Even if you’re coming to egg donor IVF having tried multiple other treatments, it can still take a little time to come to terms with the fact there’ll be no genetic link between mother and child; or the fact that your child will be legally entitled to contact your egg donor when they turn 18 (although it’s important to be aware that your donor will have no legal rights or responsibilities to any children born using their eggs). It’s natural to have lots of questions about the process and clinics will offer you counselling to help you work through everything.  There are some great organisations and forums to support you, too, such as the Donor Conception Network [https://www.dcnetwork.org].

When might I consider egg donor treatment?

There are a number of scenarios that might mean you'll want to consider using donated eggs to get pregnant.

If your eggs have been damaged by serious illness or during treatment (e.g. chemotherapy) you may not be able to use your own eggs to have a baby.

Early menopause or a high risk of passing on a genetic disease are other reasons you might need to use donated eggs.

Or you might be in a same sex couple.

Overall, women are increasingly turning to egg donation, particularly if other attempts to get pregnant using their own eggs have been unsuccessful. And the odds of getting pregnant if you're in the older age bracket are significantly improved compared to own-egg IVF, so for some the decision is largely based on the increased chance of success.

What’s the process?

In a fresh donor egg cycle, the process will broadly follow these steps.  Once a donor has been found and a date has been agreed to start the cycle with your donor, you can expect the process to take around 4-6 weeks. 

Step One: Egg donor matching

If you’re using an agency or clinic to source an egg donor, they’ll look through their donor list to see whether they’ve an appropriate match. If not, you’ll be put on a waiting list until someone suitable comes up.

In the UK, donors must be aged between 18 and 35 and have to go through rigorous screening before they are accepted by a clinic as a potential donor.

Step Two: Hormone treatment

If you’re doing a fresh egg donor cycle, both you and your donor will be given hormone treatment in order to suppress and synchronise your menstrual cycles.

Your donor will then enter the stimulation phase, where she will inject herself daily with gonadotrophin - a hormone which stimulate egg production – so she produces as many eggs as possible.

Step Three: Recipient preparation

Having an endometrial lining of at least 7mm gives your donor eggs the best chance of implantation, so while your donor is taking her injections, you will be given progesterone and oestrogen to develop your lining to the right thickness.

Step Four: Donor egg retrieval

When your donor’s eggs are fully developed, she will be given what’s known as a ‘trigger shot’ to trigger the final ripening of the eggs.

Two days later, your donor will be given a light anaesthetic and her eggs will be retrieved in a quick and simple procedure.

Step Five: Fertilisation

Your donor’s eggs are now ready to be fertilised with either your partner’s or donor sperm.

If you are using fresh (rather than previously frozen and thawed sperm), your partner or sperm donor will need to produce a sample at the same time as your donor’s eggs are collected.

The embryos which develop once the egg is put together with the sperm are monitored in the laboratory so your clinician can see which embryos are developing best.  Embryo transfers can be done on day 2, 3 or 5 and if possible, your clinic will usually push for a day 5 transfer when your embryos are becoming blastocysts.

Step 6: Embryo transfer

Once your clinic has graded your developed embryos and decided which ones look the best, you’ll be called in for the embryo transfer. The procedure takes around 30 minutes and is pretty painless: a tiny catheter is used to guide the chosen embryos into place and you can usually watch all the action happening on screen – it’s an incredibly exciting moment!

Any unused embryos from this cycle that are suitable for freezing can then be stored for future use - for example if this cycle does not result in pregnancy, or to create siblings with the same genetic link.

Step 7: Pregnancy test

Two weeks after your embryo transfer, you can take a home pregnancy test.  If it’s positive, you’ll need to book in with your clinic or GP for a blood test to confirm the pregnancy.

 

In a frozen donor egg cycle using frozen eggs from an egg bank, the process will be shorter since your donor has already gone through the stimulation and retrieval phase, so it’s only your cycle which will need to be managed and your lining prepared for transfer. You might also bypass lengthy waiting lists as you won’t need to wait until a suitable donor match comes through on your clinic’s books.

Do bear in mind there are pros and cons to weigh up when looking at fresh donor egg cycle vs frozen donor egg cycle.  For example, some studies show a slightly higher success rate in fresh donor egg cycles compared to frozen, so it’s best to do your research before going ahead.

You can find more information about egg donor IVF treatment on the HFEA’s website, www.hfea.org.ukand via the Donor Conception Network, www.dcnetwork.org.

Will I need to pay for donor eggs? 

Some individuals are able to get NHS funding for their treatment.  The best thing is to talk to your GP to find out about eligibility and funding criteria based on your age, situation and location.

If you do need to undergo private egg donor IVF (which most people do), it can be quite expensive, which is why it's important to choose your clinic and egg donor source carefully.

It is actually illegal to pay a donor for their eggs.  However, altruistic donors can be compensated up to £750 to cover their expenses.

Pricing varies significantly between clinics, who all have their own price lists, but an average egg donor IVF treatment cycle (once blood tests, scans and fees are included) can easily be upwards of £10,000 and can be as high as £15,000 in the UK.

Doing an egg share cycle (when your chosen donor shares half of her eggs with you and keeps the other half for her own use) can help reduce the costs quite significantly so it’s worth asking your clinic about this option.

Egg share donors will receive funding for either all or part of their own IVF treatment in return for donating half of their egg to the egg donor recipient.

Sourcing an overseas egg donor, either via a clinic abroad, or an international egg bank, can also be a cost-effective option, so you might want to consider this, too.
If you choose to use a donor agency they will charge a fee to find you an altruistic donor. Once a suitable match has been found you will then have to pay your chosen clinic for both your own and your donor's treatment. This can be comparatively more costly than egg sharing but the key benefit is you'll receive all of the eggs the donor produces.

Will it work?

The fantastic thing about egg donor IVF – in spite of the high costs – is that success rates are good. Couples using donated eggs have around a 10-15% higher chance of getting pregnant than with their own eggs, on average. And although stats vary between clinics, you can generally expect upwards of a 50% chance of success with donor egg IVF, with many clinics reporting success rates in the high 60s. As with any fertility treatment planning, it’s good to do your homework and compare success rates between your shortlisted clinics.  For more information on clinical success rates, visit the Human Fertilisation & Embryology Authority (HFEA) website:www.hfea.gov.uk

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