Fertility Chronicles is proud to present a special blog series, “From the Fertility Experts,” where leading fertility experts answer commonly asked questions for patients about their fertility health and treatment options. We hope this series can help patients navigate their personal fertility journeys.—Catherine T. Yang, Editor, Fertility Chronicles
Dr. Jamie Grifo, our guest blogger, shares his advice on donor eggs, donated embryos, and surrogate/gestational carriers:
If you’ve been told that you have a poor prognosis for getting pregnant with IVF, your doctor has likely calculated that you have a 5% chance or less of conceiving with your own eggs. But don’t despair. You may be able to beat the odds by trying in vitro fertilization (IVF) using donor eggs or donated embryos. You can also consider a surrogate or a gestational carrier. Costs for each of these options can vary greatly by clinic. It is best to consult clinics and providers directly for this information.
Worldwide, an estimated 10,000 babies are born each year from using donated eggs, and the procedure is becoming more common, particularly among women over 40. In 2005, about 12% of all assisted reproduction techniques used donor eggs. IVF success rates using donor eggs for couples with a poor IVF prognosis typically range from 50% to 80% per cycle, compared with a less than 5% success rate when they use their own eggs. IVF with donor eggs costs about $25,000 per cycle (or more), including administrative and legal fees, treatment expenses, and donor compensation.
Typically a woman opts for egg donation when she has poor quality eggs or no eggs at all. She is also likely to be over the age of 39. Donor eggs might also be a good choice for women who have an intact uterus but no ovaries.
IVF is the process of taking the woman’s egg — or a donated egg — and combining it with her partner’s sperm in a laboratory dish. There, the fertilized egg grows into an embryo over several days. Then, one or more embryos are transferred into the woman's uterus. The hope is that at least one embryo will implant successfully and grow into a healthy baby.
With donor eggs, doctors surgically retrieve multiple eggs from a healthy woman between 21 and 30 years old. Before the eggs are retrieved, the donor receives hormone injections to increase the number of eggs she produces. Most women only release one egg per month, but in this case, doctors are aiming for more eggs to increase the odds. Those eggs are mixed with sperm in the laboratory, and the process proceeds just as it would for non-donor IVF.
To find an egg donor, you can ask your fertility clinic, find a commercial egg donor agency or registry, or even ask a close friend for a donation. Prospective donors undergo rigorous psychological and medical screening.
For women with a poor prognosis, embryo donation is another choice. Donor embryos come from couples who produce extra embryos via IVF. Donor embryos are an option particularly for couples in which both partners have untreatable infertility or repeated IVF failures. Donated embryos can also be a good choice for couples with recurrent miscarriages that aren’t from uterine or implantation problems. Of course, both members of the couple have to be comfortable with a child not genetically related to either one of them.
If your poor prognosis is due to uterine problems, such as recurrent miscarriage or uterine defects that do not allow carrying pregnancy safely, then finding a surrogate or a gestational carrier is an option. Surrogacy is where a woman agrees to have her egg inseminated by the sperm of the male partner of the couple wishing to have the child--either through intrauterine insemination (IUI) or IVF--and to give birth to their baby. A gestational carrier agrees to have the patient couple’s fertilized embryo implanted in her uterus and to give birth to the baby.
Fertility patients can find surrogates or gestational carriers through their fertility clinic, lawyers specializing in the practice, or private agencies. Most agencies require that surrogates already have children of their own, are healthy mentally and physically, and are not motivated only by financial considerations. Patients usually pay a fee plus medical expenses to the woman carrying their baby, with costs around $50,000 or more.With each of the options above, you should get your own legal counsel to draw up a contract with the egg/embryo donors or surrogate/gestational carrier that spells out financial compensation and other terms.
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