Egg Donation at WCFC, Orange County, California
Introduction to Egg Donation
Age is one of the most important limiting factors causing infertility. It is often not appreciated that the most fertile years in a woman's life may occur when she is the least able to start her family. A woman has about 20 peak reproductive years usually from about age 15 to 35, followed by an accelerated period of declining egg quality, leading to infertility, miscarriage and birth defects. Unanticipated delays in finding a life partner or waiting too long to have children due to life's uncertainties can have a devastating effect on the family building plans for many women. Even after attempting advanced treatment such as IVF, a woman may discover too late that the effect of aging has led to irreversible changes in her egg quality, giving rise to embryos with low implantation potential. These problems accelerate faster after age 38 in some of these cases we recommend the use of healthy eggs from a young donor that match the intended mother's physical appearance. We would like to briefly explain the differences between traditional egg donation compared to the emerging science of frozen donor eggs.
Through the use of traditional egg donation, thousands of couples have achieved a pregnancy and become parents. Egg (oocyte) donation involves the intentional use of eggs (oocytes) provided by a healthy, young egg donor for in vitro fertilization and subsequent embryo transfer to a matched and synchronized recipient. Egg donors are selected to match the physical appearance of the intended mother. The donor may be a Directed donor (someone personally known by the recipient) or anonymous, which means the donor is screened and evaluated by our Center, but her personal identity is kept anonymously. Currently, most donors in the U.S. are young women who are compensated for their time commitment, travel and medical expenses.
The first successful pregnancy resulting from egg donation occurred in 1983 and involved a patient who was diagnosed with premature menopause. Today, the indications for egg donation have expanded to include not only premature ovarian failure (hypergonadotropic hypogonadism) but also young patients who have not been successful with IVF due to poor egg quality or suboptimal embryos, are excellent candidates for egg donation. Finally, the method may be chosen in order to avoid the possibility of transmitting a significant genetic illness for which the female recipient is known to be a carrier.
In vitro fertilization (IVF) and embryo transfer requires the harvest of eggs from the donor who has received ovarian stimulation to increase the number of mature eggs available for retrieval, followed by the insemination of the eggs in the laboratory. Sixteen hours later, fertilization is documented by the appearance of the 2 pro-nuclear particles inside the fertilized egg(s). The early embryos are monitored for several days prior to their transfer into the uterus of the prepared recipient. Typically, the embryos are loaded into a soft straw and guided into the uterus under ultrasound visualization to place the embryos as accurately as possible.
The egg donation process involves several important steps:
- Evaluating the potential recipient
- Selecting the donor
- Screening the donor
- Obtaining informed consent from both the recipient(s) and the donor
- Synchronizing the donor and recipient
- Prescribing hormone replacement for the recipient
- Stimulating the ovaries of the donor
- Retrieving the eggs (harvesting the donor's eggs)
- Insemination of the eggs
- Transfer of the embryos
Donor egg agencies are independently operated by individuals who recruit, interview and prepare the donors for selection from their web sites. They not associated directly with WCFC but provide their services directly to their clients. There are many agencies but some are listed here as references:
WCFC developed the frozen donor egg technique to provide couples with an alternative to traditional donor eggs as described above. Using an investigational protocol and IRB oversight, some of our patients have opted for the use of frozen donor eggs. Donors have been screened using FDA criteria and their oocytes have been frozen and catalogued. This method helps to avoid some of the logistical problems associated with traditional egg donation including difficulties with the synchronization of donor and recipient cycles, medication errors, inadvertent donor pregnancy, non-compliance with FDA regulations and others. Further, some of the travel costs and other expenses incurred with standard egg donation can be eliminated.
By inseminating only a limited number of thawed eggs, we can avoid creating surplus embryos which may be abandoned or discarded in the future, thus removing an additional burden from the intended parents. The cost saving may be considerable when using frozen/thawed eggs.
In terms of success rates, WCFC's success rate with frozen eggs from young healthy donors is on par with the success from frozen embryos. Our pregnancy rate per frozen egg transfer is 53% and compares favorably with our frozen embryo rate of 46%. The uterus is evaluated prior to using frozen eggs to verify its readiness to receive frozen eggs.
With traditional egg donation, there is simultaneous synchronization of the egg donor's menstrual cycle and the recipient mother's cycle. Although this method has been very successful in its past, there is always a possibility of problems that arise from time to time. It is often difficult to coordinate the donor's and the recipient's cycles due to donor non-compliance with FDA regulations; medication errors made by the egg donor; inadvertent pregnancy by the donor; problems with the egg donor's travel arrangements which are paid by the recipient; donor demands for excessive payment and unexpected cancellation of the cycle by the donor. Also, there is the issue of storing unused, excess embryos which may be used or often abandoned by the intended parents. The entire cost of this process must be borne by the recipient of the donated eggs.
On the other hand, with the use of the frozen donor eggs, it is possible to perform a more controlled ovarian stimulation of the egg donor independently of a recipient's menstrual cycle. Then, at her own convenience, the recipient mother can select the donor's stored cryopreserved eggs which can be thawed in order to achieve a pregnancy. This innovation in egg freezing technology, dramatically improves the efficiency of the egg donation process thus minimizing the cost donor egg fertility treatment for the intended parents.