10 Facts You Need To Know About Using Donor Eggs
Halle Tecco, MPH, MBA
According to the CDC, 12% of all IVF cycles in the U.S. involve eggs retrieved from a donor. Donor-egg IVF has the highest success rate of any fertility treatment, and is becoming an increasingly common way for families to grow. In this guide on donor eggs, we’ll cover some important stats we think you should know.
More and more families are using donor eggs
It’s hard to know exactly how many egg donation cycles happen each year in the US, but we can get a good picture through SART, which tracks data for nearly 400 clinics annually.
In 2019 there were nearly 20,000 IVF transfers using donor eggs at SART-reporting clinics. That is up 14% from the previous five years. Of those transfers:
- 1,776 used fresh donor eggs
- 2,468 used frozen donor eggs
- 15,294 transferred thawed embryos
Donor eggs can increase your chances of success
Around 53 percent of all donor egg cycles will result in at least one live birth. This percentage varies depending on the egg donor, recipient body mass index, stage of embryo at transfer, the number of oocytes retrieved, and the quality of the clinic.
At every age, the chances of birth with donor eggs is better, but those who benefit the most from donor eggs are women over 35 and those with low ovarian reserve. In fact, about one-quarter of women over 40 who succeeded with IVF did so through the use of donor eggs.
The chart was made using the SART Patient Predictor for an average woman (5’4”, 150 lbs) with diminished ovarian reserve. As you can see, the chances of live birth after one donor egg cycle is 54% for recipients under 40, and only goes down slightly after this.
The success of egg donation depends more on the age of the donor than the birth mother
It’s important to remember that your age when you get pregnant is not as important as the age of the eggs with which you get pregnant. The success of egg donation depends on many factors, but is not considered to be related to the age of the recipient.
So how old should your egg donor be? We follow ASRM guidelines that say egg donors should be between the ages of 21 and 34 years at the time of donation. Donors under 25 do not have better outcomes. So if you find a donor you love who is 30, don’t hesitate.
Younger donor eggs may not always be better
One study of infertility patients using donor eggs found the chances of live birth among cycles using egg donors < 25 years was 13% lower for those using donors age 25 to 29.
Another older but large study of 3,889 fresh donor egg cycles found that the cycles utilizing donors 30 to 34 years had a higher incidence of live birth than cycles with donors under 30 years, as well as donors over 34.
While many people gravitate towards younger donors under the assumption that she’ll retrieve more eggs, the good news is that the number of eggs retrieved - for donors at any age - is predictable. When you find a donor profile that resonates with you, your doctor will help determine if she’s a good candidate. All the donors at Cofertility are pre-qualified and most of them pass medical clearance upon match. Create a free account today to meet your match!
Similarly, women under age 25 going through IVF have been shown to have a lower success rate compared to women 25-30, and may have higher rates of miscarriage. No one understands why this may be the case for younger women, but it’s one of the reasons we recommend donors aged 25-34.
The median number of eggs retrieved from donors is 18, with half retrieving 13-25
A Harvard study of 774 egg donor cycles found that across all ages, the median number of oocytes (eggs) retrieved was 18. The middle 50% retrieved 13-25 eggs, meaning 25% of the donors retrieved over 25 and 25% retrieved under 13. Mature eggs were slightly lower, at a median of 15.
Here is the breakdown of median eggs retrieved (and middle 50%) from the study, by age:
- <25: 19 (14-26)
- 25-29: 18 (13-25)
- 30-34: 16 (10-21)
Three to five donor eggs generally leads to at least one genetically normal embryo
A 2015 study of 647 frozen donor eggs found that:
- 97.1% survived thawing
- 85.3% of the eggs fertilized
- 59.1% made it to blastocyst
- 84.2% of blastocysts were euploid (genetically normal)
So three donor eggs would yield a little over one genetically normal embryo on average while nine donor eggs would be expected to yield three to four euploid embryos on average.
So what does that mean for bringing home a baby? One study found the pregnancy rate from a single euploid is nearly 70%, and that having three euploid embryos gives you a 94.9% chance of achieving pregnancy. Since the study is from a group of infertility patients, these numbers could be even higher for donor eggs.
The number of eggs your donor will retrieve can be predicted by her AMH levels and antral follicle counts. However, it’s important to keep in mind that overall fertilization rates will vary depending on factors beyond the egg, including the quality of the sperm and the quality of the clinic.
Read more in How Many Donor Egg Cycles Does It Take To Have A Baby?
Fresh donor eggs may be better, but the jury’s still out
There is some evidence that the success rate with fresh donor eggs is higher than with frozen donor eggs. A 2021 study of 323 donor egg transfers found the following live birth rates:
- Fresh eggs: 49%
- Frozen eggs: 30%
Another study found that thawed frozen eggs were less likely to fertilize and develop into healthy embryos. Howeverly, ultimately, they found no difference in pregnancy outcomes between the fresh and frozen donor egg cycles.
Regardless, even with fresh eggs, most families decide to freeze the embryos after fertilization. This way, the embryos can undergo genetic testing and be saved for future sibling transfers. Some studies have found that frozen embryos have a higher implantation rate compared to fresh embryos, while other studies show just the opposite.
Read more in What's the Difference Between Fresh vs. Frozen Donor Eggs?
Children born through egg donation live happy, normal lives
While we still need more research into the experiences of donor-conceived people, there have been a few important studies that give us confidence that donor-conceived children have the same well-being as other children, and may even be closer to their mothers than others.
A study of 40 children born through egg donation found:
- Children in egg donation families view their relationships with their mothers as warm and enjoyable, even more so than other children
- There is no difference in the father-child relationship for children born via egg donation
- There is no difference in the egg-donor children’s rating of their own psychological well-being
When researchers asked the children about whether they would change anything about their family… The vast majority said that they would keep their family the same as it is.
Similarly, another study found that mothers through egg donation find their relations higher in joy than other mothers. And egg donation mothers have low rates of disappointment and anger. So while it may feel daunting to pursue donor eggs at first, parents quickly come to terms with the situation and have similar, if not better, experiences compared to other parents.
Read more in How Can I Come to Terms with Using Donor Eggs?
Donor compensation can be problematic
A 2021 Harvard study found that 62% of donor-conceived adults felt the exchange of money for donor gametes was wrong, and 41% were troubled by the fact that money was exchanged around their conception.
Researchers have also found that payment may incentivize donors to falsify information, which could compromise the welfare of the donor child and family. ASRM suggests that a reasonable compensation should not exceed $5,000 US dollars per cycle.
At Cofertility, we have a unique model that does not include cash compensation. Instead, egg donors keep half the eggs retrieved for their own future use. This has led us to be able to recruit a more diverse, high-caliber group of donors while serving families in a more ethical way.
Telling donor-conceived children how they were conceived is paramount
Most experts agree that it’s best to be honest with children about how they were conceived and normalize their conception from an early age.
One study found a lack of communication about the child’s genetic origins may interfere with positive interactions between mothers and their children (the study did not mention fathers). And secrecy surrounding the child’s donor conception was associated with less positive mother-child interaction. Another study of donor conceived adults found that greater parental avoidance of the topic was associated with poorer family functioning.
Sharing this information is good for the parents too. Mothers who disclose the information to their children by age 7 or 10 show lower rates of depression than those who do not disclose, and fathers have lower stress levels.
But we don’t need studies to know that honesty is important. Secrecy assumes shame, and there is nothing shameful about donor egg conception.
Read more in How to Talk to Your Donor-Conceived Child About Their Conception Story
“Anonymous” donation is not a thing
In a world of ubiquitous genetic testing and social media, no gamete donation can be guaranteed to be anonymous. Regardless of the information you have about the donor on paper, the donor-conceived child may grow up and find genetic relatives, or vice versa. Fact is:
- Many donor-conceived children become curious about their genetic origins as they get older
- A medical situation may arise and you have critical questions to ask the donor
- The donor-conceived person may find genetic relatives on a site like 23andMe
- The laws around anonymity are changing
We believe, at minimum, families should have access to the name and contact information of the donor. This doesn’t mean the family has to have a relationship with the donor, it just means that if the child grows up and wants to reach out, they can.
As egg donation becomes a more popular avenue for family-building, the industry is learning more about the nuances of the process. We’ll continue to stay ahead of the research, and use these insights to support our members. If we can be of service, don’t hesitate to reach out.
Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.
Halle Tecco, MPH, MBA
Halle Tecco is the Co-Founder and Chair of Cofertility. She is an Adjunct Professor at Columbia Business School, and proud IVF mom. Halle has her MPH from Johns Hopkins and MBA from Harvard.
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