Infertility can be a challenging journey, especially when miscarriage happens. For those who have experienced pregnancy loss or failed IVF, your doctor may have brought up the use of donor eggs. Egg donation is when a woman who is medically cleared donates her eggs to be used by another woman (or gestational carrier) who cannot conceive with her own eggs. You may be wondering whether donor eggs can decrease the risk of miscarriage and increase your chances of bringing home a healthy baby. In this article, we’ll lay it all out.
Why do miscarriages happen in the first place?
Miscarriage, also known as pregnancy loss, is a devastating experience. It occurs when a pregnancy ends on its own before the 20th week of gestation. Miscarriage can happen to anyone, and it's estimated that up to 20% of pregnancies end in miscarriage. When a family suffers two or more pregnancy losses, it is called recurrent miscarriage.
There are many reasons why miscarriage can occur, and in most cases, it's difficult to pinpoint a specific cause. Here are some common reasons why miscarriage happens:
- Chromosomal abnormalities: The most common cause of miscarriage is chromosomal abnormalities. This means that the fetus has an abnormal number of chromosomes or a structural problem with a chromosome. These abnormalities are usually random events and not related to anything the parents did or did not do.
- Infections: Infections during pregnancy can cause miscarriage, especially if left untreated. Infections such as rubella, cytomegalovirus (CMV), and toxoplasmosis can be harmful to a developing fetus.
- Structural issues: Structural issues with the uterus or cervix can lead to miscarriage. For example, if the cervix is weak or incompetent, it may not be able to support the weight of the growing fetus, leading to premature delivery or miscarriage. Uterine anomalies, such as a uterine septum, can also increase the risk of miscarriage.
- Autoimmune problems: An overactive autoimmune system can mistake the fetus as a foreign object and attack it, causing miscarriage.
- Lifestyle factors: Certain lifestyle factors can increase the risk of miscarriage. These include smoking, alcohol use, and drug abuse.
Unfortunately in most cases, the exact cause of miscarriage is unknown, and it's not always possible to prevent it from happening. Read more about the common causes of miscarriage.
What is the risk of miscarriage with donor eggs?
The short answer is that using donor eggs decreases the risk of miscarriage for most women. Especially when those miscarriages were due to chromosomal abnormalities. Because egg donors are young (under 33) and medically cleared, outcomes with donor eggs are better than outcomes with a patient’s own eggs.
Women who use donor eggs tend to be older, and age is a significant factor in miscarriage risk. As women age, the quality of their eggs decreases, and the risk of chromosomal abnormalities increases, which can lead to miscarriage. By using younger, healthier eggs from a donor, the risk of chromosomal abnormalities is significantly reduced.
Furthermore, the donor egg IVF process involves extensive screening of the donor to ensure that she is in good health and has a low risk of genetic disorders. This can further reduce the risk of miscarriage, as genetic disorders can be a significant contributor to pregnancy loss.
What does the research say?
There is a paucity of research on donor eggs. But one 1997 study of 418 embryo transfer cycles among 276 egg donor recipients at one clinic found that:
- 36.2% got pregnant on the first try with donor eggs, and 29.3% had a live birth
- 87.9% got pregnant within four cycles and 86.1% had a live birth
This data did not differ for women of various ages of diagnoses. Another study from 1998 found that the miscarriage rate for donor eggs was 7.2% for women under 45 and 16.1% for women 45-50.
However, because these studies were 25+ years ago, and each included outcomes data from a single clinic, we can take it with a grain of salt. We’ve had incredible progress in fertility treatments over the last 25 years, including ICSI and PGT testing, and one would hope for even better outcomes today.
Why do donor eggs miscarry?
Donor eggs miscarry for some of the same reasons any pregnancy ends in loss. There could be implantation issues, or issues with the lining of the uterus or other factors that make implantation more difficult, increasing the risk of miscarriage. Or there could be other health issues such as hormonal imbalances, autoimmune problems, or structural problems like fibroids. Of course, there’s also just chance / luck which is sometimes not on our side.
While donor eggs can reduce the risk of certain fertility-related issues, it does not eliminate the risk of miscarriage entirely. Miscarriages are common, and it's important to work with your doctor to understand the potential risks and to receive appropriate care throughout the pregnancy.
How to reduce the risk of miscarriage with donor eggs
We recommend adopting a relaxed lifestyle and moderating physical activity after an embryo transfer. The most important factor in predicting successful implantation is the quality of the embryo and the optimal hormone environment in the uterus. After the transfer, the most important thing you can do is to take your medications as prescribed. You can rest assure that no other external factors will impact the outcome of your cycle (ie. high stress, specific foods, bumping your abdomen against a hard surface). If you have any problems with the injections, let your clinical team know as soon as possible.
Are donor egg pregnancies high risk?
Donor egg pregnancies may be higher risk, but more research is needed. One meta-analysis of 11 studies found:
- The risk of developing hypertensive disorders is nearly 4X higher for donor egg pregnancies
- The risk of having a cesarean section is 2.71X higher for donor egg pregnancies
- Preterm delivery is 1.34X more likely with donor egg pregnancies
Another study from Columbia University found that age doesn’t impact risk of complications, and that both older and younger women had similar rates of gestational hypertension, diabetes, cesarean delivery, and premature birth. When undergoing IVF, your doctor will give you an idea of your specific health risks and how to help reduce the risk of complications.
What is the success rate of IVF with donor eggs?
Here’s some good news: donor eggs can drastically 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.
At Cofertility, the average number of mature eggs a family receives and fertilizes is 10. Some intended parents want to do two egg retrievals with the donor which is definitely possible. We also ask each of our donors whether they are open to a second cycle as part of the initial application — many report that they are!
You can see how many eggs are retrieved in the first cycle and go from there. If, for any reason, the eggs retrieved in that round do not lead to a live birth, our baby guarantee will kick in and we’ll re-match you at no additional Cofertility coordination fee.
Ready to move forward with donor eggs? We can help!
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. Create a free account today!
View all articles