IVF

Every National Infertility Awareness Week, we like to reflect upon the true meaning of “infertility awareness”. All year, we take every chance we get to increase awareness of infertility in an effort to provide proactive fertility education and de-stigmatize all paths to parenthood.

This is important because infertility can feel incredibly isolating due to lack of openness and understanding from the general public. While infertility does not discriminate, it often catches its victims off guard. Due to a lack of awareness (or just a lack of acceptance), we’re taught from an early age that getting pregnant is easy. In reality, this isn’t the case for everyone — one in four American couples struggle to conceive — and the additional stigmatization of infertility just kicks those suffering from it while they’re down. 

We’re here to change that. Myself and my co-founders all experienced challenging journeys to build our families, and we know, first-hand, that words matter. So this National Infertility Awareness Week, we’re proposing a vocabulary overhaul when it comes to outdated and straight-up offensive fertility terminology. 

Here are several fertility terms we commonly hear — in doctor’s offices, news articles, and more — that we think need to be replaced:

Fertility

• “Insurance policy” → optionality: when a woman decides to freeze her eggs, she's giving herself optionality should she experience fertility challenges down the line. While Cofertility’s mission with Freeze by Co is to enable more proactive, empowering egg freezing, we are always transparent about the fact that egg freezing is never an insurance policy.
• Poor sperm quality → sperm-related challenges: when a man experiences low sperm count or motility, or irregular morphology that may result in an unsuccessful fertilization or pregnancy. The same can apply to “poor egg quality,” and we support a similar change to reference egg-related challenges.
• Inhospitable uterus → uterine challenges: when uterine conditions, like endometriosis, cause difficulty getting or staying pregnant.
• Poor ovarian reserve → diminished ovarian reserve: when a woman’s egg count is lower than average for her age.
  

Egg donation and surrogacy

• Donor mother/parent → egg donor: the woman who donated her eggs to fertilize an embryo resulting in a child is an egg donor. The intended parents are that child’s parents, full stop.
• Surrogate mother → gestational carrier: Similar to “donor mother,” a gestational carrier, while doing an amazing thing (carrying the pregnancy of a transferred embryo using another woman’s egg) is not that child’s mother. Gestational carriers are incredible, but should not be confused with a child’s actual parents. 
• Anonymous egg donation → non-identified egg donation: we believe anonymous egg donation is a thing of the past — not only can it have negative effects upon donor-conceived children, it’s also unrealistic with the rise of consumer genetic testing. The American Society for Reproductive Medicine (ASRM) recently recommended this lexicon replacement as well. At Cofertility, we discuss the concept of disclosure at length with all donors and intended parents. You can read more about our stance on “anonymous” egg donation here.
• Buying eggs → matching with an egg donor: No one involved in this process should feel like eggs are being bought or sold (that goes for the egg donor, the intended parents, and the donor-conceived person). Rather, working with an egg donor is a beautiful way of growing a family and should feel the opposite of transactional. 
• “Using” an egg donor → working with/matching with an egg donor: An egg donor should feel like a perfect fit with your family and someone who should be respected, not “used”. Our unique model — where women can freeze their eggs for free when they donate half of the eggs retrieved to another family — honors everyone involved. Learn more here! 
  

Pregnancy loss

• Spontaneous abortion → pregnancy loss: Honestly, this term is beyond cruel given what it describes — losing a pregnancy prior to 20 weeks.
• Implantation failure → unsuccessful transfer: When an IVF embryo transfer doesn’t result in a success, that doesn’t mean it — or your body — was a failure. 
• Chemical pregnancy → early pregnancy loss: Calling a pregnancy “chemical” discredits what it actually is — a pregnancy. And losing it should be categorized as such. 

Let’s hold ourselves accountable

During National Infertility Awareness Week, consider this our rally cry for evolved terminology around the #ttc process. We’ll plan to hold ourselves accountable, but beyond talking the talk, we aim to walk the walk. 

Our goal is to make the actual family-building process more positive and accessible for anyone pursuing third party reproduction. With Family by Co, all egg donors give half of their eggs retrieved to intended parents and freeze the other half for themselves for free to preserve some of their own fertility for the future. This way, they’re able to give a life-changing gift, but also consider their own ambitions and lifestyle choices. We feel this is significantly more ethical than other donation options out there, and our intended parents love the transparent nature of our platform. 

Let’s challenge each other to evolve the surrounding verbiage. Because the family-building process should feel as good as possible, in spite of challenges along the way.

‍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!

In vitro fertilization (IVF) using donor eggs has become an increasingly popular option for couples struggling with infertility as well as LGBTQ+ families. One question that often arises is whether it is possible to choose the gender (sex) of the baby when doing donor egg IVF. In this article, we will explore the answer to this question.

First off, let’s understand gender vs. sex

Gender and sex are two distinct concepts that are often used interchangeably, but they refer to different aspects of a person's identity. 

Sex refers to the biological and physiological characteristics that define a person as male, female, or intersex. This includes chromosomes, hormones, and reproductive organs. In most cases, a person's sex is determined at birth based on their physical anatomy. 

Gender, on the other hand, refers to the socially constructed roles, behaviors, and expectations that are associated with being male, female, or non-binary. Gender is often expressed through a person's appearance, clothing, interests, and personality traits. It is a complex and multifaceted aspect of identity that can vary widely between cultures and over time. 

It's important to note that gender and sex are not always aligned, and it's possible for a person's gender identity to differ from their biological sex. While “gender selection” is the term traditional used, it’s actually “sex selection” of the embryo. 

What is gender selection and how does it work?

To answer this question, it’s important to understand the IVF process. During IVF, eggs are extracted from a woman's ovaries and fertilized with sperm in a laboratory. Once fertilized, the resulting embryos are monitored for development before being transferred to the uterus of the intended mother or a gestational carrier. In donor egg IVF, the eggs used for fertilization come from a donor, rather than the intended mother.

Gender selection with IVF is a process in which a family finds out the sex of the embryos before the embryo is transferred. This is typically done using preimplantation genetic testing (PGT), a procedure in which a small number of cells are taken from the embryos during their development in the laboratory, and their DNA is analyzed to determine their sex.

There are various reasons why someone may want to use gender selection through IVF. One common reason is “family balancing”, where a parent may want to have a child of a particular gender to balance out the gender distribution in their family. For example, a couple with three daughters may want to try for a son.

Another reason is related to genetic disorders that are linked to a specific gender. Some genetic disorders, such as hemophilia, are more common in males, and parents who are carriers of the gene may want to select a female embryo to reduce the risk of passing on the disorder to their child.

Can I select my baby’s gender when doing donor egg IVF?

When it comes to choosing the gender of the baby in IVF, it is possible to do so through PGT. As stated above, PGT is a procedure in which a small number of cells are taken from the embryos during their development in the laboratory, and their DNA is analyzed to determine their sex. The embryos of the desired sex can then be selected for transfer.

However, it's important to note that PGT is not 100% accurate. The technology used to analyze the embryos is highly sophisticated, but it is not perfect. There is still a small margin of error (<1%) that can result in the wrong gender being selected for transfer.

Some fertility clinics have guidelines around gender selection, and will only transfer the best quality embryo based on morphology. Furthermore, PGT testing for sex selection can add time and cost to your journey.  

Is gender selection ethical?

Gender selection for non-medical reasons raises some ethical concerns, and some countries even have laws that prohibit it for non-medical reasons.

Some argue that gender selection perpetuates gender stereotypes and reinforces the idea that one gender is preferred over another.  Other critics argue that allowing gender selection could lead to a slippery slope of other forms of selective breeding, such as selecting for traits like intelligence or athleticism. Furthermore, gender selection is expensive and may only be available to those with the financial means to access it, creating a divide between those who can afford it and those who cannot. Overall, the ethical considerations of gender selection are complex and depend on individual circumstances. 

Conclusion

There are various reasons a family may want to choose a baby’s gender while undergoing donor egg IVF. From medical reasons to family balancing, it’s important to talk to your doctor if gender selection is important to you. Remember, gender selection of embryos is not always accurate, and there is a small margin of error that can result in the wrong sex being selected. Ultimately, the most important goal of any fertility treatment should be the health and well-being of the baby and the family.

If you're in your 40s or 50s and looking to grow your family, you may be considering IVF with donor eggs. In fact, according to the CDC, a substantial 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. But is there an age limit for intended parents pursuing this path? Let's take a look:

Parent age and egg donor IVF

Age is one of the biggest factors in the ability to get pregnant. And even with IVF, the chances of success with our own eggs declines as we reach our 40s. The great part about IVF is that you can find out if an embryo is genetically normal (and thus less likely to miscarry) before you attempt a transfer. This can save time and heartache. 

Data from the Society for Assisted Reproductive Technology (SART) shows the following chances of a live singleton birth using your own eggs via IVF:

• 38.3% for women 35-37
• 25.1% for women age 38-40
• 12.7% for women age 41-42
• 4.1% for women over 42

It’s important to remember that your age when you (or your gestational carrier) get pregnant is not as important as the age of the eggs. That means your chances of success getting pregnant, no matter your age now, is better with younger eggs. But how do you get younger eggs? For some lucky women, they can use eggs they froze years ago. But for most of us, getting younger eggs means turning to egg donation. 

My age vs. my donor’s age: which is more important?

Studies show that your chances of success using donor eggs does not diminish in your 40s. So while getting pregnant with your own eggs may be unlikely, using donor eggs can greatly increase your chances of a successful and healthy baby well into your 40s and even 50s.  

Many women in their 40s and 50s can carry a pregnancy when using donor eggs, although some need to use a gestational carrier for a variety of reasons. 

Is there an age limit for IVF with donor eggs?

Technically, there is no age limit (legal or otherwise) in the United States for pursuing IVF with or without donor eggs.  But ASRM discourages IVF for women older than 55, and some clinics set their own age limits for patients they will treat. 

For women over 45 years old, ASRM advises:

• “Comprehensive” medical testing for cardiovascular and metabolic fitness to ensure the safety of the mother and baby during pregnancy 
• Psychosocial evaluation to determine if support is in place to raise a child to adulthood
• Counseling patients on potential increased medical risks related to pregnancy

For families using donor eggs and a surrogate, ASRM would advise that the family undergo psychological evaluation to ensure the parents are equipped to raise the child at an older-than-average age. 

Supporting mothers of all ages

There is no age limit for men having children and there is no maximum age for US domestic adoption – so why would we put an age restriction on mothers via egg donation? Generally, these restrictions are for her own health during pregnancy. 

All pregnancies have risks, and pregnancy after 50 is no exception. One small study followed 45 healthy mothers ages 50-63 who used donor eggs, and found that 35% experienced pregnancy-related hypertension (high blood pressure), 20% experienced gestational diabetes, and 78% had a cesarean section. These numbers are higher than the general population. 

But what if a gestational carrier (surrogate) carries the donor egg pregnancy? Then the argument turns to the ability to parent. 

ASRM lays out some compelling arguments in favor of donor egg IVF for women over 45:

• Older people (grandparents) raise children all the time in our society, and successfully at that. So there’s no reason to think older parents wouldn’t have the physical and psychological stamina for raising children.
• Older men often have children, and there is no set age limit for males in IVF. So why create limits for women?
• Our society respects the rights of individuals to make reproductive choices regardless of age or life expectancy. For example, we don’t ban someone with a terminal illness from becoming a parent. So why stop someone else because of their age?

Benefits of having children later

Becoming a parent at an older age certainly has pros and cons, and is different for everyone. But here are some benefits to having children in your 40s and 50s:

• Financial security: older parents tend to have more financial freedom and savings, making the financial commitment of parenting less daunting.
• Emotional maturity: Older parents feel more ready and mature. In a study of older parents, 72% of mothers and 57% of fathers expressed that the emotional maturity associated with age provided a clear advantage to having children later in life.
• Smoother parenting: One study found that older maternal age was associated with fewer behavioral, social and emotional difficulties
• More life experiences: People who start families later in life have had more opportunity to check things off their bucket list – travel, work accomplishments, hobbies – and may not feel like parenting is as much a compromise in their lives. Plus, they have more to teach their littles! 

Summing it up

There is no formal age limit for pursuing donor egg IVF, although ASRM discourages it for women over 55 and fertility clinics may set their own age limit. Anyone over 45 is recommended to undergo comprehensive medical testing, counseling, and a psychosocial evaluation. There are pros and cons to becoming a parent at any age, and these should be carefully considered when making the decision. 

FAQ

What is “advanced maternal age” (over 35) “advanced reproductive age” (over 45)

Advanced maternal age is a not-so-great term used by the medical community to describe a potential pregnancy for women over 35. Advanced reproductive age refers to women over 45.  Interestingly, there is no similar term for males trying to conceive at any age. 

Am I too old to become a parent?

This is a question only you can answer. How is your health? Do you have a support system that could help raise the child if anything were to happen to you? Are you financially ready? These are questions any parent, at any age, should ask before building a family. 

What is donor egg IVF?

Donor egg IVF is an IVF cycle that uses a young, medically-cleared woman's eggs, which are then fertilized and implanted into the uterus of the intended mother or gestational carrier. 

How can I find an egg donor?

Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. Create a free account today to get started!

If you are considering using an egg donor to start a family, you may be wondering if there will be a physical resemblance between you and your child. While it is true that the genetic makeup of a child will come from the egg donor and the father (or sperm donor), there are a few factors to consider when thinking about how closely the child may resemble the intended parent. Let’s dive in.

Will my donor-egg child look like me?

The answer is maybe. There is always a chance – whether genetic, adopted, or born through donor eggs – that a child won’t look like you. There’s also a chance that they will! I know plenty of genetically related children that look nothing like their mother or siblings. But I also know a lot of donor-egg children that look *exactly* like their mothers. In fact, I had no idea one of my closest friends used donor eggs to conceive her children until she confided in me when I began my donor egg journey.

Many families choose to match with a donor with similar physical features, especially for unique features like red hair, blue eyes, or being really tall. But keep in mind – picking a donor that looks like you in no way guarantees the child will look like you or the donor! 

What your child will derive from you

While I haven’t seen any research on donor-conceived children and how often they look like their family, we can look to some established research in the adoption space (although it’s not a perfect parallel, since with adoption the child is not genetically related to either parent and with donor eggs the child is often related to the father). 

One famous study of 7,230 parent-child pairs (504 adoptive) looked to see whether there were any physical similarities between parents and children. They found significant similarities in the stature and weight of the adoptees and their parents. This is no surprise, as we know there are non-genetic sources of human dimensional variability. Think about it this way – you may have an innate musical talent, but how musical you end up being depends a lot on nurture and what you are exposed to growing up. The same goes for certain features, like weight.  

“Looking” like someone is often just as much facial expressions and mannerisms as it is facial features. We can look to adoption research to understand attunement, which is how children can soak up their parent’s facial expressions in response to certain events. We know that children pick up physical cues, facial expressions, emotional response, and speech patterns from their parents. So even if you are not genetically related to your child, they may just roll their eyes or giggle the way you do. 

The genetics of donor eggs

When using donor eggs to conceive a child, the egg will be fertilized with sperm, either from the intended father or a sperm donor. The resulting embryo will contain the genetic material from both the egg donor and the intended father (or sperm donor), and will be genetically different from you. However, the child may have physical characteristics that resemble you, your partner, or the donor.

The egg donor's genetic makeup will contribute to the child's genetic makeup. For example, certain physical characteristics such as eye and hair color, skin tone, and facial structure. The egg donor's genetic makeup may also determine the child's risk for certain inherited diseases or genetic disorders. While egg donors do undergo screening for many genetic conditions, it's impossible to screen for every possible genetic disorder. 

All that being said – genetics are complex and many physical characteristics are determined by a combination of genetic and environmental factors. 

Will my baby have my DNA if I use a donor egg?

If you use a donor egg to conceive a child, the child will not have your DNA. The egg used to make embryos will come from a separate individual, the egg donor, and will contain her genetic material. The child will be genetically related to the egg donor, and will share a portion of the same DNA as the egg donor, and will not have any of your DNA (unless, of course, that egg donor is a relative of yours).

However, the child will be related to you in a legal and social sense as you will be the parent raising the child. You will have a legal relationship with the child as the parent, and you will have a social relationship with the child as the caregiver and nurturer.

Additionally, if you are able to carry the pregnancy, that will play a huge role. While the egg donor contributes 50% of the DNA to the genetic makeup of the child, research discussed in a 2014 Frontiers in Cell and Developmental Biology article shows that it is actually the birth mother who determines which of these genes get turned on or off. Things like maternal diet, stress during pregnancy and smoking can all make a difference in what genes get expressed.

Is an egg donor considered the biological mother?

An egg donor is considered the biological mother in the sense that she is the one who provides the egg that is fertilized and used to create an embryo. However, the egg donor is not the mother in the traditional sense, as she does not carry the pregnancy or raise the child.  The intended mother (or a gestational carrier) carries the pregnancy and gives birth to the child and raises and shapes the child’s entire life.

An egg donor has no legal rights or responsibilities to the child, and her role is limited to providing the egg for the conception process. It’s important to have the right legal agreement in place with an egg donor. If you work with Cofertility, we will make sure the legal part runs smoothly. 

What about epigenetics? 

Epigenetics refers to the study of changes in the expression of genes that do not involve changes to the underlying DNA sequence. These changes can be caused by a variety of factors, including environmental influences and lifestyle choices.

One factor that can play a role in the epigenetics of a child conceived through egg donation is the mother (or gestational carrier) carrying the pregnancy. The environment and lifestyle choices during pregnancy can affect the epigenetics of the developing fetus. For example, your diet, exposure to toxins, and stress levels can all have an impact on the epigenetics of the fetus.

Additionally, your own health and genetics can also influence the epigenetics of the growing baby. For example, certain genetic variations may affect your ability to detoxify certain chemicals, which can then affect the epigenetics of the fetus.Your own environment and lifestyle choices during pregnancy, as well as your own health and genetics, can all have an impact on the epigenetics of your egg-donor baby. 

Will my donor egg baby feel like mine?

A lot of moms using donor eggs to start a family wonder whether or not the child will feel like "theirs". And the answer is absolutely.  Every parent-child relationship is unique and what may be true for one family may not be for another. For some intended parents, the bond with their child may be immediate and strong, while for others, it may take time to develop. It's important to be open to the possibility that the bond may develop differently than expected, and to give yourself and your child the time and space to grow together.

Consider the role of parenting in forming a parent-child bond. The act of parenting, including bonding through nurturing, feeding, and raising a child, can create a strong emotional connection between a parent and child, regardless of genetics. The same goes for any potential siblings, cousins, aunts, uncles, and grandparents your child may have. 

When I think about the people I am closest to in this world – my step mom, my step sister, my adopted brother, my husband – none of them share my genetics. But they have shaped my life, and we have formed bonds far stronger than I have with many of my genetic relatives. Can you think about people in your life like this to help your mind transcend the idea that bonds are only capable through genetics? I have found this to be a helpful exercise.

Summing it up

It's important to understand that physical traits are determined by a combination of genetic and environmental factors. While the egg donor's genetic makeup will contribute to the child's physical characteristics, other factors such as the child's environment and upbringing can also play a role. 

Remember that inheritance is complex and that other factors such as environment and the characteristics of the egg donor can also play a role. But if physical resemblance is a concern, you may want to consider selecting an egg donor with similar physical characteristics.

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! 

Breastfeeding is a way of providing nourishment to newborns and infants. It has been widely recognized as the best form of nutrition for infants and has many benefits for both the mother and the baby. However, breastfeeding is not always easy and it's not for everyone. 

And if you are pursuing donor eggs to grow your family, you may be wondering if you will be able to breastfeed if the child is not genetically related to you. In this blog post, we will answer all your questions. Let’s dive in!

First off, what are the benefits of breastfeeding? 

There are loads of benefits to breastfeeding, including:

• Nutritional benefits: Breastmilk is the perfect food for infants as it contains all the necessary nutrients in the right proportions, including proteins, carbohydrates, fats, vitamins and minerals. Additionally, breastmilk changes to adapt to the baby's needs as they grow and develop.
• Health benefits: Breastfeeding can reduce the risk of certain illnesses and conditions in both the mother and the baby. For the baby, it can reduce the risk of infections, allergies, asthma, and obesity. For the mother, it can reduce the risk of breast and ovarian cancer, osteoporosis and postpartum depression.
• Bonding: Breastfeeding can create a special bond between the mother and the baby as it involves physical and emotional contact. Additionally, the release of the hormone oxytocin during breastfeeding can promote feelings of calm and well-being in both the mother and the baby.
• Convenience: Breastfeeding can be convenient as it does not require any preparation, bottles, or clean-up and it's always available and at the right temperature!

But – let’s not act like it’s easy. What are the challenges of breastfeeding?

Breastfeeding can be a wonderful experience for both the mother and the baby, but it can also be really hard, or even impossible. Here are a few common challenges that mothers may face when breastfeeding:

• Physical challenges: Breastfeeding can be physically challenging, especially in the first few weeks. Some mothers may experience sore nipples, engorgement, and mastitis. Additionally, some mothers may have difficulty producing enough milk or have a medical condition that makes breastfeeding difficult.
• Time-consuming: Breastfeeding can be time-consuming, especially for mothers who are working or have other responsibilities. It can be difficult to schedule feedings around other activities and it can be challenging to pump and store milk when away from the baby.
• Social and emotional challenges: Breastfeeding can be difficult in social situations and some mothers may feel self-conscious breastfeeding in public. Additionally, some mothers may experience emotional challenges such as postpartum depression or feelings of isolation.
• Limited flexibility: Breastfeeding can limit a mother's flexibility as it requires the baby to be close by and available for feedings. This can make it difficult to travel or have a night out without the baby.

So can I breastfeed a donor-conceived baby if they are not genetically related to me?

Yes – in general, most mothers are able to breastfeed their donor-conceived child. But, it depends on the individual case and the methods used to achieve the pregnancy. 

If you carry the pregnancy, your body will work the same way it would if you got pregnant any other way. Lactation is a biological, hormonal response that occurs during and after pregnancy. Whether your baby was conceived from your own eggs or donor eggs, your body will trigger specific hormones to initiate milk production. So if breastfeeding is easy or hard for you – know that it would be that way regardless of the genetics of the baby. 

Can I breastfeed if I use a surrogate?

Yes – it is possible for some women who did not get pregnant to breastfeed their child; but it’s  not easy. This process is known as induced lactation, a process in which a woman can stimulate milk production through a combination of techniques such as hormone therapy, breast pumping, and/or breast massage.

The process of induced lactation can take several weeks or months, and you’ll need to work closely with a lactation consultant to ensure the process is done safely and effectively. The amount and quality of milk production can vary greatly and in some cases, it might not be enough to fully sustain an infant, therefore the use of formula may be necessary (and that’s OK!).

Induced lactation is not an easy process and it may require a lot of time, effort, and dedication. You should also consider the emotional and psychological aspects of this process, as it may bring up feelings of sadness, disappointment, or loss, especially if the woman has a history of infertility or has gone through a difficult pregnancy.

Will breastfeeding pass on my DNA?

If you breastfeed a donor-conceived child, they will not receive your DNA through the breastmilk. DNA is the genetic material that is responsible for the inherited traits and characteristics of an individual. It is present in every cell of the body and is passed onto offspring through the egg and sperm cells. Breastmilk is produced by the mammary glands and contains a mix of different nutrients, antibodies, and hormones that are beneficial for the growth and development of a baby, but it does not contain DNA.

The benefits of breastfeeding your donor-conceived child

In addition to providing an important source of nutrition and immune support for your baby, breastfeeding can play a significant role in the bonding and attachment between a mother and her donor-conceived child. The act of breastfeeding can release hormones like oxytocin in both the mother and the child, which can help to promote feelings of love, calm and bonding. 

One study of mothers who breastfeed their children found that they exhibit more maternal sensitivity. Maternal sensitivity was defined as the synchronous timing of a mother’s responsiveness to her child, her emotional tone, her flexibility in her behavior and her ability to read her child’s cues. However, the effect sizes were small, so don’t stress out if breastfeeding isn’t possible.

Summing it up

If you have a baby through donor eggs, and you carry the pregnancy, you can breastfeed just as you would otherwise. Even if you use a gestational carrier (surrogate), breastfeeding is still possible, although more difficult, through induced lactation. This is a process in which you stimulate milk production through a combination of techniques such as hormone therapy, breast pumping, and/or breast massage. There are a lot of pros and cons to breastfeeding, and it’s best to work with your provider to determine what’s best for your family. We are wishing you all the best on your journey!

When it comes to starting or expanding a family, many couples and individuals may turn to assisted reproductive technologies (ART) such as in vitro fertilization (IVF) to help them achieve their goal. One aspect of IVF that many patients are offered– whether using their own eggs or donor eggs – is preimplantation genetic testing (PGT). But is it necessary to do PGT testing with embryos made from donor eggs? Let’s dive in and find out. 

What is PGT?

PGT is short for PGT-A, or “Preimplantation Genetic Testing for Aneuploidies,” and you may also hear it referred to as PGS (“Preimplantation Genetic Screening”) or PGD (“Preimplantation Genetic Diagnosis”) which are various forms of testing embryos. 

PGT testing looks at an embryo to see if it contains the correct amount of chromosomes. Embryos with the right number of chromosomes — 46 — are considered “euploid,” and those with extra chromosomes or chromosome deletions are considered “aneuploid.” PGT is a way to screen for genetic disorders in embryos created through IVF before they are transferred to the uterus. 

PGT testing and age

Here’s an annoying fact: the percentage of embryos that are euploid decreases as we get older. So not only do we have fewer eggs as we age, but the chances that any one egg turns into a healthy baby decreases too.

One study of over 15,000 embryos found that the lowest risk for embryonic aneuploidy was between ages 26 and 30, and that older age groups had the lowest chance of a genetically normal embryo. 

As you can see, chromosomal abnormalities of embryos are normally due to the age of the egg (or rather, the age of the mother or egg donor at the time the egg is retrieved). Since donors are under the age of 33 and healthy, embryos made with donor eggs have a good chance of being genetically normal. So, is it still worth PGT testing donor egg embryos? That leads us to the next section…  

The upside of PGT testing donor eggs

There are definitely some benefits to testing donor eggs:

• Gender selection. PGT testing allows for gender selection. Most clinics allow you to know each embryo’s gender, which can be helpful for families that have a preference.
• Rule out sperm issues. PGT testing of embryos made from donor eggs may also be suggested for couples with male infertility, especially if the sperm has shown chromosome translocations or abnormalities.
• Pick the healthiest embryos. PGT can detect genetic disorders such as cystic fibrosis, Tay-Sachs disease, and sickle cell anemia, allowing for the selection of embryos that do not carry these disorders.

The downside to PGT testing

However, a lot of fertility doctors will say it’s okay to pass on genetic testing with embryos made from donor eggs. Here’s why:

• It’s expensive.The cost of PGT can vary depending on the type of testing done and the clinic you're working with, but it can be thousands of dollars. 
• Added time. It can take some testing companies weeks to give you the results. Time goes so slowly during IVF, and adding additional time can be a major downer. 
• False positives or negatives. PGT can be prone to false positives or negatives, meaning an embryo that is genetically normal could be labeled as abnormal, or vice versa. 
• There’s a small risk to the embryo. The biopsy process, which removes cells from each embryo to be sent for testing, has a chance of damaging the embryo. Also because the embryo must be frozen in order to do PGT testing, there’s risk in having to be thawed and unthawed. 

But the biggest downside is that PGT might not even improve the chances of pregnancy for those using donor eggs! Remember that chart you saw above? If embryos are made from donor eggs, where the donor is under 35… the chances of each embryo being euploid is pretty high. 

Let’s look at the data. A 2020 study looked at 1,291 donor-egg cycles across 47 IVF clinics– 262 cycles with PGT testing and 1,029 without. Live birth rates occurred:

• 53.8% of donor-egg cycles with PGT testing 
• 55.8% of donor-egg cycles with without PGT testing

Yes, you read that right. The donor-egg cycles that skipped PGT actually had higher live birth rates than those who paid to have the embryos PGT tested. The researchers concluded that PGT testing in donor egg-recipient cycles does not improve the chance for live birth, nor does it decrease the risk for miscarriage. But it does increase cost and time for the patient. 

Summing it up

PGT can be a useful tool for patients who are at risk for passing on a genetic disorder or have a family history of a particular condition, however it may not be that useful for those using healthy donor eggs. The financial cost, time, false positives or negatives, and risks to the embryo are all important factors to consider. This is definitely a question and conversation you want to have with your doctor who can help you make the best decision. Good luck!

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. 

Cofertility works hard to recommend products and services that align with our brand mission of improving the family-building process for all. We sometimes earn a sales commission or advertising fee when recommending various products and services to you. As an Amazon Associate, we earn from qualifying purchases. Always be sure to consult with a doctor if you have any concerns. Prices and terms listed on our website are subject to change.

If you are considering using an egg donor to start a family, or have already done so, you may find it helpful to learn more about the donor egg parenting process by reading books on the topic. Reading books on egg donation can help you to understand the process of having and raising a donor conceived child. It can also help you to gain insight into the experiences of others who have gone through the process, which may be helpful as you navigate your own decision-making process.

Below is a list of some of our favorite books on egg donation – both for those considering using donor eggs, as well as those raising donor conceived children. We also share some of our favorite children’s books on the topics. Happy reading!

Best books for parents considering using donor eggs

"Having Your Baby Through Egg Donation" by Ellen Sarasohn Glazer & Evelina Weidman Sterling

The book: Having Your Baby Through Egg Donation (Second Edition) is an authoritative guide to negotiating the complex and emotive issues that arise for those considering whether or not to pursue egg donation. It presents information clearly and with compassion, exploring the practical, financial, logistical, social and ethical questions that commonly arise. 

The authors: Ellen Sarasohn Glazer is a clinical social worker specializing in infertility, adoption, third party reproduction, pregnancy loss and parenting after infertility. The long awaited arrivals of daughters Elizabeth and Mollie inspired Ellen's work in the field of reproductive medicine. Evelina Weidman Sterling works as a public health educator and researcher specializing in reproductive and women's health issues. 

Why we love it: This book spells it all out – including the ethical and emotional aspects of egg donation. After reading it, you will be in a far better position to decide if this family building option is right for you and, if so, to proceed as a more empowered parent. 

"Donor Family Matters" by Wendy Kramer

The book: Donor Family Matters: My Story of Raising a Profoundly Gifted Donor-Conceived Child, Redefining Family, and Building the Donor Sibling Registry is the story of Wendy's journey as the mother of a donor conceived profoundly gifted child, Ryan, whose relentless curiosity—under the tenacious guidance and support of his mother— led to his reunion against all odds not only with his biological father, Donor 1058, but also with 19 of his donor conceived half-siblings scattered across the continent.

The author: Wendy is the Co-Founder, Chair, and Executive Director of the Donor Sibling Registry. She has co-authored many published papers on donor-conception, has reviewed abstracts for ASRM and has also been a peer reviewer for the journals Human Reproduction, Reproductive BioMedicine Online, Frontiers in Global Women's Health, and the Journal of Comparative Effectiveness Research. She was Associate Producer on the Style Network's 2011 Emmy-nominated show Sperm Donor and on MTV News & Docs 2013 docu-series Generation Cryo. Wendy and her son Ryan have appeared on 60 Minutes, Oprah, Good Morning America, and many other news shows and publications.

Why we love it: This memoir provides a raw and honest account of raising a donor-conceived child as a single mother, and helping her son be the first donor-conceived person to find his biological father (donor) via a commercial DNA test, in 2005. 

Best books for parents raising donor-conceived children

"Let’s Talk about Egg Donation" by Marna Gatlin

The book: Let’s Talk about Egg Donation: Real Stories from Real People tells true stories of families who are parenting via egg and embryo donation. Their stories are woven throughout the book to craft an informative, easy-to-read narrative that focuses on positive language choices.

The author: Marna Gatlin is the founder and Executive Director of Parents via Egg Donation (PVED), a non-profit organization created to provide an informational and supportive environment where parents and parents-to-be can learn and share information about all facets of the egg donation process.
Why we love it: This is the first book written by parents through egg donation that gives you age-appropriate scripts for how to take the scary out of talking to your kids about the special way in which they were conceived.

"Three Makes Baby" by Jana M. Rupnow LPC

The book: Three Makes Baby: How to Parent Your Donor-Conceived Child offers education and awareness so parents can guide their donor conceived children through various stages of development with age-appropriate conversations.

The author: Jana M. Rupnow, LPC is an internationally recognized fertility mental health expert and author. She received a bachelor of science from Texas A&M University and a master of arts, in professional counseling from Amber University. Jana has a master's degree in professional counseling and has practiced as a licensed professional counselor since 2010. Jana has helped thousands of people facing the psychological and social challenges of infertility as well as those preparing for third-party family building and adoption. She also knows what it's like to experience infertility. She and her husband had male-factor, secondary infertility and adopted their daughter from China. 

Why we love it: This book is often recommended by fertility doctors and fertility mental health professionals – and there’s a reason why. The author uses research and best practices to lay out solid advice for parents of donor-conceived children.

Best children’s books about egg donation

"From the Start" by Stephanie Levich

The book: From the Start: A Book About Love and Making Families is an inclusive and heartfelt love letter to adopted children and children born through the help of fertility treatments such as IVF, sperm and egg donation, or surrogacy. The book focuses on hope and gratitude to highlight the special roles fertility doctors, donors, surrogates, and adoption play in helping hopeful parents start or grow their families. 

The authors: Alana Weiss and Stephanie Levich have been best friends since they were teenagers and are both mothers as a result of IVF. They have always been open about their fertility challenges and feel deeply grateful for their children and the extraordinary way they were conceived. Additionally, Stephanie is the founder of Family Match Consulting, an internationally renowned fertility consulting firm based in Los Angeles that specializes in egg/ sperm donation and surrogacy. She is also an adoptee.

Why we love it: The ways that we build our families are more dynamic than ever – this book highlights how special each of those paths can be. 

"Happy Together" by Julie Marie

The book: Happy Together, an egg donation story uses clear language and cheerful illustrations to join Mommy and Daddy bear on the journey to fulfill their greatest wish of becoming parents. With help from a doctor, an egg from a special lady called a donor and Daddy’s seed, a baby grew in Mommy’s tummy and was welcomed with great joy.

The author: As a mother through egg donation, author Julie Marie found various paths to parenthood were underrepresented in children's literature. Julie wrote Happy Together to help parents share their special family building story with their child.

Why we love it: This tender book is a favorite amongst donor-egg parents, and it’s no surprise. The story is simple enough for even young kids to understand, yet it explains the process of donor eggs well. 

"A tiny itsy bitsy gift of life" by Carmen Martínez Jover

The book: A tiny itsy bitsy gift of life, an egg donor story is a touching story of how a happy couple of rabbits have their own baby by means of egg donation. Using rabbits in this story enables children to easily understand their conception in a simple and loving way. It is through storytelling that parents can explain and help children understand these infertility treatments.

The author: Carmen Martínez Jover was born in Walton-on Thames, Surrey, England and now  lives in Mexico City. Her years of infertility prompted her to paint the roller coaster of emotions through an autobiography. As an adoptive mother she believes that storytelling can help parents share their children’s conception story and wrote this story for children conceived through egg donation.

Why we love it: We know it’s important to talk to donor-conceived children early and often about their conception story, and this book is a great way to do that. Using rabbits in this story enables children to easily understand their conception in a simple and loving way. 

"You Were Meant For Me" by Sheri Sturniolo

The book: You Were Meant For Me: Mom*Dad*Donor shows how the love and generosity of others can grow into the most wonderful gift. This book is a kid-friendly look into the unique ways that some families are grown and the journey of love that brings them together.

The author: Sheri Sturniolo is a Pediatric Registered Nurse and mother to a son and daughter—both born through the awesome gift of donors. Through her personal journey and experiences, Sheri hopes to offer a valuable tool to families searching for ways to make sense of their unique creation story. Sheri lives with her husband, son and daughter (both conceived through embryo adoption) in the San Diego area.

Why we love it: Using symbolism and sweet rhyming lyrics, You Were Meant For Me introduces the complicated topic of being born from sperm, egg or embryo donation, to a young child. By giving children the “pieces of the puzzle,” this book sparks their imagination and stimulates them to ask questions.

"Wish" by Matthew Cordell

The book: Wish is about an elephant couple that embarks on a life together, with thoughts of children far away—at first. But as the desire for a child grows, so do unexpected challenges. And it's only after thwarted plans and bitter disappointment that their deepest wish miraculously comes true.

The author: Matthew Cordell is the acclaimed author and illustrator of the 2018 Caldecott winner Wolf in the Snow. He is also the author and illustrator of Trouble Gum and the illustrator of If the S in Moose Comes Loose, Toot Toot Zoom!, Mighty Casey, Righty and Lefty, and Toby and the Snowflakes, which was written by his wife.

Why we love it: Although this book does not specifically discuss egg donation, it beautifully illustrates the angst of waiting for a child, the fear that it may not happen, and the joy when the wish finally comes true. It will make any parent who struggled with infertility tear up!

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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!

When conducting your initial research on egg donation you were most likely focused on the short-term process like how to find the right match for your family. But now you might specifically want to know more about the long-term experiences of parents and children in families created using egg donation once the baby arrives. 

As a fertility psychologist, I often get asked what it feels like to have a baby born via egg donation, and if the baby will feel like their child or if they will be able to bond. In this guide, we’ll go over several studies that illustrate the parent-child relationship in families created using egg donation, and hopefully give you peace of mind!

Infant days: bonding with your donor-conceived child

No matter how your child is conceived, the answers to these questions are not black and white. Because just like any other pregnancy, some parents immediately feel a parental connection, even while their child is in-utero. And for some it may take months post-delivery. And even once the baby arrives, it can be very normal to feel uncertain about having a baby using someone else’s DNA. But these feelings tend to dissipate. A recent study conducted in 2020 found that women who were pregnant via egg donation had concerns about whether the child would feel like their own, but by the end of the first year, they felt secure and confident as the child’s mother. 

Early childhood: relationship satisfaction 

In terms of parental psychological health, studies have established that egg donation parents are psychologically well-adjusted in terms of their levels of depression, anxiety, parenting stress, and relationship quality with their partner. They also reported lower levels of parenting stress compared with IVF and sperm donation parents when children were ages three to eight years old.  And, egg donation mothers reported greater relationship satisfaction than IVF and sperm donation mothers. Similarly, fathers' depression scores did not differ between family types, but egg donation fathers reported lower levels of anxiety than comparison groups. At age 12, no differences were found between family types in mothers' levels of depression, anxiety, or relationship satisfaction. So basically, parental psychological health is not much impacted by how their baby was born. 

Another study also found no differences between egg donation, sperm donation, and natural conception mothers or fathers in levels of parenting stress, depression, anxiety, or relationship satisfaction when children were one year of age. At ages two and three, no differences were found between family types for mothers or fathers on any of the psychological health measures. When children were age 10, egg donation mothers did not differ in their scores for maternal distress compared with sperm donation or natural conception mothers.

A US-based study of 31 egg donation families with a child aged six months to five years found that when assessing family interactions, the sample scored lower than norms on conflict scores, and higher than norms on cohesion scores. Meaning, parents whose child was born via egg donation had better perceptions of interpersonal relationships within the family than a normative sample.

Parents whose child was born via egg donation had better perceptions of interpersonal relationships within the family than a normative sample.

Another study found that egg donation mothers expressed greater enjoyment in motherhood and greater warmth toward their infant than natural conception mothers, and greater pleasure in proximity to the infant. Greater emotional involvement with the baby was also found among gamete donation parents compared with natural conception parents.

How do children feel about being donor-conceived? 

What about the emerging research on donor conceived children’s perspectives of the quality of their relationships with their parents and their own psychological well-being? The European Study of Assisted Reproduction found children conceived through egg donation to be well-adjusted in terms of their socioemotional development at ages both three to eight years of age and at age 12. 

Relationship quality collected using a semistructured interview designed to obtain children's perspectives on family relationships indicated that children in egg donation, sperm donation, and natural conception families viewed their parents similarly in terms of their affection, harshness, and anger. No differences were found between groups at either age in children's interview ratings of maternal or paternal warmth and affection, availability, or amount of interests/activities shared with parents. Unlike in natural conception families, egg donation children did not report a decline in shared activities with their mothers and fathers between the two timepoints. And in another study, when children were asked about whether they would change anything about their family, the vast majority said that they would keep their family the same as it is, suggesting contentment with their current situation.

When [donor-conceived] children were asked about whether they would change anything about their family, the vast majority said that they would keep their family the same as it is, suggesting contentment with their current situation

Longitudinal research shows that children born via egg donation do not differ in their psychological adjustment from children born through other forms of assisted reproduction or through natural conception. At all timepoints egg donation, children were similar to comparison groups of behavioral and socioemotional adjustment and in adolescence they showed similar scores for self-esteem and positive psychological functioning. 

Overall, studies that have looked at the long-term outcomes regarding family well being and the quality of relationship between parent and child indicates that families conceived via egg donation function well in terms of child adjustment, parental psychological health, and parent-child relationship quality. Some researchers conclude that this may be because those  who continue to have fertility treatments despite failures may have strong coping skills and thus may not be as affected by everyday parenting issues. With regard to the quality of parent-child relationships, researchers have consistently found a high quality of parenting relationship  between parent and child across studies. 

If you are considering using a surrogate and an egg donor to help you start or grow your family, the order in which you find a surrogate or egg donor will depend on your individual circumstances and needs. In this guide, we’ll go over a few things to consider when deciding whether to find a surrogate or an egg donor first.

Surrogacy vs. egg donation

Surrogacy is a process in which a woman carries and delivers a child for someone else. If you are considering using a gestational carrier (aka surrogate), you will likely need to work with an agency to help match with someone who has been pre-qualified to carry your child. You will also need to work through the legal and medical aspects of surrogacy, including the surrogacy agreement and the medical screening and evaluation process.

An egg donor is a woman who donates her eggs to another person or couple. If you are considering using an egg donor, you will need to match with an egg donor who is willing to donate her eggs to you. You will also need to consider the medical and legal aspects of using an egg donor, including the egg donor agreement and the medical screening, evaluation, and retrieval process.

Who would need both a surrogate and egg donor?

There are lots of cases where families need both a gestational carrier and egg donor to have a child. Here are a few examples:

• Infertility: Some individuals or couples may be unable to conceive or carry a pregnancy to term due to infertility. In these cases, they may consider using both a surrogate and an egg donor to help them increase their chances of having a child.
• Single individuals: Some single individuals, especially those born male, may consider using a surrogate and an egg donor, along with their own sperm or donor sperm, to help them become parents.
• LGBTQ+ couples: Some same-sex couples may consider using a surrogate and an egg donor to help them become parents. For example, a gay male couple may use a surrogate and an egg donor to carry and give birth to a child that is genetically related to one of the men.
• Medical conditions: Some individuals or couples may have medical conditions that prevent them from getting pregnant, undergoing IVF, and/or carrying a pregnancy to term. In these cases, they may consider using both a surrogate to carry their child for them.

So which comes first, egg donor or surrogate?

In most cases, we recommend starting by matching with an egg donor. Many surrogacy agencies cannot sign up families who do not yet have healthy embryos to transfer. This is because gestational carriers are in high demand and they don’t want to wait months after matching in order to start the transfer process. On the other hand, once you have embryos made through donor eggs, those can be frozen and used at any point in the future.

You could also begin the search for a gestational carrier and an egg donor at the same time, knowing that the waitlist for a gestational carrier is far longer than the process to get donor eggs.

How long does it take to match with an egg donor?

The timeline can vary, but in total the process from match to cycle with Cofertility is generally be two to four months. Once you create a free account, you’ll gain access to our matching platform and can start to learn more about our donors. After you match with a Split member (who will be freezing her eggs and donating half to your family), we begin the process of scheduling her screening and testing with your clinic, which generally takes a few weeks. Once your doctor gives the go-ahead, we’d set a date for the cycle at a time that is mutually convenient. 

You may decide to fertilize the embryos as soon as the eggs are retrieved or you can freeze the eggs and thaw them to be fertilized at a later date. If you do create embryos at the time of retrieval, they can be frozen in storage until you match with a surrogate or are ready to move forward with the transfer.  

How long does it take to match with a surrogate?

The process of matching with a surrogate varies in length and may depend on a variety of factors, including the location and availability of surrogates, the intended parents' preferences and requirements, and the legal and medical requirements involved in the surrogacy process based on your state. In general, the process of finding a surrogate may take several months to a year.

Learn more

Ultimately, the decision of whether to find a surrogate or an egg donor first will depend on your individual circumstances and needs. It may be helpful to speak with your doctor to determine the best course of action for your situation.

Cofertility is a human-first fertility ecosystem rewriting the egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. Create a free account today!

Donor egg in vitro fertilization (IVF) is a fertility treatment in which an intended parent uses eggs from an egg donor to have a baby. In this process, the donated eggs are fertilized with sperm from an intended parent or sperm donor in a laboratory to create embryos. Those embryos are monitored by an embryologist while they grow into blastocysts. They are then frozen, genetically tested, and transferred to the uterus of the intended mother (or a gestational carrier) in the hope that it will implant and result in a pregnancy. 

We know that using donor eggs can greatly increase the chances of success for an infertile couple. But how common is egg donation? Let’s dive in.

First, who uses donor eggs?

There are many reasons an intended parent would turn to donor eggs to have a baby:

• Infertility due to low ovarian reserve 
• Repeated IVF failures with own eggs
• Infertility due to recurrent miscarriage
• LGBTQ+
• Genetic mutations
• People without ovaries
• Single males
• Women whose own eggs have been damaged by chemotherapy or radiation treatment

Regardless of the reason, donor eggs are a viable, and increasingly common, path to parenthood. 

How common is donor egg IVF in the US?

The use of donor eggs has been increasing in recent years. While it's hard to know the exact number of egg donation cycles each year, we can get a good estimate through the Society for Assisted Reproductive Technologies (SART), which tracks data for nearly 400 US 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

How common is donor egg IVF in the UK?

More than 70,000 donor conceived children have been born in the UK since 1991. The total number of babies born via egg donation in 2019 was 1,327, up 88% from 2009. Of those, 83% used a donor egg and the partner’s sperm. The remaining 17% used both donor egg and donor sperm.

How common is donor egg IVF in Australia and New Zealand?

In Australia and New Zealand, there were 3,316 IVF cycles performed using donor eggs (or embryos) in 2017 with 727 live births reported. Of those cycles, 86% used donor eggs and the partners sperm while the remaining used a donor embryo.

How common is donor egg IVF in Europe?

According to data from the European Society of Human Reproduction and Embryology (ESHRE), the number of donor egg cycles in Europe has been steadily increasing in recent years. In 2017, the most recent year for which data is available, there were a total of 28,377 donor egg cycles reported in Europe, representing about 5% of all IVF cycles performed in the region. It is worth noting that these figures do not include data from all European countries, as not all countries report their IVF data to ESHRE.

How common is donor egg IVF in Asia?

In China, egg donation is uncommon. That is because donor eggs can only be used if they are unused leftover eggs from women who underwent IVF. Data collected by The Chinese Society of Reproductive Medicine (CSRM) of 327 fertility clinics from 2013 to 2016 found 1,642 donor egg cycles in that time, a small fraction of the 12 million cycles.

The use of donor eggs globally

Unfortunately there’s no way to know exactly how many donor egg cycles there are globally. 

But according to data from the International Committee for Monitoring Assisted Reproductive Technologies (ICMART), which collects data from 2,971 clinics in 79 countries, there were 161,139 egg donation transfers in 2018.

The use of donor eggs is more common in countries and regions with better access to IVF, and where legal, cultural, or religious beliefs make the use of donor eggs more acceptable. Plus, the use of donor eggs in IVF may be underreported in some countries, as not all countries require procedures to be reported to regulatory agencies.

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. 

Donor eggs: where do I start?

If you are looking to use donor eggs to build your family, we’d love to help. Cofertility is a human-first fertility ecosystem rewriting the 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!

After years of not being able to build your family through conventional methods, you are considering conceiving using gamete donation. Understandably you have many questions about it, particularly the psychological aspects of the mother-child relationship, questions about how it might feel to use donor eggs, or if the child will even feel like yours? All of these are valid questions and are probably just a few out of a million questions running through your mind. But when using assisted reproductive technology and donor gametes to create your family, there is no such thing as too many questions! The more questions you ask and the more knowledge you gather, the less scary it will feel and the more confident you will be about your decision to use egg donation. So let’s dive in.

More women are turning to egg donation 

Aside from health/medical issues, women are turning to egg donation because they have medically “aged out.” Sadly, age is not just a number. The stark reality is that age is one of the most important aspects when it comes to getting pregnant with your own eggs. Women are delaying childbirth for many reasons, but no one talks to them about the consequences of doing so.

In 2019, there were almost 20,000 IVF transfers using donor eggs. And as topics such as egg donation and surrogacy become more mainstream in the media, more families are starting to share their experiences with third party reproduction and how they are raising their donor conceived children. More resources for families are also becoming available, but still, many continue to struggle to navigate, understand, and experience parenting a child conceived in this way.

The mother-child relationship in egg donation families

A common question for many is regarding the impact of using a donor egg on the relationship between mother and baby. Many are afraid they will not bond with the baby or that the baby will not feel like theirs. But, studies have shown that most mothers using donor eggs to have their baby felt secure and confident as the child’s mother by the end of that first year. Which makes sense since during that first year your entire existence revolves around the baby and not much else. And making it to that first birthday is a huge milestone, not just for the baby but for the parents as well.  In that same study, it was also found that even though over 80% of mothers did think about the non-genetic aspect during pregnancy, two thirds of them reported that egg donation had not influenced their relationship with their child. The bond that was built during that first year only cemented the mother-child relationship. 

Other questions include the idea of anonymity of the donor versus knowing the donor. What, when, and how to tell the donor conceived child about their beginnings, along with deciding on what, when or if to tell family and friends. 

Psychological aspects of using donor eggs

Many parents also want to know about the psychological aspects of using donor eggs. For some the idea of having to surrender one's own DNA and all that entails in order to bring a child into the world can be a difficult idea to process. Even though the United States has one of the highest rates of blended families – consisting of half or step children, step mothers and fathers – where love and family is not based on DNA, this idea of not being genetically related to your child, can still be a difficult one to grasp. But once the longing to be a parent speaks louder than the urge to procreate, that feeling slowly begins to take a back seat. 

But once the longing to be a parent speaks louder than the urge to procreate, that feeling slowly begins to take a back seat.

The emotional journey of finding an egg donor

Another emotionally charged piece can be the process itself. The process of choosing an egg donor can feel impersonal and uncomfortable. The screening process for the egg donor to ensure she is medically and psychologically fit can be time consuming. And waiting for the results of the retrieval can be anxiety provoking. And because using an egg donor comes with extra costs, some families feel that egg donation is out of reach. And for many, the cost to build the family of their dreams may lead to mounting debt that seems daunting.  

The upside

Despite the challenges, people are still choosing to use egg donation to build their families due to the high success rate and probability that they will become parents. Typically, for a woman over 39,, using her own eggs has a success rate of about less than 10% per IVF cycle. Whereas an IVF cycle using donor eggs averages almost 50%. And because egg quality and age are the main reasons for miscarriage, those using donor eggs have lower rates of miscarriage. Also, if you are having the embryo transferred to yourself, egg donation can also give you the experience of pregnancy and childbirth and starting the connection with the baby from day one.

The decision to use an egg donor to conceive your child is not easy. Fortunately, parents using third party reproduction are not alone. Cofertility recognises and understands the sensitive nature of conceiving using donor eggs. We also understand the longing to be a parent.  Our team works really hard to make the egg donor experience a warmer, more human centric process, by offering community and support throughout this journey. Create a free account today to get started.

If you are considering conceiving using donor eggs, you may have questions about it, particularly about anonymous egg donation and what the research says about families conceived using anonymous donations. In this article, I break down some of the emerging research behind anonymous egg donations and their long term outcomes including impacts on the parent-child relationship.

To start, should you use an anonymous egg donor? 

This is a question that you need to strongly consider before choosing a donor. Although some agencies/centers tout anonymity, it is important to understand that true anonymity cannot be guaranteed. Because of relatively inexpensive and readily available at-home DNA testing, a child can easily discover their true origins. And now with changing laws, anonymity may not even be an option. 

However, some parents are still wanting to work with donors who will be anonymous. But why is that the case? In a 2011 study, parents who intentionally chose anonymous donation over known donation said they believed that anonymity would allow them to establish clear boundaries between the donor, child, and parent. And because they wanted to minimize any potential links between the donor and child in order to protect the mother–child relationship. In contrast, parents intentionally did not choose known donation as it was viewed as complicating the donor–child relationship and undermining the recipient's (intended mother) ability to feel secure in her role as mother.  But interestingly, the study also found that mothers could both express ambivalence and uncertainties about the non-genetic relationship with their child, but still feel confident and secure in their identity as the child’s mother. So in the end, the anonymity did not make a difference in how she felt about her identity or role as mother. 

So if anonymity doesn’t really impact a mother’s identity or role as a mother, why would someone want to choose a known or identified donor? One major reason for choosing a known donor is that one can have more information about the donor specifically as it pertains to their medical history. Furthermore you can also be kept abreast of any changes to the donor’s medical history in the future. This is so important if your child gets diagnosed with a medical issue or needs some sort of medical treatment. Being able to contact your donor could potentially save your child's life. 

Read more in Undisclosed vs. Anonymous Egg Donation: What’s the Difference?

What do donor-conceived people think?

We have also seen that donor conceived children are curious about their origins. So another advantage of using a known donor is that your child can potentially have knowledge or communication with their donor.  Research has shown that adolescents who were interested in their donor mostly wanted to know more about why they had donated, and some had questions about the donor’s family, or other children (half siblings) conceived using the same donor. In essence, what they wanted was to just better understand themselves. In a study with donor-conceived people, 86.5% believed that they had a right to non-identifying information about their donors; several also believed that they had a right to identifying information. In the end, they all wanted to know something about their donor and not necessarily to establish a relationship with the donor.  

In another study, donor-conceived people who were conceived as a result of anonymous donation and who had grown up knowing about the nature of their conception still perceived donor conception as an acceptable model of family-building, but only when an identifiable donor was used and where parents disclosed their use of donor conception from an early age. And approximatley 25% of the participants endorsed anonymous donation, subject to the availability of some non-identifying donor information. A 2018 study obtained first-hand data from a sample of donor-conceived and surrogacy-conceived children followed from infancy to adolescence, suggest that the concern that children born through third party reproductions (i.e. surrogacy or egg or sperm donation) would be distressed about their origins in adolescence was unfounded, and that children who were informed when young of their conception were accepting of this in adolescence.  The majority of the participants were actually indifferent about their conception, and were either interested in, or enjoyed positive relations with, their surrogate or donor. Not one of the adolescents indicated that they were distressed about their conception. 

A 2021 study recommends if future intended parents are considering gamete donation, for the future well-being of all involved, anonymous donation ought to be discouraged. If individuals want to proceed with anonymous donation, at a minimum they should inform their child about the nature of their conception to minimize any potential harm to their child. Also, whatever clinic or agency you are working with, it will be important that they explain how they plan on maintaining anonymity, and how they plan on keeping the donor’s information, and how the donor can be reached if a medical emergency were to come up. 

When making your decision, only one key fact should weigh heavily on your decision and that is what will be best for your future child's mental, physical and genetic health.

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.

If you are planning to donate your eggs or are planning to be a recipient of an egg donation, do not be surprised if you are told by your clinic or agency that you need psychological screening before proceeding. For most people, ‘psychological screening’ sounds like a test that needs to be passed in order to donate or to become parents. This can create tension, annoyance, and even anger. Some look at this step as another obstacle to meeting their end goal or just another box that needs to be checked before moving forward. But in essence, good quality programs require this meeting to ensure you understand the consequences, and are mentally prepared for all that comes along with donating or receiving donor eggs. 

As a psychologist who regularly performs these psychological screenings, my goal is to make sure you have explored all the ethical, social, and emotional ramifications that come with egg donation. This meeting allows you to think about both the short and long-term impacts of egg donation. It gives you things to ponder that you may not have thought about, and allows you the opportunity to ask questions that you were afraid to ask in an open and safe space. In this article, I will give you a glimpse into what this screening process can be like for both egg donors and recipients.

Egg donor psychological screening

For egg donors this screening is extremely important because we want to make sure she is fully prepared, ready, and understands what it means to serve as an egg donor. She needs to understand the physical, psychological, and legal risks of donating. We also want to look at why she is donating and identify any potential emotional problems that may be contraindicated to donating. These areas are assessed based on the guidelines set forth by The American Society for Reproductive Medicine (ASRM). If a donor has a spouse or long-term partner, they may also be included in the evaluation to confirm the presence of support and understanding of the process and how the results of donating could potentially impact them as well. 

Typically, this evaluation includes a clinical interview and a standardized test. The whole process can take anywhere from two to three hours to complete. Types of questions asked include: family, education, and work history, motivation to donate, current life stressors and coping skills, traumatic reproductive history, interpersonal relationships and sexual history, along with any personal and family history of mental health issues. During the evaluation the donor’s understanding of the potential emotional and social risks is also discussed and a large portion of the meeting will focus on the implications for the donor, their current or future children or partners, and how the donation may even affect their extended families. 

Donors should be prepared to share health information about not only themselves but also health information about their family. This includes their parents, siblings, grandparents, aunts, uncles and cousins. This is because we need to know if there are any possible heritable traits that could be passed on in the genes. This gives the potential parents receiving the eggs with information to make an informed decision about whether or not to work with the donor. 

Intended parent psychological screening

For those receiving oocytes, a psychoeducational consultation with a qualified licensed mental health professional who has training and education in third-party reproduction is strongly recommended. During the consultation, the implications of creating a family using gamete donation is discussed. Important topics such as disclosure are covered:

• How and when do you tell your child they were conceived via egg donation? 
• What are the long-term impacts of the donation on the family? 
• How do you get past the grief of not having your own biological child? 
• What happens if the transfer does not result in a pregnancy? 
• What is the impact of treatment failure, and do you possibly need to develop alternative plans for the future? 
• What if the embryo transfer does result in a pregnancy, what does this new transition to parenthood look like? 
• What are the challenges of donor anonymity and its implications in the future?
• Embryo management is covered, meaning what will happen to embryos that will not be used? Are they discarded? 

This meeting typically takes about one to two hours and both parents are expected to participate in the meeting.

Some programs do not require meeting with a psychologist and make it an optional meeting. I would strongly advise to meet with the psychologist even if it is not required by your clinic or agency. As you can see from above, the meeting will give you invaluable information that will guide the decisions you make and will impact how you move forward as a family that is conceived via egg donation. This meeting will inform how you think, feel and talk about having this child. Take full advantage of this meeting, take notes and ask all the questions.

The psychological screening for both the egg donor and the recipient helps them make informed decisions about egg donation and provides both parties the opportunity to explore how it may impact all involved, both in the present and in the future. Be open, ask questions. Because what you are embarking on is not easy.

Read more:

• I'm a Fertility Psychologist. Here's What I Want You to Know About Growing Your Family Through Egg Donation
• 10 Facts You Need To Know About Using Donor Eggs
• What to Look For in an Egg Donation Agency

Religions have their own moral code and teachings regarding family creation. The emerging use and evolving regulation of egg donation and assisted reproductive technologies have brought into focus the views of different religions and religious organizations. While most religions have historical and relatively outdated teachings on reproduction itself, recent years have seen emerging voices from organized religion on egg donation and assisted reproductive technologies. 

Some faith leaders cite beliefs about the purpose of sex - primarily that it is meant to be procreative and unitive, and that fertility options therefore go against or blur the lines of religious morality. Although individual members may accept and support using donated eggs, many faiths do try to limit, if not ban, the practice altogether. In this guide, we’ll go over a few examples on what religions say about egg donation.

Buddhism: 

Buddhism does not have specific teachings on the use of egg donation and ART. Dr. Schenker shares that Buddhist discourse largely accepts egg donation as long as the child has the right to know their genetic parent(s). 

Catholicism: 

One religion that has clear guidelines on the use of egg donation and assisted reproductive technologies (IVF) is Catholicism. The Roman Catholic Church holds that life begins at conception, that children must be conceived during sex, and that any conception outside a physical union is condemnable. Therefore, the Church prohibits any form of artificial reproduction that separates procreation from the conjugal act between a married heterosexual couple. This includes the use of egg donation, because it involves the separation of the procreative and unitive aspects of the conjugal act.

Hinduism: 

Hinduism does not have specific teachings on the use of egg donation and art. However, according to Dr. Schenker, an expert on religious faith and professor at Hadassah University and Medical Center, Hinduism accepts egg donation as long as the child has the right to know their genetic parents. 

Judaism: 

Jewish law and tradition strongly encourages “be fruitful and multiply” and most jewish people embrace egg donation as a way of achieving this. Most rabbinic authorities hold that egg donation and surrogacy are allowed under jewish law. However, the rabbinical world is divided on whether an intended parent should find a donor who is jewish. The conservative and orthodox movements suggest that the egg donor must be fully jewish, while the reform movement suggests that as long as the intended parent is jewish, the child is considered jewish as well. In 1996, the committee on jewish law and standards of the rabbinical assembly declared that a child born to a jewish woman is jewish, regardless of the religious status of the ovum donor. Read more in I'm Jewish. How Should I Be Thinking About A Jewish Egg Donor?

Protestantism: 

Protestant Christianity generally views the use of egg donation and ART as problematic. Unlike the Catholic Church, however, Protestant denominations do not have a centralized authority that can issue official statements on these issues. Nevertheless, the Church of England, one of the dominant voices in Protestant policy, expressed its disapproval at the prospect of offering fertility treatments to single women and gay couples at the time of the passing of the 2012 Human Fertility and Embryology Act in England. The subsequent law however gave access to single women and gay couples to egg donation fertility treatments. 

Shia Islam: 

Given the shia branch of islam is largely seen in iran, the rulings of the ayatollahs in iran have supreme jurisprudence in the Shiite Islamic world. The Iranian law on gamete donation, passed in 2003 and approved by the guardian council, allows for egg donation provided the husband marries the egg donor temporarily. However, sperm donation is forbidden as a sperm donor cannot temporarily marry an already married woman whose husband is infertile. Interestingly, embryo donation, from another married couple, is allowed.

Sunni Islam:  

Sunni Muslims follow the Fatwas issued by religious bodies such as Al-Azhar University in Cairo and the Islamic Fikh Council in Mecca on matters related to everyday life. These Fatwas and guidelines allow for assisted reproduction as long as the sperm and oocyte are those of the married couple, and the embryo is replaced into the wife’s uterus during an existing marriage. Simply, this means that third party egg donation is not allowed. 

Faith and egg donation

Different religions have different views on the use of egg donation and assisted reproductive technologies like IVF. While some religions view these technologies as problematic, others may view them as acceptable in certain circumstances. Generally, with the exception of Catholicism, the lack of a central decision making authority in other major global religions means that gray areas exist in the context of religious views on egg donation.

What if my religion does not approve of using donor eggs?

If your religion does not allow the use of donor eggs or even IVF, it is important to consider your own beliefs and values when deciding whether to pursue these options. It may be helpful to speak with a religious leader or authority within your faith tradition to learn more about the teachings and beliefs of your religion, and to explore how these teachings may apply to your situation. You may also want to consider seeking guidance from a mental health professional, who can help you navigate your thoughts and feelings about the use of donor eggs.

Ultimately, the decision to use donor eggs is a deeply personal one that should be made based on your own values, beliefs, and circumstances. It is important to consider all of the potential risks and benefits of these options, and to weigh them carefully before making a decision.

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!

Some cancers and cancer treatments can have a range of effects on a person’s current and fertility. The impact can vary depending on a number of factors, such as the type of treatment used, the dose and duration of treatment, and the person's age and general health. In this guide, we’ll dive into some of the facts about cancer, cancer treatments, fertility, and donor eggs.

Why some cancer survivors need donor eggs

While some cancer patients are given the opportunity to freeze their eggs before undergoing cancer treatment, too often this doesn’t happen. Sometimes the drugs required in egg freezing could promote the growth of hormone-sensitive cancers. Other times, the patient may not have enough time to complete a stim cycle before needing to start cancer treatment. And in some particularly unfortunate cases, the patient may not be not informed of their fertility preservation options. 

Regardless of the reason, if a cancer survivor no longer has sufficient egg quantity or quality, turning to donor eggs is one potential path to parenthood. 

How cancer treatments may affect fertility

Chemotherapy, radiation therapy, and surgery are all types of cancer treatment that can potentially affect fertility. The effects of cancer treatment on fertility can vary widely from person to person. Some people may experience temporary or permanent fertility changes as a result of treatment, while others may experience no significant changes.

• Chemotherapy can cause primary ovarian insufficiency (POI), which is when the ovaries stop  releasing eggs and estrogen. Sometimes POI is temporary and your menstrual periods and fertility return after treatment. However, even if normal ovulation resumes, chemotherapy can lower the number of healthy eggs.
• Some cancer surgeries, especially those addressing gynecologic cancers, include the removal of one or both ovaries, the fallopian tubes, uterus, vagina, or cervix. This can make getting pregnant and carrying a healthy pregnancy more difficult. 
• Radiation therapy can also cause infertility. Patients who receive abdominal or directed pelvic radiation at high doses are at greater risk for infertility. Radiation therapy can also negatively impact the number and quality of eggs, leading to a reduced ovarian reserve. 

If you are considering cancer treatment and are concerned about its potential impact on your fertility, it is important to discuss your concerns with your healthcare team. They can provide you with information about the potential effects of cancer treatment on fertility and help you understand your options for preserving your fertility before treatment begins.

Can you become pregnant after chemotherapy?

Some types of chemotherapy can temporarily or permanently damage the ovaries, which can affect a person's fertility. Chemotherapy can also cause a temporary or permanent decrease in the production of eggs, which can also affect fertility. However, the effects of chemotherapy on fertility are not uniform. 

It is also important to note that fertility can be affected by other factors, such as the underlying health condition for which the chemotherapy is being used. For example, some health conditions, such as cancer, can affect fertility even without chemotherapy treatment.

Can you do IVF after cancer and chemotherapy?

It is often possible to undergo in vitro fertilization (IVF) after cancer treatment, including chemotherapy. However, the timing of IVF treatment may need to be adjusted based on the specific type of cancer and treatment.

Chemotherapy and other cancer treatments can damage the ovaries, which can affect fertility. It may take some time for the ovaries to recover after treatment, and the timing of IVF treatment may need to be adjusted accordingly.

It is also important to note that cancer treatment can affect your overall health, which can impact the IVF experience. Some people may want or need to wait until they have fully recovered from treatment before starting IVF, while others may need to modify their treatment plan to take into account any ongoing health issues.

If you are considering IVF after cancer treatment and are concerned about its potential impact on your fertility, it is important to discuss your concerns with a fertility specialist. 

Using donor eggs to get pregnant after cancer

IVF using donor eggs is a fertility treatment option often considered by female cancer survivors who have experienced fertility changes as a result of cancer treatment. Because cancer treatment, such as chemotherapy and radiation therapy, can damage the ovaries and affect a person's ability to produce healthy eggs, using donor eggs may be the best option for achieving pregnancy.

Donor egg IVF involves using eggs from a healthy donor to create embryos, which are then transferred to the uterus of the intended parent or a gestational carrier. This can allow cancer survivors who have experienced fertility changes as a result of treatment to have a child. 

Donor egg IVF is an increasingly common fertility treatment, and an option that may be considered if other fertility treatment options are not feasible or have not been successful. Using donor eggs can greatly increase the chances of a healthy pregnancy, especially for women over 35. 

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!