Knowledge is at the heart of our work

We’ve created a library of articles covering everything you need to know about the egg donation process, how to support your donor-conceived child, and more.

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LGBTQ+

Preparing for Parenthood as a Gay Couple Using Donor Eggs: Tips from a Fertility Psychologist

If you are a single cis male or in a same-sex male relationship, you will need a gestational carrier to carry and deliver your baby along with donor eggs to create embryos. A fertility psychologist can work with you to discuss the implications of becoming parents, how to talk to your child about their conception and to others around you about your journey. They can also walk you through your feelings, fears, and educate you about the process of becoming parents through third party reproduction.

Donor eggs

Parenting

The decision-making process

The decision-making process of using donor eggs as a gay couple is a little different than heterosexual couples needing to use donor eggs. One is deciding who will provide the sperm. If both are planning on being biologically related, then you need to decide whose sperm will be used first. You both have to agree upon a donor, a carrier and who will be called what (e.g. I will be dad and you will be papa)

Emotional and psychological considerations

The emotional and psychological considerations involved in using donor eggs as a gay couple include who will provide the sperm or should you have twins? What if it works for one partner but not the other? What if the cycle does not work the first time? How many times will you try? How and when to tell your child about their conception story? Then there is the worry about the donor, such as how much, if any, contact you will have with her now and in the future. What if the donor or your child wants a deeper relationship, does the donor have any rights over your baby?

This process can be stressful and it can create pressure on your relationship as well. Especially because it can be costly and it can be time consuming. And sometimes a gestational carrier backs out or a donor you want is not available. It is vital for you to always communicate, openly, honestly and thoroughly.

The impact on the child not having a mother

At some point, your child will start asking questions about not having a mother and about how they were conceived. This is natural especially once the child starts school and sees that some children have mothers. You and your partner should discuss how and when you will tell your child about their donor. You may also want to speak with family and friends about what terminology you would like them to use as well (for example, how will the donor be referred?)

Two dads, no mom, and the kids are all right

A report, published by the American Academy of Pediatrics states that three decades of research concur that kids of gay parents are doing just fine. “Many studies have demonstrated that children’s well-being is affected much more by their relationships with their parents, their parents’ sense of competence and security, and the presence of social and economic support for the family than by the gender or the sexual orientation of their parents,”

Legal considerations

All intended parents should have an egg donor contract. The contract should state that the egg donor is waiving her parental rights and that all children born from her donated eggs will be the intended parents’ children. The egg donor contract can also spell out payments, and terms of any potential future relationship between the donor and your child. For example, having an option for allowing future contact with the donor once the child reaches a certain age. If you work with Cofertility to match with an egg donor, we will help you with this part.

You should also understand the laws where you live regarding same sex parents, egg donation and surrogacy. For example, some countries will recognize both of you as legal parents of the child, while other countries might not. Some states in the U.S. do not allow single men or gay couples to become parents - meaning you may have to look outside of where you live.

Navigating the medical process

Typically gay men need more education and counseling about the female reproductive system than heterosexual couples undergoing donor egg IVF. So you will need to brush up on female anatomy and biology so you have a better understanding of the entire process. When selecting a fertility clinic, you want to make sure that it is LGBTQ+ friendly and understands the unique needs of gay fathers.

Next will be selecting your donor. Before you start searching for your donor, decide on some basic characteristics that you would like to have in your donor. This may include things like physical appearance, education level, athletic or musical ability. Perhaps someone of a certain culture or religion is of importance. Remember, you will never find anyone that meets your requirements 100%. So have your list and then divide it into your must have and nice to haves.

Find your match

Once your donor has completed all the necessary screening and legal contracts, the egg donor will receive hormone medications to stimulate her ovaries to produce multiple eggs. A fertility doctor will retrieve the donor’s eggs once they are mature. These eggs, or oocytes, can then be fertilized using your sperm and transferred to your carrier or frozen (as embryos) for future use.

If you are wanting each partner to have a biologically related child, will want to either split the eggs that are retrieved so you both get half or you may want to do more than once cycle to ensure each partner has enough eggs to create enough viable embryos.

For same-sex male couples, to have a biological baby was once just a dream, now it is a reality. Medical science is giving people the chance to find their happiness by having a family of their own. It can be a long, stressful process but know that Cofertility will be by your side, giving you the support you need while navigating this new path to parenthood.

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Parenting

Surrogacy: Coping With The Grief Of Not Carrying Your Child

Grief is something that is experienced after a deep and meaningful loss. We usually think of grief in terms of a death. However, grief in surrogacy is also very real, as the death of the dream of having and carrying a child of your own, may no longer be a reality.

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Gestational surrogacy involves a woman agreeing to carry and give birth to a baby for someone else. After the baby is born, the gestational carrier (GC) gives custody and guardianship to the intended parent or parents via a legal document. This document states that the baby is not hers and that she has zero claim over the baby and surrenders all rights. The baby may have all, partial or none of the DNA from the intended parents. Due to medical reasons, carrying your own baby may not be a possibility and that may create some very strong negative feelings. Feelings of guilt, anger, loss and failure are very common.

The grief of not carrying your child

During the surrogacy process, grief can be felt after failed IVF attempts or miscarriages. There may be grief about the loss of a biological connection if donor gametes need to be used. There may be grief about missing out on the pregnancy milestones such as feeling the baby kick. There may even be anticipatory grief of believing that one may be unable to bond with the baby after birth.

Stages of grief and how they manifest

Grief during surrogacy can manifest itself in many ways. It doesn’t always manifest as sadness as we would expect. During surrogacy, the intended parent(s) may go through stages of denial, anger, depression, and even guilt.

Denial

Denial is typically the first way grief manifests during surrogacy. Unless you have always known that you will not be able to carry your own child, that realization that you will not be carrying and birthing your own child, can be a difficult pill to swallow. Because you may look or feel healthy, you may not believe what you are being told. You may refuse to believe that this is true.

Anger

Anger can be aimed at self, partners or doctors. Even at random pregnant women walking down the street. Since this all seems very unfair, you may be easily set off by the most minor things. Your reactions may vary from minor irritability to intense rage.

Depression

When the sadness just doesn’t go away. When it becomes more and more difficult to engage with life, depression may be setting in. There may be a sense of hopelessness and a loss of interest in things that used to create joy and happiness. There may be sleep issues - too much sleep or not sleeping at all. There may be a lack of appetite and social isolation.

Guilt

Surrogacy guilt is real. The feeling that it is your fault and that maybe you are a bad person or are doing something wrong can start to appear as you go through a surrogacy. It may manifest as embarrassment, shame or a sense of inferiority.

It is important to understand that all these feelings and emotions are normal. It is also important to understand that with the right help, these feelings can be processed and managed. You can get to the other side.

How to deal with questions from nosy people

Sometimes questions that we consider to be personal are unavoidable. If you are using a gestational carrier to have a baby and you ask for maternity leave or tell people you are expecting when you’re not visibly pregnant, you can only expect people to be curious.

Luckily you have options. You are never obligated to tell anyone anything. It is afterall a personal matter and you are in charge of who gets to know what information. You can decide to share and tell your story while leaving out some information. You can do this by crafting an answer that you feel comfortable with. Write out some answers and start testing them - how does it feel when you say it?

Coping strategies

The path through grief is winding and often disorienting. But equipped with coping strategies and the validation that your emotions are to be honored, not ignored, you are better poised to traverse this emotional landscape. Here are some coping strategies to try:

Find support through counseling or support groups

Navigating the emotions when using a gestational carrier often necessitates external assistance for emotional equilibrium. The act of consulting a therapist or joining a support group can serve as a respite from the mental weight one is carrying. Therapeutic interventions have been shown to improve emotional well-being and reduce symptoms of depression and anxiety). In the company of a trained therapist or a community of people sharing similar experiences, you are granted the space to explore your emotions and thoughts candidly. The collective wisdom found in these gatherings might provide unanticipated insights or coping strategies that you hadn't previously considered.

Communicate with your partner, friends, or loved ones

Solitude might offer a temporary refuge, but enduring support often lies in meaningful dialogues with those who share your life. Quality communication fosters emotional intimacy and provides a backdrop against which you can more fully understand your own feelings and concerns. By confiding in someone you trust, you externalize your emotions, creating room for insight and understanding to settle in.

Spend time with people you love

In the abyss of grief, companionship can be a lifeline. While the impulse to isolate may be strong, seclusion seldom serves the healing process. Human interaction releases oxytocin, a hormone proven to reduce stress and create feelings of well-being. Time spent with loved ones offers a reprieve, however brief, from the emotional turmoil you're enduring.

Spend time doing things you love

When enshrouded in grief, it's all too easy to forget the activities that once elicited joy. Though it may require a conscious effort, engaging in a beloved pastime can redirect focus and uplift spirits. Whether it's reading a treasured book or painting a canvas, these activities serve as emotional anchors, grounding you in a reality that still contains elements of pleasure and fulfillment.

Listen to your body

Grief can be visceral, a physical ache that demands your attention. If you feel the urge to cry, let the tears come. Emotional tears have been found to contain stress hormones and are thought to be a way for the body to achieve emotional release. Denying your body's signals to grieve can delay healing, whereas acknowledging them can pave the way for emotional relief.

Give yourself compassion

Self-compassion is not merely an emotional indulgence but a psychological necessity. Self-compassion is often linked to better mental health outcomes and resilience. It provides you with the psychological space to accept your feelings without judgment. Offering yourself compassion means acknowledging that grief is an inherently human experience, worthy of patience and understanding.

Keep a journal

Writing down your thoughts and feelings is akin to speaking them out loud but in a more introspective manner. By committing your feelings to paper, you're not only creating an emotional release valve but also establishing a written record that can help you track your emotional journey and healing progress over time.

Maintain a healthy lifestyle

A robust mind is often housed in a robust body. Regular exercise, balanced nutrition, and adequate sleep can have a profound effect on emotional health. It may be tempting to neglect these basics when grief strikes, but maintaining a healthy lifestyle provides the physiological support needed to cope effectively with emotional strain.

As you journey through, remember, the path is not to be walked alone. Seek and extend support; empathy and understanding are companions you need not leave behind.

Conclusion

Surrogacy can be an emotionally challenging journey. One fraught with many ups and downs. Aside from the complex medical procedures and legalities and costs, there needs to be an acknowledgement of the grief that also accompanies the process.

Seeking support and resources before embarking on the journey, during and even after are important to managing emotions and the psychological impact of surrogacy. So prioritizing support is vital for the well-being of everyone involved. Cofertility is here to guide you every step of the way.

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Donor eggs

Single vs. Double Embryo Transfer: A Comprehensive Guide

You may be wondering if you should transfer one (single embryo transfer, or SET) or two (double embryo transfer, or DET) embryos, to increase your chances of a happy, healthy baby. This article will dissect the complexities of this decision-making process, taking into consideration both personal choices, and also help answer this question to intended parents using donor eggs.

Egg sharing

The embryo transfer is an exciting and pivotal time in the in vitro fertilization (IVF) process. It’s when the embryo is transferred to the uterus of the intended mother or a gestational carrier, in hopes that it snuggles in for nine months and becomes the child you’ve always dreamt of.

You may be wondering if you should transfer one (single embryo transfer, or SET) or two (double embryo transfer, or DET) embryos, to increase your chances of a happy, healthy baby.

This article will dissect the complexities of this decision-making process, taking into consideration both personal choices, and also help answer this question to intended parents using donor eggs.

First off, what is an embryo transfer?

Understanding what an embryo transfer entails is important to appreciating the decision-making process between single or double embryo transfer.

After an egg, or eggs, are fertilized with sperm, an embryo develops in a controlled laboratory environment for a few days under the careful watch of a trained embryologist. If and when the embryo reaches a particular developmental stage (ie. blastocyst stage), it is suitable for transfer.

Now, at this point, some families opt to do PGT testing, which looks to see if the embryo 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. Read more about PGT testing.

All embryos are then “graded” by the embryologist to evaluate their quality and chances of developmental success into a healthy pregnancy. Based on this assessment, your fertility doctor will recommend the order and number of embryos to be transferred. This is the stage where the choice between a single embryo transfer or a double embryo transfer is usually made.

Finally, the selected embryo(s) is transferred to the uterus via a thin catheter, typically under ultrasound guidance. If the embryo implants in the uterine lining, it may lead to pregnancy.

Embryo transfers and the history of IVF

When IVF was in its infancy, following the birth of the first IVF baby, Louise Brown, in 1978, the process was distinctly different from what it is today. In the early days, IVF involved the transfer of fresh embryos, without the technological advancements available now. This is because we didn’t have the technology to freeze and preserve embryos for genetic testing or future transfer.

At the time, this approach was taken to increase the likelihood of pregnancy, compensating for the uncertainties around embryo viability. However, this practice led to a higher incidence of multiple pregnancies (pregnancies of twins, triplets, or more), with associated health risks for both mothers and children.

With the development of cryopreservation techniques, it became possible to freeze embryos for later use, allowing for more flexibility and planning in the transfer process. This technology also enabled better timing for embryo transfer, and gave patients a break between the egg retrieval and embryo transfer.

Simultaneously, genetic testing of embryos significantly increased the success rates of IVF, even with the transfer of a single embryo.

Guided by these advancements, the American Society for Reproductive Medicine (ASRM) now recommends elective single embryo transfer (eSET) in most cases, especially for women under the age of 35 with a favorable prognosis. This shift towards eSET reflects a growing emphasis on minimizing the risks associated with multiple pregnancies without compromising success rates.

Find your egg donor

So how many embryos should I transfer?

The decision regarding the number of embryos to transfer should weight the potential success rate against the risks associated with multiple pregnancies. Factors such as age, the quality of the embryos, previous IVF attempts, and individual patient preferences play an important role in this decision.

Let’s go through the pros and cons of each option:

Elective single embryo transfer (eSET)

Pros:

Reduced risk of multiple births: eSET almost eliminates the chance of a multiple pregnancy (twins, triplets, etc.), thus reducing the associated health risks for both the mother and the babies.

Cons:

Possibly lower success rates: Some studies have shown that eSET may yield a slightly lower live birth rate compared to double embryo transfer.

Double embryo transfer (DET)

Pros:

Potentially higher success rates: By transferring two embryos, DET may improve the chances of pregnancy, especially when there are concerns about embryo quality.
Chance to have twins: If you always wanted twins, transferring two embryos gives you a better chance of that dream.

Cons:

Riskier pregnancy and birth: DET significantly increases the risk of twins or higher-order multiples, leading to more complicated pregnancies and a higher chance of preterm births and low birth weight.

It’s important to discuss this with your fertility doctor and get their input. Because ASRM usually recommends a single embryo be transferred, in most cases fertility doctors will recommend just that.

How many donor egg embryos should I transfer?

When donor eggs are utilized, a couple other factors need to be considered. Donor eggs are from younger women who have gone through extensive medical screening, and thus, embryo quality tends to be higher. Because of this, it increases the chances of success, even if the mother is older, or if she experienced failed IVF in the past. In donor egg cases, eSET is generally preferred to minimize the risk of multiple pregnancies while maintaining a satisfactory success rate.

Summing it up

If you are wondering if eSET or DET is right for you, talk to your fertility doctor. They can help talk you through the pros and cons, and help select an approach that best fits your needs.

For those using donor eggs, the generally higher quality might lean the decision towards eSET, while personal preferences and specific medical situations might suggest otherwise. By carefully considering the nuanced pros and cons, you can make a well-informed choice in your pursuit of parenthood. We wish you all the best!

Donor eggs

Does Donor Egg IVF Increase Chances of Twins?

Does donor egg IVF increase the chances of conceiving twins? In this guide, I’ll dive into the essentials of donor egg IVF, its odds for success, the chances for twins, and the potential risks associated with multiples.

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The world of fertility treatments is a rapidly-evolving landscape, teeming with options, intricacies, and promises of renewed hope for LGBTQ+ families as well as those struggling to conceive. Among these treatments, donor egg in vitro fertilization (IVF) has become an increasingly common path, with a substantial 12% of all IVF cycles in the U.S., over 16,000 a year, involving eggs retrieved from a donor.

But does donor egg IVF increase the chances of conceiving twins? In this guide, I’ll dive into the essentials of donor egg IVF, its odds for success, the chances for twins, and the potential risks associated with multiples.

What is donor egg IVF?

IVF with donor eggs is a medical procedure where eggs are collected from a donor, fertilized in a laboratory with the intended father's or a donor's sperm, and the resulting embryo is then implanted in the uterus of the intended mother or a gestational carrier.

This process may be an option for women with diminished ovarian reserve, repeated IVF failure, infertility due to recurrent miscarriage, or those who carry genetic disorders that they do not want to pass on to their children. It is also an option for LGBTQ+ families and single males.

Donor egg IVF typically involves several steps: the selection of an egg donor, extraction and fertilization of the donor eggs, and transfer of the embryo(s). To learn more about the process, check out this article.

What are the odds of getting pregnant with donor eggs?

Success rates for donor egg IVF are often more promising compared to traditional IVF. At Cofertility, the average number of mature eggs a family receives and fertilizes is 10. Some intended parents want to do two egg retrievals with the donor which is definitely possible. We also ask each of our donors whether they are open to a second cycle as part of the initial application — many report that they are!

Around 53 percent of all donor egg cycles will result in at least one live birth. This percentage varies depending on the egg donor, recipient body mass index, stage of embryo at transfer, the number of oocytes retrieved, and the quality of the clinic.

At every age, the chances of birth with donor eggs is better, but those who benefit the most from donor eggs are women over 35 and those with low ovarian reserve. In fact, about one-quarter of women over 40 who succeeded with IVF did so through the use of donor eggs.

The chart was made using the SART Patient Predictor for an average woman (5’4”, 150 lbs) with diminished ovarian reserve. As you can see, the chances of live birth after one donor egg cycle is 54% for recipients under 40, and only goes down slightly after this.

The advantage is primarily due to the utilization of eggs from younger donors, typically between the ages of 21 and 34.

It’s important to remember that your age when you get pregnant is not as important as the age of the eggs with which you get pregnant. The success of egg donation depends on many factors, but is not considered to be related to the age of the recipient.

Chances of twins with donor eggs

One question we get a lot is the likelihood of conceiving twins with donor egg IVF.

According to the CDC, in 2021 live births from donor egg IVF had a slightly higher chance of twins compared to IVF with a patient’s own eggs.

General population: 3.2%
IVF with patient’s own eggs: 5.2%
Donor egg IVF: 6.0%
Donor embryo IVF: 7.4%

But as you can see from the data above, IVF (regardless of whose eggs are used) is associated with higher chances of twins.

How does that work? First, the chances of an embryo splitting and becoming monozygotic twins (aka identical twins) is 2.25 times higher with IVF than with unassisted conception.

But twins after IVF are usually due to a patient having more than one embryo transferred to the uterus, making them dizygotic twins. When IVF was just starting out, there was no genetic testing and fertility doctors would transfer multiple embryos at one time. This led to a multiples rate of over 20% for those who underwent IVF. Nowadays, as technology has advanced, single embryo transfers are the norm, and the incidence of twins has gone down drastically.

Can I transfer two donor egg embryos?

The transfer of two embryos is an option in some fertility clinics, and it often increases the chances of pregnancy. However, it's important to consider the associated risks, benefits, and guidelines.

The American Society for Reproductive Medicine (ASRM) recommends that clinicians and patients carefully discuss the number of embryos to be transferred, considering factors like maternal age, embryo quality, and the patient's individual medical situation. In some cases, transferring two embryos may be a viable option, while in others, a single embryo transfer may be the preferred route to minimize the risk of multiples,

Risk of pregnancy with multiples

While the prospect of twins may be appealing to some, there are increased risks associated with multiple pregnancies. Twin pregnancies are associated with higher rates of preterm birth, low birth weight, and maternal complications such as gestational diabetes and preeclampsia.

Preterm birth, defined as delivery before 37 weeks of gestation, occurs more frequently in multiple pregnancies. Preterm infants may face an array of health challenges, including respiratory distress syndrome, infections, and long-term developmental issues. These risks underscore the importance of careful monitoring during pregnancy and specialized neonatal care following birth.
Low birth weight, often linked to preterm birth, is a common occurrence in twin pregnancies. Infants born with low birth weight are at increased risk for health problems both immediately after birth and later in life. Challenges may include difficulties with feeding and temperature regulation, as well as potential long-term developmental delays.
Other complications from twin pregnancies due to added stress on the mother's body can lead to an increased risk of gestational diabetes and preeclampsia, a condition characterized by high blood pressure and damage to organs such as the liver and kidneys. Other potential complications may include an increased likelihood of cesarean section (C-section), excessive bleeding during childbirth, and higher rates of postpartum depression.

You should understand these risks and engage in thoughtful, well-informed planning and decision-making with your fertility doctor if you are considering the transfer of multiple embryos in donor egg IVF.

The bottom line

Donor egg IVF represents a beacon of hope for many aspiring parents. With its relatively high success rate, more and more families are turning to donor eggs to build their family.

However, the decision to pursue this treatment—and whether to transfer one or two embryos—requires careful consideration of the odds, potential risks, and individual medical circumstances. Consulting with fertility doctors, understanding the available scientific data, and considering personal preferences and ethical considerations will equip you to make informed choices on your journey towards parenthood. We wish you all the best!

Learn about egg sharing

At Cofertility, our program is unique. After meeting with hundreds of intended parents, egg donors, and donor-conceived people, we decided on an egg donation model that we think best serves everyone involved: egg sharing.

Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

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 to get started today!

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Infertility

Navigating Social Media with Infertility: A Guide to Improving Your Feed

If social media is bringing you daily triggers, I wrote this guide for you. It’s a guide to help tailor your social media environment, and serves not just as a practical tool but as a necessary aspect of self-care and emotional wellbeing. This guide aims to provide clear instructions and support, enabling you to create a more controlled and comforting digital experience.

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Social media's incessant flow of perfectly filtered life updates and photos can be a double-edged sword. For those who are dealing with infertility, a simple scroll through a feed can sometimes turn into a painful reminder of what we are struggling with. An ad for diapers, pregnancy announcements, gender reveals, or family vacation photos can all trigger feelings of sadness and loss.

These digital fragments, seemingly innocuous to others, can become acute pain points, echoing the unfulfilled desires and dreams of those grappling with infertility. In a space designed for connection, sharing, and joy, the unintended emotional toll can be heavy.

How the algorithms works against you

Algorithms are the unseen force shaping what we see and interact with online. Social media platforms leverage sophisticated machine learning and data analysis to create a feed tailored to our interests, behaviors, and interactions. However, for those grappling with infertility, these algorithms can inadvertently contribute to emotional distress.

The algorithms work by tracking your interests and behavior. Platforms like Facebook, Instagram, and Pinterest analyze your clicks, likes, shares, and time spent on specific content to understand your interests. If you've ever looked at baby products or followed pregnancy-related accounts, the algorithm remembers. This informs personalized advertising, where advertisers target you with specific content. Algorithms also suggest posts, accounts, and hashtags to follow. While this usually helps discover content that aligns with your interests, it can backfire if you're trying to avoid specific triggers.

Simultaneously, “cookies” record your visits to other websites, such as online stores looking at baby products or blogs about parenting. These digital crumbs allow advertisers to follow you back to social media, serving ads that align with your browsing history. The integration of algorithms with cookies means that a casual glance at a baby stroller can transform into a series of targeted ads on your social media feed.

Despite the overwhelming influence of these invisible algorithms powering our online experience, the reality is that you have the ability to take control and change the way these algorithms affect you. You can transform your social media experience into one that supports rather than undermines your emotional well-being.

You're not entirely at the mercy of the machines. You have tools at your disposal, and the agency to shape a better online experience. In the sections below, we will explore specific strategies and methods to do just that.

How to reduce triggering posts and ads on social media

Let’s dive into the strategies for changing your social media algorithms.

Unfollow or mute those who tend to post triggering content

You know those friends and influencers who continually post content that might be triggering. Their posts are not ill-intended, but they can still sting. If they aren’t a friend, you can simply unfollow them as a necessary step in self-care. But if they’re someone you can’t simply unfriend without some drama, try muting them.

Muting someone is a feature that allows you to temporarily hide their content without unfollowing or unfriending them.

Instagram: Allows you to mute posts and stories from specific users without unfollowing them. Just tap the three dots in the top right corner of the post, and select "Mute."
Facebook: You can "snooze" friends for 30 days, which is akin to a temporary mute. Click the three dots at the top right of a post and select "Snooze for 30 days."
X (Twitter): You can mute accounts, meaning you will not see their posts in your timeline. Click on the three dots next to the Tweet, then click "Mute @[username]."
Pinterest: Pinterest does not have a specific mute feature, but you can unfollow users by clicking on their profile and hitting the "Unfollow" button. If you want to give feedback on a particular pin, click on the three dots and choose "Hide Pin."
TikTok: Allows you to mute users. Just go to the profile of the person you want to mute, tap the three dots in the top right corner of the screen, and select “Mute.”
Threads: Allows you to mute users. Go to the profile of the user you want to mute. Tap the three-dots-in-a-circle icon in the top right corner and select “Mute.”

Change your advertising settings

It is not just posts from friends that can be triggering; targeted advertising related to pregnancy and babies can be equally distressing. After I lost my twins in the second trimester, I could avoid the baby aisle at Target but I had to manually shut off the pregnancy and newborn ads on social media platforms.

Advertisers know how to utilize sophisticated algorithms and user data to target individuals with specific content. This results in ads for baby products or parenting services being presented to those who have recently engaged with related content. For someone grieving a loss or grappling with infertility, these ads can be more than mere marketing messages; they can become haunting reminders of dreams unfulfilled and hope deferred, reinforcing a cycle of emotional distress that one might be striving to overcome.

Instagram: Allows you to change ad preferences. Go to “Settings and privacy,” then “Accounts Center,” then tap on “Ad preferences.” There, you can manage ad topics and remove interests related to pregnancy or babies.
Facebook: If your Instagram and Facebook accounts are tied to the same phone number, you don’t have to do this again as ad settings for Instagram will automatically apply for Facebook as well.
X: Click on “Privacy and safety,” then “Ads preferences.” Turn off personalized ads, so you get generic ads instead of those tailored to your activity.
Pinterest: Allows you to turn off personalized ads. Click on “settings,” select "Privacy and data," and uncheck personalized ads.
Google: With My Ad Center and About this Ad, you can block ads you don’t want to see. On any ad itself, select “More,” and then drop down to select “Block ad.”
TikTok: Go to “Settings and privacy” and tap “ads” to see how your ads are personalized. You can turn off any interests that TikTok may have added. It can also be helpful to switch genders to confuse the app.

Improve the algorithm by setting content preferences

The algorithms that govern your social media feeds aren't immutable; you can actively tailor them to suit your needs. By hiding certain words, phrases, or even emojis that might be triggering, you can create a more personalized and considerate online environment. Here's how to do that on different platforms:

Instagram: Go to “Settings and Privacy,” then go to “Hidden Words” and choose the words or phrases you don’t want to see on your feed or in your DMs.
Pinterest: Go to “Settings” and “Tune your home feed” where you can add/remove interests, boards, and pins.
Facebook: You can see and adjust your Facebook Feed preferences by going to “Settings and privacy” then clicking on “Feed.”
Twitter: Allows you to mute words, phrases, or hashtags. Go to "Settings and privacy," click on "Privacy and safety," then click "Mute and block” where you can choose muted words that won’t show up in your timeline.
TikTok: Limit content by going to “Settings and privacy” then “Content preferences.” There you can filter keywords that you don’t want to see.

Refill your feed with content that makes you happy

Okay now that you have removed a lot of accounts, ads, and keywords that could be triggering, it’s time to add back in some content that will make you happy. Find joy in funny animal videos? Love food tutorials? Following accounts that focus on interests rather than personal life events can provide a welcome distraction.

Avoid social media when you're feeling especially down

The online world will always be there, but sometimes a break is necessary. If you’re feeling particularly sad one day, step away from the apps and find solace in the real world.

The bottom line

In a digital era where our lives are intertwined with social media, navigating the online world can be both empowering and perilous. The very platforms that offer connection and inspiration can also become minefields of triggers and distress, especially for those dealing with infertility or pregnancy loss.

Your virtual environment can and should be a sanctuary, reflecting your needs and nurturing your emotional health.

Through the conscious and intentional modification of settings and preferences, you can reshape your social media experience. From muting and unfollowing content that triggers pain to fine-tuning advertising settings, the power to create a safe and supportive online experience rests in your hands.

But this journey is also about mindfulness and introspection. Knowing when to embrace the virtual world and when to seek refuge in the tangible one is a subtle art of balance. Replacing the triggers with content that resonates with joy, humor, and personal interests can breathe fresh air into your digital life.

Ultimately, the algorithms, the advertisers, and the endless stream of posts don't define your online experience—you do. With the tools and insights shared in this guide, you're well-equipped to turn social media into a space of comfort rather than conflict.

In the end, social media is not just a reflection of what algorithms think we want to see; it's a reflection of who we are, what we value, and how we choose to engage with the world around us. The control is yours.

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Donor eggs

How To Respond To Nosy Questions About Using Donor Eggs

Navigating nosy questions others around you may ask about you and your decision to use donor eggs to start your family.

Infertility

Even if you have accepted your infertility diagnosis and have accepted the idea of using donor eggs to start your family, others around you may still question you and your decision. Sometimes it comes in the form of nobody talking about it and sometimes the pendulum swings in the other direction and you may hear nosy questions such as:

"Why couldn't you have your own child?"
"Doesn't it bother you that your child won't be biologically related to you?"
"Did you have trouble getting pregnant?"
"Are you worried your child won't look like you?"
"Did you have to spend a lot of money on this process?"
"Isn't it weird to use someone else's eggs?"
"Did you have to convince your partner to do this?"
“Are you worried one day the kids will want to meet their donor?”

So, what are some things you can say to those “well meaning” but nosy questions?

Set boundaries

It's important to set boundaries with those who may be asking personal questions. You can politely decline to answer by saying that it is a private matter or that you prefer not to discuss it. Setting boundaries isn’t always easy. But boundaries are important if you want to feel safe and protected. It is okay if the other party feels offended, but healthy boundary setting doesn’t mean you’re being hurtful. The boundaries you set can allow you to build a better, more respectful, relationship because they help establish a precedent for what you both expect from each other.

Educate

Even though it may seem obvious to you, some people really do not understand the process of using donor eggs and may be asking out of curiosity. Consider sharing educational resources or information about the process to help them understand better.

Be honest

If you are comfortable sharing, you can be honest about why you chose to use donor eggs. Whether it was due to fertility issues or personal preference, sharing your story can help to normalize the process and reduce stigma and in turn helps educate others around you.

Redirect the conversation

If you don't want to discuss your own experience (which is totally okay), redirect the conversation to a more general topic. You could say, "I appreciate your interest, but I prefer to keep my personal life private. Can we talk about something else?"

Seek support

Coping with nosy questions about using donor eggs can be emotionally challenging. Consider seeking support from a therapist, support group, or other individuals who have gone through a similar experience.

The bottom line

Some questions may come across as tasteless and hurtful. Yes, most of this stems from a lack of knowledge about egg donation, but some of it also comes from a place of genuine curiosity and wanting to understand. At the end of the day, this is your journey and your path. You get to decide who, when and how much information you share.

Find your match with Cofertility

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IVF and donor egg costs

Can I Pay For Donor Eggs Using HSA/FSA?

delve into the question of whether Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can be utilized to pay for donor eggs. Explore other financing options available to individuals seeking fertility treatments.

Egg sharing

Donor eggs

If you’re considering using donor eggs to grow your family, oftentimes, the associated costs can be a significant financial burden. In this comprehensive guide, we delve into the question of whether Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can be utilized to pay for donor eggs. We also explore other financing options available to individuals seeking fertility treatments.

The TLDR: you can use your HSA or FSA towards some (but not all) expenses related to donor egg cycles, and if you’re part of the LGBTQ+ community, you may unfortunately face a harder time getting reimbursed, given what the IRS defines as “medical necessary”.

Let’s dive into the details.

How HSAs and FSAs work

First, it’s important to have a fundamental understanding of how HSAs and FSAs work. These are both valuable financial tools that allow you to allocate pre-tax dollars toward qualified medical expenses, and can help reduce the burden of healthcare costs and out-of-pocket expenses.

To maximize the benefits of HSA and FSA accounts, it is important to understand eligibility criteria and contribution limits set by the IRS. These guidelines ensure compliance and provide you with an opportunity to save for future healthcare expenses.

While HSAs and FSAs serve a similar purpose, there’s actually some nuance to it. their differences to make an informed decision about which one best suits your needs. Let's delve into the specifics of each type of account, and how it relates to donor eggs.

Health Savings Accounts (HSAs)

To be eligible for an HSA, you must be enrolled in a high-deductible health plan (HDHP). Here's what you need to know about HSAs:

Pre-tax contributions: Contributions to an HSA are made with pre-tax dollars, which means the money is deducted from your paycheck before taxes are calculated. This offers an immediate tax benefit by reducing your taxable income.
Tax-free growth: Any contributions made to your HSA can grow tax-free through investment opportunities. This allows your HSA funds to accumulate over time and be used for future medical expenses.
Portability: HSAs are portable, meaning you can take the account with you even if you change jobs or health insurance plans. The funds in your HSA remain available for qualified medical expenses, regardless of your employment status.
Contribution limits: The IRS sets annual contribution limits for HSAs, which may change each year. For 2023, the contribution limit for an individual is $3,650, while for a family, it's $7,300. Individuals aged 55 or older can make additional catch-up contributions.

Flexible Spending Accounts (FSAs)

FSAs are another tax-advantaged option for healthcare expenses. Unlike HSAs, FSAs are typically offered through employers. Here are the key aspects of FSAs to consider:

Pre-tax contributions

Like HSAs, contributions to an FSA are made with pre-tax dollars, resulting in a reduction in your taxable income. However, unlike HSAs, there is no requirement for enrollment in a high-deductible health plan.

Use-it-or-lose-it rule

FSAs operate under a “use-it-or-lose-it” rule, which means any funds contributed to the account must be used within the plan year or within a limited grace period. However, some employers offer a carryover option or a grace period to allow some unused funds to be carried forward.

Employer control

FSAs are typically established and managed by employers. The employer determines the contribution limit and plan rules, such as eligible expenses and rollover options. It's important to review your employer's FSA plan details to understand its specific features.

Contribution limits

The IRS sets annual contribution limits for FSAs as well. For 2023, the maximum contribution limit is $2,850 per individual. However, employers may set lower limits, so it's essential to check with your employer for their specific FSA contribution limit.

Using HSAs and FSAs for donor eggs

HSA and FSA accounts can potentially be used to pay for donor eggs. When utilizing these accounts for payment, you’ll need to obtain detailed receipts from whatever party you are working with to match with an egg donor (be it an agency, egg bank, or matching platform like ours). This receipt can then be submitted to your HSA or FSA plan administrator for reimbursement, ensuring that the process is in compliance with the account guidelines. Better yet, discuss with them upfront what the pricing breakdown looks like so you know what expenses are involved ahead of time.

HSA and FSA eligibility for donor eggs

While HSA and FSA funds can generally be used for eligible medical expenses related to egg donation, depending on your unique expenses, it’s not outside the realm of possibility that something might not be covered. To be 100% sure, we recommend discussing with a tax professional or your company’s specific plan administrator which expenses are eligible for reimbursement.

LGBTQ+ considerations for HSAs and FSAs

The IRS guidelines and regulations governing eligible medical expenses are periodically updated to accommodate the changing landscape of fertility treatments. And when it comes to tax deductions, benefits, and credits in general, LGBTQ+ individuals may be impacted by the IRS’ specific wording around eligible expenses.

If you are part of the LGBTQ+ community, we recommend speaking to a tax professional to find out what may apply to you — at least until the Equal Access to Reproductive Care Act gets passed and modernizes federal tax codes to be more inclusive.

IRS guidelines and equal treatment

The Internal Revenue Service (IRS) has provided guidance to ensure that same-sex couples have equal access to the benefits and rights associated with HSA/FSA accounts. According to the IRS, same-sex couples who are legally married or in registered domestic partnerships are eligible to establish and contribute to an HSA or FSA, just like opposite-sex couples.

Qualified medical expenses and donor eggs

However, the IRS defines “qualified medical expenses” as those incurred for the diagnosis, treatment, or prevention of a medical condition. While specific guidance regarding the eligibility of donor eggs for HSA/FSA reimbursement is not explicitly stated, the expenses related to fertility treatments, including donor eggs, may be eligible if you meet the criteria for qualified medical expenses. However, with courts narrowly defining infertility as a medical inability to conceive, this unfortunately limits many LGBTQ+ couples.

Documenting eligible expenses

To ensure compliance and facilitate potential reimbursement, it is crucial to maintain proper documentation of your medical expenses. This includes obtaining detailed receipts and documentation of every related expense.

Maximizing HSA and FSA benefits for donor eggs

Strategic planning can help you maximize the benefits of using HSA and/or FSA funds for donor eggs. Understanding the timing of fund availability and expenses is important. Some people choose to utilize their funds earlier in the year, while others may find it advantageous to wait until the end of the year.

In addition to timing considerations, HSA and FSA accounts offer potential tax advantages and savings. The contributions made to these accounts are typically tax-free, and qualified withdrawals for eligible medical expenses are also tax-free. By understanding and leveraging these benefits, you can optimize you financial resources for fertility treatments.

Other financing options for donor eggs

Beyond HSAs and FSAs, there are other avenues to explore when seeking financial support for donor eggs. Insurance coverage for donor eggs varies depending on individual plans and policies, making it crucial to research and discuss potential coverage options with insurance providers.

Tax deductions may also be available for certain fertility treatments, including those involving donor eggs. Consulting with a tax professional can help determine eligibility criteria and potential deductions, providing individuals with further financial relief.

Additionally, there are grants, scholarships, and financial assistance programs specifically designed to support individuals undergoing fertility treatments. Researching and applying for those programs can offer additional avenues of financial assistance to those pursuing the dream of building a family through donor eggs.

At Cofertility, we understand the financial challenges individuals and couples face when pursuing fertility treatments, especially the use of donor eggs. To make the journey more accessible, we work with financing partners that can help alleviate the financial burden. While we do charge a coordination fee, we’re committed to accessibility and improving the family building process for all. To learn more about how we can help you grow your family via egg donation, create a free account to get started.

Costs of donor eggs with Cofertility

Our goal is to provide a family building experience that’s as human-centered and transparent as possible. As such, you can find a full breakdown of all costs involved with a donor egg journey through Cofertility, right here on our website.

Here’s how our unique egg sharing model works: rather than compensate a donor with cash, we empower women to take control of their own reproductive health while giving you the gift of a lifetime. Through our program, egg donors keep half of the eggs retrieved for their own future use, and donate the other half to your family. Because our donors aren’t paid in exorbitant cash lump sums, our structure helps lower costs for intended parents. It also means that the women in our program are truly incredible — and especially motivated to successfully help grow your family. Our model honors everyone involved: the intended parents, the donor, and ultimately, donor-conceived children.

When you work with Cofertility, your Member Advocate will be sure to provide itemized receipts and necessary paperwork that you may need to submit to your HSA or FSA plan.

Find your match

Financial help can be out there

The journey to parenthood through donor eggs may present financial challenges, but with careful planning, research, and exploration of available resources, it may be possible to find the support you need. We’re here sending luck (and a helping hand) your way.

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LGBTQ+

First-Time vs Repeat Egg Donors: Which One Should I Pick?

Exploring the differences between first time and repeat egg donors

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Intended parents are often asking me if they should choose a first-time or proven egg donor. While it may initially seem like a major consideration, in reality, it often plays a relatively minor role in the overall process. In this article, I hope to clarify this question and guide you towards more consequential aspects in your decision-making process.

Understanding egg donation

Egg donation involves a woman donating her eggs to help another family conceive via in-vitro fertilization (IVF). These donated eggs are fertilized in a laboratory, and the resulting embryos are then transferred into the recipient's uterus or a gestational carrier. Most donors are first-time donors who have never donated before, but some are proven donors who have previously donated eggs which have resulted in successful pregnancies.

First-time vs. repeat egg donors

A first-time donor has no history of successful pregnancies, however this does not mean that she is not a wonderful donor. Even though it may provide some pause that the donor has not donated before, the number of eggs likely to be retrieved in a donation cycle can be predicted based on markers like anti-Mullerian hormone (AMH) levels and antral follicle count (AFC). These metrics provide solid indicators of ovarian reserve and, consequently, the potential success of an egg retrieval procedure.

On the other hand, proven donors have a track record of successful pregnancies through their donated eggs, which can offer some reassurance to intended parents going through egg donation. It’s another data point to give you confidence. However, a proven donor's history of successful pregnancies doesn't guarantee future success. Plus, a donor who has donated more than once means that your future child is more likely to have biological half-siblings.

What matters most: family fit

As shared above, reliable estimates for the quantity of eggs that are likely to be retrieved during a donation cycle can be made based on biomarkers such as AMH and AMC. These critical measures serve as robust predictors of ovarian reserve and, therefore, help project the likely outcome of the egg retrieval process. A donor who has been medically cleared by a fertility doctor – whether she has donated before or not – has a good chance of a successful retrieval. In fact, donor egg IVF has better outcomes than other forms of ART.

Once an egg donor has been medically cleared, we think the "fit" of the donor with your family is arguably more critical. This fit might involve physical attributes, ethnicity, education, or other aspects that matter to you in relation to your future child. Donor profiles and interviews can provide valuable insights into these aspects, guiding your choice towards a donor who aligns with your vision for your family.

Browse our donors!

A downside of a “proven” donor: the biological half-sibling factor

A less commonly discussed aspect of using a proven donor is that your child may have biological half-siblings resulting from previous successful donations. While this fact doesn't influence the potential success of your IVF process, it's an important ethical and emotional consideration for many potential parents. For some, this potential genetic connection to other families might be concerning or undesirable.

However, simply because a first time donor has not donated eggs before, it does not mean she will not potentially donate to other families in the future. This would also lead to biological half-siblings for your children. This is not something to be nervous or hesitant about though as it can be a beautiful thing. It has been seen that children born from the same donor sometimes seek each other out, and find family in the USA or around the world, and have stories to share between each other of being a donor conceived child. A very unique bond can be established between donor conceived children.

It's important to note that the possibility of having numerous genetic half-siblings doesn't inherently detract from the unique bond and relationship you will develop with your child. Yet, it's a factor to be aware of and something to consider based on your personal values and vision for your future family.

How many times can an egg donor donate?

There is a limit to how many times a woman can donate eggs, primarily based on ethical and safety guidelines. In the United States, for example, the American Society for Reproductive Medicine (ASRM) recommends that donors should not donate eggs more than six times during their lifetime. This guideline aims to minimize potential health risks for the donor and limit the number of offspring born from any one donor's eggs (although to be clear, even if a donor donates six times through an egg bank, those eggs could be distributed to far more than six families). At Cofertility, we follow these guidelines and actually find that most of our donors don’t plan on donating to more than one or two families because they are not doing it for cash compensation.

Summing it up

Remember that while the choice of an egg donor is significant, it is just one aspect of the broader journey to parenthood. Other aspects, like ensuring the health of the mother or gestational carrier, preparing for the emotional and financial commitment of parenthood, and creating a nurturing environment for your child, are critical contributors to your child’s life.

While the decision between a first-time and proven egg donor can seem overwhelming, remember that this is just one factor among many in your fertility journey. Reliable fertility markers, such as AMH and AFC, offer significant predictors of egg retrieval success. Furthermore, the alignment of a donor with your vision of your future family is of paramount importance.

Each family's journey is unique, and there is no 'one size fits all' answer. Being patient with the process, staying informed, and leaning on the support of medical and mental health professionals can guide you towards the decisions that feel right for you and your family.

How Cofertility is different

We started this company with the vision of serving all families, regardless of what brought them here. We promise to provide you with the care we would want for our families. With our commitment to transparency, inclusivity, and innovation, we are striving to be the best in the industry.

Our unique egg sharing model empowers donors and enables families to find the perfect egg donor match quickly and easily, setting a new standard for excellence in our field. Whether you are just becoming educated on egg donation or are ready to move forward, we want to help you achieve your goals and build the family of your dreams.

Create a free account to get started today!

Donor eggs

Understanding Embryo Grading: What It Means, Why It Matters, and How to Evaluate "Good" Grades

Everything you need to know about embryo grading

Egg sharing

Embryo grading plays a critical role in assisted reproductive technology (ART), providing valuable insights into the quality of embryos and their potential of developing into a healthy pregnancy. But — and I speak from personal experience — embryo grading can also be one of the most complicated aspects of ART (an already complex process!) to navigate. In my case, I actually had one fertility clinic — where I did my retrieval cycles — disagree with my new clinic about which embryo was the best quality to transfer. When transfer day came and the embryologist read aloud which embryo they’d be using, imagine my surprise when it was a different embryo than the one I expected.

Thankfully, my (very patient) reproductive endocrinologist walked me through my clinic’s data on various embryo grades and the success rates of each. And luckily, this embryo transfer resulted in the healthy birth of my son. But, since we all don’t know what we don’t know, the goal of this article is to ensure that you are armed with all the facts about embryo grading. We’ll discuss how different embryo grades influence the chances of success in ART procedures, including IVF. That way, you can ask the right questions, make more informed decisions, and maximize your prospects of achieving a successful pregnancy — with donor eggs or your own. Let’s jump in.

What is embryo grading?

Embryo grading involves the visual assessment of morphological characteristics of an embryo by a trained embryologist, to evaluate the quality of embryos and their chances of developmental success into a healthy pregnancy. In other words, embryo grading is important because it can give you an idea of your odds of success prior to transferring that embryo. It can also provide insight into whether or not another IVF cycle might be beneficial, with or without adjustments to the treatment protocol.

During the embryo grading process, embryologists evaluate factors such as cell number, cell symmetry, fragmentation, and the appearance of the zona pellucida. These assessments are typically conducted at the embryo’s cleavage stage (day 2 or 3 of development) and the blastocyst stage (day 5 or 6 of development) following fertilization, for embryos that have made it to this point.

Understanding different embryo grades and their significance

Embryo grading systems provide a framework for embryologists to assign ratings based on specific morphological features. And while these systems are standardized, the grading system used can vary depending on the clinic. Embryo grading systems are equally applicable in donor egg IVF cycles, enabling the evaluation of embryos derived from donor eggs.

Some commonly used embryo grading systems include:

Gardner's blastocyst grading system

The Gardner embryo grading system (sometimes referred to as the Gardner and Schoolcraft system) is widely used, and takes into account three main factors: expansion grade, inner cell mass (ICM) grade, and trophectoderm (TE) grade. Here's a breakdown of each component:

Expansion grade

The expansion grade refers to how much the embryo has grown and expanded in the culture medium. It is usually assessed on a scale from 1 to 6. Here's what each grade means:

Grade 1: The embryo is not expanded or only slightly expanded.
Grade 2: The embryo has started to expand, with a small fluid-filled cavity called a blastocoel.
Grade 3: The embryo has further expanded, and the blastocoel is larger.
Grade 4: The embryo is even more expanded, with a significant blastocoel.
Grade 5: The embryo has expanded further, with the blastocoel filling most of the embryo.
Grade 6: The embryo has fully expanded, with a large blastocoel and thinning of the outer layer.

A higher expansion grade generally indicates better developmental potential.

Inner Cell Mass (ICM) grade

The ICM is a cluster of cells inside the embryo that will eventually develop into the fetus. It is graded based on its appearance and overall quality. Here's a simplified breakdown of ICM grades:

Grade A: The ICM is tightly packed, with many cells and high density.
Grade B: The ICM is looser or slightly less dense than Grade A, but still considered good quality.
Grade C: The ICM is fragmented or has fewer cells, indicating lower quality.

Embryos with a higher ICM grade have a higher likelihood of successful implantation and pregnancy.

Trophectoderm (TE) grade

The trophectoderm is the outer layer of cells that will develop into the placenta. It is also graded based on its appearance and overall quality. Here's a simplified breakdown of TE grades:

Grade A: The TE is tightly packed, forming a cohesive layer.
Grade B: The TE is slightly looser or has minor irregularities but is still considered good quality.
Grade C: The TE is fragmented or has more significant irregularities, indicating lower quality.

Embryos with a higher TE grade generally have a higher chance of successful implantation and pregnancy.

Combining the expansion grade, ICM grade, and TE grade provides an overall assessment of the embryo's quality and potential for successful implantation and pregnancy. However, the grade of the embryo is just one piece of the puzzle. The success of embryo transfer depends on various individual factors, including your age, overall fertility health, uterine environment, and the skill of the doctor.

Society for Assisted Reproductive Technology (SART) grading system

The SART embryo grading system focuses on the evaluation of cleavage-stage embryos (day 2 or 3). It takes into account parameters such as the number and symmetry of blastomeres, the presence of fragmentation, and the appearance of the cytoplasm. Embryos are generally graded on a scale from 1 to 4:

Grade 1: These embryos are considered of excellent quality. They have equal-sized and symmetrical blastomeres (cells) without any fragmentation. These embryos have a higher likelihood of successful implantation and pregnancy compared to lower-graded embryos.
Grade 2: These embryos are still of good quality but may show minor asymmetry or minimal fragmentation. Although they may have slight imperfections, they still have a reasonable chance of successful implantation and pregnancy.
Grade 3: These embryos have moderate asymmetry or fragmentation. The presence of moderate irregularities may slightly decrease their chances of successful implantation and pregnancy compared to higher-graded embryos.
Grade 4: These embryos exhibit significant asymmetry or fragmentation. These embryos have more substantial irregularities, significantly reducing their chances of successful implantation and pregnancy compared to higher-graded embryos.

Cummins' embryo grading system:

The Cummins' grading system is another method used to assess cleavage-stage embryos. It is quite similar to the SART system, but while the SART system primarily focuses on the symmetry of blastomeres and the degree of fragmentation, the Cummins system emphasizes the size and fragmentation of those blastomeres.

Unlike the SART grading system, through the Cummins embryo grading system, embryos are actually scored on a scale from 1 to 5 (vs. 4):

Grade 1: Embryos that receive a Grade 1 are considered of excellent quality. They have blastomeres (cells) that are of equal size and show no fragmentation. Grade 1 embryos have a higher chance of successful implantation and pregnancy compared to lower-graded embryos.
Grade 2: Grade 2 embryos are still considered good quality, but they may have minor imperfections. These embryos might have some minor asymmetry or minimal fragmentation, meaning that the blastomeres may not be perfectly equal in size, and there may be some small fragments. Grade 2 embryos still have a reasonable chance of successful implantation and pregnancy.
Grade 3: Embryos with Grade 3 have moderate asymmetry or fragmentation. This means that the blastomeres may show more unevenness in size, and there may be a moderate amount of fragmentation present. Grade 3 embryos have a slightly lower chance of successful implantation and pregnancy compared to higher-graded embryos.
Grade 4: Grade 4 embryos have significant asymmetry or fragmentation. The blastomeres may show significant variation in size, and there may be a substantial amount of fragmentation present. Grade 4 embryos have a lower chance of successful implantation and pregnancy compared to higher-graded embryos.

How important are embryo grades, anyway?

Embryo grades provide valuable insights into the developmental potential of embryos, but they are not the sole determining factor of success. It’s important to recognize that grading systems primarily evaluate morphological characteristics and do not consider other crucial aspects, such as genetic abnormalities or the embryonic environment.

While higher-graded embryos generally have higher implantation rates, it is not uncommon for lower-graded embryos to still result in successful pregnancies. The decision regarding embryo selection should involve a comprehensive evaluation of individual patient factors, including age, fertility history, and the number of available embryos.

How to know a "good" embryo grade

Understanding how to interpret embryo grades is vital for patients undergoing IVF. Typically, embryos with higher grades possess certain characteristics indicative of better developmental potential. For instance, in the Gardner system, high-quality blastocysts often have a fully expanded blastocoel, a tightly packed ICM with many cells, a well-formed TE with few or no fragments, and a smooth and even zona pellucida. These features suggest a greater likelihood of successful implantation and subsequent pregnancy.

While these grading systems provide a standardized approach, there may still be some variability in interpretation between embryologists and clinics, based on that clinic’s own success rate data with embryos of different grades. Additionally, newer systems and modifications continue to emerge, aiming to improve the accuracy and reliability of embryo grading.

Understanding the grading system used by your fertility clinic and discussing it with your reproductive specialist can help you interpret and interpret the grading of your embryos more effectively. Remember, the grading system used may influence the way embryos are selected for transfer or cryopreservation.

Which embryo should I transfer first?

If you’ve made it to the point where you have more than one blastocyst embryo available to transfer, congratulations! That’s a huge weight off of your shoulders. Now, you’re likely focused on the next big decision: which embryo should I transfer first? Doctors may have different opinions on this, depending on various factors. Here are a few considerations as you and your doctor weigh this decision:

Implantation potential

As we previously mentioned, higher graded embryos generally have a higher potential for successful implantation and pregnancy. They often exhibit better morphological characteristics and developmental quality, which can increase the chances of successful embryo implantation and subsequent pregnancy. Therefore, some clinicians may recommend transferring higher graded embryos first to maximize the likelihood of achieving a successful pregnancy.

Number of embryos

If you have a limited number of embryos available for transfer, some doctors may advise starting with the higher graded embryos. This approach aims to optimize the chances of achieving a pregnancy early in the treatment process, preserving any remaining higher graded embryos for future transfer attempts.

Depending on how many kids you want, other doctors may advise the opposite — if you know you want two children, but you transfer a higher graded embryo earlier and get pregnant right away, that will delay your availability to potentially do another IVF cycle again should your lower-graded embryos not result in another pregnancy. Also, if you transfer a lower graded embryo and it does stick, that will only further increase your chances of a successful pregnancy down the line with another embryo, especially a higher graded one!

Patient-specific factors

Factors such as your age, fertility history, previous IVF outcomes, underlying medical conditions, and specific treatment goals should be taken into consideration. If you’ve undergone previous IVF cycles and had unsuccessful outcomes with higher graded embryos, your doctor might consider altering the approach and prioritize transferring lower graded embryos first to try something different. Although higher graded embryos generally indicate better chances of a successful pregnancy, it’s not impossible to have a baby using a lower graded embryo. They still show implantation potential and result in successful pregnancies in some cases.

We recommend talking with your REI to receive personalized guidance based on your specific situation. They can provide the most up-to-date clinical information, evaluate your individual factors, and offer recommendations tailored to your needs and timeline.

Embryo grading for donor egg IVF cycles

With a donor egg IVF cycle, embryo grading is equally important. However, other factors, such as the intended parent or gestational carrier’s uterine environment and receptivity, still play a significant role in the success of donor egg IVF cycles. It’s also critical to understand that embryo grading is not indicative of the presence or absence of chromosomal abnormalities or specific genetic factors.

At Cofertility, the average number of mature eggs a family receives and fertilizes is 10. Some intended parents want to do two egg retrievals with the donor which is definitely possible. We also ask each of our donors whether they are open to a second cycle as part of the initial application — many report that they are!

You can see how many eggs are retrieved in the first cycle and go from there. If, for any reason, the eggs retrieved in that round do not lead to a live birth, our baby guarantee will kick in and we’ll re-match you at no additional Cofertility coordination fee.

Find your match

In conclusion

Embryo grading serves as a valuable tool in assessing the developmental potential and quality of embryos in assisted reproductive technology (ART). While higher-graded embryos generally exhibit higher implantation rates and better chances of success, embryo grade is not the end-all-be-all when it comes to predicting pregnancy outcomes.

Grading systems primarily evaluate morphological characteristics and do not account for genetic abnormalities or the embryonic environment. Because of this, the decision regarding embryo selection should involve a comprehensive evaluation that considers multiple factors beyond just the assigned grade. Your fertility doctor can provide personalized guidance to optimize your chances of achieving a successful pregnancy based on their specific circumstances. We wish you all the best!

IVF and donor egg costs

Does Health Insurance Cover Donor Eggs?

The journey to parenthood can be complex, particularly when it involves in-vitro fertilization (IVF) using donor eggs. One question that often arises as part of this process is, "Does health insurance cover donor eggs?" The answer to this question is nuanced, and will depend largely on your specific health insurance policy, your place of residence, and several other factors. This article will explore the ins and outs of insurance coverage for procedures involving donor eggs, providing a roadmap for prospective parents navigating this intricate terrain.

Donor eggs

Understanding health insurance and ART

Before delving into specifics, let’s discuss the fundamental relationship between health insurance and assisted reproductive technology (ART). Health insurance policies vary significantly in their coverage of fertility treatments. Some plans offer comprehensive coverage, including multiple cycles of IVF, while others might only cover diagnostic procedures, or nothing at all. What’s more, some plans limit coverage to people facing infertility, leaving out same-sex couples and those pursuing IVF for genetic reasons. So an important first step is understanding the specifics of your individual insurance plan’s coverage of fertility treatment. From there, you can investigate potential coverage of procedures involving donor eggs.

Insurance coverage for donor eggs

The insurance landscape for donor egg IVF is even more complex. For starters, if your insurance plan does cover IVF, it doesn't necessarily guarantee that it also covers procedures involving donor eggs. Those plans that do offer coverage for IVF using donor eggs can also vary - some may cover the medical procedures related to egg retrieval and embryo transfer but might not cover the costs associated with the donor herself. These costs can include compensation for the donor, legal fees, agency fees, and the donor's medical and psychological screenings, among others.

Location-based variations

Your location can also significantly impact the extent of coverage you might have for fertility treatments involving donor eggs. Across the country, 17 states (and counting!) have laws requiring insurance companies to cover or offer coverage for infertility diagnosis and treatment.

However, the specifics of these laws vary from state to state, and not all necessarily mandate coverage for procedures involving donor eggs. While most laws are vague without any mention of donor eggs, a few specifically require coverage of donor eggs. Let’s look at those:

Delaware

The DE law states that “in vitro fertilization, including IVF using donor eggs, sperm, or embryos and IVF where the embryo is transferred to a gestational carrier or surrogate must be covered.”

Maine

The ME law states that health plans must cover fertility diagnostics and treatment, without “any limitations on coverage for any fertility services based on an enrollee's use of donor gametes.” However, any nonmedical costs for using donor eggs can be excluded from coverage.

Massachusetts

The MA law requires insurance plans to cover treatment of infertility including donor egg procurement.

New Hampshire

The NH law states that health plans must provide coverage for medically necessary fertility treatment, including “treatments associated with the procurement of donor eggs.”

New Jersey

NJ law requires health plans to provide coverage for four egg retrievals per lifetime, and IVF using donor eggs.

An important note: Even if your state has infertility coverage laws in place, your specific health plan might not be required to comply. Self-insured or self-funded insurance plans are exempt from state law and employers do not have to follow the state insurance laws. Some states also exempt employers under a certain size from having to provide coverage. The best way to find out is to talk to your health plan directly.

Other ways to pay for donor eggs

If your insurance plan does not cover procedures involving donor eggs, there are still options you can explore to help manage the costs. These can include employer-sponsored reimbursement options (like Carrot Fertility), fertility financing companies, grants and scholarships from non-profit organizations, and discounted treatment packages or refund programs from fertility clinics. It's worthwhile to explore these avenues and to discuss potential options with a financial counselor at your fertility clinic.

Read more in Eggonomics: Seven Options for Paying for Donor Egg IVF

Find an amazing egg donor at Cofertility

We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
Baby guarantee. We truly want to help you bring your baby home, and we will re-match you at no additional Cofertility Coordination Fee until that happens.
Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

Find your match

Summing it up

Navigating health insurance coverage for procedures involving donor eggs can be complex and sometimes overwhelming. Unfortunately most plans do not cover any IVF, let alone donor egg IVF.

Start by understanding your individual insurance plan, and don't hesitate to seek clarification from your insurance provider about the specifics of your coverage. Exploring other financing options can also help manage costs if insurance coverage is limited or non-existent.

Importantly, remember that our team is here for you every step of the way, before and after matching. If you have questions about how an egg donor journey with Cofertility would be covered by your insurance, don’t hesitate to reach out. We wish you all the best!

Read more:

a graphic with the words Anonymous, Known, Disclosed, Open ID on a mauve background

Donor eggs

Understanding the Language of Egg Donation Disclosure: Anonymous, Known, Disclosed, Open ID

At Cofertility, we pride ourselves on guiding our members through the journey of egg donation, ensuring a supportive, transparent, and ethical process for all parties involved. One aspect of this process involves helping our members understand the various terms used within the realm of egg donation, and pros and cons of each type of disclosure status.

Parenting

Each relationship is unique and depends on both the desires of the donor and family, as well as what’s best for any future donor conceived children.

This guide is meant to aid you in making informed decisions that align with your personal beliefs, comfort level, and the best interest of any potential donor conceived children.

Let’s dive into the terms:

Anonymous egg donor: an outdated term used to describe someone whose identity is not shared with the family. In today’s age of social media and genetic testing, we think “anonymous” is a misnomer.
Non-anonymous egg donor: an outdated term used to describe when an egg donor and intended parents have each other’s contact information.
Known egg donor: usually used to describe an egg donor who knows the intended parents, like a family member or friend.
Unknown egg donor: an egg donor that does not know the intended parents, and vice versa.
Disclosed donation: the intended parents and egg donor exchange contact information and communicate directly. This does not mean they have an ongoing relationship, just that they have the names of one another.
Undisclosed donation: the intended parents and egg donor do not exchange contact information.
Open ID: the intended parents and egg donor do not exchange contact information, but the egg donor agrees to have her identity disclosed to the child born from her donation once the child reaches a certain age, typically at 18 years.
Identity-release: another term for open ID.

The problem with “anonymous” egg donation

Traditionally, egg donations were often declared "anonymous," meaning the identities of the egg donor and the intended parents were kept secret from each other. However, in today's world, where genetic testing is widely accessible, we believe no donation can be truly anonymous. We caution against believing anyone who tells you otherwise!

Read more about why we don’t believe in anonymous egg donation.

Known and unknown egg donation

A known donor is someone that you have some level of connection with - be it a friend, a family member, or an acquaintance. In the early days of donor egg IVF, working with a known donor wasn’t the norm because it was thought that having a relationship with the donor could create confusion between the parties. But now, with more education and research being done on this type of donation, more people are turning to family and friends to help with building a family.

Yet most egg donation cycles are with "unknown" egg donors, where there is no previous relationship. You can have an “unknown” egg donor that you get to know, or they can remain undisclosed.

Disclosed and undisclosed egg donation

Disclosed and undisclosed are the terms we prefer to use at Cofertility to describe the two types of disclosure agreements possible.

In a disclosed donation with Cofertility, you and the donor will exchange contact information and can communicate directly. We highly encourage this model as it promotes transparency and aligns with feedback from the donor-conceived community.

In an undisclosed donation, you do not exchange contact information and only communicate via Cofertility. Although we recommend disclosed donations, we respect the individual's choice for undisclosed donation after understanding the potential implications for the donor-conceived child.

Regardless of your donation disclosure status being disclosed or undisclosed, you may choose to meet the donor during the matching period without exchanging contact information.

The scope and degree of communication in a disclosed donation (both during and post-match) is what both parties make of it and can be outlined in your legal agreement. Communication can range from sharing an annual holiday card to direct, regular communication between the donor and your donor-conceived child.

Your disclosure status does not necessarily dictate the relationship with the donor. For instance, you may opt for a disclosed donation, where you share contact information, but decide against maintaining regular communication.

Find your match

Open ID egg donation

For those who choose an undisclosed donation, open ID (sometimes called identity release) is an alternative. This model allows for the donor's identity to be disclosed to the child resulting from the donation once the child reaches a certain age, typically 18 years.

This arrangement respects the potential desire of the donor conceived child to know more about their genetic background and potentially connect with the donor. The open ID agreement is often structured based on the comfort and consent of all parties involved and takes into consideration the best interest of the donor conceived person.

Read more about Open ID

Exploring real-life scenarios: understanding the fluidity of relationships in egg donation

Every single relationship is different, and ultimately up to the intended parents and egg donor to decide. To illustrate how the various terms and models of egg donation work in practical scenarios, let’s explore three real-life examples:

Scenario 1: Unknown, undisclosed donor with Open ID agreement

In this scenario, a family chooses to work with an unknown, undisclosed donor they find through Cofertility. This means that the family and the donor do not exchange contact information, and all communication is handled through Cofertility. This ensures a certain level of privacy and confidentiality while still allowing the exchange of crucial information.

However, the family decides to opt for an Open ID agreement. This arrangement acknowledges the potential curiosity of the donor-conceived child about their genetic roots. Once the child reaches age 18, they will be granted the opportunity to learn about the donor’s identity and, if mutually agreed upon, potentially establish a connection.

Scenario 2: Known, disclosed donor

In the second scenario, a family chooses to work with a known, disclosed donor who happens to be a relative – in this case, a sister. This situation represents one of the highest levels of openness in egg donation, with full knowledge and likely frequent contact between the donor and the intended parents.

In such a model, there's often an ongoing relationship between the donor and the child. The child grows up knowing about their genetic heritage, understanding that their aunt was the generous person who made their existence possible.

Scenario 3: Unknown, disclosed donor

In our third example, a family works with an unknown, disclosed donor. Here, while the donor's identity is initially unknown, the family and the donor exchange contact information via Cofertility and choose to maintain a certain level of contact.

In this case, the family sends the donor a card every year, marking the child's birthday or a holiday, for instance. The donor is not a major part of the family’s day-to-day life, but there's a small bridge of connection that keeps her updated and maintains a cordial relationship. This scenario underlines the flexibility within the disclosed donation model, wherein the extent and nature of communication can be customized to each party's comfort level.

These examples illustrate that egg donation relationships can vary immensely and can be tailored to meet the unique needs, comfort levels, and preferences of all parties involved. At Cofertility, we are committed to facilitating such arrangements that respect and honor the donors, the intended parents, and the donor-conceived children

The power of choice: respecting cultural preferences & unique circumstances

While we advocate for disclosed or open ID donations, and the benefits of being open with children about their donor-conceived origins, we respect the cultural needs and unique circumstances of those who prefer undisclosed donations. At Cofertility, we strive to connect intended parents with research and experts, aiding in informed decision-making, and respecting cultural considerations.

Understanding these terms and the principles behind them can make your journey through egg donation smoother and more transparent. At Cofertility, we are here to guide you, ensuring a process that honors all parties involved, including the donor, the intended parents, and most importantly, the donor conceived children.

Find an amazing egg donor at Cofertility

We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

Preparing for Parenthood as a Gay Couple Using Donor Eggs: Tips from a Fertility Psychologist

The decision-making process

Emotional and psychological considerations

The impact on the child not having a mother

Two dads, no mom, and the kids are all right

Legal considerations

Navigating the medical process

Surrogacy: Coping With The Grief Of Not Carrying Your Child

The grief of not carrying your child

Stages of grief and how they manifest

Denial

Anger

Depression

Guilt

How to deal with questions from nosy people

Coping strategies

Find support through counseling or support groups

Communicate with your partner, friends, or loved ones

Spend time with people you love

Spend time doing things you love

Listen to your body

Give yourself compassion

Keep a journal

Maintain a healthy lifestyle

Conclusion

Single vs. Double Embryo Transfer: A Comprehensive Guide

First off, what is an embryo transfer?

Embryo transfers and the history of IVF

So how many embryos should I transfer?

Elective single embryo transfer (eSET)

Double embryo transfer (DET)

How many donor egg embryos should I transfer?

Summing it up

Does Donor Egg IVF Increase Chances of Twins?

What is donor egg IVF?

What are the odds of getting pregnant with donor eggs?

Chances of twins with donor eggs

Can I transfer two donor egg embryos?

Risk of pregnancy with multiples

The bottom line

Learn about egg sharing

Navigating Social Media with Infertility: A Guide to Improving Your Feed

How the algorithms works against you

How to reduce triggering posts and ads on social media

Unfollow or mute those who tend to post triggering content

Change your advertising settings

Improve the algorithm by setting content preferences

Refill your feed with content that makes you happy

Avoid social media when you're feeling especially down

The bottom line

How To Respond To Nosy Questions About Using Donor Eggs

Set boundaries

Educate

Be honest

Redirect the conversation

Seek support

The bottom line

Can I Pay For Donor Eggs Using HSA/FSA?

How HSAs and FSAs work

Health Savings Accounts (HSAs)

Flexible Spending Accounts (FSAs)

Pre-tax contributions

Use-it-or-lose-it rule

Employer control

Contribution limits

Using HSAs and FSAs for donor eggs

HSA and FSA eligibility for donor eggs

LGBTQ+ considerations for HSAs and FSAs

IRS guidelines and equal treatment

Qualified medical expenses and donor eggs

Documenting eligible expenses

Maximizing HSA and FSA benefits for donor eggs

Other financing options for donor eggs

Costs of donor eggs with Cofertility

Financial help can be out there

Top Questions to Ask Your Egg Donor Agency as a Gay Dad

1. Understanding the process

What is the entire egg donation process and timeline?

What experience do you have with gay parents?

Can you help me find a clinic?