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IVF Success Rates by Age
IVF success is highly correlated with the age of the mother. Understanding this age-related impact can help set realistic expectations and make informed decisions about fertility treatment, and this article will help spell it all out for you.
More and more families are turning to In Vitro Fertilization (IVF) to build their families. In fact, 2% of all babies in the U.S. are now born thanks to IVF. For a treatment that’s only been around for 40 years, that’s a lot of babies!
But, many more people undergo IVF than successfully have babies via IVF. About 21.3% percent of IVF cycles using fresh embryos have a live birth. Some people have to go through multiple cycles in order to have their miracle babies. Others end up needing donor eggs. And yet others pursue other life options.
IVF success is highly correlated with the age of the mother. Understanding this age-related impact can help set realistic expectations and make informed decisions about fertility treatment, and this article will help spell it all out for you.
The biological basis: egg quantity and quality
As females age, our ovarian reserve–the number of remaining eggs–naturally diminishes. The quality of those existing eggs also declines over time. Older eggs are more prone to chromosomal abnormalities, which can hinder successful fertilization and healthy embryo development. This natural, age-related decline is the primary factor driving lower IVF success rates in older people.
IVF and Age
The influence of age on IVF outcomes is an unfortunate, but undeniable part of biology and life. As we've discussed, this is primarily due to the natural decline in both the quantity and quality of eggs as someone gets older. This age-related impact can be disheartening for those who want to start a family “later” in life, but it’s always better to be equipped with this knowledge. Here's why understanding this relationship is important:
- Realistic expectations: Being aware of how age affects potential success rates helps you set realistic expectations from the outset of your IVF journey. This knowledge allows you to be mentally and emotionally prepared for the possibilities.
- Informed decision-making: Understanding the role of age empowers you to make informed decisions about your fertility treatment. If you are of older maternal age, you might consider a shorter time frame between IVF cycles, explore options like donor eggs earlier in the process, or consider alternative paths to family building.
- Proactive planning: For younger people considering IVF in the future, awareness of this age-related aspect might motivate proactive measures like egg freezing to preserve fertility potential.
There are of course a host of other factors that go into fertility beyond just someone’s age. And, remember that IVF success isn't solely about the female partner. Any underlying male factor infertility will also play a role in IVF outcomes.
Let’s look at the data: IVF success rates by age
Reliable sources like the Society for Assisted Reproductive Technology (SART), which is part of the Centers for Disease Control and Prevention (CDC), provide valuable insights into IVF outcomes by age.
According to SART data from 2021, live birth rates per egg retrieval using someone's own eggs for IVF are significantly impacted by age, showing a clear downward trend as we get older.
- Under 35: 44.5%
- 35-37: 32.4%
- 38-40: 20.2%
- 41-42: 9.6%
- Over 42: 2.9%
While age is a major predictor, it's not the only factor influencing IVF success. The underlying cause of infertility, overall embryo quality, lifestyle choices (like smoking or unhealthy weight), sperm health, and the specific clinic's success rates all play a role in the outcome. You’ll want to consider these additional variables when assessing your individual chances of success.
Donor eggs increase your chances of a healthy pregnancy at all ages
Here’s some good news: donor eggs can drastically increase your chances of success. Around 53 percent of all donor egg cycles will result in at least one live birth. This percentage varies depending on the egg donor, recipient body mass index, stage of embryo at transfer, the number of oocytes retrieved, and the quality of the clinic.
At every age, the chances of birth with donor eggs is better, but those who benefit the most from donor eggs are those over 35 and those with low ovarian reserve. In fact, about one-quarter of people 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.
Summing it up
IVF can be a big commitment– physically, emotionally, and financially. It's natural to feel a mix of hope and anxiety throughout the process. Knowledge is empowering; by understanding how age impacts IVF outcomes, you can make decisions that align with your values and goals.
Remember, statistics represent trends, not individual destinies. While they give us a general picture, each person's fertility journey is unique. If you are of older maternal age, it doesn't automatically mean IVF won't work for you. Exploring options like using donor eggs or pursuing alternative paths to parenthood should all be part of your informed decision-making process.
The IVF experience can sometimes feel isolating. Don't be afraid to seek support from your loved ones, mental health professionals, or online communities dedicated to infertility and IVF. Connecting with others who understand the challenges and triumphs of this journey can be a source of strength and encouragement.
Find an egg donor through 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 donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family. 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.
At Cofertility, the average number of mature eggs a family receives and fertilizes is 12. 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.
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!
Read more:
- What You Should Know About Getting Pregnant with Donor Eggs in Your 40s and 50s
- What Parents via Egg Donation Want You To Know
- Six Reasons Why Egg Sharing is a Better Egg Donation Model for Intended Parents
- I'm a Fertility Psychologist. Here's What I Want You to Know About Growing Your Family Through Egg Donation
How Many Times Should I Try IVF with My Own Eggs Before Turning to Donor Eggs?
Going through fertility treatments to build your family is hard enough, deciding when it’s time to move onto donor eggs can feel impossible. It’s not just the genetic tie that you might be thinking about, but also the time, money, and commitment. How many attempts with your own eggs are reasonable before considering alternative options like donor eggs? While there's no single right answer, this guide will help you confidently make your decision.
Going through fertility treatments to build your family is hard enough, deciding when it’s time to move onto donor eggs can feel impossible. It’s not just the genetic tie that you might be thinking about, but also the time, money, and commitment.
How many attempts with your own eggs are reasonable before considering alternative options like donor eggs? While there's no single right answer, this guide will help you confidently make your decision.
First consideration: your age
Understanding the impact of age on fertility is helpful. Knowing the chances of IVF success with and without IVF can help you predict the chances of it working in either scenario.
Females are born with a finite number of eggs, and both the quantity and quality of those eggs diminish over time. This decline in fertility accelerates significantly after the age of 35. According to the Society for Assisted Reproductive Technology (SART), the average live birth rate per IVF cycle using a woman's own eggs is around 53% for women under 35, but falls to just 4% for women over 42. These statistics highlight the challenges associated with using your own eggs at an older age.
If you have already spent a lot of time, effort, and money on failed IVF, you may be eager to move forward with donor eggs and have a baby ASAP. The good news is that the chances of success with donor eggs has more to do with the age of the donor than the age of the mother (or gestational carrier).
The time to match with a donor can be just days (we have hundreds of pre-qualified donors ready to match with your family). After that, a donor cycle with fresh eggs can take 60-90 days from match to completion of the cycle. Frozen eggs can be quicker, but it sometimes means you can’t meet the donor beforehand.
As you can see from the SART data above, the chances of getting pregnant per cycle is much higher with donor eggs and the gap increases with age of the patient.
Read Dr. Meera Shah’s article Donor Egg Success Rates: a Breakdown.
Second consideration: your ovarian reserve
Your fertility doctor will likely perform a series of tests to assess your ovarian reserve – the remaining supply of eggs in your ovaries. These tests provide a more personalized estimate of your chances of success using your own eggs. Key tests include:
- Follicle-Stimulating Hormone (FSH): A high FSH level, particularly on day 3 of your menstrual cycle, can indicate diminished ovarian reserve.
- Anti-Mullerian Hormone (AMH): A low AMH level suggests a lower egg count and may signify reduced responsiveness to fertility medications.
- Antral Follicle Count (AFC): Performed via ultrasound, this test counts the number of small, developing follicles in your ovaries. A lower count could indicate a lower ovarian reserve.
These hormone tests will give you and your doctor a good idea of your chances of success. In fact, your chances of success with IVF are even more correlated with your AMH than your age.
Third consideration: the emotional impact of unsuccessful attempts
The journey of infertility often comes with significant emotional burdens. Experiencing multiple unsuccessful attempts with your own eggs can lead to disappointment, frustration, anxiety, and even depression. It's super important to prioritize your mental health during this process. Seek support from therapists specializing in infertility, join support groups, or lean on loved ones for emotional strength.
Think about how many failed attempts using your own eggs you are willing to endure before moving on. And keep in mind, donor eggs may increase your chances of success but they aren’t a guarantee.
Fourth consideration: finances
Unfortunately, fertility treatments can be costly, and using donor eggs will likely increase those expenses. Before making decisions, have a realistic understanding of your financial resources. Explore options like insurance coverage, financing plans, or grants that might help offset treatment costs.
Read more in How to Finance Your Infertility or Egg Donation Journey
Fifth consideration: time
Time is a precious factor in the fertility journey, especially as you grow older. Every month, every cycle, counts. If you've experienced multiple unsuccessful IVF attempts with your own eggs, the time it takes to pursue additional cycles may significantly impact your chances of achieving a successful pregnancy. And, as you age, it increases the likelihood of a higher risk pregnancy. It's important to consider your desired timeline for building a family and how pursuing further IVF with your own eggs may align with those goals.
When should I switch to donor eggs?
While there's no hard-and-fast rule, your doctor may suggest donor egg IVF if you meet some of these criteria:
- Age over 42: Success rates with own eggs decline sharply after 42, and donor eggs offer a significantly higher chance of pregnancy.
- Diminished ovarian reserve: Test results indicating low ovarian reserve may encourage a quicker transition to donor eggs to increase your chances of success, especially if you’re over age 40.
- Multiple failed cycles or pregnancy losses: After several unsuccessful attempts with your own eggs, it may be time to explore other options to avoid further emotional and financial strain.
- Genetic factors: If you are a carrier of a genetic condition, using donor eggs can minimize the risk of passing it on to your child.
Ultimately, the decision of whether to continue with IVF using your own eggs or transition to donor eggs is deeply personal. There is no right or wrong choice. The best way to navigate this decision is through open communication with a trusted fertility doctor, a counselor, fertility coach, or even a religious leader if your faith plays a significant role in your family planning decisions. They can assess your individual circumstances, discuss the pros and cons in greater detail, and help you make a decision that aligns with your goals and values.
Remember: There is no shame in using donor eggs. It's a testament to your unwavering desire to build a family. Choosing donor eggs empowers you to take control of your fertility journey and create the family you've always dreamed of.
Finding your path to parenthood
The journey to parenthood can take many unexpected turns. While the desire for a biological connection is understandable, remember that the love you have for your future child transcends genetics. If you decide to move forward with donor eggs, you're making a powerful choice based on love, commitment, and your unwavering determination to build a family.
Donor eggs offer a path to parenthood that might have seemed impossible before. Don't hesitate to explore this option with open-mindedness and a willingness to learn. Connect with agencies like ours that specialize in egg donation, we can guide you through the process, address your concerns, and provide the support you need throughout your journey.
You are not alone. Communities, support groups, and mental health professionals specializing in infertility can offer invaluable support and understanding.
Remember: Building a family is guided by love. Whether through your own eggs or through the generosity of a donor, you are embarking on a beautiful journey toward fulfilling a profound desire.
Read more:
What is Third-Party Reproduction (TPR)?
In this article, dive into TPR, exploring its various facets, the science behind it, and the unique considerations involved. Whether you're a couple struggling with infertility, a single parent by choice, or an LGBTQ+ individual seeking to build a family, understanding TPR can empower you to make informed decisions about your fertility journey.
As a reproductive endocrinologist (aka a fertility doctor), every day I witness firsthand the profound yearning to build a family. For many individuals and couples, the path to parenthood may not be a straightforward one. Fortunately, advancements in assisted reproductive technologies (ART) have opened doors to alternative family-building options. Third-party reproduction (TPR) can offer hope for those facing fertility challenges or seeking alternative means to complete their families. But what is it?
In this article, I'll dive into the world of TPR, exploring its various facets, the science behind it, and the unique considerations involved. Whether you're a couple struggling with infertility, a single parent by choice, or an LGBTQ+ individual seeking to build a family, understanding TPR can empower you to make informed decisions about your fertility journey.
What is third-party reproduction?
When you hear the term third-party reproduction, it’s referring to a range of techniques that involve using genetic material or gestational services from a third party, someone who is not the intended parent, to achieve pregnancy. This broadens the possibilities for those who may not be able to conceive using their own gametes (eggs and sperm) or carry a pregnancy themselves. Here's a breakdown of the types of TPR:
- Sperm donation: Viable sperm from a carefully screened donor is used to fertilize eggs through intrauterine insemination (IUI) or in vitro fertilization (IVF).
- Egg donation: Donor eggs, retrieved from a healthy egg donor who has undergone rigorous medical and psychological evaluation, are fertilized with the intended father's sperm or donor sperm for implantation in the uterus via IVF.
- Embryo donation: Frozen embryos created by another family undergoing IVF are donated to another couple or individual for implantation.
- Gestational surrogacy: A gestational carrier, also known as a surrogate, carries a pregnancy for the intended parents using an embryo created either through the intended parents' own gametes or donated sperm and eggs. The gestational carrier has no genetic link to the baby.
- Double donor: Both donor sperm and donor egg come together in IVF.
More and more families are turning to third-party reproduction to build their families. Third-party reproduction is part science and medicine, and part generosity from someone else who wants to help you build your family. There is a lot of coordination and legal work involved to protect all parties, and if you work with a group like Cofertility, we will help you all along the way.
What types of families use third-party reproduction?
Third-party reproduction (TPR) opens doors for a diverse range of individuals and couples who may not be able to conceive unassisted or carry a pregnancy to term. I have worked with so many different types of families, who come to me for various reasons. Here's a closer look at some of the families who find hope and fulfillment through TPR:
- Couples facing infertility: Infertility, the inability to conceive after one year of unprotected intercourse, affects millions of couples worldwide. TPR can offer hope for those struggling with infertility due to various factors including low sperm count, blocked fallopian tubes, or hormonal imbalances. For these couples, TPR, whether through sperm donation, egg donation, or even embryo donation, allows them to experience the joy of parenthood and build their families.
- Single parents by choice: An increasing number of single intended parents are opting for TPR to build their families. They can utilize sperm donation, egg donation, and/or surrogacy to create their dream families.
- LGBTQ+ families: TPR plays a significant role in expanding family-building options for LGBTQ+ individuals and couples. Same-sex male couples can utilize egg donation and surrogacy to have a biological child within their family. Lesbian couples have the option of using sperm donation, either from a known or anonymous donor, and either partner can carry the pregnancy or utilize a gestational carrier. Transgender individuals can also explore TPR options to complete their families.
- Individuals with medical conditions: Certain medical conditions may render pregnancy unsafe or even impossible. Uterine fibroids, endometriosis, or a history of complex medical procedures or births are just some examples. TPR, through gestational surrogacy, allows these women to experience parenthood by having a genetically related child (through egg donation and sperm from their partner) or by adopting an embryo.
- People with genetic concerns: For couples at risk of passing on a known genetic condition to their biological children, TPR offers a path toward a healthy family. Preimplantation genetic diagnosis (PGD) can be performed on embryos created through IVF, allowing for the selection of embryos free from the identified genetic condition. This can give couples peace of mind and increase their chances of having a healthy child.
Regardless of the specific route taken through TPR, the common thread is the unwavering desire to build a loving family. While genetics play a role, the emotional bonds cultivated through love, nurturing, and shared experiences are the true cornerstones of a family. Studies have shown that children born through TPR thrive in loving environments and develop strong attachments to their intended parents.
The emotional journey of TPR
The decision to pursue TPR is rarely made lightly. It's often born out of a deep longing for parenthood and may be accompanied by a spectrum of emotions. Intended parents may experience a mix of hope, excitement, anxiety, and sometimes even a sense of grief if facing infertility or the inability to use their own genetic material. Open communication is absolutely vital – between intended parents, with any known donors or gestational carrier, with your agency, and within oneself. Exploring personal feelings and expectations throughout the process is essential for ensuring everyone is emotionally aligned.
Donors and gestational carriers also carry complex emotional feelings throughout the process. Donors may derive a sense of altruism and fulfillment from helping others build families. Gestational carriers often express feelings of deep satisfaction from carrying a child for intended parents who cannot do so themselves. However, feelings of uncertainty, potential vulnerability, and even moments of hesitation are also natural parts of the experience.
Psychological support in the form of counseling provides a safe space to unpack these emotions for everyone involved. It can help intended parents cope with potential setbacks, foster healthy communication with stakeholders, and build a strong emotional foundation as they navigate their unique path to parenthood.
If you work with Cofertility, we have a fertility psychologist on our team who supports all parties involved.
Do I need a doctor who specializes in third-party reproduction?
The short answer is yes! Building a family through third-party reproduction involves a mix of medical, legal, and emotional considerations. While seeking guidance from any fertility doctor is a good starting point, partnering with a board-certified reproductive endocrinologist who specializes in TPR will go a long way. These specialists possess in-depth knowledge of the various TPR techniques, from sperm and egg donation to embryo donation and gestational surrogacy. Their expertise allows them to create tailored treatment plans that perfectly align with your unique circumstances – whether that means selecting the right donor, navigating IVF procedures, or understanding complex legal agreements.
A fertility doctor with TPR experience understands the potential risks and necessary medical monitoring throughout the process. They ensure your safety and well-being, always keeping your best interests in mind. Perhaps just as importantly, they offer compassionate support throughout your emotional journey, answering any questions and providing a safe space to process the complex feelings that may arise. Building a trusting relationship with your doctor is important when making personal decisions that affect your ability to build a family.
Finding the right specialist takes a little research. Look for board-certified reproductive endocrinologists affiliated with reputable fertility clinics that offer comprehensive TPR services. Ask for recommendations from trusted sources or schedule consultations with a few specialists to find a provider whose approach aligns with your needs. Ask them about their experience with TPR, and how they approach treatment differently. Ultimately, a specialist in TPR will be your invaluable guide, increasing your chances of a positive outcome on your path to creating the family you've always dreamed of.
Summing it up
Third-party reproduction (TPR) is a powerful testament to where science and compassion meet. It expands our horizons of possibility, offering alternative paths to parenthood for many individuals and couples. Whether it's sperm donation, egg donation, embryo donation, or working with a gestational carrier – the techniques behind TPR are ever-evolving, giving more people the chance to fulfill their dreams of family.
While the science is complex, the heart of TPR is simple: it's about love, determination, and the generosity of those who offer the incredible gift of helping others build their families. Naturally, navigating the medical, emotional, and legal aspects of TPR necessitates a guiding hand. That's where a specialized reproductive endocrinologist, a team like Cofertility, and a strong support system are invaluable, turning what can seem daunting into a well-supported, empowering journey.
If this is a path calling to you, know that you're not alone. Seek out the knowledge and support that will enable you to make informed choices and feel confident at every step along the way. The joy of parenthood, experienced through whichever means resonate with you, is a beautiful path of unwavering love.
Find an amazing egg donor at Cofertility
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 of 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!
Read more:
Can I Do IVF While On a GLP-1 Medication Like Ozempic®?
Let’s review the potential benefits, concerns, and important factors you should discuss with your doctors before making any decisions about GLP-1 medication use in conjunction with IVF.
If you're considering In Vitro Fertilization (IVF) while using or contemplating a GLP-1 medication, like Ozempic®, you’ll want to understand how these treatments might interact.
GLP-1 medications are widely considered safe and have been approved by regulatory bodies like the FDA. But, they aren’t safe for everyone. And they may interact with other medications.
Let’s review the potential benefits, concerns, and important factors you should discuss with your doctors before making any decisions about GLP-1 medication use in conjunction with IVF.
What are GLP-1 medications?
GLP-1s are a class of medications designed to aid in weight loss and blood sugar management, which can indirectly have positive effects on fertility.
Glucagon-like peptide-1 (GLP-1) is a naturally occurring hormone in the body that plays important roles in digestion, blood sugar regulation, and appetite control. GLP-1 receptor agonists are a class of medications that mimic the effects of GLP-1, leading to several benefits including weight loss, improved blood sugar control, and potential cardiovascular benefits. Common examples of GLP-1 medications include semaglutide (Wegovy®, Ozempic®), liraglutide (Victoza®, Saxenda®), dulaglutide (Trulicity®), tirzepatide (Mounjaro®), and others.
While it feels like these medications have shown overnight success for help with weight loss, they’ve actually been around for a long time. Initially prescribed for the treatment of type 2 diabetes, their weight-loss potential became a notable side effect. This led to further research, higher-dosage formulations specifically for weight management, and the widespread popularity we see today.
GLP-1 medications, obesity, and fertility
Obesity is a known factor that can negatively impact fertility treatment outcomes in both men and women. It's associated with conditions like Polycystic Ovarian Syndrome (PCOS), hormonal imbalances, and changes to the uterine lining that can reduce the chances of successful embryo implantation.
Since GLP-1 medications aid in weight loss and blood sugar control, they have the potential to improve some of the underlying factors that contribute to infertility. However, more research is needed to really understand how GLP-1 medications can impact IVF outcomes.
Can you do IVF if you are on GLP-1 medications?
It's best to discuss the use of GLP-1 medications directly with both the doctor who prescribes them as well as your fertility doctor. Many doctors recommend pausing GLP-1 medications for a few weeks before procedures involving sedation or anesthesia, including the egg retrieval portion of IVF, to reduce potential risks.
The reason being, there have been reports that the delay in stomach emptying due to the GLP-1 medication could be associated with an increased risk of regurgitation and aspiration of food into the airways and lungs. And, because you are unconscious, you can’t clear your lungs or eliminate the obstruction on your own. There is currently a lack of scientific data on how GLP-1 medications affect patients having procedures like IVF, so most doctors like to play it safe.
Can you take GLP-1 medications while pregnant?
Even if you're planning to pause GLP-1 medications like Ozempic® for your egg retrieval during IVF, your doctor may not recommend you get back on them after the retrieval if you plan on getting pregnant. That is because these medications are not currently recommended during pregnancy or lactation. The full safety profile of GLP-1 medications is still under investigation.
This means that most OBGYNs will advise you to discontinue GLP-1 medications before attempting to conceive, whether unassisted or through IVF. They will work with you to create a safe and optimal plan for your fertility and pregnancy journey.
Summing it up
While GLP-1 medications offer benefits for weight loss and blood sugar control that may indirectly help with fertility, their direct impact on IVF outcomes and safety during pregnancy needs further research. You’ll want to have open discussions with your fertility doctor, your prescribing doctor, and potentially your future OBGYN about the best medication strategy for your individual circumstances.
Here are some key points to remember:
- Temporary pause: You might be advised to take a break from GLP-1 medications prior to your egg retrieval procedure.
- Discontinuation before pregnancy: There is not enough human data yet to support GLP-1 medications during pregnancy and lactation, so currently it is not recommended.
- Collaboration is key: Work closely with all your doctors to make the safest and most informed decisions regarding your medication use, fertility treatment, and any pregnancy plans.
Research into the relationship between GLP-1 medications and fertility is ongoing. As we gather more data, clearer guidelines may emerge regarding safe and effective use of these medications alongside IVF treatment. It's always encouraged to consult with your doctors for the latest information and recommendations specific to your situation. We wish you all the best!
What the Recent Supreme Court Ruling in Alabama Means For Donor Egg IVF
Understand the far-reaching effects of the recent Alabama Supreme Court ruling on donor egg IVF. Learn about the legal ramifications, implications for fertility care, and discover resources available to those affected.
This article was last updated on March 1, 2024. The Alabama Supreme Court ruling is a quickly unfolding situation. Be sure to consult official news sources or legal experts for the most up-to-date information and guidance.
On February 16th, 2024, the Alabama Supreme Court ruled that frozen embryos can be considered children under state law, a ruling that sent shockwaves through the reproductive health community and raised widespread concerns regarding its potential impact on fertility care. Several of the state’s in vitro fertilization (IVF) clinics have since paused services, and lawmakers, doctors, and patients are raising concerns about the far-ranging impacts of the ruling on healthcare and reproductive technology.
While there’s still a great degree of uncertainty, in this article, we'll delve deeper into the implications of this significant legal shift, exploring how it specifically impacts donor egg IVF procedures. Additionally, we'll explore what resources may be available to those affected by this ruling and provide insights on how you can engage in advocacy efforts to address these challenges.
What is the Alabama court case about?
The recent ruling by the Alabama Supreme Court was the result of a lawsuit filed by three couples who underwent IVF treatment at a fertility clinic in Alabama. Following successful IVF procedures that resulted in the birth of healthy babies, the couples, like many undergoing such treatments, had additional embryos preserved by the clinic which was located inside of a hospital.
However, in December 2020, a patient at the hospital gained unauthorized access to the fertility clinic's cryo-preservation unit and mishandled the frozen embryos, resulting in their destruction. This tragic incident led the plaintiffs to file lawsuits against both the fertility clinic and the hospital where it was located.
One of the lawsuits centered around the application of Alabama's Wrongful Death of a Minor Act. Initially dismissed by the trial court, which ruled that embryos in vitro did not qualify as minors under the act, the case was escalated to the Supreme Court of Alabama. The Alabama Supreme Court diverged from the trial court's stance. They asserted that the Wrongful Death of a Minor Act applied to all unborn children, regardless of their location—in utero or in vitro—at the time of the incident. By deeming the in vitro embryos as persons under the law, the court allowed the couples to proceed with their lawsuit, seeking punitive damages for what they perceived as the wrongful death of their children.
What are the implications for Alabama fertility patients?
The recent ruling by the Alabama Supreme Court does not explicitly impose any bans or restrictions on IVF procedures. However, legal experts suggest – and we’re already seeing in practice – that the decision may create confusion regarding the legality of certain aspects of IVF within Alabama.
For context, data from the Centers for Disease Control and Prevention indicates that approximately 2% of babies in the United States are conceived using assisted reproductive technology. Among the various treatments available, IVF stands out as the most commonly utilized method. IVF is a complex procedure that begins with a stimulated cycle wherein a woman undergoes hormone injections to prompt her ovaries to produce numerous eggs. These eggs are then harvested and united with sperm, giving rise to embryos that undergo incubation for development.
After a few days, the embryos undergo assessment, with only the most viable ones selected for transfer into the woman's uterus. The goal is for the transferred embryo to implant successfully, leading to a healthy pregnancy and ultimately the birth of a child. Any surplus high-quality embryos from the stimulated cycle are typically cryopreserved for potential future use. Not all harvested eggs are suitable for fertilization and not all embryos may be deemed suitable for transfer. Subpar-quality eggs, abnormally fertilized embryos, and embryos displaying poor quality are routinely discarded as part of the process.
The crux of the matter in the recent ruling lies in the classification of embryos as persons under Alabama law. This designation has already raised significant questions regarding the permissible usage and storage of embryos by fertility clinics. In essence, the interpretation of Alabama law equates the legal protection of frozen embryos to that of living children. Under this interpretation, individuals who inadvertently or intentionally destroy a frozen embryo in Alabama could potentially face severe penalties, including manslaughter or murder charges.
This ruling has the potential to significantly disrupt access to fertility care as it may introduce additional regulatory burdens in an already complex medical landscape and could potentially drive up procedural costs. Although the extreme of the financial implications remains unclear, factors such as additional storage fees and liability expenses may further contribute to the rise in expenses.
On top of existing clinics closing, the ruling might lead to a reduction in IVF providers in the state. Even if clinics reopen, fertility doctors may be hesitant to practice in or relocate to Alabama. In light of the perceived risks tied to freezing or destroying embryos within this legal framework, fertility clinics across the state are already proceeding with caution, opting to restrict their IVF services, including retrievals and cryopreservation. Consequently, patients are already finding themselves compelled to seek treatment outside of Alabama, a situation that might intensify if clinics can’t get back to operating at full capacity.
How does this affect donor egg IVF?
Egg donation itself is not in as much legal limbo as eggs are not considered fetuses under current law. However, given the end goal of fertilizing and transferring the donor eggs, the ruling of course affects the donor egg IVF process.
Donor egg IVF encompasses several stages, including egg retrieval, fertilization, and subsequent embryo transfer to the intended parent's or surrogate's uterus. This ruling may necessitate procedural changes in IVF, potentially influencing the number of embryos created and transferred per cycle. Moreover, frozen embryo transfers are commonly utilized in donor egg IVF for preimplantation genetic screening. The ruling could introduce additional regulations or restrictions on the use of frozen embryos.
Many individuals and couples pursuing donor egg IVF have already been through lengthy, challenging, and expensive fertility journeys. This is particularly true for LGBTQIA+ individuals and couples who often depend on donor egg IVF to grow their families. In short, the Alabama Supreme Court only introduces more complexity and potential hardship to a landscape that’s already fraught with challenges. Regardless of where someone is in this family-building journey, this ruling has the potential to alter their trajectory.
What resources are available to those impacted and how can I get involved?
In response to these challenges, several organizations have stepped up to support individuals and families in Alabama.
Cofertility's storage partner, TMRW Life Sciences, is offering one year of free cryostorage for frozen eggs and embryos to patients who live in Alabama and who wish to move their embryos to TMRW’s biorepository in NYC.
Conceive is offering a free one-month membership to Conceive Premium for anyone in Alabama. Conceive Premium provides invaluable assistance and guidance throughout your fertility journey by offering 24/7 support from fertility nurses, peer coaching, community forums, and more.
Furthermore, there are various ways individuals can get involved with advocacy efforts aimed at supporting Alabama families and protecting IVF access across the country. You can show your support for organizations that fight to uphold reproductive rights and ensure equitable access to fertility treatments like the American Society for Reproductive Medicine (ASRM) and RESOLVE, the National Infertility Association. To stay in the loop, sign up for alerts from RESOLVE’s Advocacy Network and follow @resolveorg on Instagram.
Sharing personal stories through public channels like social media can help raise awareness and amplify the voices of those affected. You can also use easily-accessible, online forms to send a letter to Congress and encourage them to address the issue. Lastly, local support groups, such as RESOLVE peer-led support groups in Alabama, provide a supportive environment for individuals to connect with others facing similar challenges.
Cofertility’s position
We at Cofertility are deeply concerned about the recent verdict and have been monitoring the situation closely. Our team is diligently tracking developments and working with our legal and professional advisors in order to navigate any potential implications side by side with our members. We understand the importance of safeguarding the rights and interests of donors and intended parents alike.
We believe the decision to seek medical support in family planning is profoundly personal and should be guided solely by patients and their healthcare providers. We believe that access to safe and effective medical care should be available to all individuals on their journey to parenthood, regardless of their location.
As a proactive measure until the law becomes clearer, we are temporarily suspending the facilitation of retrievals in Alabama where legislative uncertainty or restrictions pose potential risks to our members. We are also actively engaging with any intended parents in Alabama to assess their specific situations and explore potential paths forward. We’re focused on providing these members of our community with comprehensive support and guidance as they navigate these challenging times. If you are a Cofertility member and have any questions, concerns, or would like to get in contact with our team to talk through the specifics of your situation and how we may be able to help, please don’t hesitate to reach out.
Can a Menopausal Woman Get Pregnant with Donor Eggs?
For many, the journey to parenthood is straightforward, but for others, it's a path marked by challenges and the need for medical intervention. Among these challenges, menopause has traditionally been seen as a definitive end to a woman's fertility. In this article, we answer the question, can a menopausal woman get pregnant with donor eggs?
In the world of reproductive medicine, the boundaries of what's possible are constantly being pushed further by advances in technology and science. For many, the journey to parenthood is straightforward, but for others, it's a path marked by challenges and the need for medical intervention. As a fertility doctor who has worked with countless patients over the years, I understand the desire to build a family, regardless of the obstacles that may stand in the way.
Among these challenges, menopause has traditionally been seen as a definitive end to a woman's fertility. In this article, I’ll answer the question, can a menopausal woman get pregnant with donor eggs?
Understanding menopause and fertility
Menopause is a natural biological process marking the end of a woman's reproductive years, characterized by the cessation of menstrual cycles for twelve consecutive months. This transition typically occurs between the ages of 45 and 55 but can happen earlier or later. Menopause signifies the depletion of ovarian follicles and a significant decline in estrogen and progesterone levels, hormones crucial for ovulation and pregnancy.
The question of fertility during or after menopause is complex. Naturally, menopause signifies the end of a woman's ability to conceive using her own eggs. However, this does not mean the end of her capacity to carry a pregnancy to term. The uterus, if healthy, can still support a pregnancy with the help of hormonal support, regardless of the woman's age or menopausal status.
Can you get pregnant with donor eggs after menopause?
Donor egg IVF is a common path for those who cannot conceive using their own eggs. This process involves using eggs donated by a younger woman (if you work with Cofertility to match with an egg donor, the donor donates half of the eggs retrieved and keeps the other half for her own future use), which are then fertilized with sperm (from a partner or a sperm donor) in a laboratory setting. The resulting embryos are transferred to the recipient's uterus.
For menopausal women, donor egg IVF offers a viable path to pregnancy. The critical factor is then the ability of the uterus to maintain a pregnancy. Before the procedure, the recipient undergoes hormonal treatment to prepare the uterus for implantation, mimicking the hormonal conditions of a natural pregnancy.
All pregnancies carry risks, and pregnancy over 45 is no exception. One small study followed 45 healthy mothers ages 50-63 who used donor eggs, and found that 35% experienced pregnancy-related hypertension (high blood pressure), 20% experienced gestational diabetes, and 78% had a cesarean section. It is important to undergo a consultation with your OBGYN or a high-risk specialist to ensure pregnancy is safe. For those who cannot safely or healthfully carry a pregnancy, surrogacy is also an option.
Read more in: What Matters More: The Age of My Egg Donor, or of Who is Carrying The Pregnancy?
It’s important to remember that your age when you (or your gestational carrier) get pregnant is not as important as the age of the eggs. That means your chances of success getting pregnant, no matter your age now, is better with younger eggs. But how do you get younger eggs? For some lucky women, they can use eggs they froze years ago. But for most of us, getting younger eggs means turning to egg donation.
Is there an age limit for IVF with donor eggs?
Technically, there is no age limit (legal or otherwise) in the United States for pursuing IVF with or without donor eggs. But ASRM discourages IVF for women older than 55, and some clinics set their own age limits for patients they will treat.
For women over 45 years old, ASRM advises:
- “Comprehensive” medical testing for cardiovascular and metabolic fitness to ensure the safety of the mother and baby during pregnancy
- Psychosocial evaluation to determine if support is in place to raise a child to adulthood
- Counseling patients on potential increased medical risks related to pregnancy
For families using donor eggs and a gestational carrier, ASRM would advise that the family undergo psychological evaluation to ensure the parents are equipped to raise the child at an older-than-average age.
Navigating the journey with Cofertility
At Cofertility, we've embraced a unique egg sharing model that empowers donors and helps families find the perfect egg donor match quickly and easily. We understand the multitude of questions and concerns that come with considering donor egg IVF, from the screening process for donors to the potential outcomes of the IVF cycle.
Our approach is rooted in compassion and understanding, acknowledging the emotional and financial investment involved in fertility treatments. That’s why we've designed the most parent-friendly Baby Guarantee in the market, aiming to alleviate some of the financial stress and uncertainty that can accompany this journey. Our goal is to provide you with the care and support we would want for our own families, guiding you through every step of the process.
Addressing concerns and providing support
We know that considering donor eggs, especially during or after menopause, is a significant decision. Concerns about the donor's health and the success rate of the procedure are common. Our rigorous screening process ensures that all donors meet stringent health criteria. Additionally, advancements in reproductive technology have significantly improved the success rates of donor egg IVF, offering encouraging news for those who choose this path.
The decision to pursue pregnancy through donor eggs is deeply personal and involves careful consideration of many factors, including physical, emotional, and financial aspects. At Cofertility, we are here to provide information, support, and guidance, helping you navigate these considerations and make informed decisions about your fertility journey.
Summing it up
The question of whether a menopausal woman can get pregnant with donor eggs is met with a hopeful yes, thanks to the remarkable advancements in reproductive medicine. At Cofertility, we stand at the forefront of these innovations, committed to serving all families with a vision of inclusivity and support. Our unique egg sharing model and comprehensive care approach aim to set a new standard for excellence in the field, offering a beacon of hope for those dreaming of building their family. As we continue to push the boundaries of what's possible in fertility treatment, we promise to provide the support, care, and innovation needed to turn those dreams into reality.
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Parental Recognition: What Gay Dads Need to Know About Birth Certificates
Can a gay couple put both names on the birth certificate? Who is on the birth certificate with gay dads? The question of whose names appear on a birth certificate when a child has two dads is one we hear a lot. This question not only touches on the legal mechanisms at play but also the emotional and societal implications of such recognition, or the lack thereof, for LGBTQ+ families. In this article, we’ll discuss parental recognition, and how birth certificates work for babies with gay dads.
Can a gay couple put both names on the birth certificate?
Who is on the birth certificate with gay dads?
The question of whose names appear on a birth certificate when a child has two dads is one we hear a lot. This question not only touches on the legal mechanisms at play but also the emotional and societal implications of such recognition, or the lack thereof, for LGBTQ+ families.
In this article, we’ll discuss parental recognition, and how birth certificates work for babies with gay dads.
Can gay men legally become parents?
Gay men can absolutely become parents, but the legal landscape surrounding LGBTQ+ parenting rights can be complex, and there are still some challenges that gay dads may unfortunately face. You’ll need a great lawyer who knows the specific laws of your state (if you work with Cofertility, we can help you find one).
There are no federal laws that prevent gay men from using donor eggs and a gestational carrier, but the laws can vary depending on the state. Some states have laws that specifically prohibit surrogacy arrangements, or only allow it when both parents are genetically related to the child. Other states make it difficult to get both parents on the birth certificate.
Can gay dads put both names on the birth certificate?
The short answer to this question is that it depends on where the baby is born. The legal acknowledgment of gay fathers on birth certificates is not uniform across jurisdictions, reflecting a patchwork of policies that navigate parental rights.
In many countries and states within the United States, legal advancements have facilitated the listing of both fathers on a child's birth certificate, particularly in cases of adoption or when using assisted reproductive technologies (ART), including surrogacy and donor egg in vitro fertilization (IVF).
However, this progress is not universal. Unfortunately, in jurisdictions with more conservative legal frameworks, challenges persist. There, the non-biological parent among gay fathers may have to undergo adoption procedures to be recognized legally, a process that can be both time-consuming and financially burdensome.
Read more in Navigating the Legal Landscape: A Guide to Egg Donation & Surrogacy Laws for Gay Dads
What you should know about birth certificates and surrogacy
Donor egg IVF plays a pivotal role for gay fathers in starting their families, and the legal system significantly affects whose names appear on the birth certificate. In cases where a gestational carrier is involved, legal parentage may initially rest with the surrogate and, depending on the location, the biological father (the one whose sperm was used). Subsequent legal steps are often necessary to establish the non-biological father's legal parentage.
Countries and states that have embraced more inclusive definitions of family have implemented procedures to simplify the recognition of gay fathers from the outset. For instance, pre-birth orders and parentage judgments can establish both fathers' legal parentage before the child's birth, ensuring their names are on the birth certificate from day one.
The unfair psychological and social implications of parental right challenges for gay dads
The inclusion of both gay fathers on a birth certificate transcends legal formalities, bearing significant psychological and social implications for the entire family. This recognition affirms the fathers' relationship to their child and each other, providing a sense of legitimacy and security that benefits the child's emotional well-being. It can also impact practical matters, from medical decisions and schooling to inheritance rights and social services.
The absence of a legal bond can render the non-biological parent's relationship with their child vulnerable, particularly in situations of medical emergencies or separation. It's a stark reminder of the ongoing disparities facing LGBTQ+ families, despite strides toward equality.
The legal battle for fair parental recognition
Legal battles have often paved the way for changes in policy regarding the recognition of gay fathers on birth certificates. Cases brought before courts have challenged discriminatory practices, leading to landmark rulings that favor the equal treatment of LGBTQ+ families. These legal precedents not only affect the families involved but also set the stage for broader legal and societal shifts.
Resolve, a non-profit I’m on the board of, has tirelessly fought to help forward positive family building bills as well as work to stop harmful legislation from being enacted into law. As part of our overall mission to increase access to care, we will continue fighting for future families for the LGBTQ+ community.
Resolve tracks and advocate for LGBTQ+ legislation in gestational surrogacy, adoption policies and bills, and increasing infertility insurance coverage. Here is where you can learn more about Resolve’s LGBTQ+ specific legislative initiatives.
What is second-parent adoption?
Even if a child is biologically related to one of the dads, without a legal adoption, the non-biological parent may not have any legal parenting rights to their child. This means that if the biological parent passes away or becomes incapacitated, the non-biological parent, even if they have been an equal parent, may not have any legal rights to parenting. This is where second-parent adoption comes in.
In some states, the non-biological parent may be able to establish legal parentage through a pre-birth order or a marriage or domestic partnership. However, second-parent adoption is often the most secure way for non-biological parents to establish their parental rights and ensure that their child is legally protected.
Individual state laws surrounding this process can be complex. The National Center for Lesbian Rights has a great PDF outlining Adoption by LGBT Parents. The states that make it hardest for unmarried same-sex couples include:
- Alabama
- Arizona
- Kansas
- Kentucky
- Mississippi
- Nebraska
- North Carolina
- Ohio
- Utah
- Wisconsin
Especially if you live in one of these states, you’ll want to work with an experienced attorney who can guide you through the legal landscape and ensure that your family is protected.
Summing it up
If you are a gay dad expecting a child through donor eggs and surrogacy, you’ll need to know the laws and parental recognition requirements of the state and country where the child is born as well as where you reside. We highly recommend working with a family lawyer who specialties in third party reproduction. If you work with us at Cofertility, we can help recommend a lawyer from our network.
All parents – regardless of sexual orientation – deserve to be on their child’s birth certificate. As legal and social narratives continue to evolve, the hope is for a future where the question of whose names appear on a birth certificate is merely procedural, not a battleground for recognition or rights.
While significant strides have been made, the variability in legal recognition across jurisdictions highlights the need for ongoing advocacy and reform. Ultimately, the goal is to ensure that all families, regardless of their makeup, are afforded equal respect and protection under the law, reflecting the diverse and evolving nature of family in the 21st century.
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Seeking an Egg Donor? Here's How to Keep Stress at Bay
Making the decision to work with an egg donor to start your family is a major life decision that can cause a lot of stress. Here's a psychologist's perspective on how to keep stress at bay.
As someone who has been working as a Psychologist in the field of fertility for many years, egg donation is a common topic of conversation that I have with my clients. Many who come to see me are working with egg donors and they express the high level of stress they feel and want to learn how to manage all the emotional challenges involved in seeking and working with an egg donor.
Understanding the stress factors in egg donation
Making the decision to work with an egg donor to start your family is a major life decision. A major life decision that can cause a lot of stress. Stress due to uncertainty, financial costs, failure…. the list goes on.
Stress is your body’s response to something you perceive to be difficult. Your body responds to this by going into fight or flight. Meaning your body is ready to do what it needs to feel safe again. Everyone experiences stress differently. It may cause you to experience physical, emotional, or mental distress or pressure. But one thing is common, the feeling of overwhelm. It can just feel like too much. Some start to feel emotionally detached and even start to feel numb to the whole process. On the other end of the spectrum, some may become overly hyper-vigilant. Obsessively checking their emails from their clinic or wanting every single piece of information to ensure an informed decision. Stress can also show up as irritability, heart palpitations or shortness of breath, and even panic attacks.
All of this is normal. Your body and mind are doing what they think is right to protect you from harm. But there are ways you can cope with stress.
Setting realistic expectations
When potential intended parents tell me they are stressed out about working with an egg donor, inevitably we discover that they have very unrealistic expectations about timelines and outcomes. The thing is, even the best laid plans can go awry and this is especially true with third-party reproduction. Think about it, there are a minimum of 10 people involved with one egg donation cycle. The chance of all 10 being synced up at the same time doesn't always happen. Being realistic means being flexible and adaptable. Knowing that this journey is not a linear progression. There will be delays, cancellations, and obstacles. These things are given. Those rigid expectations need to be loosened up.
Emotional preparedness and support
Having a solid support network can help build resilience and help manage stress. One of the best ways to be prepared is to prepare your network of friends and family. Many keep this journey to themselves for a myriad of reasons and that is fair. At the same time knowing that you can lean on someone can alleviate some stress. Communicate what it is that you need from them and allow them to help.
Support groups that focus on egg donation can be a shining star, especially in times of darkness. You can find people that are going through similar things and can understand how you are feeling. These are great places to learn coping skills that have worked for others in your same situation.
Staying informed and making informed decisions
You cannot underestimate the power of information. Yet, this is also one area that also causes extreme stress. Yes, please understand the egg donation process thoroughly. But you do not need to understand it at the same level as your REI or embryologist. Take that burden off your shoulders and put trust into your team. Understand the basics, ask questions, read reputable journals if you wish, but once you have chosen your team, trust them and let them do their job.
Stress-reduction techniques
- Mediation and mindfulness. These are definitely two buzzwords we hear all the time in popular literature. But honestly, they aren’t for everyone and contrary to popular belief they don’t necessarily reduce stress. In fact, some research shows that they can increase stress. This is because you are so focused on your thoughts or physical sensations that your stress increases. If you find these tools to be beneficial then by all means go for it.
- Organize your time. If you know you only have 15 minutes to get to your appointment before you need to get back to work, then don’t schedule your appointment for that time. Don’t schedule appointments back-to-back either. Give yourself some breathing room. Many times parents are sitting in my therapy room, staring at the clock because they need to be at their doctor's appointment so they can’t focus on anything, only increasing their stress.
- Make a list. Write down all the things that you need to do. Organize them in order of importance.
- Set easy to reach goals. Setting smaller, more achievable goals can help us feel more satisfied and in control. For example instead of: go to the gym 5 days a week for 1 hour. Write: go to the gym on Monday at 3pm and ride the stationary bike for 20 minutes.
- Be honest. Things that seemed easy and no big deal before you started this journey can feel a lot more difficult. That is because they are more difficult. You have a lot on your mind and a lot going on. So, If you can’t go to that birthday dinner after your blood tests, then don’t go. If you take on too much during this time, you will feel even more stressed.
Summing it up
While you are seeking an egg donor just expect that you will feel stressed, overwhelmed, and tired. Now is the time for self-compassion, patience and self-care. Lean on your people, take a break and be kind to yourself.
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Your Donor Egg IVF Care Team
Here, we delineate the various members of your fertility care team and the services they offer, providing clarity on who you will be collaborating with during your journey with an egg donor.
When embarking on the journey of building a family with the help of an egg donor, there are a lot of people trained and ready to help you. Understanding who these individuals are, their functions, and the right time to engage them can be pivotal in your path to parenthood.
Here, we delineate the various members of your fertility care team and the services they offer, providing clarity on who you will be collaborating with during your journey with an egg donor.
Obstetrician-Gynecologist (OBGYN)
An OBGYN, specializing in women's reproductive health, provides essential insights into fertility and hormonal health. While not directly involved in the egg donation process, their advice is a critical step towards more specialized treatment.
Reproductive Endocrinologist (REI)
An REI, an OBGYN with additional training in reproductive endocrinology, is pivotal in your journey. They specialize in the hormonal and medical aspects of fertility, overseeing the egg donation process, including the screening and preparation of the donor eggs.
Nurse Coordinator
Acting as a central figure in patient care, the Nurse Coordinator ensures smooth coordination of patient education, scheduling, and medication management, vital for synchronizing the efforts of the entire fertility team.
Embryologist
The Embryologist, based at the fertility clinic, plays a crucial role. They are responsible for the fertilization and cultivation of embryos, using the donated eggs, and ensuring their optimal development.
Egg Donation Agency
For additional guidance and support, agencies like Cofertility streamline your journey. We assist in finding the right clinic, connecting with egg donors, and filling in gaps beyond what a standard fertility clinic offers.
Surrogacy Agency
A Surrogacy Agency is helpful for intended parents who need a gestational carrier in their journey. Agencies can help handle various aspects, including legal agreements, surrogate screening, and coordination of the pregnancy journey, ensuring a smooth and supportive surrogacy process.
Read: Which Should I Find First: An Egg Donor or a Surrogate?
Financial Counselor
Understanding and navigating the financial aspects of egg donation is a significant concern. Financial Counselors, who are generally employed by a fertility clinic, specialize in clarifying this area, helping you explore insurance and financing options.
Fertility Courier
The Fertility Courier, though often unseen, is entrusted with the critical task of safely transporting frozen embryos from the egg donor’s clinic to yours, playing a vital role in the logistical aspect of your journey.
Cryostorage Facility
A cryostorage facility serves as the vault for your frozen tissue. Specializing in the preservation of biological material, these facilities are where your eggs and embryos reside when not in use. We have a partnership with TMRW where we have negotiated discounted rates for our members.
Genetic Counselor
Being a carrier doesn't mean you have the condition, but it can still be concerning when your genetic testing reveals you have a genetic predispositions to certain conditions. Your genetic counselor helps you understand the implications of your carrier status. They can explain the risks, potential impacts on future children, and provide guidance on family planning.
Third-Party Reproductive (TPR) Care Coordinator
A clinic employee who works in the field of assisted reproductive technology (ART) and reproductive medicine. Their primary role is to facilitate and coordinate various aspects of third-party reproduction, which involves using donated eggs, sperm, or embryos, as well as gestational surrogacy.
If you work with Cofertility, there are even more people you will work with along the way.
Our Family by Co platform honors families and egg donors with a thoughtful, human-centered matching experience. Our unique model empowers women to take control of their own reproductive health while giving families the gift of a lifetime.
Member Advocate
At Cofertility, the Member Advocate serves as your personalized concierge, easing communication among all the parties above and ensuring a smooth journey from start to finish. A Member Advocate plays a crucial role in supporting you through the complex and highly regulated process of egg freezing and donation, helping you navigate the medical, emotional, and logistical aspects of preserving your fertility with compassion, evidence-based research and trustworthy guidance.
Fertility Psychologist
Emotional support is invaluable. A Fertility Psychologist on the team offers therapeutic support, addressing the psychological and emotional dimensions of your journey.
Third-Party Reproduction Lawyer
Upon matching with a donor, a Fertility Lawyer ensures all agreements adhere to legal standards. We can help you find a lawyer with expertise in this space, or you can find your own.
Each individual's journey is unique, and not everyone will need the same team or services. It's crucial to ask questions and advocate for your needs, as your path should be as unique as you are. The most important member of your fertility team is you.
Cofertility has a preferred network of partners nationwide, ready to assist in every aspect of your egg donation journey, from legal contracts to embryo storage. While this list might seem daunting, working with us ensures that most interactions are efficiently managed on your behalf.
Six Facts to Know About Surrogacy
Whether you're contemplating surrogacy as an intended parent or surrogate, or simply aiming to better understand this evolving domain of third-party reproduction, here are facts you should know about surrogacy.
Whether you're contemplating surrogacy as an intended parent or surrogate, or simply aiming to better understand this evolving domain of third-party reproduction, here are facts you should know about surrogacy.
1. Two main types of surrogacy exist
There are generally two kinds of surrogacy: traditional and gestational. In traditional surrogacy, the same person is both the egg donor and the gestational carrier, making her the biological mother. In gestational surrogacy, the surrogate carries a pregnancy but has no genetic link to the child. Gestational surrogacy is more commonly used today.
2. Surrogacy laws vary widely by state and country
Surrogacy laws are not uniform and can differ dramatically from state to state in the U.S. and among different countries. Some states have permissive laws, while others may criminalize surrogacy agreements.
The American Society for Reproductive Medicine (ASRM) has a comprehensive guide to surrogacy laws across the United States. The guide outlines the surrogacy laws for each state, including whether surrogacy is legal, the type of surrogacy arrangements permitted, the eligibility criteria for intended parents and gestational carriers, and any specific legal requirements, such as pre-birth orders or post-birth adoption procedures.
Read more: What Do I Need to Know About Surrogacy Laws?
3. Nearly 5% of IVF embryo transfers are to a gestational carrier
In 2020, the latest year where we have data, 4.7% of embryo transfer cycles used a gestational carrier. That’s up from 2% in 2013.
Considering that 2% of annual births in the U.S. are from IVF, that would mean roughly 4,000 births each year are to gestational carriers.
4. Gestational carriers must pass strict requirements
The American Society for Reproductive Medicine (ASRM) has established recommended requirements for surrogates. These requirements are designed to ensure the health and well-being of both the carrier and the baby. Key requirements include:
- Age criteria: Surrogates must be legally adult, with a preferred age range of 21 to 45 years. In certain cases, carriers older than 45 years may be considered, but all involved parties must be fully informed about the increased pregnancy risks associated with advanced maternal age.
- Previous pregnancy success: It is essential for a surrogate to have experienced at least one successful pregnancy prior to becoming a gestational carrier for another couple. This criterion helps to gauge the surrogate’s ability to carry a pregnancy to term.
- Limit on previous deliveries: A surrogate should not have had more than five total deliveries in the past, and no more than three of these should have been cesarean sections. This limitation is to reduce health risks associated with multiple pregnancies and deliveries.
- Stable family environment: The surrogate must have a supportive and stable family setting. This support system is crucial in helping her handle the added stress and responsibilities that come with being pregnant as a gestational carrier.
- Psychological screening: Undergoing psychological evaluation is mandatory for all surrogates. This screening ensures that the surrogate is mentally and emotionally prepared for the unique challenges of gestational surrogacy.
These guidelines are in place to safeguard the interests and health of both the gestational carrier and the intended parents, and to promote a successful and healthy surrogacy arrangement.
5. Surrogacy is expensive
The cost of surrogacy can run you anywhere from $100,000 to $200,000 in the United States — depending on where you live, who your gestational carrier is, and just exactly what fertility services you need along the way.
Read more: Can Someone Break Down the Costs of Surrogacy?
6. There are many reasons someone may need a gestational carrier (and being a celebrity is not one of them)
There are many reasons someone may need a gestational carrier to have a baby, including:
- Same-sex male couples or single men: those who wish to have a biological child but require a surrogate for gestation
- Absence or problems with the uterus: women who are born without a uterus or have uterine abnormalities that prevent a healthy pregnancy.
- Severe health risks: conditions like severe heart disease or other serious illnesses where pregnancy could be life-threatening.
- History of recurrent miscarriages: individuals who have experienced multiple miscarriages due to unknown or unresolvable causes.
- Post-hysterectomy: women who have had a hysterectomy due to cancer or other medical conditions.
- Previous pregnancy complications: a history of severe complications during pregnancy that pose a risk in future pregnancies.
- Immune system disorders: conditions where the body's immune system adversely affects pregnancy.
Despite the headlines of celebrities (Paris Hilton, Kim Kardashian, Rebel Wilson) going the surrogacy route – simply being rich or famous is not a reason for needing a gestational carrier, and most fertility doctors do not allow non-medically necessary cases.
Read more:
How does Cofertility Screen Egg Donors?
If you decide to work with Cofertility to match with an egg donor, you’ll know the donor went through a rigorous process. Our team screens thousands of donors each year through a multi-step process to ensure each person is qualified and prepared to become an egg donor, going above and beyond FDA and ASRM-recommended screening guidelines. In this article, we share a little more about this process.
Thanks to scientific advances in the fertility industry, egg donation has increased tremendously over the past several decades. The option of working with an egg donor provides hope for those who otherwise would not be able to build a family.
If you decide to work with Cofertility to match with an egg donor, you’ll know the donor went through a rigorous process. Our team screens thousands of donors each year through a multi-step process to ensure each person is qualified and prepared to become an egg donor, going above and beyond FDA and ASRM-recommended screening guidelines.
In this article, I’ll share a little more about this process.
The importance of a thorough egg donor vetting process
To optimize safety and outcomes, donors go through a rigorous vetting process. This comprehensive donor screening occurs to ensure proper informed consent from the donor and to ensure there are no contraindications to donating. Because of potential long-term medical and psychological consequences to donating one’s DNA, the vetting process needs to be very thorough.
How are egg donors screened?
Application & Medical Screening
Donors apply to our program with an in-depth application that includes questions about their personal and family medical history, lifestyle, gynecological background, education and professional background, and other areas. This application can take over an hour to complete. Donors complete the family medical history with their own medical history in mind, as well as first and second degree relatives (parents, siblings, aunts, uncles and grandparents).
Our clinical operations team reviews each application closely to evaluate eligibility based on personal and family medical history. These eligibility guidelines come from the FDA and ASRM guidelines for egg donation, as well as from our team of medical advisors. Donors who are approved are healthy and do not have a history of heritable diseases. Many donors don’t get through this initial process, whether that be because their personal and/or family history makes them ineligible or because they do not have all of the information that is required.
Interview
Once the prospective egg donor has completed the initial application and has passed all the basic requirements, we meet with them personally. During this meeting, donors get a chance to ask questions and learn more about egg donation and the staff gets a chance to get to know the donor, understand her reasoning to donate and to make certain she fully understands short term and long term consequences related to their donation.
Meeting 1:1 with every donor to get at the core of who she is as a person— her values, her goals, her personality— allows us to provide you with the most thoughtful match possible.
AMH (ovarian reserve) test
An AMH test measures the amount of anti-mullerian hormone (AMH) in your blood. AMH is produced by the cells inside the follicles - tiny fluid-filled sacs in the ovary that contain and release eggs. AMH levels can tell us the number of eggs a woman has. This is also known as the ovarian reserve. It is important to have this number for egg donation because this test may tell us how well a woman might respond to injectable fertility drugs that will be used during the donation.
Physical medical exam
After a match and typically around day 3 of the donor’s menstrual cycle, a physical medical exam will be conducted. During this exam a pelvic ultrasound will assess the pelvic anatomy, including the ovaries. The antral follicle count will look at the number of egg-containing follicles developing in the ovaries. These results can tell even more information about the ovarian reserve.
Psychological screening
When cleared by the medical staff a psychological assessment will take place. This is a two to four-hour assessment that will address the moral, ethical, emotional, and social issues related to egg donation. The assessment also includes a standardized and empirically validated test designed to screen mental and behavioral disorders. This assessment looks to ascertain donor suitability for this elective process. To make certain that there are no psychological contraindications for egg donation and that the potential egg donor will be able to fulfill her responsibilities for the cycle, such as following medical protocols.
Genetic testing
Every donor also undergoes genetic testing. Genetic screening may include a genetic karyotype as well as screening for more common diseases, including Tay-Sachs disease, Canavan disease, sickle cell anemia, α-Thalassemia, β-Thalassemia, and cystic fibrosis. Depending on the donor’s ethnic background and family history, there may be more genetic screening.
Find an amazing egg donor at Cofertility
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 of 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!
Do Moms Of Donor Egg Babies Have Attachment Issues?
Whether an egg donor is needed to create a baby or not, many parents do not immediately connect, attach or bond with their baby. The purpose of this article is to examine attachment between mother’s and their donor conceived babies and to give a better understanding of attachment and how it works.
One of the first things a woman may think about after learning that an egg donor is required in order to have a child, is the worry of attachment. Specifically, will I have issues attaching to my baby because we are not genetically related? The reason for this train of thought may stem from common misconceptions or stereotypes that all mother’s immediately bond and connect with their child and that a genetic relationship is required for that attachment to even take place.
Social media definitely loves to show that “perfect” moment after a woman gives birth where the mother looks lovingly into her healthy child’s perfect round face - with her hair, makeup and lighting fully on point - proclaiming this to be her greatest love of all. But rarely do we get to peek at what is happening behind the curtain.
Whether an egg donor is needed to create a baby or not, many parents do not immediately connect, attach or bond with their baby. This lack of attachment has nothing to do with a lack of genetic connection, but everything to do with this new found responsibility, the shock of a new identity and purpose, hormones, lack of family support, lack of sleep, and just trying to survive those first few months. The purpose of this article is to examine attachment between mother’s and their donor conceived babies and to give a better understanding of attachment and how it works.
Attachment theory and parent-child bonding
Psychologist John Bowlby described attachment as the emotional connection between an infant and their primary caregiver. The parent-child attachment lays the foundation for the child's life choices, overall behavior, and the strength of the child’s social, physical, mental, and emotional health. According to Bowlby, attachment develops through interactions between infant and caregiver that evolves and grows deeper over time. This attachment typically occurs when a child is about six months old.
Research and findings: attachment in donor egg families
Evidence from the attachment literature focuses on the importance of parental responsiveness as to what differentiates the type of attachment formed between parent and child - not whether they are genetically related. From the perspective of attachment theory, what is important for secure attachment to occur is not genetics but the consistency, availability and love that is shown to the child by the caregiver. It is parental responsiveness, rather than biological relatedness, that is considered to be important for the development of secure attachment relationships between a parent and a child. Meaning genetics does not play a role in secure attachment.
It is parental responsiveness, rather than biological relatedness, that is considered to be important for the development of secure attachment relationships between a parent and a child.
Further insights from the adoption literature suggest that overall, parents who adopted their children reported few differences in the attachment behaviors between them and their adopted children versus parents and non-adopted children. Further adopted children and adolescents did not report feeling less secure in their relationships with their parents compared to non-adopted children.
It appears that the caregivers' behaviors played a more important role when it comes to attachment. For example, Bowlby found that children whose parents were sensitive and responsive were likely to view themselves as loveable and have a positive sense of self. Whereas children whose parents were emotionally unavailable or rejecting, were more likely to develop a lack of self-worth.
So the question of “will I have attachment issues to my baby because we are not related?” is not the question to ask, rather, “am I ready to be emotionally available to a child? Am I ready to be a parent?”
Existing research on attachment in families with donor egg children found that families with no genetic link between mother and the child showed more positive outcomes than families where the mother was genetically related to the child. The authors posed the possible explanation that perhaps this was true because these parents took the extra steps required to intentionally choose to raise a child who was not genetically related to them. Since that strong desire for parenthood was more important to them than genetic relatedness and since they had to move mountains to become parents, they found parenting to be more satisfying than those who become parents through “traditional routes.” Remember, this is just a hypothesis and it is definitely not implying that genetically related parents love their children less than parents not genetically related to their children. It could mean that the parents using donor eggs were perhaps more prepared - as they may have spent years planning for this baby. And finally having that dream realized makes them not take having this baby for granted.
What does genetics have to do with attachment?
Not much. A longitudinal study compared 46 donor insemination families and 48 egg donation families, with 68 natural conception families on the child’s second birthday. The results showed gamete donation mothers to have more joy towards parenting and more positive maternal feelings towards their child by the time the child had reached two years of age. Adding further evidence to the growing body of literature that genetics do not play a role in the development of a positive relationship between a gamete conceived child and its parent.
Social perceptions and stigmas
Societal views on donor egg conception vary with differing social perceptions and stigmas. Depending on your culture, your religion, your sexual orientation, your age, your belief system, your fertility journey, your level of education and understanding of gamete donation, and even your socio-economic status, your views on egg donation will be very different. So depending on all those different variables society's views may potentially impact a mother-child relationship in a negative or positive manner.
It seems as though everyone has an opinion on how we should raise our children from what they should eat, watch on television, ipad or no ipad, which school they should attend, and how to get that constipation resolved. It really never ends. It is very easy to say “don’t let people’s opinions impact you and your relationship with your child.” But it is never that easy, is it?
We have evolutionarily evolved to want to be a part of a tribe, a village if you will. And their opinion matters. Because guess what? If you fell out of favor with your tribe thousands of years ago, you wouldn’t be able to survive. Things are a little bit different today than our caveman times but people’s opinions and views of how we live our life, can still negatively impact us. This is where the role of a mental health professional and support groups can be of tremendous benefit.
Counseling and support
A healthy attachment style starts from the day you take your first breath. But what if you did not have a healthy secure attachment with your own parents? How is that now informing your relationship with your child? What if you don’t have a positive sense of self? What if you don’t feel cared for by others? What if you don’t have a sense of closeness with other people? These are just some possible indicators of not having had a secure attachment to your own caregivers. Working with a therapist to work on your own attachment issues can really inform how you end up attaching to your own children, regardless if they are genetically related to you or not.
Working with a mental health professional, you can learn how to self regulate your emotions, build your self-esteem, learn how to effectively communicate your needs, and how to set boundaries. Learning some of these skills by working with a mental health professional can be an important way for you to learn how to become more self-aware, how to stop self-sabotage and even how to get over that imposter syndrome you may be feeling when it comes to parenting. And learn how to deepen and securely attach to those you love.
Summing it up
To sum it up, do moms of donor egg babies have attachment issues? Sometimes. But then again so do most parents, regardless if they are genetically related to their child or not. Attachment can take time, it doesn’t happen overnight. If you don’t immediately fall in love with your baby the second you lay your eyes on them, you are not alone. Every single relationship in this world takes time. Learn to cut out the outside noise, learn to listen to your own voice, and just go with what feels right.
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