- Age and Fertility
- CDC Report on Fertility Clinic IVF Success Rates
- Chromosomal Abnormalities in Eggs
- Donor Eggs
- Egg Banking
- Egg Donation
- Egg Donation Cost
- Egg Freezing
- Egg quality
- Embryo freezing
- Embryo implantation
- Fertility Preservation
- Frozen embryo transfer
- IVF Clinic Success Rates
- IVF Cost
- IVF Poor Responders
- IVF success rates
- Low ovarian reserve
- Micro IVF
- Mild IVF
- Mini IVF
- Minimal Stimulation IVF
- Number of IVF Embryos to Transfer
- Oocyte Cryopreservation
- Ovarian Reserve
- Ovarian Reserve Tests
- Preimplantation Genetic Screening
- Single Embryo Transfer
Fertility, IVF and Egg Donation
Egg donation has been utilized to help infertile couples since the early 1980s. Donor egg IVF utilization has continued increasing as more couples delay childbearing until their late 30s and 40s. In the United States in 2009 there were over 15,000 cycles using fresh donor eggs reported to SART (Society for Assisted Reproductive Technologies) from their member clinics. Links to the SART and CDC IVF and donor egg success rate reports
Until the last few years all donor eggs cycles were done with fresh eggs retrieved and fertilized the same day with the male partner’s sperm. Over the years egg donation using fresh eggs has become highly successful at some fertility clinics in the US.
Live birth rates with fresh donor eggs are over 70% per fresh transfer procedure at the best egg donation clinics. Success rates at these same donor egg programs using fresh eggs are over 50% for live birth per transfer using a single embryo for transfer. This approach almost totally eliminates the risk for multiple pregnancy.
In recent years the techniques for freezing and thawing eggs have advanced significantly. As a result of these advances, success rates at some frozen donor egg banks has increased from about 10% success in the past to approximately 50% – at least this is what they claim.
Accordingly, business models have developed for frozen donor egg banks. Egg banks sell frozen donor eggs on a per batch or per egg basis. This can make the cost of using frozen eggs seem to be less than the cost of egg donation with fresh eggs. However, there are some significant problems with this approach.
- Uncertain and relatively low success rates – with low success rates the cost per baby is actually higher
- Uncertainty about long-term health issues for the children born from frozen eggs
Currently, success rates using frozen donor eggs are not well documented – or consistent between different centers. There are certainly babies being born from frozen eggs. However, the number of births is tiny in comparison to the many thousands of births using fresh donor eggs that occur every year in our country. There are very few published reports on live birth success rates per cycle using frozen donor eggs.
A few egg bank centers claim to have success rates above 50% with frozen donor eggs. However, other clinics using frozen donor eggs are not saying anything about their live birth success rates – and this is not being tracked and reported publicly by SART or the CDC at this time. In my opinion, the use of frozen donor eggs is an area in our field with a high likelihood for couples to pay a lot of money for something with (at best) very uncertain results.
The business model for selling frozen donor eggs can be attractive for those interested in recruiting donors, stimulating them, retrieving the eggs and freezing them for later sale to recipient couples. This is very similar to the current situation for donor sperm banking.
The big difference is that sperm freezes and thaws quite well but eggs are much larger cells and do not tolerate the freezing and thawing process well. Because of the damage to the egg that can occur with the freeze/thaw process, success rates with frozen eggs are generally reported to be significantly lower than with fresh eggs.
Another concern is the potential for birth defects or other problems in the children arising from frozen eggs. It is very possible that this will not be a problem at all. However, at this time there are not enough studies that have looked at the long-term health of the offspring using frozen eggs to make a thorough assessment of whether there are negative consequences for the resulting children.
Donor sperm is been frozen and kept in quarantine for 6 months, then the sperm donor is retested for infectious diseases. If the repeat testing for infectious diseases is negative then the sperm can be released from quarantine for use.
The sperm quarantine process should eliminate the risk of infection from virus (such as HIV) in the semen because it allows time for antibodies to develop in the donor within the 6 month quarantine time. The repeat testing of the sperm donor would find the antibodies and the sperm would be disposed of.
As far as I know, there has never been a case of an infectious disease passed on through transfer of a donor egg. With hundreds of thousands (possibly millions) of egg donation cycles performed worldwide over the past 30 years, the risk is extremely low for any significant infection to be transmitted with fresh egg donation.
Therefore, we should not think we need frozen egg banks in order to reduce the risk of infectious disease transmission – because this does not seem to be a significant risk. It appears that the main reason that frozen eggs are used for egg donation at this time is that it suits the business models for some providers of fertility services.
Egg banks could also provide a convenient way for couples to search online egg donor databases to find a suitable donor. However, I suggest that this is not a good reason to move from the tried and tested, safe and effective method of fresh egg donation.
The best approach is to continue using fresh donor eggs until:
- Research demonstrates that using frozen eggs is a safe procedure for the resulting children
- Success rates with frozen donor eggs are better documented for the clinics providing that service
Consumers of egg donation services should certainly know if they are paying their money for a a 70% expectation to have a baby – or only a 10% chance for success.
Another way to say it is, “If it ain’t broke, don’t fix it”.
A comparison of clinic success rates may not be meaningful because patient medical characteristics, treatment approaches and entrance criteria for ART may vary from clinic to clinic.
Welcome to the
Richard Sherbahn, MD is a Board Certified Reproductive Endocrinology and Infertility specialist.
Dr. Sherbahn founded the Advanced Fertility Center of Chicago in 1997.
He will post regularly about fertility issues.
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- Advanced Fertility Center of Chicago
- American Society for Reproductive Medicine
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