During my 20+ years as a physician, I have treated thousands of patients for infertility. Third-party reproduction, or using a third party such as an egg donor, sperm donor, or gestational surrogate in order to have a baby, has always been a special passion of mine. It is also a treatment option that necessitates extra care and guidance for all parties involved.

Over the years, I have seen many similar questions and concerns arise. With the exception of same-sex couples who know third party reproduction is a necessary part of their journey, most individuals and couples didn’t envision needing help to have a child. To provide support, we have a team of behavioral health specialists who specialize in treating patients who are presented with the decision of how to move forward after an unexpected diagnosis.

We also offer a free webinar, Egg Donation: Parenthood Starts Here, to help streamline the egg donor process. The webinar includes an overview of egg donor program options, steps to prepare for treatment, and treatment expectations. You can learn more at our Fertility Education page that lists all of our free events.

It is my hope that the below list helps others as they process a diagnosis and decide what choice is best for them.

There is a grieving process.

Accepting a diagnosis and learning that the plan of a biological child may not be possible is a deeply personal one. The response will vary from couple to couple and partner to partner, but it takes time before any decisions are made. Some patients take a break, even if just for a month, to take some time to think about and move through their emotions. Many couples speak with a behavioral health specialist during this time.

There are several egg donor options to choose from.

There are many different routes of treatment that will lead you to the same destination. Frozen donor eggs allow couples to access eggs very quickly because the entire process is complete. Selecting a donor from a database and going through the entire ovarian stimulation and egg retrieval process will require more time. Using fresh eggs allow for sperm to be injected into the egg to create an embryo before experiencing a freeze. Not all eggs or embryos will survive the thaw, so using fresh eggs may increase the amount of frozen embryos stored for future use. It is important to note that the pregnancy success rates using frozen donor eggs and fresh donor eggs are virtually the same.

Selecting the right egg donor takes time.

Both partners must feel right about the donor they choose, which means that selecting a donor will require patience. The best first step is for each partner to write down what is most important to them, then compare notes. For example, if a couple is Jewish, it may be important that their donor is also Jewish. Many different characteristics are shared in an egg donor profile such as eye color, hair color, education level, religious practices, personal interests and talents, height, weight, and more.

Anonymity is a choice on the part of the donor.

Donors traditionally have entered egg donor agreements as anonymous donors and this is an agreement drawn up by her reproductive attorney. However, the donor also has an option for increased openness if that is her wish, but this must be explicitly stated in her legal agreement.

Even if a family member or friend would like to donate, there is screening involved.

Egg donors and intended parents undergo screening prior to treatment being approved. For donors, this includes infectious disease testing as well as testing for carrier status of genetic diseases. Using frozen donor eggs allows intended parents to skip this step as it has already been completed. For intended parents, they experience must also be screened for infectious diseases.

The cost will vary based upon what you choose.

The egg donor is compensated for each donation. This may vary by geographic area, but the compensation varies from $5,000-$8,000 per donor egg retrieval. The cost of meds for each donor cycle also varies, but the medical cost for the donor stimulation varies from $2,000-$4,000 with the overall cost approximately $25,000 per cycle. The costs are somewhat lower for frozen donor egg cycles, as these costs are already calculated into the overall fee. The cost for a frozen egg cycle is approximately $18,000 per egg lot of 5-7 eggs.

The amount of treatment time required will also vary widely based on that choice.

The process for using a frozen donor egg can require 1-3 months and includes acquiring frozen donor eggs, thawing them, then injecting the eggs with sperm and incubating the embryos as they develop. The female partner or gestational carrier are then given medication to prepare the uterus for an embryo transfer. Two weeks after an embryo transfer, a pregnancy test is taken. The process for using an egg donor to acquire fresh eggs can require 3-6 months and includes egg donor screening, stimulation of an egg donor’s ovaries, egg retrieval, injecting the eggs with sperm, incubating the embryos and preparing the uterine environment for transfer, then transferring an embryo to the female partner or gestational carrier.

You will be collaborating with several parties during the process.

At Fertility Centers of Illinois, we offer all third-party reproduction services at one center such as egg donation, sperm donation, and gestational carrier. If you are working with a fertility center that does not have a third party reproduction program, you may be working with a separate egg donation agency, and possibly an additional agency if a gestational carrier is required. It is important to do your research before embarking on this process to ensure the process is smooth.

Pregnancy success rates with egg donors are higher.

Pregnancy rates overall are based on maternal age. However, donors are in their twenties, and fresh donor success rates are approaching 75% per embryo transfer. Frozen donor success rates are comparable.

It’s disappointing, but egg donor cycles do get cancelled.

Whether an egg donor has gone through the process before or not, there is always the chance that an egg donor’s response to stimulation medication will require the cycle to be cancelled. This happens primarily if the ovaries are not producing enough eggs to warrant an egg retrieval procedure. The intended parents incur the cost of the medication and monitoring even if the cycle is not completed, however, a portion of their initial fee is commonly refunded.

If you’d like additional children, your first egg donor may or may not be available.

When planning your family, if you know that you’d like to have more than one child, it is best to keep that in mind during treatment. Trying to use the same egg donor three years later may not be possible. Egg donors may no longer be donating or are no longer a viable egg donor candidate due to age, pregnancy, or personal circumstances. However, with a fresh egg donor cycle, it’s not unusual to have frozen embryos leftover even after the live birth from the initial transfer. If possible, it is best to do more than one egg donor cycle to ensure as many frozen embryos as possible for future treatment.

Author Bio: Dr. Jane Nani

Dr. Nani is board certified in Obstetrics and Gynecology and in Reproductive Endocrinology and Infertility (REI), and has been practicing medicine since 1996. Dr. Nani completed her residency in Obstetrics and Gynecology at Cook County Hospital in Chicago in 1994, followed by a fellowship in REI at Beth Israel Hospital/Harvard Medical School in Boston. She has presented numerous scientific papers at national meetings and gave the Presidential Plenary Talk at the Society for Gynecologic Investigation. She is passionate about helping couples and individuals achieve their dream of parenthood, and has a specific interest in third-party reproduction. Her professional interests also include Polycystic Ovarian Syndrome (PCOS) and hysteroscopic surgery.