In March 2014 my physician colleague Dr. Jane Nani reported on the various services Fertility Centers of Illinois patients can choose utilizing a “third party”, including donor eggs or sperm, donor embryos, or a gestational carrier. We are very proud of our Center for Collaborative Reproduction team, a dedicated group of clinicians and support staff, who guide patients through the process of creating their families using these third party services. The goal of this letter is to provide you with an overview of a patient’s decision to choose egg donation and how Fertility Centers of Illinois helps patients make the best decision for building their family.
The choice of egg donation to build a family has increased steadily in popularity since its beginning over 30 years ago, with the first reported birth occurring in Australia (Lutjen P, et al, Nature 1984; 307:174-5). The recently released 2012 outcome statistics from the Society of Assisted Reproductive Technology (www.sart.org) report favorable success rates for IVF cycles utilizing donor eggs (56.6% live births from 9250 fresh embryo transfers; 37.2% from 7608 thawed embryo transfers). The live birth outcome for Fertility Centers of Illinois River North’s program in 2012 is above the national average for live births, for both fresh and frozen embryo transfers (58.6% and 42.3%). In terms of babies born, egg donation is our most successful service for patients. We offer our patients access to donors we have fully screened through our in-house donor program, as well as access to frozen donor eggs through the egg bank we partner with, Donor Egg Bank USA.
Later-in-life marriages and delayed childbearing have had a significant impact on reproductive choices. The largest group of patients who are counseled by their physician to consider egg donation are women in their late 30’s and their 40’s. Fertility Centers of Illinois physicians also work with patients who have experienced premature ovarian failure, have no viable oocytes due to genetic or hormonal causes or after treatment for cancer, and with patients who carry a genetic trait they do not want to risk passing on to their child. Although, the majority of our patients choosing egg donation are heterosexual couples, we also treat single women who wish to utilize donated eggs, and gay male couples who are using a surrogate.
On an emotional level, the decision to build a family (or expand the family you already have) with the help of an egg donor is complicated. For many women, the news that their ovarian reserve or egg viability is poor comes as a shocking disappointment. When expectations of success through ART with the couple’s own gametes are overturned, it is common for the patient to feel sad, defective, and less of a woman. Her partner is also very distressed. Their dream was to have a baby that came from both of their family lineages. Some patients already have a child from their joint genetics and long to repeat that success.
After their physician has recommended egg donation, the next step is a consultation with a Fertility Centers of Illinois psychologist. My colleague, Dr. Ariadna Cymet-Lanski, and I typically meet 5-10 couples a week who are looking into egg donation. This meeting acknowledges that egg donation is much more than a medical choice; it is a different way to build their family which includes genetics from a third person. Patients have many questions and concerns that can be addressed in the consultation. Not everyone we meet goes on to pursue egg donation. Some patients will ultimately be successful with their own eggs. Some patients will decide to pursue adoption or to live without directly parenting.
Topics that are discussed in a typical consultation include:
The meaning of loss of genetic connection to a child:
Will I resent my partner?–“uneven” contribution of each parent
Will I feel connected to my child?
Nature vs. nurture—what makes a child “mine/ours”?
Who decides to be a donor and why?
What will I know about a donor?
How do people select a donor?
Can I use someone I know as my donor?
Pros and cons of a known donor
Telling and talking:
Do I tell my family? Friends?
Do people tell their children? When? How?
Can the donor ever come back?
Can I find the donor if I need to or my child does?
How do children feel about this as they grow?
What can I do if I have frozen embryos I can’t use myself?
What will this cost?
Can I embark on something with a high chance of success but not 100%?
How does this choice compare to adoption?
The advantages of egg donation are also addressed. The genetics of the partner are part of the child. The couple chooses their donor and has a lot of information about her. Their baby’s prenatal care is under their control and they experience birth together. There is a high probability that there will be frozen embryos from a donor cycle, providing an opportunity to have additional children with the same genetic background. The decision to use an egg donor often takes time to work through. Couples who wish to have more than one meeting with the psychologist are invited to come back.
Fertility Centers of Illinois has additional resources to offer our patients who want to become more informed about egg donation. Twice each quarter we offer a patient seminar called “Choosing Egg Donation as Your Path to Parenthood”, where our patients and the general community are invited to hear presentations and have questions answered. We have recently added a new webinar to our Patient Education program offerings; Egg Donation: Your Journey Starts Here!, which gives patients, who are considering egg donation, an opportunity to learn more about this process from our Third-Party Nurse Coordinator, Julie Wiese and other third party staff. You are welcome to attend these seminars to enhance your understanding of a patient’s perspective, as they go through this journey.
We also refer patients to a wealth of resources in print and online. In the U.S., for example, we recommend the organization Parents Via Egg Donation (www.pved.org). In the U.K. there is the well-established group Donor Conception Network (www.dcnetwork.org). Both groups offer support and advice on a range of issues relevant to egg donation. We also can connect our patients with a local Chicago group of families, who have children through egg donation. Our goal is to support and help our patients arrive at the best decision for them on their journey to parenthood.
Thank you for the opportunity to share information about the unique journey patients experience when using collaborative reproduction.