Donors & Surrogacy
Donors & surrogacy at a glance
- If a couple cannot use their own eggs and sperm, in vitro fertilization (IVF) may be performed with donor sperm, donor eggs, or donated embryos.
- A patient may choose to use a donor to become pregnant due to problems with their own sperm or eggs, one or both partners having a genetic disease that could be passed on to a child, the woman reaching menopause, or a woman’s ovaries that do not produce good quality eggs.
- Less commonly, a woman may be unable to carry a pregnancy, and a gestational carrier is needed.
Sperm donors are either known or anonymous. If the donor is known, the sperm will be collected and frozen and quarantined for six months. The donor will be tested at the time of collection, and then again at six months, prior to releasing the sperm in order to make sure that he does not carry any transmissible diseases. The sperm sample will then be thawed and washed before the insemination or IVF procedure.
In most cases, however, donor sperm is obtained through a sperm bank from an anonymous donor. Sperm bank donors undergo extensive medical and genetic screening and are tested for infectious diseases. Then, the sample is frozen for six months. At the end of this period, the donor is re-tested for infectious diseases including the AIDS virus, and if all the tests are still negative, the sperm are released and can be used for insemination or IVF. Overall, frozen sperm versus fresh sperm success rates are about equal.
Eggs from a fertile woman can be donated so that an infertile woman can use them in an assisted reproductive procedure like IVF. The eggs are fertilized with the male partner’s sperm, and the resulting embryo(s) are transferred to the patient’s uterus.
Who should consider donor eggs?
Many women cannot conceive using their own eggs, often because of their age. Ovarian function declines causing egg quality to decrease for women in their late 30s to early 40s. Some women may undergo treatments for cancer that can also compromise egg quantity or quality. Other women may have life-threatening genetic diseases that can be passed on if they use their own eggs. In these instances, egg donation for IVF may be the only means available to achieve pregnancy and give birth to a healthy baby. The reproductive clinic will work with the infertile couple to choose an appropriate egg donor.
Because donating eggs is a complex and time-consuming procedure, women donating in the United States will generally receive monetary compensation for their participation. The donor will take ovarian stimulation medication, and then undergo an egg retrieval procedure. Meanwhile, the recipient takes hormone medications so her uterus is ready for implantation. Once the eggs are retrieved, they are fertilized using the male partner’s sperm, and the resulting embryos are transferred to the recipient’s uterus. Although the patient undergoing IVF will not be genetically related to the baby, she will get to carry the pregnancy and give birth.
Egg donation is a highly successful family building option, but emotional factors and increased cost should be taken into careful consideration. The cost of the egg donation process – donor selection, screening and treatment – adds to the overall costs of IVF. However, it may provide infertile couples with the best chance of having a successful pregnancy, with a live birth rate of about 50 percent nationally. Donor eggs are used successfully in roughly 10 percent of all assisted reproductive treatments.
Using both donor sperm and donor eggs
Sometimes both the man and the woman in a couple are infertile, but still want to achieve pregnancy. In this situation, donor sperm and eggs can be used together. Infertile couples may also consider using frozen embryos from certain IVF programs that allow patients who are done building their family to donate their unused embryos. Embryo donors must be screened using federal and state guidelines.
Using donated sperm and eggs, or embryos means the child will not be genetically related to either parent, and so is a complex decision. Because of this, it is wise to talk with a trained counselor or mental health professional that is familiar with the issue and can help weigh the choice. In addition, if the couple knows the donor(s), the doctor may recommend both the couple and the donor receive counseling and speak with an attorney. Most IVF clinics will recommend an attorney’s help in the donation process, and some states require it.
In some cases, the woman partner may have uterine problems, medical problems that make carrying a pregnancy dangerous, or a previous hysterectomy procedure that prevents her from carrying a pregnancy. In this case, a couple may opt to have the pregnancy carried by a gestational carrier. If the woman partner has viable eggs, a couple may choose to use a gestational carrier, who carries the pregnancy produced using the couple’s eggs and sperm through IVF. Gestational carriers have no genetic relationship to the babies they carry. Psychological and legal counseling is advisable for both the couple and the gestational carrier.