The science of egg donation has allowed many women and couples to build their families, despite some of the biologic issues that would otherwise make conception impossible. Many women come to egg donation after multiple failed attempts with medical treatments, including often In-Vitro Fertilization (IVF) with their own eggs. These failed attempts are due predominantly due to declining genetic and biologic quality of the human egg with age. Egg donor solves this age- related decline in egg quality through the use of the eggs of younger women. These high quality eggs are obtained via IVF from known or anonymous egg donors. The eggs are then fertilized with husband, partner or donor sperm and transferred back to the uterus of the intended parent (s). Pregnancy rates are dramatically improved with this technology due the improved biology of reproduction as a direct result of the use of younger eggs. Access to these successful treatments, however, has been limited as a direct result of cost and lack of health insurance coverage for this medical care. New possibilities for different types of egg donation, improved science and technology, as well as creative pricing, can help to improve access to these treatments.
Traditional Egg Donation- Anonymous: In traditional anonymous egg donation, the intended parent (s) is matches with a single egg donor. In this process, donors are recruited either locally through print and online media or through egg donor agencies. Anonymity is created through the separation of the egg donor and recipient. The donor and recipient are synchronized in their menstrual cycles, so that the recipient is hormonally primed and ready to receive the donated eggs after fertilization and embryo transfer. The advantage of this form of egg donation that the recipient has access to a large number of high quality eggs, with the potential for high success with the initial cycle, as well as potential for future success with frozen embryos that are created after the initial cycle. The anonymity between donor and recipient also helps to prevent future entanglements and emotional stress that can result due to knowledge of the donor. This form of egg donation also can be the most expensive, especially if a donor agency is utilized.
Traditional Egg Donation-Known Donor – In egg donation using a known donor, the egg donor is generally a family member or close friend. This has a significant cost advantage, since in this scenario the donor does not received financial compensation for their services. Many individuals and couples want to know their donor. This is especially true if the donor is a family member and they may want some level of genetic connection to the donor. It is imperative, however, that the expectations for future contact and relationships between the donor, intended parents (s) and child created as a result of this treatment be fully defined in order to avoid future difficulties.
Shared Donor: In shared donor, two or more egg donor egg recipients share a single donor. This treatment can also significantly decrease the cost of egg donation, since two parties are now splitting the total costs. On occasion a three way split of a single donor cycle can lead to an even great cost savings for the recipient individual or couple. Shared donation has the disadvantage of the recipients having access to fewer eggs, with the potential for decreased current and future success. In cases where the donor produces less than expected number of eggs, the recipients may need to understand the cycle might convert to a single donor / recipient cycle, with the possibility of enhanced cost.
Frozen Egg Banks: With the advent of exciting new technology that has allowed the possibility of freezing and successful thawing of the unfertilized egg, affordable egg donation can be even more widely utilized. In this type of treatment, the unfertilized eggs are produced by egg donors and stored either locally in individual clinics or in commercial egg banks. The recipient would receive generally 6-8 mature frozen eggs that would then be fertilized after thawing with husband, partner or donor sperm. This treatment is extremely cost-effective, since the majority of expense relates to screening and treatment of the cost, which has already been accomplished. Also, the use of commercial egg banks can allow for a large selection egg donors by the potential recipient/ intended parent (s), similar to the currently widely available commercial sperm banks. Due to excellent viability of the eggs and now proven success for initiation for pregnancy, this medical treatment is becoming increasing popular. The recipient, however, does receive fewer eggs, with the potential for decreased success as a result.
Conclusion: New strategies for affordable egg donation are evolving to help improve our ability to offer state of the art reproductive medical care. Increased education can help improve knowledge of and understanding of these treatments, and allow us to help those who dream of having a child and building a family.
Daniel Levine, MD