Our industry leading Egg Donation Program is run by Dr. Jain, who is truly an expert in the field of egg donation. He completed his training in the Division of Reproductive Endocrinology and Infertility at the University of Southern California, the location of the first successful egg donation cycle in 1987. He remained at USC for almost a decade as a tenured professor of Obstetrics and Gynecology during which time he published a landmark article in the Journal of the American Medical Association on egg donation in women over fifty years of age. More significantly, he helped pioneer the next generation of egg donation utilizing frozen donor eggs. He was also instrumental in creating one of the first frozen donor egg banks in the world. Dr Jain has developed our inhouse egg donation program in order to provide the absolute best outcomes and care possible, to both intended parents and egg donors.
Video transcript →
Egg donation offers a real chance for a couple to have a child. It’s associated with the highest pregnancy rates in all of fertility care, its also associated with one of the most difficult decision making processes because that woman is giving up her genetic legacy. It’s usually a decision that takes time to reach, usually a decision that is made after trying IVF and other fertility treatments and it’s definitely not a decision that should be taken lightly. So egg donation is often sought by women who have reached a certain age and no longer have viable eggs or for gay men who need an egg donor to have a child.So once a couple decides they would like to pursue egg donation they seek an egg donor from an egg donor agency and they usually look for ethnic matches, maybe physical characteristics that match the intended mother, also family history, maybe proclivity toward athletics or academics. Interestingly a woman doesn’t have to choose an egg donor based on her blood type it doesn’t matter, it doesn’t impact the outcome at all.
Egg donors are typically women in their twenties who are in college or post-college or just working. It should be known that egg donor agencies are typically run by non-medical personnel so when seeking an egg donor it is important to work with a reputable and good agency that provides you know honest and transparent information.
So once a couple choses a donor the donor has to go through a battery of screening tests. They have to see a psychologist and undergo psychological screening, talk to a genetic counselor and have genetic tests, they have to see the medical doctor – the fertility specialist and have a battery of tests for infectious disease screenings. That’s mandatory put up by the food and drug administration and it has to be done within thirty days of egg retrieval and then the donor is represented by an attorney so that the decision is binding. Once all of that is done then the donor can proceed to egg donation.
Most egg donation cases in United States are done anonymously. There is also an opportunity for the intended parents to have their child meet the donor when that child is eighteen again that is not in all cases but in most cases and its at the pure discretion or sole discretion of the intended parents not of the donor.
In traditional egg donation after a couple chooses an egg donor from the agency and that donor is qualified medically she begins the process of in-vitro fertilization, so the donor takes injections of hormones to help recruit multiple eggs, now interestingly those eggs are only good for one month, that donor would lose the eggs anyway. So very importantly the donor is not affected by the process as it relates to her future fertility.
We then retrieve the egg from the egg follicles in the operating room under anesthesia, the eggs are then provided to the intended parents where sperm is injected into the eggs. The embryo is allowed to develop for five days, and on the fifth day we transfer one embryo to the intended mother. Additional embryos can be frozen and there is no shelf life on those embryos.
A common question I have from intended mothers using an egg donation is what is my role with the baby? And it is true that the hardwiring the DNA of the sperm and egg do influence things like the characteristics of the child but we are learning more about something called epigenetics whereby the womb is a place where that woman, that mother starts to influence the DNA of the actual fetus. Actually putting molecules on the DNA of the fetus and those molecules influence things like personality intellect, nerve developmental issues and probably many more phenomena of human existence, we are just learning about. So really motherhood begins in the womb.
Now we are seeing pregnancy rates from frozen embryos comparable to those of fresh embryos almost identical so whether a couple chooses to have a fresh embryo transfer or a frozen embryo transfer it doesn’t matter, we see the same pregnancy rate. The good news about having frozen embryos is if the first embryo transfer doesn’t work they have an immediate backup. And of course if the first embryo transfer works and it works sixty-six percent of the time then the frozen embryos could be a second child in years to come.
At Santa Monica Fertility we really specialize in shared egg donation and this is based on my observation that couples have a very hard time navigating egg donation agencies and all the moving parts so we find donors that are excellent donors, proven donors and provide those donors to our intended parents. So with shared egg donation donors go through the same screening process as they would with traditional egg donation but when we get the eggs more than one couple uses those eggs. So for example a good donor will make about sixteen eggs, one couple will get eight eggs and from those eight eggs because it’s a proven good donor we often get three or more of the advanced embryos we call them Blastocyst. Each one has a chance of sixty-six percent in giving rise to a birth. So we transfer one embryo and we freeze the rest. If the couple does not achieve a pregnancy with the first transfer then the second and the third transfers are free. So our program is really built in partnering with patients and donors getting good donors proven donors that make great eggs proven eggs and then assigning a lot of the eggs. And then assigning a portion of the eggs that allows the couple to have multiple chances at a baby. And of course one of the biggest benefits is because more than one couple is sharing the eggs the costs are much less than with traditional egg donation. And we found this program to be very effective, patients like the idea that the doctor is intimately involved in selecting the donor.
There has been a recent increase in frozen donor egg banks and frozen donor eggs are basically eggs that are not used at the time of egg retrieval and frozen for future use. Of course the benefit is they are readily available so couple can obtain the eggs and very quickly thaw those eggs and have a chance at a pregnancy but there are some down sides. Whereas fresh embryos or even frozen embryos have birth rates of about sixty-six percent, the rate we see with frozen eggs is about fifty five percent.
So it’s not bad but it is less than the rate with fresh. We also don’t get as many embryos from frozen eggs as we do with fresh eggs, it’s more variable because the egg were frozen and thawed they are more vulnerable that way. So couples who seek frozen eggs should really work with a clinic that has treated the donor and a clinic where the embryologist themselves have frozen the egg. And with the recent advent of donor egg banks or egg banks that offer donor eggs I caution patients to be careful with that because freezing the egg and caring for the donor somewhere else and then shipping them to a clinic or lab that never worked with these eggs really leads to lower pregnancy rates. And so in seeking frozen eggs which are good option a couple should seek centers where the donor has her care and where the eggs are frozen by the same embryologist who is going to be thawing the eggs for best success rates.
Egg Donation is a fertility treatment where a young, fertile woman donates some of her eggs to a recipient who is otherwise unable to get pregnant. This may be due to advanced maternal age or infertility. Egg donation is also a way for gay men to build a family using an egg donor and a surrogate. The donated eggs are fertilized with sperm and grown through the blastocyst stage to become an embryo. The embryo, either fresh or frozen, is then implanted into the recipient’s uterus to achieve pregnancy.
The technique is most commonly used in women who are unsuccessful after undergoing multiple cycles of in vitro fertilization (IVF), those with premature ovarian failure or elevated FSH levels, and those over the age of 43. The combination of young eggs and optimal preparation of both the donor and intended mother or surrogate, makes egg donation a very successful fertility procedure with a live birth rate of 70% per transfer.
Egg donation doesn’t affect the egg donors’ ovarian reserve since the retrieved eggs would have been discarded by the donor’s body with the next menstruation.
The process of egg donation requires that the components of a single IVF cycle be divided between the donor and the intended mother or surrogate. The donor undergoes the initial steps of IVF, including ovarian stimulation and egg retrieval, and the intended mother undergoes the embryo transfer.
In the fresh egg donation cycle the donor and recipient must have synchronized menstrual cycles. This is accomplished by using a combination of birth control pills and Lupron. When the cycle begins, the medications required for a standard IVF cycle are administered to the egg donor, while the intended mother or surrogate takes a combination of estrogen and progesterone to prepare the uterine lining for embryo implantation. However, with recent improvements in embryo freezing, we are now observing comparable pregnancy rates between fresh and frozen donor egg embryos allowing much greater flexibility in embryo transfer scheduling.
Once the donor’s eggs are mature, they are retrieved using the standard trans-vaginal ultrasound-guided method of follicle aspiration. The sperm is provided by either one of the intended parents, or a donor, and fertilization takes place in the laboratory.
Alternatively, sperm can be shipped to our clinic, where we then create the embryos by using donor eggs and provided sperm, and freeze them for use at a convenient time.
Typically the embryo transfer is scheduled 3 or 5 days after the retrieval The intended mother or surrogate continues to take estrogen and progesterone through the end of the first trimester to mimic the hormones produced by the ovary during natural conception. At the end of the first trimester (twelve weeks gestational age, or approximately ten weeks after the embryo transfer), the placenta produces the necessary hormones, and estrogen and progesterone supplementation is no longer required.
Alternatively, the embryo can be frozen and prepared for transfer at a later date.
Our egg donation program is unique because our donors participate in shared rather than traditional egg donation. In our experience, most egg donors produce more eggs than are needed for one recipient. Because of this, in traditional egg donation, many frozen embryos are not needed and discarded. In our program the eggs from each cycle are secured by a number of intended parents in batches, beginning with a batch size of 8 fresh eggs. Intended parents may secure as many of the batches as are available or secure a batch plus additional eggs.
Dr. Jain consults with intended parents to decide on the size of the package that will help them achieve their fertility goals. Because shared egg donation may be more affordable than securing all the eggs from the cycle which happens in traditional egg donation, our egg donors may be matched much more quickly.
Fertility patients and egg donors may have questions around the legal aspects of egg donation. Who owns the eggs? Can a donor try to reclaim embryos created from donated eggs? Can a donor petition the courts for access to a child resulting from an egg donation? Can a donor be legally required to take responsibility for a child that is born as a result of their donated eggs?
The practice of using donor eggs in fertility treatment has been around since the 1980s. Contracts protecting recipients and recognizing them as parents have consistently been upheld in courts. The rules apply to any eggs retrieved, embryos created using these eggs, and babies born from pregnancies that involve donor eggs. While we cannot guarantee that the laws won’t change, we have no reason to believe that the legality of egg donation is under threat.
All parties are represented by attorneys experienced in reproductive law in the United States throughout the egg donation process. These lawyers ensure that the agreements entered into are carefully drafted to comply with both state and federal laws and avoid any confusion or misinterpretation regarding the rights, responsibilities, or intent of all parties.
In the United States, egg donation can be anonymous, and most intended parents and donors choose that and will never meet. The confidentiality will always be upheld by the egg donation agency and medical clinic. In anonymous egg donation, recipients will have access to medical information and photos as necessary to select a donor, but not any personal information that would help them identify or locate the egg donor. The donor will not have any information about the intended parents.
Patients who wish to use donor eggs from someone they know (directed or known egg donation) should seek counsel from an attorney who specializes in reproductive law to avoid potential complications.
We are here to answer any questions or concerns you may have. If you are ready to begin your journey to parenthood through egg donation or would like to find out more about donating your eggs, please contact us or call our egg donation coordinator on 310 566 1470.