Should I Use Fresh or Frozen Donor Eggs?

Pros and Cons of Each
Egg donation has made it possible for thousands of women who couldn’t conceive with their own eggs to get pregnant and have a baby. Donor eggs may be used in IVF treatment for women who have premature ovarian failure (menopause before age 40) or diminished ovarian reserve, lower quantity of eggs due to the woman’s age. Other reasons to use donor eggs are previous failed IVF cycles, which may be due to poor egg quality, or being a carrier for genetic abnormalities which can be inherited. A woman over 40 has nearly the same chance of getting pregnant and having a healthy baby with donor eggs as a younger woman using her own eggs.

In the past, the only donor eggs available were fresh ones. In states where egg donation is legal, the fertility clinic synchronizes the cycles of the egg donor and the recipient. The donor’s eggs are fertilized in the embryology lab and the resulting embryos are transferred to the recipient or frozen, if extra embryos result. This is still the way most egg donation is done in the U.S. and around the world.

In recent years, new technology has made it possible to freeze unfertilized eggs. The process, called vitrification, freezes the eggs ultra-fast so they are less likely to be harmed by the process than in the past. This is new technology, and the jury is still out on success rates with frozen eggs. But there are advantages to either fresh or frozen.

Fresh Eggs Are Proven
Fresh donor eggs have been in use in IVF in the U.S. since 1984. Over 47,000 live births from egg donation have been recorded since then in the U.S., according to the Centers for Disease Control and Prevention (CDC). IVF with fresh donor eggs has a lot of history and research behind it. It’s proven to work, and you can read a clinic’s success rates with donor eggs on the SART (Society for Assisted Reproductive Technology) website or the CDC website.

On the down side, the donor’s cycle and the recipient’s cycle have to be synchronized, which can cause scheduling challenges and may make you wait longer for embryo transfer. Fresh donor egg IVF cycles typically are more expensive than IVF cycles with frozen donor eggs. However, the cost per live birth may not be higher, depending on a clinic’s success rates with frozen eggs. It is also possible to share a donor’s eggs with another recipient in order to lower your cost.

Frozen Eggs Are Convenient
It’s important to remember that frozen donor egg banks are not required by law to report success rate data to the government like fertility clinics are. The technology has not been in use for very long, and data on success is scarce. The national average for live births from embryos using frozen eggs is still lower than that of fresh eggs. In a study published in the Journal of the American Medical Association last year, the live birth rate from frozen eggs was 47.1 percent, while the rate from fresh eggs was 56.1 percent. However, this varies from clinic to clinic, and the rates are improving.

Some of the frozen egg banks make extravagant claims for success rates, but their claims are not validated and may be exaggerated or inaccurate. Make sure to work closely with your reproductive endocrinologist and the fertility clinic to choose the right kind of donor or donor egg bank for you. That said, there are some advantages to frozen eggs. You don’t have to synchronize your cycle with the donor, because the donation has already been done. Time between choosing a donor and having embryo transfer can be shorter. Costs per treatment cycle are generally lower using frozen eggs. The added convenience and the lower cycle cost have to be balanced against the lower success rate to decide what makes sense for you.

Starting Your Family with IVF
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