Though it is possible for a woman to get pregnant at any point up until she has reached menopause, the fact is that with age, the quality and quantity of a woman’s eggs decrease. It becomes harder to get pregnant and there is a greater likelihood of birth defects. Egg donation may offer a solution to this and other medical issues that affect fertility. Egg donation can also be a way for same-sex male couples to have a child.
Implantation of a donor egg is done via in vitro fertilization (IVF). You should put careful consideration into determining whether this is right for you. At the Yale Fertility Center, specialists in the Third Party Reproductive Program are available to answer your questions and help you make an informed decision.
“For a number of patients, egg donation is the only option that will allow them to achieve parenthood. This is an approach with a high probablility of success,” says Emre Seli, MD, a reproductive endocrinologist and infertility specialist at Yale Fertility Center. “We provide individualized care through a team approach. First, our social worker ensures that the recipients understand what the process entails and that they are ready to proceed. Then, we collect detailed medical information and a thorough screen. Next, we match recipients to a donor. Finally, we schedule and manage the treatment cycle with extreme care to details.”
Yale Fertility Center has achieved successful results for couples from around the country, and in fact, all over the world. The center offers state-of-the-art treatment, has high success rates, and rapidly matches egg donors to recipients.
Who can benefit from egg donation?
Egg donation as part of their IVF treatment may be the only option for women with certain chromosomal or genetic conditions who want to achieve pregnancy, such as those who have premature ovarian insufficiency (when the ovaries stop functioning normally before age 40) due to mosaic Turner or fragile X carrier status. Egg donation may also be an alternative for the following patients:
- Women whose ovaries were surgically removed.
- Women with premature ovarian failure (the ovaries don’t produce normal amounts of estrogen or release eggs regularly).
- Women who are postmenopausal.
- Women with a history of recurrent pregnancy loss.
- Women with a history of multiple failed IVF cycles and/or who are poor responders to ovarian stimulation.
- Male same-sex couples
Where do donated eggs come from?
Individuals or couples can receive eggs from a donor in the community or from a relative or friend. All donors are carefully screened. For anonymous donors, their identities are never revealed.
Is age a factor?
Yale Fertility Center physicians recommend that women over the age of 45 undergo cardiovascular testing and a high-risk obstetrical consultation with Yale Medicine’s Maternal-Fetal Medicine specialists before undertaking IVF with donor eggs. We do not recommend this procedure for women ages 52 and older.
What is the first step to receiving eggs from a donor?
First, you’ll meet with a Yale Fertility Center counselor, such a Dorothy Greenfeld, MSW. Topics of discussion include background about the program and donor recruitment, donor screening, the matching process, treatment protocols and program costs. This talk also includes a discussion of social and psychological aspects of egg donation.
“I make sure they have a good understanding of everything that is going to happen. I’m also there for support as they go through the process,” Greenfeld explains.
Couples then have a medical consultation with a Yale Fertility Center physician, such as Dr. Seli or Patrizio Pasquale, MD, MBE. At this appointment the doctor will describe the donation process and provide an evaluation and review of the recipient couple’s medical history. There will also be a medical examination, an overview of treatment protocols and a discussion of possible side effects and medical complications.
What does the screening process entail for donor recipients?
As donor recipients, you and your partner must undergo blood tests, a semen analysis, and an evaluation of the uterine cavity via sonohysterography, a highly specialized ultrasound. You may need additional testing, based on your age, medical or genetic history.
How are donors selected?
All donors must meet the Third Party Reproductive Program’s criteria. Donors must be between the ages of 21 and 32, and in good medical and psychological health.
Our program strictly adheres to U.S. Federal Drug Administration (FDA) regulations on donor screening. In addition to a comprehensive medical and psychological screening, egg donors undergo laboratory testing for transmissible, hormonal and common genetic disorders.
The following donation services are available to you:
- Anonymous donors: Women are recruited and screened by our program. Couples are provided with a current photo of the donor and comprehensive information including her health history, family health history, eye color, hair color, height, weight, blood type, ancestry, educational level, occupation, interests and outcome of previous donations (if applicable).
- Private recruiting agencies: In some cases, you may be looking for characteristics in the donor that we’re not able to provide; or you may wish to meet the donor before participation, a request that we can’t fulfill through our anonymous program. We work with donor agencies who recruit donors around the country and locally. We are happy to provide a recommended list to you.
- Directed egg donors: These donors are generally recruited by you, and are screened by our program. We do not accept intergenerational (i.e. daughter to mother) donations—all donations by family members are evaluated on a case-by-case basis. You are welcome to bring your own donor as long as she meets our criteria for acceptance, but cycles using directed donors tend to be less successful.
- Donor egg banks: We have agreements with My Egg Bank and Fairfax Egg Bank.
How does donor matching happen?
Once all medical testing requirements are completed, participants are ready to be matched. The team takes into careful consideration your preferences for donor characteristics, including eye color, hair color, height, weight, ancestry, educational level and previous donation history.
“When people meet with me, I typically ask them, ‘What is important to you about a donor and what are you looking for?’” says Greenfeld. “For the typical couple, an intended mother wants a donor she can feel some kind of connection with. Maybe it’s just a shared ancestry or hair color, but it matters to her.”
When you and your partner agree on a suitable match, you’ll meet with one of the Yale Fertility Center physicians, who will discuss with you the donor’s personal and family health history, genetic test results and previous donation history. The physician will then set up the treatment cycle for donor and recipient.
How long does it take to be matched with a donor?
It typically takes about one month to be matched to a donor once the entry requirements have been completed. There is no waiting list.
What is a mock cycle and why is it important?
This is a trial cycle that mimics the medication instructions that you’ll follow during an oocyte (immature egg) transfer cycle. Its purpose is to evaluate the response of your uterine lining to the medications that are used to prepare the uterus for implantation (attachment) of an embryo.
"We call it a ‘trial run’ to see how you respond to the protocol,” Greenfeld explains. “If you don’t respond the way we want, it’s not a bad thing. We simply tweak it and go from there.”
What is involved in the treatment cycle?
The treatment cycle most commonly involves pituitary suppression using a daily injection of Lupron, and endometrial preparation using estrogen and progesterone. Your hormonal treatment will continue until the 12th week of pregnancy. The coordinators will review with you the medication instructions and how to administer them.
The male intended parent will provide semen on the day eggs are retrieved from the donor. If necessary, his stored frozen sperm or sperm from a previously chosen donor may also be used. The doctors will transfer the embryo/s into your uterus about three to five days after the retrieval. The day of the transfer is based on the number and development of the embryos.
In total, the treatment cycle is completed in four to eight weeks.
Is a legal contract necessary?
If you choose to use a Yale Fertility Center egg donor, you are not required to have an outside legal contract—you and the donors are protected under the legal guidelines provided by the university. As part of the consent process, the donor waives all rights to the donated oocytes, which become your property.
But if you choose to use a directed or agency donor, you’ll need to have an outside legal contract with the donor. If you use an agency donor, the legal contract is usually provided by the agency.
What are program costs?
Total costs vary depending on whether you and your partner have coverage for testing and medications. You will meet with a financial coordinator at the time of your initial visit for a complete review of the fee schedule.
What stands out about Yale Medicine’s approach to egg donation?
Yale Fertility Center’s Third Party Reproductive Program has consistently high pregnancy rates. Also, as an academic medical center, we are equipped to treat patients with a broad range of conditions that might affect fertility, including coagulation defects, metallic cardiac valves and rheumatic disorders. We will provide an individualized treatment program for you based on cutting-edge science and technology and compassionate care.
“We have very good success rates, and we have a really caring team,” Greenfeld says.