What Is Pregnancy Like When Using Donor Eggs?

Pregnancy can be an exciting and nerve-wracking experience for many, but when carrying life made from a donor egg, it can be a unique and challenging experience. In this article, we will explore the process of using a donor egg, the potential risks and benefits, and what to expect during pregnancy.

What is a donor egg pregnancy?

A donor egg is an egg that has been harvested from an egg donor who is not the intended mother. This egg is then fertilized with sperm from the intended father (or sperm donor) and implanted into the uterus of the intended mother or a gestational carrier. This process is known as egg donor in vitro fertilization (egg donor IVF).

Why would someone use donor eggs?

There are several reasons why someone might choose to use donor eggs to build their family. For example, you may have fertility issues that prevent you from producing viable eggs, or you may be at an increased risk of passing on genetic disorders to her child. Additionally, same-sex male couples or single men who wish to have a biological child may also choose to use an egg donor and gestational carrier.

The donor egg process

The process of using a donor egg typically begins with selecting an egg donor. Egg donors are healthy women who have undergone extensive medical screening and genetic testing to ensure that their eggs are likely healthy and free from genetic disorders. 

Once an egg donor has been selected, she will undergo ovarian stimulation, which involves taking medication to encourage the ovaries to produce multiple eggs. This process can take several weeks and involves regular monitoring to ensure that the eggs are maturing properly.

When the eggs are ready, they are retrieved from the donor through a minimally invasive procedure called transvaginal ultrasound-guided egg retrieval. During this procedure, a needle is inserted through the vaginal wall and into the ovaries to collect the mature eggs.

Once the eggs are retrieved, they are fertilized with sperm in a laboratory setting. The resulting embryos are then monitored for a few days to ensure that they are developing properly. At this point, some families choose to do preimplantation genetic screening. The best quality embryos are then selected for transfer to the intended mother or gestational carrier.

What to expect during donor egg pregnancy

A pregnancy via donor egg IVF is treated the same as any IVF pregnancy. You will likely require additional hormone support (progesterone) during the early stages of pregnancy, for 8 to 10 weeks. After that, you will “graduate” and be discharged to the care of your OBGYN.

It is likely you waited a long time for this pregnancy – so cherish the miracle that you are experiencing! 

Medical risks of an egg donor pregnancy

There is evidence that donor egg pregnancies are independently associated with a higher rate of pregnancy risk. For instance, a Columbia University study found that women who use egg donation to become pregnant are at an elevated risk for obstetrical complications, particularly hypertensive disorders and cesarean section¹. 

However, the risk association remains a challenge to substantiate because of confounding variables (e.g. other characteristics of those who are more likely to need donor eggs). One hypothesis is that an immunological maladaptation causes placenta-mediated disorders in egg donation pregnancies², but this has not been proven. 

Gestational hypertension

Gestational hypertension is a type of high blood pressure that occurs in pregnant women who did not have high blood pressure before pregnancy. It usually develops after 20 weeks of gestation and resolves after you give birth. 

Gestational hypertensive disorders affect 5-10% of all pregnancies in the United States³. But the risk of gestational hypertension is 3X more prevalent in egg donation pregnancies compared to pregnancies from other methods of assisted reproductive technology (such as IUI and IVF) and 7.94X greater than in unassisted pregnancies³.

If you get diagnosed with gestational hypertension, it’s helpful to know that pregnancy outcomes for people diagnosed with mild gestational hypertension are similar to those of the general obstetrics population³.

Preeclampsia

Preeclampsia during pregnancy is defined as the combination of high blood pressure and protein in your urine or other problems after 20 weeks of pregnancy.  Preeclampsia happens in about 1 in 25 pregnancies in the United States⁴. Research has suggested that there may be a slightly higher risk of preeclampsia in pregnancies conceived using donor eggs compared to other pregnancies. One study found that the risk of preeclampsia is 2.54X higher in egg donation pregnancies compared with pregnancies from other methods of assisted reproductive technology and 4.34X higher than in unassisted pregnancies³. 

Mild preeclampsia may be treated with bed rest and close monitoring of blood pressure and urine protein levels. Severe cases may require hospitalization, medication to lower blood pressure, and sometimes early delivery of the baby to prevent further harm to the mother and baby. 

Getting the care you need

We generally see that egg donor IVF pregnancies, especially when the intended mother is over 35, see a maternal fetal medicine (MFM) specialist in addition to their OBGYN. This is a good thing, as people who receive MFM care get additional attention and support. 

Connecting with your baby in utero

Connecting with your baby during pregnancy can be an incredible experience, as it creates a sense of closeness and bonding. While your baby is growing and developing inside you, there are so many ways to connect with them before they arrive. 

One of the easiest ways to connect with your baby is to simply talk to them. Whether it's singing a lullaby, telling them about your day, or expressing your excitement about their upcoming arrival, your baby will be able to hear your voice and recognize it after birth. 

You can also try playing music for your baby, gently massaging your belly, and taking time each day to rest and focus on your baby's movements. 

You can also write letters to your baby, letting them know your journey and how hard you fought to bring them into this world. These simple practices can help you feel more connected to your baby during pregnancy and beyond.

Do I need to tell my doctor I’m pregnant via donor eggs?

I don’t see any reason not to tell your doctor your pregnancy is with donor eggs. Given the rise in use of donor eggs, you are certainly not their first patient to conceive via egg donation. Plus, there may be certain screening tests based on using donor eggs.

There is no shame in using donor eggs to get pregnant. And if you feel judged or misunderstood by your OBGYN, then by all means find a doctor who understands. 

If you’re finding that you feel guilty, ashamed, or embarrassed about using donor eggs, it may actually be something you can discuss with your doctor, who can provide support and connect you with resources such as counselors or support groups. Remember, using donor eggs does not diminish your ability to be a parent or your love for your child, and you should be free to focus on the joy and excitement of becoming a mother.

What is the risk of miscarriage with donor eggs?

The short answer is that using donor eggs decreases the risk of miscarriage for most women. Especially when those miscarriages were due to chromosomal abnormalities. Because egg donors are young (under 33) and medically cleared, outcomes with donor eggs are better than outcomes with a patient’s own eggs. 

Women who use donor eggs tend to be older, and age is a significant factor in miscarriage risk. As women age, the quality of their eggs decreases, and the risk of chromosomal abnormalities increases, which can lead to miscarriage. By using younger, healthier eggs from a donor, the risk of chromosomal abnormalities is significantly reduced.

Furthermore, the donor egg IVF process involves extensive screening of the donor to ensure that she is in good health and has a low risk of genetic disorders. This can further reduce the risk of miscarriage, as genetic disorders can be a significant contributor to pregnancy loss.

Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account today! 

More resources:

• Epigenetics and Donor Eggs
• Will My Baby Look Like Me If I Use an Egg Donor?
• Will a Donor Conceived Child Have My DNA?

‍

Sources:

1. Kort DH, Gosselin J, Choi JM, Thornton MH, Cleary-Goldman J, Sauer MV. Pregnancy after age 50: defining risks for mother and child. Am J Perinatol. 2012;29(4):245-250. doi:10.1055/s-0031-1285101
2. Savasi VM, Mandia L, Laoreti A, Cetin I. Maternal and fetal outcomes in oocyte donation pregnancies. Hum Reprod Update. 2016;22(5):620-633. doi:10.1093/humupd/dmw012
3. Masoudian P, Nasr A, de Nanassy J, Fung-Kee-Fung K, Bainbridge SA, El Demellawy D. Oocyte donation pregnancies and the risk of preeclampsia or gestational hypertension: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;214(3):328-339. doi:10.1016/j.ajog.2015.11.020
4. High Blood Pressure During Pregnancy CDC. Accessed May 2023.