fertility treatments

As the 2024 election in the US approaches, conversations about reproductive rights are front and center across the country. In fact, recent survey data found that 90% of American women are concerned about potential restrictions on fertility treatments. While the focus has largely been on abortion rights—especially following the overturning of Roe v. Wade—it’s important to know that other areas of reproductive healthcare, including egg donation and IVF, could also be influenced by election outcomes.

At Cofertility, we’re committed to helping intended parents navigate their family-building journey with clarity and confidence. As this election season unfolds, we’re closely monitoring how political shifts could impact donor egg IVF and the future of fertility care. In this article, we’ll walk you through what you need to know to stay prepared and informed on these important issues so you can make the best choices to protect your options for the future.

Issues facing egg donation and reproductive healthcare access

This election season, reproductive healthcare policies are under intense scrutiny, especially in states where abortion restrictions are either already in place or on the horizon. Currently, fertility treatments like egg retrieval, egg freezing, and in vitro fertilization (IVF) remain widely accessible. However, ongoing changes in reproductive health policies may introduce new questions about accessibility, oversight, and insurance coverage for these treatments. In light of these shifts, staying informed is more essential than ever, helping intended parents feel secure and prepared as they navigate their options.

Understanding state-level implications for donor egg IVF

Because reproductive healthcare policies are largely determined at the state level, intended parents considering donor eggs will find their options are heavily dependent on where they (and their donor) live. In states with robust protections for reproductive healthcare, donor egg IVF remains reliably accessible. These states often have fewer regulatory barriers and, in some cases, expanded insurance coverage for fertility treatments.

In states with more restrictive policies—like the recent Alabama Supreme Court ruling— intended parents pursuing donor egg IVF may have more hurdles to overcome. While these laws don’t typically focus on egg donation specifically, changes in how embryos are handled, fertility clinic operations, or insurance mandates could still influence the logistics or costs of care. For intended parents pursuing egg donation, IVF is an essential step in the family-building journey, whether the intended mother plans to carry the pregnancy or if you’re working with a surrogate. Understanding the nuances of state-level policies is crucial, and completing your care in a state with strong protections for reproductive healthcare can help ensure smoother access to the support and services you need.

Insurance gaps and high costs

As more people pursue fertility treatments, there’s a growing movement for broader access and better support for individuals seeking assistance with growing their families. This election season, expanding insurance coverage for fertility treatments has become a central issue, with advocates pushing for policies that make family-building more accessible and equitable.

With this momentum, there’s a growing emphasis on providing inclusive care options for all intended parents, regardless of background or location. By breaking down cost barriers, these policy changes could empower more families and underscore the fertility industry’s commitment to accessible, inclusive care.

Impact on LGBTQ+ intended parents

Access to fertility treatments isn’t consistent for everyone, and LGBTQ+ intended parents face added challenges, especially when insurance coverage is limited to heterosexual couples. This can create additional financial and logistical hurdles for LGBTQ+ families seeking to build their families through egg donation.

As the election nears, policies that shape access to fertility treatments could play an important role in ensuring that all intended parents—regardless of gender, sexual orientation, or marital status—can pursue family-building. Equal access to fertility care is essential, as restrictive policies could worsen existing disparities and further limit family-building options for LGBTQ+ individuals and couples.

Access to egg donation and donor egg IVF amid political changes

Despite the focus on reproductive healthcare access in today’s political climate, IVF remains widely accessible for intended parents across the U.S. While policy discussions around reproductive healthcare often focus on abortion, new rulings and legislative proposals about embryo handling and clinic oversight are also introducing considerations for fertility treatments like donor egg IVF. Staying informed on these shifts may be helpful, as they could indirectly impact access to egg donation in some areas.

To support consistent and secure family-building options, many fertility providers are concentrating their services in states with strong reproductive protections. Some states have even responded to these discussions by expanding insurance coverage for fertility treatments, recognizing the essential role these treatments play in supporting diverse paths to parenthood.

At Cofertility, we’re here to help you navigate these changes with confidence. Our clinic-agnostic model and partnerships in states prioritizing reproductive healthcare protections allow us to offer flexible, secure options that meet your needs, whether you’re just starting out or further along on your journey to parenthood. We’re committed to helping you make informed choices in this evolving landscape.

Key election topics to watch this season

As you move forward on your fertility journey, here are a few key areas to keep an eye on this election:

1. Healthcare policy and reproductive rights: Any shifts in reproductive rights could have downstream effects on egg donation and IVF services in some regions. Even when specific treatments aren’t directly targeted, related legislation could influence healthcare providers’ ability to offer certain services‍
2. Insurance and cost coverage: Candidates advocating for expanded insurance mandates for fertility treatments could support broader access. Understanding candidate positions on these mandates can help clarify future coverage possibilities.‍
3. State-by-state differences: With reproductive healthcare policies managed at the state level, where you (or your donor) live can influence your access to donor egg IVF. Following the election, it may be helpful to monitor your and your donor’s state legislative landscape for changes.‍
4. Access for LGBTQ+ families: Policies that define infertility and coverage eligibility could affect who qualifies for fertility treatments. For LGBTQ+ intended parents, inclusive family-building policies are an essential advocacy point

How Cofertility can support your family-building journey

Reproductive health rights are at risk in the United States. Whether it’s abortion, egg freezing, or IVF–there are policymakers who do not believe women should be able to make decisions about their own bodies. As you explore your options, understanding the broader policy landscape can help you make confident decisions about your family-building journey.

At Cofertility, we’re dedicated to supporting intended parents throughout their egg donation journey, providing resources to help you explore your options and advocating for accessible, inclusive care. To ensure stability and security, we’ve proactively partnered with facilities in states that uphold strong reproductive protections. Our clinic-agnostic model empowers you and your donor to establish care in locations where family-building policies align with your values, offering secure and flexible options no matter where you’re located."

This election, as you weigh your options, we encourage you to reflect on the policies that matter most to you. Your voice—and your vote—can help create a future where everyone has the opportunity to build the family they envision.

The world of fertility treatments is a rapidly-evolving landscape, teeming with options, intricacies, and promises of renewed hope for LGBTQ+ families as well as those struggling to conceive. Among these treatments, donor egg in vitro fertilization (IVF) has become an increasingly common path, with a substantial 12% of all IVF cycles in the U.S., over 16,000 a year, involving eggs retrieved from a donor.

But does donor egg IVF increase the chances of conceiving twins? In this guide, I’ll dive into the essentials of donor egg IVF, its odds for success, the chances for twins, and the potential risks associated with multiples.

What is donor egg IVF?

IVF with donor eggs is a medical procedure where eggs are collected from a donor, fertilized in a laboratory with the intended father's or a donor's sperm, and the resulting embryo is then implanted in the uterus of the intended mother or a gestational carrier. 

This process may be an option for women with diminished ovarian reserve, repeated IVF failure, infertility due to recurrent miscarriage, or those who carry genetic disorders that they do not want to pass on to their children. It is also an option for LGBTQ+ families and single males. 

Donor egg IVF typically involves several steps: the selection of an egg donor, extraction and fertilization of the donor eggs, and transfer of the embryo(s). To learn more about the process, check out this article. 

What are the odds of getting pregnant with donor eggs?

Success rates for donor egg IVF are often more promising compared to traditional IVF. At Cofertility, for those who match with a donor in our fresh egg donation program, the average number of mature eggs a family receives and fertilizes is 12. The number of eggs retrieved varies by patient and cycle, but can be predicted by a donor’s age, AMH, and antral follicle count, all of which will be known to you after the donor’s initial screening. Qualified candidates have an ample ovarian reserve for both their own needs and sharing. Egg share donors also often work closely with a fertility doctor to determine, based on their own medical history, the optimal number of eggs needed for their own future family-building goals. Should it make sense for the donor, they may choose to pursue a second egg-sharing cycle to maximize the chances of success for everyone.

Matching with a donor in our frozen program can provide the opportunity to move forward with your family-building plans faster, as frozen eggs can be fertilized or shipped to your clinic immediately or as soon as the cycle is complete. Donors undergoing frozen cycles complete equally rigorous ovarian reserve testing. While the total number of frozen eggs available will vary based on the donor’s retrieval outcomes, every frozen match is guaranteed to have a minimum of at least 6 frozen eggs. To learn more about these programs and the differences between them, click here.

Around 53 percent of all donor egg cycles will result in at least one live birth. This percentage varies depending on the egg donor, recipient body mass index, stage of embryo at transfer, the number of oocytes retrieved, and the quality of the clinic.

At every age, the chances of birth with donor eggs is better, but those who benefit the most from donor eggs are women over 35 and those with low ovarian reserve. In fact, about one-quarter of women over 40 who succeeded with IVF did so through the use of donor eggs. 

The chart was made using the SART Patient Predictor for an average woman (5’4”, 150 lbs) with diminished ovarian reserve. As you can see, the chances of live birth after one donor egg cycle is 54% for recipients under 40, and only goes down slightly after this.

The advantage is primarily due to the utilization of eggs from younger donors, typically between the ages of 21 and 34.

It’s important to remember that your age when you get pregnant is not as important as the age of the eggs with which you get pregnant. The success of egg donation depends on many factors, but is not considered to be related to the age of the recipient.

Chances of twins with donor eggs

One question we get a lot is the likelihood of conceiving twins with donor egg IVF. 

According to the CDC, in 2021 live births from donor egg IVF had a slightly higher chance of twins compared to IVF with a patient’s own eggs.

• General population: 3.2%
• IVF with patient’s own eggs: 5.2%
• Donor egg IVF: 6.0%
• Donor embryo IVF: 7.4%

But as you can see from the data above, IVF (regardless of whose eggs are used) is associated with higher chances of twins. 

How does that work? First, the chances of an embryo splitting and becoming monozygotic twins (aka identical twins) is 2.25 times higher with IVF than with unassisted conception. 

But twins after IVF are usually due to a patient having more than one embryo transferred to the uterus, making them dizygotic twins. When IVF was just starting out, there was no genetic testing and fertility doctors would transfer multiple embryos at one time. This led to a multiples rate of over 20% for those who underwent IVF. Nowadays, as technology has advanced, single embryo transfers are the norm, and the incidence of twins has gone down drastically. 

Can I transfer two donor egg embryos?

The transfer of two embryos is an option in some fertility clinics, and it often increases the chances of pregnancy. However, it's important to consider the associated risks, benefits, and guidelines.

The American Society for Reproductive Medicine (ASRM) recommends that clinicians and patients carefully discuss the number of embryos to be transferred, considering factors like maternal age, embryo quality, and the patient's individual medical situation. In some cases, transferring two embryos may be a viable option, while in others, a single embryo transfer may be the preferred route to minimize the risk of multiples,

Risk of pregnancy with multiples

While the prospect of twins may be appealing to some, there are increased risks associated with multiple pregnancies. Twin pregnancies are associated with higher rates of preterm birth, low birth weight, and maternal complications such as gestational diabetes and preeclampsia.

• Preterm birth, defined as delivery before 37 weeks of gestation, occurs more frequently in multiple pregnancies. Preterm infants may face an array of health challenges, including respiratory distress syndrome, infections, and long-term developmental issues. These risks underscore the importance of careful monitoring during pregnancy and specialized neonatal care following birth.
• Low birth weight, often linked to preterm birth, is a common occurrence in twin pregnancies. Infants born with low birth weight are at increased risk for health problems both immediately after birth and later in life. Challenges may include difficulties with feeding and temperature regulation, as well as potential long-term developmental delays.
• Other complications from twin pregnancies due to added stress on the mother's body can lead to an increased risk of gestational diabetes and preeclampsia, a condition characterized by high blood pressure and damage to organs such as the liver and kidneys. Other potential complications may include an increased likelihood of cesarean section (C-section), excessive bleeding during childbirth, and higher rates of postpartum depression.

You should understand these risks and engage in thoughtful, well-informed planning and decision-making with your fertility doctor if you are considering the transfer of multiple embryos in donor egg IVF.

The bottom line

Donor egg IVF represents a beacon of hope for many aspiring parents. With its relatively high success rate, more and more families are turning to donor eggs to build their family.

However, the decision to pursue this treatment—and whether to transfer one or two embryos—requires careful consideration of the odds, potential risks, and individual medical circumstances. Consulting with fertility doctors, understanding the available scientific data, and considering personal preferences and ethical considerations will equip you to make informed choices on your journey towards parenthood. We wish you all the best!

Learn about egg sharing

At Cofertility, our program is unique. After meeting with hundreds of intended parents, egg donors, and donor-conceived people, we decided on an egg donation model that we think best serves everyone involved: egg sharing.

Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
• Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
• Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
• Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
• Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

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 to get started today!

Religion can be a great source of comfort and solace during the most difficult of times. Religion has been implicated in reduced mortality, expedited recovery from illness, and improved mental health. It can encourage healthy lifestyles, provide social support, and provide meaning to life. But it can also impact help seeking behavior, especially when it comes to fertility treatment. Religiosity has been associated with greater concerns about infertility treatment, which, in turn, decreases the likelihood of help seeking (i.e IVF, egg donation etc).

Religion and assisted reproductive technology (ART)

The use of donor gametes to create embryos can ignite some serious debate in many faith circles. Some faiths say fertility treatments go against their beliefs and should not be used, even if it means someone will never become a parent otherwise. Meanwhile, other religions have no issues with it at all, as long as certain “rules” are followed. 

A Pew Research study conducted in 2013 asked people living in the United States about the moral acceptability of using in-vitro fertilization to have a family. One-third said it is morally acceptable, 12% said it was morally wrong, and 46% said it was not even a moral issue. The survey found modest differences in opinion among social and demographic groups, including religious groups, about the moral acceptability of IVF. 

But for many religious people their religious beliefs strongly inform their understanding of fertility and parenthood. Procreation can be an important tenet of a religion along with prescribed roles for the male and female partner when it comes to parenthood. So what if you want a family and the only way that family can be created is through egg donation? And what if you are someone who holds strongly to their faith - a faith that carried you through troubled times - only to discover that very faith does not give you its blessing to have the family you have prayed for? 

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What if you are someone who holds strongly to their faith - a faith that carried you through troubled times - only to discover that very faith does not give you its blessing to have the family you have prayed for?

How do I navigate making a decision?

You want to adhere to the teachings of your religion and at the same time you also have a very strong desire to have a child.  What should you consider when deciding how you want to proceed so you can feel good about your decision? How can you find a way to remain connected to your beliefs even if your choice is different from what is taught by your religion?

Give yourself permission to imagine different options

Play your life tape forward and really imagine how it feels to go against your beliefs in order to achieve pregnancy. Now imagine how it feels to stay strong in your beliefs and never be a parent. Discuss these options with your partner. Write them down in a journal and come back to them in a few weeks. Does one evoke a bigger emotion? Does one feel better than the other? There is no right or wrong and there is no judgment - you are allowed to imagine and really think through your different options. 

Speak to trusted members of your community.

Speak to respected and trusted members of your faith community. Ask questions to fully understand what your religion’s expectations are regarding parenthood and regarding ART and IVF and donor eggs. What are your expectations? Do they match or are they very different? 

If they are different, would you ever make a decision to pursue donor egg IVF that isn’t sanctioned by your religious teachings? If yes, how would your community support you? Would you be ostracized? What does it mean to be against these teachings?  If you would never go against the teachings, then how can your religion provide guidelines about living child free? Would you be able to find peace regarding infertility from your religious teachings? Studies have shown that infertile women with higher levels of spiritual well-being reported fewer depressive symptoms and less overall distress from their infertility experience because of the support from their religious community.  

Summing it up

Faith can be an essential aspect of a person’s life. Sometimes it is possible that not all  tenants align. But that does not necessarily mean that you forsake your faith, nor does that necessarily mean you give up your desire for a family. It may mean digging even further and leaning even stronger into your faith.  It may mean exploring all your different options by researching, talking, asking questions, and praying. All of these things can open doors and create alternative paths to parenthood that you may not have ever considered.

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Going through fertility treatment can be full of stress, fear, sadness, and even shame. One of you may feel hopeful that donor egg IVF will work, while the other is afraid and not very sure. There are countless doctor visits, endless paperwork, and thousands of dollars being spent. In-between comes finding an egg donor, egg retrieval, embryo creation, hormonal injections, and implantation. But it’s not over yet. Now comes the dreaded two-week wait to find out if all of this has been successful or not.  Although fertility treatment can give you hope and a glimmer of light, it can also steal your peace of mind, and at times, what feels like your sanity. 

A donor egg IVF cycle can be a roller-coaster of emotions and what your partner needs most during this time is support. As the partner of someone going through IVF, what can you do to ensure they feel loved, supported, and understood? 

Actively listen

One of the best things the non-carrying partner can do to help support their partner through this time is to actively listen. Don’t try to fix anything and don’t try to solve anything. Don’t interrupt and be fully present in the conversation. Ask open-ended questions and let them talk. The point is for you to listen for understanding not for responding. 

Ask questions

When times are good and treatment is going well, it is easy to know what to say and do. But when things are not going well, the opposite is very true. It can be very hard to know what to say and how to help. So in times like these, it is okay to simply ask what you can do to make your partner feel loved and supported. Sometimes support may look and feel very different depending on the situation. Asking does not mean that you don’t care, it simply means you care so much that you want to make certain their needs are being met. 

Attend appointments

As the partner, you are also part of the treatment process, regardless if you are involved medically or not, the process of getting pregnant through IVF requires that both of you are present from start to finish. Attending appointments is important for so many reasons. One is so you can tag-team asking the doctor questions, and secondly having two sets of ears can also help verify the understanding of complicated procedures. Having you there helps your partner feel that they are not alone. The doctor’s office can be cold and sterile and having a warm hand to hold can ease some of that discomfort and fear. 

Create a safe space

It can be so difficult to be vulnerable, especially if treatment is not moving according to plan. It may make one feel that they are letting everyone down. Creating a non-judgmental space for your partner to be open, vulnerable, and honest is invaluable. Give them space to tell you how they are really feeling. Be empathic, loving, and non-judgemental. Actively listen and give them time to be fully seen and heard. Intentionally set time aside to be fully present and be open to whatever emotions that may come.

Educate yourself

To really support your partner you need to know what they are going through.  One way to do this is to educate yourself about the treatments, understand the procedures, know the medical terminology, risks, side effects, and outcomes. Read books, articles, and blogs about donor egg IVF. Listen to podcasts, join groups, and ask questions. LIke the ‘90s PSA used to say, “the more you know” the more we can increase empathy and understanding.

Respect your partner’s decisions

Throughout this article I have expounded the importance of you and your partner as a team in this fertility journey. That it takes both of you from start to finish. You both agreed on this plan to grow your family. But after multiple (or maybe even one) attempt, what if they are ready to stop and you aren’t?  You can be honest with what you want and how you feel. But, don’t make guilt a driving force for them to continue with treatment if they are done. At the end of the day it is their body and whatever they choose to do with their body, respect that decision. Sometimes this isn’t so dramatic as wanting to end treatment completely. It can also look like wanting to take a break, wanting to change clinics, adding holistic treatment to the plan. Whatever it may look like, have their back and respect their choices. 

Show tangible support

Showing emotional support is obviously important. But so is taking over responsibilities or chores you don’t normally do. Things like making dinner, making sure the laundry or grocery shopping is done, the dog’s vaccines are up-to-date. Toilet paper roll empty? Replace it. Just the everyday little things that need to be done on a daily basis. Taking some of those things off their plate can relieve a lot of unnecessary stress.

Seek professional help 

Sometimes the emotional toll of IVF can be too much. It is okay to seek professional help for you, or even both of you. Support groups that specialize in donor egg IVF can be a wonderful source of psychological and emotional support. As your partner’s main support it is also important for you to find support and time for self-care as well.

Skip baby-oriented events

If you or your partner is struggling with being around children, it is okay to decline invitations to baby showers, birthdays, or family gatherings that will be full of children. These events can trigger some pretty strong emotions. So when you see that invite, take the initiative and be the one to decline and send a gift in the mail.  

If you have a partner who is going through egg donor IVF, there are many things that you can do to help support your partner through this time. What support looks like may mean different things for different people, but one of the main things is that your partner feels that you are their safe place, and ultimately can be themselves and honest with you. Remember, you are both on the same team and only want the best for each other. Knowing you can count on each other to be there when times are tough strengthens the belief that together you can face whatever life throws at you. 

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Epigenetics is a field of study that has gained increasing attention in recent years for its potential implications in various aspects of health and disease. In the context of third-party reproduction, epigenetics plays an important role in the development and growth of embryos, and can also have implications for offspring conceived through assisted reproductive technologies (ART) such as donor egg IVF. In this article, we will explore the concept of epigenetics and how it relates to the use of donor eggs in fertility treatment.

What is epigenetics?

Epigenetics refers to changes in gene expression that occur without a change in the DNA sequence itself. These changes can be heritable and can impact how genes are expressed throughout an individual's lifetime. Epigenetic modifications can occur in response to environmental factors such as diet, stress, and toxins, as well as during embryonic development. These modifications can affect the way that genes are expressed, leading to alterations in cellular function and potentially contributing to the development of certain diseases.

Epigenetics and donor eggs

In donor egg IVF, the genetic material from the egg donor is used to create an embryo that is implanted into the uterus of the intended mother or a gestational surrogate. This means that the resulting offspring will have a different genetic makeup than the intended mother, and therefore may have different epigenetic profiles as well.

Research suggests that epigenetic modifications can occur during embryonic development, and may be influenced by factors such as the age of the egg donor, the method of fertilization, and the environment in which the embryo develops. Studies have found differences in DNA methylation patterns, histone modifications, and gene expression profiles between embryos created using donor eggs and those created using the intended mother's own eggs.

What does this mean for children conceived through donor egg IVF? While it is still unclear what the long-term implications of these differences may be, we know the majority of children conceived through donor egg IVF are healthy and do not experience any adverse health effects related to epigenetic differences.

It begins in the womb

Epigenetics research has revealed that the quality of life inside the womb has a lasting impact on a baby's health. Scientists have found that the most significant influence on gene function occurs in utero, making a birth mother's womb the baby's first and most crucial environment. This underscores the importance of a mother's (or gestational carrier) lifestyle choices in shaping the overall health and well-being of the individual for the rest of their life.

Stress is a significant environmental factor that can influence your child's genetic expression. Managing stress and anxiety during pregnancy can significantly impact the way their baby's genes develop. To cope with stress, there are various relaxation techniques available, including group therapy, meditation, acupuncture, yoga, exercise, journaling, spending time with people you love, and doing things that bring you joy. 

Epigenetics and early childhood

The idea that genes are “set in stone” has been disproven. We now know that early life experiences, such as stress, nutrition, and caregiving, can influence gene expression and ultimately affect a child's development on who they become. 

These epigenetic changes can have long-term effects on physical and mental health, as well as cognitive and behavioral outcomes. The positive experiences you create for your child, such as responsive caregiving and supportive relationships, can also have positive epigenetic effects and promote healthy development.

"The positive experiences you create for your child, such as responsive caregiving and supportive relationships, can also have positive epigenetic effects and promote healthy development."

Will a donor egg baby look like me?

The answer is maybe. There is always a chance – whether genetic, adopted, or born through donor eggs – that a child won’t look like you. There’s also a chance that they will! I know plenty of genetically related children that look nothing like their mother or siblings. But I also know a lot of donor-egg children that look *exactly* like their mothers. In fact, I had no idea one of my closest friends used donor eggs to conceive her children until she confided in me when I began my donor egg journey.

Many families choose to match with a donor with similar physical features, especially for unique features like red hair, blue eyes, or being really tall. But keep in mind – picking a donor that looks like you in no way guarantees the child will look like you or the donor! 

Ethical considerations

The use of donor eggs in fertility treatment raises a number of ethical considerations, particularly when it comes to the potential impact of epigenetic differences on offspring. While it is important for individuals and couples considering donor egg IVF to be aware of the potential implications of epigenetics, it is also important to recognize that the majority of children conceived through this method are healthy and lead normal lives.

Summing it up

Epigenetics is a complex and rapidly evolving field of study with important implications for fertility and reproduction. While the use of donor eggs in IVF can lead to epigenetic differences between offspring and their intended parents, the majority of children conceived through this method are healthy and lead normal lives. 

Even if you use donor eggs or donor embryos, you play a vital role in the development of your baby. While genetics play a role, it's the interaction between genetics and epigenetics that shapes your baby into the individual they become. Don’t forget that you contribute more than you may realize to the growth and development of your child.

If you are considering using donor eggs, register for a free account and get instant access to our egg donor database.

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‍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!

With advances in reproductive technologies, more and more families are turning to in vitro fertilization (IVF) to build their families. While some may experience smooth IVF journeys, others may face obstacles such as poor ovarian response (POR). POR is a condition that can affect your ability to produce an optimal number of eggs during fertility treatment. 

In this article, we will explore what POR means for patients, its prevalence, diagnostic methods, potential treatments, and available options for those diagnosed with this condition.

What is meant by low response to ovarian stimulation?

Poor ovarian response (POR) refers to a suboptimal response (actual or predicted) of the ovaries to stimulation during fertility treatment. 

During IVF, fertility medications are used to stimulate the ovaries, which culminates in the retrieval of multiple eggs. However, those with POR may produce fewer eggs than expected, which can significantly impact their chances of successful conception or even lead to a canceled cycle. 

POR is often associated with reduced ovarian reserve, which refers to the diminished quantity and eggs remaining in the ovaries.

How common is POR?

The estimated prevalence of POR ranges from 6% to 35%. This wide range is primarily due to researchers and clinicians having varying definitions of POR. In fact, one systematic review of 47 studies focusing on POR patients found a staggering 41 different definitions of POR being utilized. 

The likelihood of encountering POR increases with age, as ovarian reserve naturally diminishes over time. However, it is important to know that POR can occur in women of all age groups, including younger patients.

What is considered a “poor response” to IVF? Diagnosing POR

The European Society of Human Reproduction and Embryology (ESHRE) working group established criteria for defining a poor response in IVF. 

According to their report, having two or more of the following three features is considered having poor ovarian response: 

• Advanced maternal age or any other risk factor for POR 
• A history of previous POR
• An abnormal ovarian reserve test 

Or, if you experience two episodes of POR after IVF, it is considered a poor response, even without advanced maternal age or low ovarian reserve. Since the term POR specifically refers to the ovarian response, at least one egg retrieval is required for diagnosis. 

However, patients of advanced age with an abnormal ovarian reserve may also be classified as poor responders because both factors indicate reduced ovarian reserve and can serve as predictors of the outcome of an ovarian stimulation cycle. If that’s the case, a more accurate term would be "expected poor responders."

How IVF can fail

Each fertility journey is unique, and various factors, including underlying medical conditions, genetic factors, and individual response to medications, can influence the ovarian response to IVF.

Sometimes, IVF isn’t even a viable option due to low ovarian reserve. Ovarian reserve refers to the quantity of eggs remaining in the ovaries. Assessing ovarian reserve through markers such as anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) can provide insights into your potential ovarian response to IVF. A predicted poor response may be indicated by low AMH levels or a reduced number of antral follicles observed during ovarian reserve testing.

Sometimes, even with normal ovarian reserve, you can experience an inadequate ovarian response to stimulation medications, which leads to fewer follicles developing than you would hope. Follicles are fluid-filled sacs within the ovaries that contain developing eggs. During an IVF cycle, hormonal medications support the growth and development of multiple follicles to increase the chances of obtaining viable mature eggs for fertilization. In general, 10–15 follicles is considered to be the optimal response to fertility medications during IVF. In cases of poor ovarian response, the ovaries may not respond adequately to these stimulation medications, resulting in limited follicular development. This poor response may be indicated by a reduced number of developing follicles observed during ultrasound monitoring throughout the stimulation phase of the IVF cycle.

Typically, a good IVF response involves the retrieval of a sufficient number of eggs, allowing for a higher likelihood of successful fertilization and subsequent embryo development. But sometimes, you simply don’t get enough eggs. A poor response can also be characterized by a lower-than-expected number of eggs retrieved, which may fall below the average range for your age group.

Is POR curable?

While POR poses challenges, it does not necessarily mean that you cannot conceive. The severity of POR can vary, and treatment options are available to optimize the chances of successful conception.

Treatment strategies for POR aim to improve ovarian response and enhance the chances of successful egg retrieval. The specific approach will depend on a lot of factors, including the underlying causes of POR and any other reproductive health obstacles you face. Some common treatment options include:

• Adjusting stimulation protocols: Your fertility doctor may modify the medication protocols used during IVF to enhance ovarian response. This may involve altering the dosage or type of fertility medications administered.
• Adding supplements: There is some evidence that DHEA and CoQ10 may improve IVF pregnancy rates for those facing POR. 
• Human growth hormone (GH): Some evidence suggests that treatment with GH for POR patients could lead to a higher number of retrieved eggs. 
• Third-party reproduction: In certain cases, fertility doctors may recommend alternative approaches such as the use of donor eggs or embryo adoption. These options can increase the chances of success.

What comes next after POR

Navigating a poor response to IVF can be challenging, and you’ll want to work closely with a fertility doctor who can evaluate the specific circumstances and develop an individualized treatment plan. The treatment approach may involve adjusting medication protocols, exploring alternative techniques, or considering options such as donor eggs.

While a poor response to IVF can be disheartening, it does not signify the end of the fertility journey. Advances in reproductive medicine continue to offer new possibilities and hope for those facing challenges in conceiving. With the right support, guidance, and perseverance, individuals and couples can explore alternative paths and find the best course of action to achieve their dream of building a family.

Get the emotional support you need

Dealing with a diagnosis of POR can be emotionally challenging. It is crucial to recognize the emotional impact and seek support from loved ones, support groups, or mental health professionals who specialize in fertility-related concerns. The journey to conception can be complex, and emotional well-being is an essential aspect of the process.

We are here to help you find the perfect egg donor

At Cofertility, our program is unique. After meeting with hundreds of intended parents, egg donors, and donor-conceived people, we decided on an egg donation model that we think best serves everyone involved: egg sharing. We didn’t invent the concept of egg sharing, but we are the first to take it national (and even global!).

Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

• Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
• Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
• Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
• Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

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 to get started today!

Even if you have accepted your infertility diagnosis and have accepted the idea of using donor eggs to start your family, others around you may still question you and your decision. Sometimes it comes in the form of nobody talking about it and sometimes the pendulum swings in the other direction and you may hear nosy questions such as:

• "Why couldn't you have your own child?"
• "Doesn't it bother you that your child won't be biologically related to you?"
• "Did you have trouble getting pregnant?"
• "Are you worried your child won't look like you?"
• "Did you have to spend a lot of money on this process?"
• "Isn't it weird to use someone else's eggs?"
• "Did you have to convince your partner to do this?"
• “Are you worried one day the kids will want to meet their donor?”

So, what are some things you can say to those “well meaning” but nosy questions?

Set boundaries

It's important to set boundaries with those who may be asking personal questions. You can politely decline to answer by saying that it is a private matter or that you prefer not to discuss it. Setting boundaries isn’t always easy.  But boundaries are important if you want to feel safe and protected. It is okay if the other party feels offended, but healthy boundary setting doesn’t mean you’re being hurtful. The boundaries you set can allow you to build a better, more respectful, relationship because they help establish a precedent for what you both expect from each other. 

Educate 

Even though it may seem obvious to you, some people really do not understand the process of using donor eggs and may be asking out of curiosity. Consider sharing educational resources or information about the process to help them understand better.

Be honest

If you are comfortable sharing, you can be honest about why you chose to use donor eggs. Whether it was due to fertility issues or personal preference, sharing your story can help to normalize the process and reduce stigma and in turn helps educate others around you.

Redirect the conversation

If you don't want to discuss your own experience (which is totally okay), redirect the conversation to a more general topic. You could say, "I appreciate your interest, but I prefer to keep my personal life private. Can we talk about something else?"

Seek support

Coping with nosy questions about using donor eggs can be emotionally challenging. Consider seeking support from a therapist, support group, or other individuals who have gone through a similar experience.

The bottom line

Some questions may come across as tasteless and hurtful. Yes, most of this stems from a lack of knowledge about egg donation, but some of it also comes from a place of genuine curiosity and wanting to understand. At the end of the day, this is your journey and your path. You get to decide who, when and how much information you share.  

If you're considering In Vitro Fertilization (IVF) while using or contemplating a GLP-1 medication, like Ozempic®, you’ll want to understand how these treatments might interact. 

GLP-1 medications are widely considered safe and have been approved by regulatory bodies like the FDA. But, they aren’t safe for everyone. And they may interact with other medications. 

Let’s review the potential benefits, concerns, and important factors you should discuss with your doctors before making any decisions about GLP-1 medication use in conjunction with IVF.

What are GLP-1 medications?

GLP-1s are a class of medications designed to aid in weight loss and blood sugar management, which can indirectly have positive effects on fertility. 

Glucagon-like peptide-1 (GLP-1) is a naturally occurring hormone in the body that plays important roles in digestion, blood sugar regulation, and appetite control. GLP-1 receptor agonists are a class of medications that mimic the effects of GLP-1, leading to several benefits including weight loss, improved blood sugar control, and potential cardiovascular benefits. Common examples of GLP-1 medications include semaglutide (Wegovy®, Ozempic®), liraglutide (Victoza®, Saxenda®), dulaglutide (Trulicity®), tirzepatide (Mounjaro®), and others.

While it feels like these medications have shown overnight success for help with weight loss, they’ve actually been around for a long time. Initially prescribed for the treatment of type 2 diabetes, their weight-loss potential became a notable side effect. This led to further research, higher-dosage formulations specifically for weight management, and the widespread popularity we see today.

​​GLP-1 medications, obesity, and fertility

Obesity is a known factor that can negatively impact fertility treatment outcomes in both men and women.  It's associated with conditions like Polycystic Ovarian Syndrome (PCOS), hormonal imbalances, and changes to the uterine lining that can reduce the chances of successful embryo implantation. 

Since GLP-1 medications aid in weight loss and blood sugar control, they have the potential to improve some of the underlying factors that contribute to infertility. However, more research is needed to really understand how GLP-1 medications can impact IVF outcomes.

Can you do IVF if you are on GLP-1 medications?

It's best to discuss the use of GLP-1 medications directly with both the doctor who prescribes them as well as your fertility doctor. Many doctors recommend pausing GLP-1 medications for a few weeks before procedures involving sedation or anesthesia, including the egg retrieval portion of IVF, to reduce potential risks.

The reason being, there have been reports that the delay in stomach emptying due to the GLP-1 medication could be associated with an increased risk of regurgitation and aspiration of food into the airways and lungs. And, because you are unconscious, you can’t clear your lungs or eliminate the obstruction on your own. There is currently a lack of scientific data on how GLP-1 medications affect patients having procedures like IVF, so most doctors like to play it safe. 

Can you take GLP-1 medications while pregnant?

Even if you're planning to pause GLP-1 medications like Ozempic® for your egg retrieval during IVF, your doctor may not recommend you get back on them after the retrieval if you plan on getting pregnant. That is because these medications are not currently recommended during pregnancy or lactation. The full safety profile of GLP-1 medications is still under investigation.

This means that most OBGYNs will advise you to discontinue GLP-1 medications before attempting to conceive, whether unassisted or through IVF. They will work with you to create a safe and optimal plan for your fertility and pregnancy journey.

Summing it up

While GLP-1 medications offer benefits for weight loss and blood sugar control that may indirectly help with fertility, their direct impact on IVF outcomes and safety during pregnancy needs further research.  You’ll want to have open discussions with your fertility doctor, your prescribing doctor, and potentially your future OBGYN about the best medication strategy for your individual circumstances.

Here are some key points to remember:

• Temporary pause: You might be advised to take a break from GLP-1 medications prior to your egg retrieval procedure.
• Discontinuation before pregnancy: There is not enough human data yet to support GLP-1 medications during pregnancy and lactation, so currently it is not recommended.
• Collaboration is key: Work closely with all your doctors to make the safest and most informed decisions regarding your medication use, fertility treatment, and any pregnancy plans.

Research into the relationship between GLP-1 medications and fertility is ongoing. As we gather more data, clearer guidelines may emerge regarding safe and effective use of these medications alongside IVF treatment.  It's always encouraged to consult with your doctors for the latest information and recommendations specific to your situation. We wish you all the best!

Going through fertility treatments to build your family is hard enough, deciding when it’s time to move onto donor eggs can feel impossible. It’s not just the genetic tie that you might be thinking about, but also the time, money, and commitment. 

How many attempts with your own eggs are reasonable before considering alternative options like donor eggs? While there's no single right answer, this guide will help you confidently make your decision.

First consideration: your age

Understanding the impact of age on fertility is helpful. Knowing the chances of IVF success with and without IVF can help you predict the chances of it working in either scenario.  

Females are born with a finite number of eggs, and both the quantity and quality of those eggs diminish over time. This decline in fertility accelerates significantly after the age of 35. According to the Society for Assisted Reproductive Technology (SART), the average live birth rate per IVF cycle using a woman's own eggs is around 53% for women under 35, but falls to just 4% for women over 42. These statistics highlight the challenges associated with using your own eggs at an older age.

If you have already spent a lot of time, effort, and money on failed IVF, you may be eager to move forward with donor eggs and have a baby ASAP. The good news is that the chances of success with donor eggs has more to do with the age of the donor than the age of the mother (or gestational carrier). 

The time to match with a donor can be just days (we have hundreds of pre-qualified donors ready to match with your family). After that, a donor cycle with fresh eggs can take 60-90 days from match to completion of the cycle. Frozen eggs can be quicker, but it sometimes means you can’t meet the donor beforehand.  

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As you can see from the SART data above, the chances of getting pregnant per cycle is much higher with donor eggs and the gap increases with age of the patient. 

Read Dr. Meera Shah’s article Donor Egg Success Rates: a Breakdown.

Second consideration: your ovarian reserve

Your fertility doctor will likely perform a series of tests to assess your ovarian reserve – the remaining supply of eggs in your ovaries.  These tests provide a more personalized estimate of your chances of success using your own eggs. Key tests include:

• Follicle-Stimulating Hormone (FSH): A high FSH level, particularly on day 3 of your menstrual cycle, can indicate diminished ovarian reserve.
• Anti-Mullerian Hormone (AMH): A low AMH level suggests a lower egg count and may signify reduced responsiveness to fertility medications.
• Antral Follicle Count (AFC): Performed via ultrasound, this test counts the number of small, developing follicles in your ovaries. A lower count could indicate a lower ovarian reserve.

These hormone tests will give you and your doctor a good idea of your chances of success. In fact, your chances of success with IVF are even more correlated with your AMH than your age. 

Third consideration: the emotional impact of unsuccessful attempts

The journey of infertility often comes with significant emotional burdens. Experiencing multiple unsuccessful attempts with your own eggs can lead to disappointment, frustration, anxiety, and even depression. It's super important to prioritize your mental health during this process. Seek support from therapists specializing in infertility, join support groups, or lean on loved ones for emotional strength.

Think about how many failed attempts using your own eggs you are willing to endure before moving on. And keep in mind, donor eggs may increase your chances of success but they aren’t a guarantee. 

Fourth consideration: finances

Unfortunately, fertility treatments can be costly, and using donor eggs will likely increase those expenses. Before making decisions, have a realistic understanding of your financial resources.  Explore options like insurance coverage, financing plans, or grants that might help offset treatment costs.

Read more in How to Finance Your Infertility or Egg Donation Journey

Fifth consideration: time

Time is a precious factor in the fertility journey, especially as you grow older.  Every month, every cycle, counts. If you've experienced multiple unsuccessful IVF attempts with your own eggs, the time it takes to pursue additional cycles may significantly impact your chances of achieving a successful pregnancy.  And, as you age, it increases the likelihood of a higher risk pregnancy. It's important to consider your desired timeline for building a family and how pursuing further IVF with your own eggs may align with those goals.

When should I switch to donor eggs?

While there's no hard-and-fast rule, your doctor may suggest donor egg IVF if you meet some of these criteria:

• Age over 42: Success rates with own eggs decline sharply after 42, and donor eggs offer a significantly higher chance of pregnancy.
• Diminished ovarian reserve: Test results indicating low ovarian reserve may encourage a quicker transition to donor eggs to increase your chances of success, especially if you’re over age 40.
• Multiple failed cycles or pregnancy losses: After several unsuccessful attempts with your own eggs, it may be time to explore other options to avoid further emotional and financial strain.
• Genetic factors: If you are a carrier of a genetic condition, using donor eggs can minimize the risk of passing it on to your child.

Ultimately, the decision of whether to continue with IVF using your own eggs or transition to donor eggs is deeply personal. There is no right or wrong choice.  The best way to navigate this decision is through open communication with a trusted fertility doctor, a counselor, fertility coach, or even a religious leader if your faith plays a significant role in your family planning decisions. They can assess your individual circumstances, discuss the pros and cons in greater detail, and help you make a decision that aligns with your goals and values.

Remember: There is no shame in using donor eggs. It's a testament to your unwavering desire to build a family. Choosing donor eggs empowers you to take control of your fertility journey and create the family you've always dreamed of.

Finding your path to parenthood

The journey to parenthood can take many unexpected turns. While the desire for a biological connection is understandable, remember that the love you have for your future child transcends genetics.  If you decide to move forward with donor eggs, you're making a powerful choice based on love, commitment, and your unwavering determination to build a family.

Donor eggs offer a path to parenthood that might have seemed impossible before. Don't hesitate to explore this option with open-mindedness and a willingness to learn.  Connect with agencies like ours that specialize in egg donation, we can guide you through the process, address your concerns, and provide the support you need throughout your journey.

You are not alone. Communities, support groups, and mental health professionals specializing in infertility can offer invaluable support and understanding.

Remember: Building a family is guided by love. Whether through your own eggs or through the generosity of a donor, you are embarking on a beautiful journey toward fulfilling a profound desire.

Read more:

• I'm a Fertility Psychologist. Here's What I Want You to Know About Growing Your Family Through Egg Donation
• Does Using Donor Eggs Decrease the Chance of Miscarriage?
• Six Reasons Why Egg Sharing is a Better Egg Donation Model for Intended Parents

More and more families are turning to In Vitro Fertilization (IVF) to build their families. In fact, 2% of all babies in the U.S. are now born thanks to IVF. For a treatment that’s only been around for 40 years, that’s a lot of babies!

But, many more people undergo IVF than successfully have babies via IVF. About 21.3% percent of IVF cycles using fresh embryos have a live birth. Some people have to go through multiple cycles in order to have their miracle babies. Others end up needing donor eggs. And yet others pursue other life options.  

IVF success is highly correlated with the age of the mother. Understanding this age-related impact can help set realistic expectations and make informed decisions about fertility treatment, and this article will help spell it all out for you. 

The biological basis: egg quantity and quality

As females age, our ovarian reserve–the number of remaining eggs–naturally diminishes. The quality of those existing eggs also declines over time. Older eggs are more prone to chromosomal abnormalities, which can hinder successful fertilization and healthy embryo development. This natural, age-related decline is the primary factor driving lower IVF success rates in older people.

IVF and Age

The influence of age on IVF outcomes is an unfortunate, but undeniable part of biology and life. As we've discussed, this is primarily due to the natural decline in both the quantity and quality of eggs as someone gets older. This age-related impact can be disheartening for those who want to start a family “later” in life, but it’s always better to be equipped with this knowledge. Here's why understanding this relationship is important:

• Realistic expectations: Being aware of how age affects potential success rates helps you set realistic expectations from the outset of your IVF journey. This knowledge allows you to be mentally and emotionally prepared for the possibilities.
• Informed decision-making: Understanding the role of age empowers you to make informed decisions about your fertility treatment. If you are of older maternal age, you might consider a shorter time frame between IVF cycles, explore options like donor eggs earlier in the process, or consider alternative paths to family building.
• Proactive planning: For younger people considering IVF in the future, awareness of this age-related aspect might motivate proactive measures like egg freezing to preserve fertility potential.

There are of course a host of other factors that go into fertility beyond just someone’s age. And, remember that IVF success isn't solely about the female partner. Any underlying male factor infertility will also play a role in IVF outcomes.

Let’s look at the data: IVF success rates by age

Reliable sources like the Society for Assisted Reproductive Technology (SART), which is part of the Centers for Disease Control and Prevention (CDC), provide valuable insights into IVF outcomes by age. 

According to SART data from 2021, live birth rates per egg retrieval using someone's own eggs for IVF are significantly impacted by age, showing a clear downward trend as we get older.  

• Under 35: 44.5%
• 35-37: 32.4%
• 38-40: 20.2%
• 41-42: 9.6%
• Over 42: 2.9%

While age is a major predictor, it's not the only factor influencing IVF success.  The underlying cause of infertility, overall embryo quality, lifestyle choices (like smoking or unhealthy weight), sperm health, and the specific clinic's success rates all play a role in the outcome.  You’ll want to consider these additional variables when assessing your individual chances of success.

Donor eggs increase your chances of a healthy pregnancy at all ages

Here’s some good news: donor eggs can drastically increase your chances of success. Around 53 percent of all donor egg cycles will result in at least one live birth. This percentage varies depending on the egg donor, recipient body mass index, stage of embryo at transfer, the number of oocytes retrieved, and the quality of the clinic.

At every age, the chances of birth with donor eggs is better, but those who benefit the most from donor eggs are those over 35 and those with low ovarian reserve. In fact, about one-quarter of people over 40 who succeeded with IVF did so through the use of donor eggs. 

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The chart was made using the SART Patient Predictor for an average woman (5’4”, 150 lbs) with diminished ovarian reserve. As you can see, the chances of live birth after one donor egg cycle is 54% for recipients under 40, and only goes down slightly after this.

Summing it up

IVF can be a big commitment– physically, emotionally, and financially. It's natural to feel a mix of hope and anxiety throughout the process.  Knowledge is empowering; by understanding how age impacts IVF outcomes, you can make decisions that align with your values and goals.  

Remember, statistics represent trends, not individual destinies. While they give us a general picture, each person's fertility journey is unique.  If you are of older maternal age, it doesn't automatically mean IVF won't work for you. Exploring options like using donor eggs or pursuing alternative paths to parenthood should all be part of your informed decision-making process.

The IVF experience can sometimes feel isolating.  Don't be afraid to seek support from your loved ones, mental health professionals, or online communities dedicated to infertility and IVF.  Connecting with others who understand the challenges and triumphs of this journey can be a source of strength and encouragement.

Find an egg donor through Cofertility

We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

• Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
• Donor empowerment. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family. It’s a win-win.
• Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
• Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

For those who match with a donor in our fresh egg donation program, the average number of mature eggs a family receives and fertilizes is 12. The number of eggs retrieved varies by patient and cycle, but can be predicted by a donor’s age, AMH, and antral follicle count, all of which will be known to you after the donor’s initial screening. Qualified candidates have an ample ovarian reserve for both their own needs and sharing. Egg share donors also often work closely with a fertility doctor to determine, based on their own medical history, the optimal number of eggs needed for their own future family-building goals. Should it make sense for the donor, they may choose to pursue a second egg-sharing cycle to maximize the chances of success for everyone.

Matching with a donor in our frozen program can provide the opportunity to move forward with your family-building plans faster, as frozen eggs can be fertilized or shipped to your clinic immediately or as soon as the cycle is complete. Donors undergoing frozen cycles complete equally rigorous ovarian reserve testing. While the total number of frozen eggs available will vary based on the donor’s retrieval outcomes, every frozen match is guaranteed to have a minimum of at least 6 frozen eggs. 

To learn more about these programs and the differences between them, click here.  

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 to get started today!

Read more:

• What You Should Know About Getting Pregnant with Donor Eggs in Your 40s and 50s
• What Parents via Egg Donation Want You To Know
• Six Reasons Why Egg Sharing is a Better Egg Donation Model for Intended Parents
• I'm a Fertility Psychologist. Here's What I Want You to Know About Growing Your Family Through Egg Donation

Genetic carrier screening is an important part of family building with assisted reproductive technologies (ART), particularly donor egg IVF.  It provides essential information about the genetic makeup of both donors and recipients (the person receiving the eggs), enabling them to make informed decisions about their family-building journey and increasing the chances of a healthy baby. 

Carrier screening helps assess the risk of passing on inherited genetic conditions to future offspring. It empowers intended parents to understand their risks and make proactive choices about their reproductive health. In this article, we’ll dive deeper into what carrier screening is, its significance in donor egg IVF, and the different options available.

What is carrier screening?

Carrier screening is a type of genetic testing that reveals whether an individual "carries" a gene linked to a particular genetic disorder. Being a carrier doesn't mean a person has the disease themselves, but they have the potential to pass the gene to their offspring. This type of screening originally emerged in the 1970s to prevent the transmission of certain diseases, focusing mainly on high-risk ethnic groups with known elevated chances of carrying specific disorders, such as Tay–Sachs disease in the Ashkenazi Jewish populations.¹

Over time, carrier screening has evolved and advanced. In 2010, expanded carrier screening (ECS) emerged as a more affordable and comprehensive option². This allows for testing hundreds of genes, not just the handful targeted in older methods. ECS is offered regardless of a person's ancestry or ethnicity, as it aims to identify carriers for a wider array of genetic conditions. The American College of Medical Genetics and Genomics (ACMG) now recommends a standardized panel for carrier screening, including a list of 113 conditions.³

Most carrier screening today focuses on recessive disorders. These conditions only manifest when a child inherits two copies of a mutated gene, one from each parent. If only one copy is inherited, the person is considered a carrier. Carriers typically don't experience any symptoms of the disorder, or might have very mild ones, and often remain unaware of their carrier status.⁶

ASRM recommendations

The American Society for Reproductive Medicine (ASRM) strongly recommends that all egg donors be screened for cystic fibrosis, spinal muscular atrophy, and conditions like thalassemia and sickle cell disease.⁴ Additionally, screening for fragile X syndrome is recommended for donors with a family history of related disorders, and may be considered for all donors regardless of their history. 

The ASRM also suggests that expanded carrier screening (ECS), which looks at a wider range of genetic conditions, should be considered, ideally using the same panel for both the egg donor and the intended parent.⁴ While this isn't always mandatory, it's the most effective way to assess potential risks to future children. These recommendations are meant to guide decision-making, not create rigid rules. You’ll want to talk to your fertility doctor about tailoring these recommendations to your specific situation.

How is carrier screening done? 

Genetic carrier screening for both egg donors and recipients typically involves a simple blood test or saliva sample. The lab then analyzes the DNA within the sample for specific gene variants or mutations that might increase the risk of certain genetic conditions. The results are usually ready within 3-4 weeks and are discussed with a genetic counselor and/or your fertility doctor.

What does a positive carrier screen mean?

A positive result means that the person tested carries one copy of a gene mutation associated with a specific condition. Research suggests that all individuals carry at least one genetic variant that could lead to a severe recessive childhood disease. Therefore, as expanded carrier screening panels test for a greater number of genes and associated conditions, the likelihood of a positive carrier screen also increases.⁷ 

Remember, being a carrier doesn't mean you have the condition yourself. However, if both you and the donor (or your partner in the case of autologous IVF) are carriers of the same recessive condition, there is a higher risk of your child inheriting the condition.

What does a negative carrier screen mean?

A negative result means that no mutations were detected for the conditions tested. While a negative carrier screening result is reassuring, it's important to understand it doesn't completely eliminate the risk of passing on a genetic condition. Current technology allows us to test for a wide range of known genetic mutations, but it's impossible to screen for every possible one.⁵

Are genetic carrier screens accurate?

While carrier screening is generally reliable, it's important to understand that, like any medical test, there is a small chance of receiving inaccurate results.⁶

• False negative: This occurs when the test indicates a negative result, suggesting the absence of a gene variant, even though the individual is actually a carrier for the condition.
• False positive: This happens when the test indicates a positive result, indicating the presence of a gene variant, even though the individual does not actually carry it.

While false-positive results can lead to anxiety and further testing, false-negative results can be more concerning as they may provide false reassurance about the risk of passing on a genetic condition. That being said, these tests are considered safe and reliable. 

How is carrier screening different from PGS testing?

If you plan to do preimplantation genetic screening (PGS) of embryos, do you also have to do carrier screening? And if you do carrier screening, do you still have to do PGS testing of embryos? It's important to understand that carrier screening and PGS are not the same thing:

• Carrier screening: This tests the egg donor's genes as well as the intended father’s (or sperm donor’s) genes to assess the risk of passing on certain genetic conditions. Your future child could inherit a condition if both parties carry the same recessive gene.
• PGS (also called PGT-A): This tests embryos created during IVF for chromosomal abnormalities. This can help identify embryos with the highest chance of leading to a healthy pregnancy.

While both carrier screening and PGS testing play important roles in IVF, they serve different purposes. Carrier screening identifies potential risks carried in the DNA of the intended mother (or egg donor) and intended father (or sperm donor), while PGS assesses the chromosomal health of embryos after they've been created. 

Most families choose to undergo both carrier screening and PGS. Carrier screening helps you understand if you or the potential donor carry recessive genes, which helps during the donor matching process. Most clinics would not recommend a recipient move forward with a particular donor if both the sperm source and the donor are carriers for the same gene. With Cofertility, we’d offer a free rematch in this scenario. PGS, on the other hand, ensures the embryos being transferred are chromosomally normal, increasing the chances of a successful pregnancy and reducing the risk of miscarriage.

Even if you have a normal carrier screen with no known genetic risks, eggs can still carry an incorrect number of chromosomes, a condition called aneuploidy. Aneuploidy increases with age and affects ~10–25% of eggs in women in their early 30s, and more than 50% of eggs from women over 40. This is why the use of donor eggs is so common for women over 40. 

Ultimately, the decision of whether to pursue either or both types of testing is up to you, best made in consultation with your fertility doctor and a genetic counselor. They can help you weigh the benefits and limitations of each test based on your individual circumstances and family history.

Why is carrier screening important in donor egg IVF?

Carrier screening is important when using donor eggs because it allows both the egg donor and the intended father (or sperm donor) to be tested for the same set of genetic conditions. If both the donor and the intended father (or sperm donor) are carriers for the same condition, the risk of passing that condition to their child increases significantly. By knowing this information beforehand, you and your doctor can make informed decisions about which donor to match with. 

What do different panels mean?

Carrier screening panels can vary in the number and types of conditions they test for. There are smaller panels that focus on common recessive disorders and larger, expanded carrier screening (ECS) panels that look at a broader range of conditions. Many clinics recommend donors complete a panel around 275 genes, but  there isn't one "right" panel for everyone.  Your fertility doctor will be able to help recommend a test that aligns with your individual risk factors and family history.

Do we need to use the same carrier screening test as the donor?

There are several genetic testing companies, including Natera, Fulgent, Myriad, and each has panels of varying sizes. When you’re working with a donor, the testing company doesn’t have to be the same, but you will want to make sure the panel looks at the same set of conditions. This ensures that you are both screened for the same things, allowing for accurate risk assessment. If you’ve already completed testing, you can share the panel you completed ahead of time to ensure that your donor is tested for the same genes.

What's the difference between carrier screening and genetic counseling?

Genetic counseling is a process where a trained healthcare professional, called a genetic counselor, guides individuals or families through complex information about genetic health. They provide support and education about how inherited conditions might affect them or their children, interpret genetic test results, and help them make informed decisions about their healthcare.

Carrier screening is best done in conjunction with genetic counseling. A genetic counselor can help you understand your results, discuss the implications, and navigate any decisions about family planning.

The bottom line

Carrier screening is an important tool in the donor egg IVF journey, offering a window into the genetic health of both donors and recipients. By proactively understanding your genetic risks, you gain the power to make informed decisions about your family-building options. While a positive result may seem daunting, it doesn't automatically rule out certain paths. With guidance from your doctor and a genetic counselor, you can explore various possibilities to ensure the best possible outcome for your future child.

Remember, genetic carrier screening is not about eliminating all risk, as no test is perfect. It's about empowering you with knowledge and enabling you to navigate this process with more confidence. If you're considering egg donation, don't hesitate to talk to your fertility doctor about carrier screening. It's an important step towards building a healthy and happy family.

References

1. Kraft, S.A., Duenas, D., Wilfond, B.S. et al. The evolving landscape of expanded carrier screening: challenges and opportunities. Genet Med 21, 790–797 (2019). https://doi.org/10.1038/s41436-018-0273-4
2. Srinivasan BS, Evans EA, Flannick J, et al. A universal carrier test for the long tail of Mendelian disease. Reprod Biomed Online. 2010;21(4):537-551. doi:10.1016/j.rbmo.2010.05.012
3. Crockin S, Gibbons W. Genetic carrier screening in donors: a challenging frontier. F S Rep. 2023;4(1):20-21. Published 2023 Feb 8. doi:10.1016/j.xfre.2023.02.003
4. ASRM. “Guidance regarding gamete and embryo donation”.  2021. URL.
5. CDC. “Genetic Testing”. 2022. URL. 
6. ACOG. “Carrier Screening”. 2022. URL. 
7. Payne MR, Skytte AB, Harper JC. The use of expanded carrier screening of gamete donors. Hum Reprod. 2021;36(6):1702-1710. doi:10.1093/humrep/deab067

Choosing a fertility clinic is a significant decision. While the expertise and bedside manner of the Reproductive Endocrinologist (REI) is what most patients focus on, there's another important aspect that often remains hidden in plain sight: the IVF laboratory.

The lab is where your embryos will be created, nurtured, and stored – so it's essential to ensure they have the expertise, technology, and track record to optimize your chances of success. 

In this article, I’ll share key questions you can ask to ensure your chosen clinic has a lab that can maximize your chances of success.

First off, why is a good IVF lab important?

Within the controlled environment of the lab, highly skilled embryologists meticulously handle your eggs, sperm, and embryos, employing cutting-edge technologies and adhering to rigorous protocols. This is where fertilization takes place, where embryos develop, and where critical decisions are made that can significantly impact your chances of achieving a healthy pregnancy.

A high-performing IVF lab will impact the chances your fertility treatment is successful. Even the most experienced and compassionate REI cannot compensate for a lab that lacks state-of-the-art equipment, meticulous protocols, or a team of highly trained embryologists.

You may never see the lab, but it still plays an enormous role. It's where your eggs and sperm are carefully prepared for fertilization, where delicate procedures like intracytoplasmic sperm injection (ICSI) are performed, and where your embryos are nurtured and monitored during their crucial early stages of development. The lab's environment, technology, and expertise directly influence the quality and viability of your embryos, ultimately affecting your chances of a successful pregnancy and a healthy baby.

By asking the right questions and understanding the key factors that contribute to a lab's success, you can ensure that your embryos are in the best possible hands, increasing your chances of achieving your dream of parenthood. So let’s take a look at some of the questions you can ask:

Embryologist qualifications and staffing:

1. Education: What are the educational backgrounds of the embryologists? Ideally, they should have master's degrees or higher in reproductive science or a related field. Some states, such as New York, New Jersey, Florida, and California, have specific requirements for the laboratory director.
2. Experience: How many years of experience do the embryologists have? Inquire about their specific experience with procedures relevant to your case (e.g., ICSI, PGT-A). 

The lab supervisor should have documented completion of training in and performance of a minimum of 60 ART procedures under supervision with attestation from the training laboratory. 

3. Staffing levels: How many embryologists are on the team? The American Society for Reproductive Medicine (ASRM) recommends 2-3 embryologists at minimum for clinics with under 150 annual cycles. That number goes up to 4-5 for clinics with 301–600 annual cycles. It’s also good to ask whether the lab director is on site or not.
4. Communication: How often will I receive updates on my embryos' development? Will you hear from the lab or your fertility doctor? Clear and frequent communication is helpful to feeling informed and involved in your IVF journey.

Lab technology and procedures:

5. Disaster preparedness: How are the embryos stored? Every ART laboratory needs to maintain an up-to-date disaster preparedness or emergency plan which includes robust protocols for power outages or disasters, such as backup generators and alarm systems. 
6. Incubators: What type of incubators do you use? The most advanced labs use "desktop" incubators with 5% oxygen levels, which mimic the conditions of the fallopian tube and promote embryo development. Avoid labs that use "big box" incubators with 20% oxygen.
7. Cleanliness: How often are the incubators and other equipment cleaned and maintained? Rigorous hygiene practices are essential to prevent contamination and ensure embryo health.
8. Air quality: What measures are in place to control air quality within the lab? IVF labs should have specialized air filtration systems to remove particles and pollutants.

Note: Questions 6-8 are not necessary to ask if your clinic has good success rates, as you can assume they are doing the little things right. However, they could be helpful if the clinic is new or does not have known success rates.

Lab performance and outcomes

9. Certification and accreditation: Is the lab certified? The Society for Assisted Reproductive Technology (SART) requires its members to have an embryology laboratory that is accredited by either the College of American Pathologists (CAP) or The Joint Commission (TJC). 
10. Fertilization rates: What percentage of the eggs fertilize? A good lab should have a fertilization rate between 65-70%. 
11. Blastocyst development rate: What percentage of embryos reach the blastocyst stage (day 5 or 6) in your lab? A good lab should have a 50% blastocyst rate.
12. ICSI or insemination: Does the lab do 100% ICSI or do they use conventional insemination? Every clinic has their own protocol, and most are 100% ICSI.
13. Success rates: Can you provide data on the clinic's IVF success rates, specifically for patients with similar characteristics to me? Ask about live birth rates, pregnancy rates, and implantation rates. You can also refer to SART.org for this data.
14. Research involvement: Does the lab participate in any ongoing research or clinical trials? Participation in research can indicate a commitment to staying at the forefront of IVF technology and techniques.

The IVF lab isn't just a sterile environment filled with microscopes and petri dishes; it's the birthplace of your dreams, the silent partner working tirelessly to bring your hopes for a family to fruition. By taking the time to investigate and understand the inner workings of the lab, you empower yourself to make informed decisions about your fertility treatment.

Remember, your journey to parenthood and the choice of an IVF clinic should reflect your individual needs and priorities. Don't hesitate to ask the hard questions and seek out detailed information. A good clinic will be proud of their lab and willing to share answers to all your questions! I’m wishing you the best of luck on your journey!

Read more:

• What are Some Tips on How to Find the Best Fertility Clinic?
• IUI vs. IVF: Can Success Rates Help Me Choose?
• Does Insurance Cover IVF? (Please Say Yes!)
• How Common is Donor Egg IVF?

For gay men embarking on the journey to fatherhood, egg donation and surrogacy offer a promising path to creating the family they've always dreamed of. This route to parenthood, while filled with excitement and hope, also comes with a unique set of considerations and decisions. Among these, the role of genetics in egg donation is a topic we’re often asked about. 

Many prospective gay dads find themselves grappling with questions about genetic inheritance, donor matching, and the biological connections that will shape their future child. This article aims to demystify these genetic factors, providing a comprehensive guide to understanding the role of DNA in egg donation. By breaking down the science into accessible terms and exploring the practical implications, we hope to equip prospective gay dads with the knowledge they need to navigate this journey with confidence. 

Whether you're just starting to explore your options or you're further along in the process, this guide will offer valuable insights to help you make informed decisions as you take this exciting step towards fatherhood.

Understanding genetics in reproduction

Genetics plays a big role in human reproduction, influencing everything from physical traits to predispositions for certain health conditions. Each biological parent contributes 50% of their genetic material to their offspring, resulting in a unique combination that determines the child's characteristics.

During the reproductive process, an egg and sperm each contribute 23 chromosomes, forming a complete set of 46 chromosomes in the resulting embryo. These chromosomes carry thousands of genes that influence traits such as eye color, height, and even aspects of personality and intelligence.

In third-party reproduction, genetic material or gestational services from a third party, someone who is not the intended parent, is utilized to have a baby. This broadens the possibilities for those who may not be able to conceive using their own gametes (eggs and sperm) or carry a pregnancy themselves. If donor eggs are used, as is the case with gay dads, then the child will share DNA with the egg donor.

While genetics play a significant role, environmental factors also contribute to a child's development. The interplay between genetics and environment, known as epigenetics, is a growing field of study that highlights the complexity of human development.

Using donor eggs

For gay male couples, creating a family often involves using donor eggs and a surrogate. The egg donation process typically begins with selecting a donor, followed by in vitro fertilization (IVF) where the donor's eggs are retrieved and fertilized with sperm from one (or both!) of the intended fathers.

At Cofertility, the egg donor selection process is thoughtful and comprehensive. Potential donors undergo rigorous screening, including genetic, medical, and psychological evaluations. Intended parents can review detailed profiles of donors on our website, which include information about physical characteristics, medical history, educational background, and personal interests.

Once your family matches with a donor, her eggs are retrieved and fertilized in a laboratory setting. Or, if you match with an egg donor who has already frozen her eggs, the eggs will be shipped to your fertility clinic. The resulting embryos are then transferred to a surrogate who will carry the pregnancy to term. This process allows gay couples to have a child who is genetically related to one of the fathers.

Read more in Gay Men Having Babies: Four Genetic Options with Donor Eggs

The genetic influence of the egg donor

The egg donor contributes half of the genetic material to the child, influencing many physical and potentially some behavioral traits. This genetic contribution means that the choice of egg donor can have a significant impact on the future child's characteristics.

When selecting an egg donor, intended parents often consider factors ranging from physical appearance to health history, ethnicity, and even talents. If one intended father is providing the sperm, some couples may seek a donor who shares similar traits to the non-biologically related father to create a sense of physical connection with both parents.

Genetic screening is a required part of the egg donation process. Donors undergo genetic testing to identify whether they are carriers for any potential hereditary conditions. This screening helps minimize the risk of passing on any genetic disorders to the child.

Balancing genetic and non-genetic factors in donor selection

While genetics are important, they're not the only factor to consider when choosing an egg donor. Non-genetic aspects such as the donor's personality, values, and life experiences can also be significant. Some intended parents find comfort in choosing a donor whose personal qualities align with their own.

It's also important to remember that while genetics influence many traits, they don't determine everything about a person. Environmental factors, including parenting and life experiences, play a substantial role in shaping a child's development and personality.

We live in a world where adoption, step and foster families and blended families are the norm. 

Research shows that in general, there are no differences in the bonds created between parents and children born unassisted versus those born through surrogacy or egg donation. 

The psychological impact

The decision to use an egg donor can have psychological implications for both the intended parents and the future child. For the parents, it may involve coming to terms with the lack of a genetic connection for one father. It's normal to experience a range of emotions during this process, and many find it helpful to work with a mental health professional who specializes in fertility and family building.

For the child, questions of identity and genetic origins may arise as they grow older. Being open and honest about the child's conception story from an early age can help foster a healthy understanding of their unique family structure.

Read more in I'm a Fertility Psychologist. Here's What I Want You to Know About Growing Your Family Through Egg Donation

Summing it up

Understanding the role of genetics in egg donation is important for gay couples pursuing fatherhood. While genetics play a significant role in shaping a child's characteristics, it's important to remember that love, nurture, and shared experiences are equally vital in creating a family bond.

As you navigate egg donation, don't hesitate to reach out to us. We can help provide support and educational information tailored to your unique situation.

Cofertility is committed to supporting LGBTQ+ families throughout their family-building journey. We aim to make the path to parenthood as smooth as possible for gay dads-to-be. Remember, your journey to fatherhood is unique, and there's no one-size-fits-all approach. Trust in your ability to make the best decisions for your future family, and embrace the exciting path ahead. Your family’s story has many authors, and science is just one of them.

Read more:

• The Gay Dad's Guide to Egg Donation
• Which Should I Find First: An Egg Donor or a Surrogate?
• Preparing for Parenthood as a Gay Couple Using Donor Eggs: Tips from a Fertility Psychologist
• Gay Men Having Babies: Four Genetic Options with Donor Eggs

In vitro fertilization (IVF) is often seen as a beacon of hope for those struggling with infertility. However, the journey to parenthood through IVF isn't always straightforward, and for many, it can end in disappointment. If you're reading this because your IVF treatment didn't result in a successful pregnancy, know that you're not alone. At Cofertility, we understand the emotional toll this can take, and we're here to support you through this challenging time.

In this article, we'll explore the reality of IVF success rates, reasons why IVF might not work, and most importantly, what steps you can take moving forward. We'll discuss how to process your emotions, decide whether to continue treatment, and understand your options, including egg donation. We'll also walk you through what to expect after a failed IVF cycle and provide guidance on making the difficult decision to try again or explore other paths to parenthood. Our goal is to provide you with comprehensive, compassionate information to help you navigate this challenging phase of your fertility journey.

The reality of IVF success rates

Before we dive into next steps, it's important to understand that IVF failure is more common than many people realize. According to the Society for Assisted Reproductive Technology (SART), the average live birth rate for IVF across all age groups is around 30% per egg retrieval. This means that for about 70% of cycles, IVF doesn't result in a live birth.

These statistics aren't meant to discourage you, but to help you understand that if IVF didn't work for you, you're in the company of many others who have faced similar challenges. It's a difficult reality, but it's also an opportunity to reassess, regroup, and consider your options moving forward.

Reasons IVF doesn't work

Understanding why IVF might not have been successful can be crucial in deciding your next steps. While every situation is unique, here are some common reasons why IVF cycles may not result in pregnancy:

• Age factor: As women age, both the quantity and quality of eggs decrease, making the number of viable embryos per cycle fewer.
• Embryo quality: Sometimes, even if fertilization occurs, the resulting embryos may not be of high enough quality to implant successfully.
• Implantation issues: In some cases, the uterine environment may not be receptive to embryo implantation.
• Genetic factors: Chromosomal abnormalities in embryos can prevent successful implantation or lead to early miscarriage.
• Underlying health conditions: Certain medical conditions, such as endometriosis or autoimmune disorders, can affect IVF success rates.
• Lifestyle factors: Smoking, excessive alcohol consumption, and being significantly overweight or underweight can all impact IVF success.
• Unexplained factors: Often, despite everything appearing to be optimal, IVF still doesn't result in pregnancy for reasons that aren't fully understood.

What to do when IVF doesn't work?

1. First, process and give yourself time to grieve

The emotional impact of a failed IVF cycle shouldn't be underestimated. It's completely normal and valid to feel a range of emotions - disappointment, anger, sadness, or even a sense of loss. It is so important to acknowledge these feelings and give yourself time to process them.

Consider the following steps:

• Allow yourself to feel: Don't try to suppress your emotions. It's okay to cry, to be angry, or to feel whatever you're feeling.
• Seek support: Talk to your partner, friends, or family. Consider joining support groups or speaking with a therapist who specializes in fertility issues.
• Practice self-care: Engage in activities that bring you comfort and joy. This might be anything from reading a book to taking a relaxing bath or going for a walk in nature.
• Take time off if needed: If possible, take some time off work or reduce your commitments to focus on your emotional wellbeing.

Remember, there's no set timeline for grieving. Be patient with yourself and take the time you need.

2. Then decide if you want to keep trying with IVF

After you've had time to process your emotions, the next step is to consider whether you want to continue pursuing fertility treatments. This is a personal decision that depends on various factors, including:

• Your emotional readiness
• Your financial situation
• Your age and overall health
• Your doctor's recommendations
• Your personal values and beliefs

It's important to have open and honest conversations with your partner (if applicable) about your feelings and expectations moving forward. Remember, it's okay if you're not on the same page immediately - these discussions often take time.

3. Know your options, including egg donation

If you decide to continue your fertility journey, it's important to understand all your options. These may include:

• Trying another round of IVF
• Exploring egg donation
• Looking into embryo adoption
• Considering traditional adoption
• Choosing to live child-free

At Cofertility, we specialize in egg donation and believe it can be a wonderful option for many individuals and couples. Egg donation can significantly increase the chances of a successful pregnancy, especially for those who have had multiple failed IVF cycles or who are of advanced maternal age.

Our unique Split program allows intended parents to receive half of the eggs retrieved from a donor, while the donor keeps the other half for her own family-building journey. This approach not only makes egg donation more accessible but also creates a special connection between donors and recipients.

What is the process after a failed IVF?

If you decide to pursue further treatment after a failed IVF cycle, the process typically involves the following steps:

1. Follow-up consultation: Your fertility doctor will review your cycle in detail, discussing what went well and what could be improved.
2. Additional testing: Your doctor may recommend further tests to identify any issues that might have contributed to the unsuccessful cycle.
3. Treatment plan adjustment: Based on the review and any new test results, your doctor may suggest modifications to your treatment plan. This could involve changes in medication, different timing, or alternative options like egg donation.
4. Mental health support: Some clinics offer counseling services or can refer you to mental health professionals specializing in fertility issues.
5. Physical preparation: If you decide to try again, you may choose to wait for a certain period to allow your body (and mind) to recover. Use this time to focus on your overall health and wellness.

Looking ahead with hope

Regardless of the path you choose, know that there is hope. At Cofertility, we've seen many individuals and couples find their way to parenthood through various means, including egg donation. We've also supported those who have chosen to embrace a child-free life and find fulfillment in other ways.

If you're considering egg donation as your next step, we're here to guide you through the process with compassion and expertise. Our team understands the challenges you've faced and is committed to providing you with the support and information you need to make the best decision for your family.

Remember, your worth is not defined by your fertility journey. You are strong, resilient, and deserving of support and love, regardless of the outcome of your IVF treatment. Whatever you decide, we at Cofertility are here to support you every step of the way.

Fertility treatments can be emotionally challenging due to the unpredictable nature of things. And when things don’t go as planned, and you have to reconsider the next steps, the emotional challenges can intensify. Depending on the case, people facing infertility may start with medication, then move onto IUI, then IVF, and then maybe donor egg IVF or surrogacy. The more treatments that are tried, the deeper the emotional investment, making the highs and lows more intense. Being kind to yourself, allowing for grief, and taking the time you need before deciding the next step is important in preserving your emotional well-being.

Coping with changes in your fertility plan

After unsuccessful attempts, the original plan may no longer be feasible and individuals or couples face difficult decisions about what to do next. This is a real loss. Loss doesn’t just apply to physical loss; it also applies to the emotional loss of plans changing. Give yourself permission to grieve this loss as you would any other major life event. Mourning this change can help you find closure and peace over time. Seeking therapy, joining support groups, or talking with trusted people can be valuable. 

It’s easy to fall into a cycle of self-blame, especially if you feel like you’ve done everything that you were ‘supposed to do.’ Treat yourself with compassion, the same way that you would treat  a dear friend. Some days may feel okay, and others might be more difficult. Grief isn’t linear, and healing from the loss of your original plan will likely take time and patience.

Managing uncertainty and anxiety

Infertility brings a profound sense of unpredictability, and coping with that uncertainty often requires emotional resilience and a shift in mindset. Our minds like predictability. Uncertainty brings anxiety, fear, and discomfort. So it's only natural to feel anxious about something so significant and life-changing and uncertain. It’s important to accept that some level of uncertainty will always be part of the fertility journey and instead of struggling in the quicksand, try to acknowledge uncertainty as a reality of this process, which can make the anxiety feel less overwhelming. 

Strategies for emotional resilience

One step in managing anxiety is embracing the idea that you have to become an observer of your thoughts and “name it to tame it.” Acknowledging the thoughts and the accompanying emotions rather than pushing them aside allows you to begin processing the loss of change in your plans in a healthy way. While you may not be able to control the outcomes, you can control how you approach each step. Create a flexible plan with small, achievable goals, such as focusing on one treatment cycle at a time or researching alternative paths if you need to change course. Having backup plans or a range of possibilities can help you feel more in control, knowing that even if one option doesn’t work out, there are others to explore.

Instead of viewing changing treatments as a failure, try to see it as another step in your fertility journey. Every step, even the ones that didn’t work, bring you closer to understanding what you need to reach your goals. Understanding what didn’t work can provide valuable insight for the next steps, and viewing it as progress, even if not in the way you initially hoped, can help foster hope. 

Seeking information and understanding

If you’re feeling overwhelmed about changing treatments, ask your doctor for more clarity. Sometimes understanding the science behind the change and how it may increase your chances can help restore your confidence in the process. If you’re interested in understanding the latest research, look for peer-reviewed studies in medical journals like Fertility and Sterility or Human Reproduction.  Use trusted websites that offer scientifically-backed information about fertility treatments such as:

• American Society for Reproductive Medicine (ASRM)
• Society for Assisted Reproductive Technology (SART)
• Mayo Clinic
• National Institutes of Health (NIH) 

Considering donor eggs: Emotional challenges and acceptance

If one of the changes in plans includes donor eggs, it can be emotionally challenging and may involve grieving the loss of a personal vision of parenthood. It’s natural to feel sadness, disappointment, a sense of failure, or even guilt about not being able to use your own DNA. Acknowledge that it’s okay to feel these emotions, and give yourself permission to process them without judgment. Take time to mourn the loss of the genetic connection you had hoped for. This grief is normal and part of the journey. 

Parenthood is about more than biology—it’s about creating a family and building strong emotional bonds.  Families are built through various means; what’s most important is the love, care, and nurturing you’ll provide your child. While using donor eggs may not have been your original plan, it still provides an incredible opportunity to become a parent. Embracing gratitude for the possibility of creating a family through donor eggs can help shift your mindset toward acceptance. The love and bond you’ll form with your child will transcend any genetic considerations, and embracing this new path can ultimately lead to a fulfilling and joyful experience as a parent.

Choosing the right egg donor and egg donor program is a significant decision in your fertility journey. Start by exploring different fertility clinics, donor agencies, or programs that offer egg donation services. Look into their reputation, success rates, and feedback from other patients. Egg donation programs can vary, so decide if you want to go through an anonymous program or a known or open donation program.

Before starting the egg donor selection process, identify the characteristics that are most important to you. Perhaps you want  a donor with similar physical traits - such as hair color, eye color, skin tone, or height. If sharing the same ethnic or cultural background is important, focus on donors who match your background. Some intended parents look for donors with specific educational achievements or interests - such as musical talent or athletic ability. At some point, the decision may come down to a gut feeling. Trust your instincts, and select a donor with whom you feel a connection, even if it’s through a profile.

Deciding to end fertility treatments

Deciding to end your fertility treatments is an incredibly difficult and deeply personal decision. It often comes with complex emotions such as grief, disappointment, and even a sense of failure. However, making this decision is also an act of self-compassion, recognizing your limits, and finding a new way forward. Acknowledge the effort, hope, and dedication you’ve put into this process. IVF is physically, emotionally, and financially demanding, and making the decision to stop is a recognition of the strength you’ve shown. Stopping IVF doesn’t mean giving up or failing; it’s an acknowledgment that you have reached your personal limits, and that’s okay. 

Talking openly about your fears, frustrations, and hopes can help lighten the emotional load. It’s okay to seek reassurance and emotional support. Connecting with others who understand the complexities of changing fertility treatments, such as fertility groups, can be incredibly validating. Hearing others’ stories, while sharing your own story can help you feel less alone.

Conclusion: Navigating the emotional journey

Fertility treatments can be emotionally challenging for many reasons and when fertility treatments don’t work and you have to reconsider the next steps, the emotional challenges can intensify. Grieving the loss of the original plan is an emotional process. This loss can feel as real as losing something tangible, as it involves letting go of the hopes and dreams you had for your fertility journey. Giving yourself time and space to heal while being open to new possibilities is key to moving forward, even if it's a challenging process. Being kind to yourself, allowing for grief, and taking the time you need before deciding the next steps is important in preserving your emotional well-being. Be gentle with yourself and seek the support and coping strategies that resonate most with you.