infertility

Infertility can be a challenging journey, especially when miscarriage happens. For those who have experienced pregnancy loss or failed IVF, your doctor may have brought up the use of donor eggs. Egg donation is when a woman who is medically cleared donates her eggs to be used by another woman (or gestational carrier) who cannot conceive with her own eggs. You may be wondering whether donor eggs can decrease the risk of miscarriage and increase your chances of bringing home a healthy baby. In this article, we’ll lay it all out.

Why do miscarriages happen in the first place?

Miscarriage, also known as pregnancy loss, is a devastating experience. It occurs when a pregnancy ends on its own before the 20th week of gestation. Miscarriage can happen to anyone, and it's estimated that up to 20% of pregnancies end in miscarriage. When a family suffers two or more pregnancy losses, it is called recurrent miscarriage.

There are many reasons why miscarriage can occur, and in most cases, it's difficult to pinpoint a specific cause. Here are some common reasons why miscarriage happens:

• Chromosomal abnormalities: The most common cause of miscarriage is chromosomal abnormalities. This means that the fetus has an abnormal number of chromosomes or a structural problem with a chromosome. These abnormalities are usually random events and not related to anything the parents did or did not do.
• Infections: Infections during pregnancy can cause miscarriage, especially if left untreated. Infections such as rubella, cytomegalovirus (CMV), and toxoplasmosis can be harmful to a developing fetus.
• Structural issues: Structural issues with the uterus or cervix can lead to miscarriage. For example, if the cervix is weak or incompetent, it may not be able to support the weight of the growing fetus, leading to premature delivery or miscarriage. Uterine anomalies, such as a uterine septum, can also increase the risk of miscarriage. 
• Autoimmune problems: An overactive autoimmune system can mistake the fetus as a foreign object and attack it, causing miscarriage.
• Lifestyle factors: Certain lifestyle factors can increase the risk of miscarriage. These include smoking, alcohol use, and drug abuse. 

Unfortunately in most cases, the exact cause of miscarriage is unknown, and it's not always possible to prevent it from happening. Read more about the common causes of miscarriage. 

What is the risk of miscarriage with donor eggs?

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

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

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

What does the research say?

There is a paucity of research on donor eggs. But one 1997 study of 418 embryo transfer cycles among 276 egg donor recipients at one clinic found that:

• 36.2% got pregnant on the first try with donor eggs, and 29.3% had a live birth
• 87.9% got pregnant within four cycles and 86.1% had a live birth

This data did not differ for women of various ages of diagnoses. Another study from 1998 found that the miscarriage rate for donor eggs was 7.2% for women under 45 and 16.1% for women 45-50. 

However, because these studies were 25+ years ago, and each included outcomes data from a single clinic, we can take it with a grain of salt. We’ve had incredible progress in fertility treatments over the last 25 years, including ICSI and PGT testing,  and one would hope for even better outcomes today. 

Why do donor eggs miscarry?

Donor eggs miscarry for some of the same reasons any pregnancy ends in loss. There could be implantation issues, or issues with the lining of the uterus or other factors that make implantation more difficult, increasing the risk of miscarriage. Or there could be other health issues such as hormonal imbalances, autoimmune problems, or structural problems like fibroids. Of course, there’s also just chance / luck which is sometimes not on our side. 

While donor eggs can reduce the risk of certain fertility-related issues, it does not eliminate the risk of miscarriage entirely. Miscarriages are common, and it's important to work with your doctor to understand the potential risks and to receive appropriate care throughout the pregnancy.

How to reduce the risk of miscarriage with donor eggs

We recommend adopting a relaxed lifestyle and moderating physical activity after an embryo transfer. The most important factor in predicting successful implantation is the quality of the embryo and the optimal hormone environment in the uterus. After the transfer, the most important thing you can do is to take your medications as prescribed. You can rest assure that no other external factors will impact the outcome of your cycle (ie. high stress, specific foods, bumping your abdomen against a hard surface). If you have any problems with the injections, let your clinical team know as soon as possible.

Are donor egg pregnancies high risk?

Donor egg pregnancies may be higher risk, but more research is needed. One meta-analysis of 11 studies found: 

• The risk of developing hypertensive disorders is nearly 4X higher for donor egg pregnancies
• The risk of having a cesarean section is 2.71X higher for donor egg pregnancies
• Preterm delivery is 1.34X more likely with donor egg pregnancies

Another study from Columbia University found that age doesn’t impact risk of complications, and that both older and younger women had similar rates of gestational hypertension, diabetes, cesarean delivery, and premature birth. When undergoing IVF, your doctor will give you an idea of your specific health risks and how to help reduce the risk of complications.

What is the success rate of IVF with donor eggs?

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 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.

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.

Ready to move forward with donor eggs? We can help!

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!

Every National Infertility Awareness Week, we like to reflect upon the true meaning of “infertility awareness”. All year, we take every chance we get to increase awareness of infertility in an effort to provide proactive fertility education and de-stigmatize all paths to parenthood.

This is important because infertility can feel incredibly isolating due to lack of openness and understanding from the general public. While infertility does not discriminate, it often catches its victims off guard. Due to a lack of awareness (or just a lack of acceptance), we’re taught from an early age that getting pregnant is easy. In reality, this isn’t the case for everyone — one in four American couples struggle to conceive — and the additional stigmatization of infertility just kicks those suffering from it while they’re down. 

We’re here to change that. Myself and my co-founders all experienced challenging journeys to build our families, and we know, first-hand, that words matter. So this National Infertility Awareness Week, we’re proposing a vocabulary overhaul when it comes to outdated and straight-up offensive fertility terminology. 

Here are several fertility terms we commonly hear — in doctor’s offices, news articles, and more — that we think need to be replaced:

Fertility

• “Insurance policy” → optionality: when a woman decides to freeze her eggs, she's giving herself optionality should she experience fertility challenges down the line. While Cofertility’s mission with Freeze by Co is to enable more proactive, empowering egg freezing, we are always transparent about the fact that egg freezing is never an insurance policy.
• Poor sperm quality → sperm-related challenges: when a man experiences low sperm count or motility, or irregular morphology that may result in an unsuccessful fertilization or pregnancy. The same can apply to “poor egg quality,” and we support a similar change to reference egg-related challenges.
• Inhospitable uterus → uterine challenges: when uterine conditions, like endometriosis, cause difficulty getting or staying pregnant.
• Poor ovarian reserve → diminished ovarian reserve: when a woman’s egg count is lower than average for her age.
  

Egg donation and surrogacy

• Donor mother/parent → egg donor: the woman who donated her eggs to fertilize an embryo resulting in a child is an egg donor. The intended parents are that child’s parents, full stop.
• Surrogate mother → gestational carrier: Similar to “donor mother,” a gestational carrier, while doing an amazing thing (carrying the pregnancy of a transferred embryo using another woman’s egg) is not that child’s mother. Gestational carriers are incredible, but should not be confused with a child’s actual parents. 
• Anonymous egg donation → non-identified egg donation: we believe anonymous egg donation is a thing of the past — not only can it have negative effects upon donor-conceived children, it’s also unrealistic with the rise of consumer genetic testing. The American Society for Reproductive Medicine (ASRM) recently recommended this lexicon replacement as well. At Cofertility, we discuss the concept of disclosure at length with all donors and intended parents. You can read more about our stance on “anonymous” egg donation here.
• Buying eggs → matching with an egg donor: No one involved in this process should feel like eggs are being bought or sold (that goes for the egg donor, the intended parents, and the donor-conceived person). Rather, working with an egg donor is a beautiful way of growing a family and should feel the opposite of transactional. 
• “Using” an egg donor → working with/matching with an egg donor: An egg donor should feel like a perfect fit with your family and someone who should be respected, not “used”. Our unique model — where women can freeze their eggs for free when they donate half of the eggs retrieved to another family — honors everyone involved. Learn more here! 
  

Pregnancy loss

• Spontaneous abortion → pregnancy loss: Honestly, this term is beyond cruel given what it describes — losing a pregnancy prior to 20 weeks.
• Implantation failure → unsuccessful transfer: When an IVF embryo transfer doesn’t result in a success, that doesn’t mean it — or your body — was a failure. 
• Chemical pregnancy → early pregnancy loss: Calling a pregnancy “chemical” discredits what it actually is — a pregnancy. And losing it should be categorized as such. 

Let’s hold ourselves accountable

During National Infertility Awareness Week, consider this our rally cry for evolved terminology around the #ttc process. We’ll plan to hold ourselves accountable, but beyond talking the talk, we aim to walk the walk. 

Our goal is to make the actual family-building process more positive and accessible for anyone pursuing third party reproduction. With Family by Co, all egg donors give half of their eggs retrieved to intended parents and freeze the other half for themselves for free to preserve some of their own fertility for the future. This way, they’re able to give a life-changing gift, but also consider their own ambitions and lifestyle choices. We feel this is significantly more ethical than other donation options out there, and our intended parents love the transparent nature of our platform. 

Let’s challenge each other to evolve the surrounding verbiage. Because the family-building process should feel as good as possible, in spite of challenges along the way.

‍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!

We all sit through awkward and embarrassing Sex Ed classes in high school, but when it comes down to it, none of us really learned when to actually have sex during your cycle in order to get pregnant. In fact, we didn't really learn much of anything useful about our menstrual cycles. Like, what even happens to us every month? And what does any of it have to do with getting pregnant?

Now that you’re in the phase of life where you might be trying to get knocked up, a little info would go a long way. So imagine we’re your junior-year P.E. teacher, because we’re about to tell you everything you need to know about what your uterus gets up to every month. Spoiler alert: it basically has a life of its own.

I've heard there are different phases of my cycle...is that true?

Yup. Your monthly cycle is divided up into two phases: the follicular and the luteal. The follicular phase starts when your period kicks off and lasts about two weeks, ending when you release a ready-to-be-fertilized egg in ovulation. Once that happens, you move into the luteal phase, which also lasts about two weeks and ends when you get your period. Then the whole process starts alllllll over again.

Most menstrual cycles are about 28 days, on average, but really there’s a range of normal here. According to the Mayo Clinic, a cycle can last anywhere from 21 to 35 days.

What happens during each phase?

Let’s pretend you have a totally textbook 28-day period (yeah, we know—you’re not a robot, but just go with us here).

On the first day of the follicular phase, Aunt Flo shows up for a visit. You’re crampy and bloated and cranky and bleeding. (So. Much. Fun.) But according to Dr. Jane Frederick, reproductive endocrinologist at HRC Fertility in Orange County, California, there’s also hormonal stuff happening, too: your brain is secreting hormones from your pituitary and sending signals to your ovary to stimulate egg production. You’ll bleed for about 3 to 7 days and then have 7 to 10 days where not a whole lot goes on that you can see.

But behind the scenes, explains Frederick, your hormones are communicating like crazy. At some point, the dominant follicle in your ovary will produce estrogen and then send a message back to your brain: Stop sending egg production signals...I’m ready to ovulate! The ovary releases the egg and it moves through your fallopian tubes. (This is the point in your cycle when you could become pregnant, but we’ll circle back to that in a few.)

Once ovulation is complete, you move into the luteal phase. If you have a 28-day cycle, it’s probably about day 14 of your cycle, give or take. Now your hormones are doing a Freaky Friday-style switcharoo: the estrogen that peaked before ovulation is dropping and your progesterone levels are rising instead. According to Dr. Frederick, if you have a fertilized egg, progesterone will help it implant in the lining of the uterus and develop successfully into a pregnancy.

On the other hand, if your egg didn’t get fertilized during ovulation, your progesterone levels drop and your endometrial lining starts to shed in menstruation. Aunt Flo’s back in town again!

Okay, but when am I most fertile?

Despite what your sex ed teacher might have told you, a woman can only get pregnant during a very short window of time every month. And that’s right around the time of ovulation, because once the egg has been released from the ovary it’s only good for 24 hours, which would be considered your fertile window.

So if you’re looking to become pregnant, you either want to have some sperm already swimming around in your reproductive tract ready to pounce (pro tip: those guys can survive in there for up to 5 days), OR make sure you have sex within that magic 24-hour window as this is when a female is most fertile.

To be clear, when exactly is my fertile window?

This part can be tricky as everyone’s fertile window is different. If you don’t have a perfect 28-day cycle, pinpointing ovulation closely enough to get your conception timing right can feel like a guessing game. The good news is that there are ways to figure out when to have sex to get pregnant.

The best way to indicate your fertile window is by monitoring your cycle. Luckily, there are ovulation calculators and easy-to-use tracking apps on your phone that are super simple to implement in your daily life.

But getting back to your fertile window, it all depends on the length of your cycle. Every woman’s cycle length varies, but the commonality is that ovulation occurs about 14 days before your next period with your most fertile days typically being the 3 days leading up to ovulation, including the day of ovulation.

For example, if you have a 28-day cycle, you are expected to ovulate around day 14 with your most fertile days being days 12, 13, and 14. Whereas, if you have a 24-day cycle you’ll be ovulating around day 10 with days 8, 9, and 10 being your fertile window.

But wait...can you get pregnant on non-fertile days?

The honest answer is that you must be fertile to conceive, but this doesn’t necessarily mean that you can only have sex on the days you are fertile to become pregnant. As previously mentioned, those little swimmers known as sperm can survive in a woman’s reproductive tract for up to 5 days. That means if you have unprotected sex on day 7 of your cycle but don’t ovulate until day 12, you may still have a chance of becoming pregnant. While the odds may not be as favorable compared to your ovulating day, it’s still possible.

Does that mean I can get pregnant during my period?

If you have unprotected sex during your period, it is possible to get pregnant depending on the length of your period and when your fertile window occurs. Going back to the example, a 28-day cycle means that you are fertile during days 12, 13, and 14. Therefore, if you have sex on day 7 of your cycle and you still have your period, you may very well end up pregnant since the sperm is able to survive within the reproductive tract for 5 days.

Am I considered fertile after my period, too?

Depending on what days you are talking about, the answer can be yes or no. If you have sex during your fertile window or five days prior to your fertile window, there is a possibility of becoming pregnant. However, after you reach that day of ovulation and the released egg does not become fertilized within that 24-hour window, your egg jumps ship and heads on down to your uterus since it knows it won’t meet its match this time. Your hormone levels then begin to go back to normal, your uterine lining will shed, and cause you to menstruate to start your cycle all over again.

In other words, this means that your chances of becoming pregnant after ovulation continue to go down.

Wondering if you're fertile after having a baby?

Whether you’re looking to add some more limbs to the family tree, or just want a break from pregnancy…no judgment. The chances of becoming pregnant right after giving birth vary for each woman. Depending on a few factors, women may experience their first postpartum period anywhere from four weeks after giving birth to 24 weeks! That’s quite a difference, which is why if you’re trying to plan your next pregnancy, contraception will be your best friend until you have a better sense of your cycle.

Tracking your fertile window

As we mentioned, the best way to determine your fertile window is to monitor your cycle. You can use some of the many mobile apps or online calculators that exist, but you can also do some simple math in your head or predictor kits if you want precise indications.

Ovulation predictor kits

Around day 10 of your cycle, you can start peeing on a stick to see whether or not you're ovulating yet. Dr. Frederick says it’s best to do this in the evenings after you’ve been hydrating all day. If you see a positive indicator for ovulation, she recommends having sex that night and the next night to optimize your pregnancy chances. Cue the Marvin Gaye!

Cycle tracking

You ovulate about 12 to 16 days before you start menstruating, so you can spend a few months keeping track of how many days your cycles usually are and counting back from the first day of your period to figure out which days in your cycle are prime ovulation territory.

To get pregnant, you would want to have sex for several days during that window. A recent Fertility and Sterility study suggests that daily sex during your fertile window will be the most successful—especially if you do it the day before ovulation. However, some doctors still recommend sex every other day to build a good supply of sperm.

Other fertility awareness methods

Are you ready to get down and dirty with your fertility? These methods are not for slackers, but they can be pretty effective in calculating your day of ovulation if you’re willing to commit. There are a few different varieties, but basically you’ll need to take and chart your basal body temperature (BBT) each morning the second you wake up with a super-accurate thermometer and/or keep tabs on your cervical mucus throughout the day by fishing around in your vagina to see what’s up down there.

Why? Because your body goes through several natural changes throughout your cycle, which you can observe if you’re paying enough attention. Around the time of ovulation, for example, your cervical mucus becomes slippery and stretchy, like egg whites—and right after ovulation, your BBT spikes by a few decimal points. If you know when this stuff is happening and chart it, you can become, like, a total fertility detective (which might eliminate all that pesky ovulation guesswork).

One disclaimer: Dr. Frederick says that tracking ovulation works best when you ovulate regularly, so if you only get one period every 45-60 days, tracking ovulation will be much trickier (though not impossible). There are tons of apps out there that make cycle tracking a breeze if you’re not a pen and paper kind of gal.

Summing it up

Here’s the moral of this story: if you’re trying to get pregnant, start tracking your cycle. If you really want to get crazy, grab a basal thermometer, get familiar with your cervical mucus, and start tracking all that stuff, too. Understanding your cycle does not have to be one of life’s great mysteries. Knowledge is power, girl—go get some.

According to The American College of Obstetrics and Gynecologists (ACOG), a woman's peak reproductive years are between her late teens and late 20s. By age 30, fertility starts to decline, and once a woman reaches her mid-30s, this decline starts to happen at a much faster rate. By the time she reaches 45, fertility has declined so much that getting pregnant naturally is not very likely. 

Although the female ovarian reserve is the most crucial component of a couple’s per cycle fertility, the age of the male partner also has a significant impact on reproduction. Beyond the fact that older men tend to have older female partners, increasing male age is associated with increased time to conception. Of course, these are the general statistics – there are always outliers. 

But with more people delaying childbirth due to a myriad of reasons, and with more options such as egg donation, sperm donation, surrogacy, and IVF allowing people to become parents well past their peak reproductive years, many are wondering, am I just too old to be a parent? 

Am I too old to become a parent?

Just because medical technology is allowing people to become parents later in life, does it mean they should?  Is there an age where it is maybe too late to be a parent? The motivation for wanting to become a parent, regardless of age, is similar. The only difference is that one set has postponed parenting and will be entering parenthood at a later stage of life. This postponement can be due to many reasons. Personal, professional, financial, or medical reasons can all play a role as to why someone has postponed parenthood. 

But is there a cut off point? Should people in their 40s and beyond be more realistic about their ability to physically parent? And why, regardless of the potential negatives associated with being older parents, are so many still choosing to be parents after the age of 40? 

A 2009 Pew Research Center survey found that half of the 50-year-olds in their survey reported feeling 10 years younger than their actual age. This experience of feeling younger with the fact that people are living longer, paired with what we are shown in the media, there is no wonder that we feel that parenthood after 40 is the norm or is easily attainable. When in actuality, it is not the norm, and requires a lot of medical intervention. It is also no surprise that we overestimate our mortality and underestimate the difficulties of being an older parent and don’t spend enough time considering the potential negative impacts for both the parents and the children. 

Society definitely has thoughts and opinions on what is too old. Bowman and Saunders surveyed 44,000 people across 25 countries about ‘how old is too old to be a parent?’ 96% cited 41.7 for women and 90% cited 47.3 for men. Yet interestingly, the median age of U.S. women giving birth for the first time rose from 27 years to 30, the highest on record. It appears that decisions by college-educated women to invest in their education and careers, as well as the desire by working women to wait until they are more financially secure, has contributed to the shift toward older motherhood.

What are the advantages to being an older parent?

Some benefits that have been cited by older parents include: having established careers with financial security, and  flexibility with their time, emotional preparedness, committed relationships, and a positive overall family experience. 

One study found that children born to older men - men who had higher than average paternal age - are more likely to have a high IQ and are more likely to achieve educational success, which leads to a stronger socioeconomic status which can lead to a better quality of life.  Another study found that aging sperm might actually produce children with longer telomeres that protect DNA while being copied, which is linked to longevity for not one, but two generations of offspring. So your child and their child might live a longer life.  

Harvard scientist Ellen Langer, who studies how the mind influences the body, found that older first-time mothers are often healthier as they age than women who have their first children younger, perhaps because they are spending their time with younger women at playgrounds and preschools.  A 2016 University of Southern California study examined a group of over 800 women between the ages of 41 and 92. Researchers found that women who had their last baby after 35 had better cognition and verbal memory later in life than those who first became parents at a younger age. So there is a protective factor when it comes to mental acuity.  

A 2016 Danish study found that older mothers were more adept at setting boundaries with their kids, and were less likely to yell at and harshly punish them, leading to fewer behavioral, social, and emotional difficulties down the road. They also had less anxiety during pregnancy, had more stable relationships, and were in better shape financially.  Researchers studied 462 women and found that women who had their last child after 33 were more likely to live to 95. In fact, they have twice the chance to live to 95 or older than those who had their last child before their 30^th birthday.

What are the disadvantages of being an older parent?

‍With all these advantages, it is hard to imagine what could be so bad about becoming a parent later in life. Some disadvantages that have been cited by older parents include: the unexpected difficulty in conceiving that culminated in the use of IVF and resulted in a smaller family than desired, lack of energy for parenting, less available lifetime to spend with children, and anticipated stigma as older parents.

Sometimes feeling, looking, and acting young is not the same as being young. And sometimes age is more than just a number. Think about your energy levels in your 20s. Now compare that to your energy levels now - which may be one, two, or three decades later, chances are, it just isn’t the same. Because of this, older parents find it difficult to keep up with their younger children - who by the way - maybe four or five decades younger.  Let’s face it, as we age, we slow down, we get tired, and parenting becomes more difficult. 

Becoming a parent at an older age also means learning how to become more flexible and adaptable in thinking and behavior. And that can be especially difficult the older one is since you are probably set in your ways, have your routines, and like things to be a certain way. Your pristine home? Your morning pilates or your weekly happy hour with friends? That will all change. Things will be different. And for some, even though all they have ever wanted was to be a parent, these changes and disruptions in their everyday life can be an extreme source of stress and anguish.

If you are between the ages of 35 - 54, you are what is known as the sandwich generation. According to the American Psychological Association’s 2007 Stress in America survey, this group feels more stress than any other age group because they are sandwiched between caring for growing children and their aging parents. The survey reveals that nearly 40 percent of women in this group report extreme levels of stress. This stress takes a toll not only on personal relationships, but also on their own well-being as they struggle to take better care of themselves, their young children, and their aging parents. Adding a newborn into the mix only exacerbates the stress and makes everything so much more difficult. 

Impact on children

‍Morris and Yarrow published books about the experiences of children who were born to parents between the ages of 35 and 40. Both positive and negative themes emerged from the research. 

On the positive end, the now adults, stated that they felt that their parents were mature, were stable in their relationships, and in their finances, and were very patient with them as children. They loved and appreciated their parents, but did wish they could have been born to those same parents earlier. 

One of the biggest negative themes included an intense fear of losing their parents. This concern about losing parents can be backed by data. As discussed in Fertility Counseling, less than 5% of children will lose their fathers by the time they turn 15 if fathered by a 35-year old man, 10% of children fathered by a 45-year-old man will lose their father by the time they turn 15, and 20% of children fathered by a 55-year old will lose their father by the time they turn 15. These numbers only get higher and higher as parental age gets higher. 

Age is a main risk factor for disease. Once you reach a certain age, not only are you worried about your child's health, but your own health starts to become a focus as well. Anyone at any age can have health issues, but statistically, as we get older, there is an increased risk of medical problems. And if you become a parent later in life, your child may not have you around for as long as you both would want. You do take a greater risk of not being there for them and not seeing them through the different phases of their life. 

For the children of older parents another impact was the sense of loss in terms of not having the influence of grandparents in their lives. And for many, being only children brought about loneliness during childhood. Children of older parents were also more likely to become caretakers for their parents at a younger age and thus felt higher levels of responsibility compared to their peers.  

Is there an optimal age?

According to Live Science, University of California, San Francisco, researchers set out to establish an “optimal” age for parenting. Most respondents believed being an “older” parent was more advantageous than being a younger parent, mostly because they were more “emotionally prepared.” Parents of both genders in the study overwhelmingly said their 30s would’ve been the ideal parenting age. 

Is it ever too late to be a parent?

Age impacts fertility and our ability to conceive naturally. But medical technology has found a way to circumvent biology and as a result, people in their 40s and 50s and even beyond now have the ability to be parents. Although there are many positives for parenting at a later stage in life, there are also some challenges. Having a clear understanding of the involved risks and taking into consideration the impact on future children, can help make better informed decisions.

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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The path to parenthood can take many roads. There is no single “right way” to become a parent, so you may be debating which path is the right one for you. Two options include egg donation or adoption. If you’re asking yourself “should I adopt or find a donor?” then this article is for you.  Let’s delve into some of the pros and cons to see what feels best for you and your future family. 

Egg donation

The first child born from egg donation was reported in Australia in 1983 and the first American child born from egg donation was in February 1984. Before this medical intervention, for most,  adoption was the only path to parenthood. Egg donation opened the door for more people to become parents. With egg donation, those who are experiencing infertility, have high risks of passing on genetic disorders to their offspring, or have dealt with multiple IVF failures in the past, can have children. 

Pros of using donor eggs

• You can fulfill your dream of raising a child and becoming a parent.
• Donor egg IVF has high success rates, allowing childless people / couples to start a family.
• The opportunity to have a child with a biological relation to the father and biologically related siblings.
• If you are biologically female and plan on carrying the pregnancy, you can still experience delivery and nursing.

Cons of using donor eggs

• It can take a long time to find a donor that you connect with.
• It can be expensive, though with our Family by Co platform, we’ve removed cash compensation for donors from the equation. Instead, our members freeze their eggs entirely for free when giving half of the eggs retrieved to your family.
• Loss of a genetic tie to the mother.
• Fear about telling your child and other people in your life
• There are no guarantees that an embryo will be created.

Adoption

Adoption is the legal process through which a person assumes the parenting responsibilities for someone else's biological child. The concept of adoption exists across cultures and countries and may be traced all the way back to 6th century AD Roman Law. During this time, if the family patriarch did not have a male heir, an heir could be adopted. This was important for the Romans because by adopting one another’s sons, the nobility ensured the wealth would stay within a few families. In the United States, the first modern adoption legislation, the Adoption of Children Act, was passed in Massachusetts in 1851. This act required judges to determine that adoptive parents had “sufficient ability to bring up the child” and that “it is fit and proper that such adoption should take effect.” Today, adoption can take many forms - open, semi-open, domestic and international. 

Pros of adoption

• You can fulfill your dream of raising a child and becoming a parent.
• You get to share your love with a child that may otherwise not have had the best opportunities in life. Studies have shown that adoptive children are less likely to abuse drugs or alcohol and more likely to graduate from high school and go on to college than those who remain in foster care. They are also more likely to have successful careers and strong relationships.
• Because you are helping birth parents who may have not otherwise been able to care for the child, the parents can feel at peace knowing their child will be loved and taken care of.

Cons of adoption

• It can take a long time - anywhere from 9 to 12 months - to find an adoption opportunity.
• It can be very expensive. For domestic infant adoption the cost can be anywhere from $40k to $70k and up.
• The birth parent has a right to change their mind. Depending on the state, that may be anytime while pregnant or up to 30 days after the adoption. 
• Since most adoptions are open, there is a chance that the birth parent may want to be a part of the child’s life, and that may be difficult for some adopting parents.
• Different states have different laws on who can become an adoptive parent based on age, sexual orientation and even religious affiliation.

Embryo donation

Embryo donation is typically not the first choice for most couples starting  infertility treatment, but if you have not been successful with traditional infertility treatment using your own eggs and/or sperm, or are having problems finding a donor, this is a great viable option. 

Pros of embryo donation

1. You can fulfill your dream of raising a child and becoming a parent.
2. Because the embryos are already created and readily available, you can get started whenever you are ready.
3. Can be less expensive than egg and sperm donation and adoption.
4. You can still experience pregnancy, delivery, and nursing.
5. There won’t be a genetic imbalance if only one partner uses a donor.

Cons of embryo donation

1. Embryo donation is technically an adoption. Because you may not have all the medical history of one or both the donors, it can potentially introduce some unpredictability into the genetic makeup of the family.
2. Although readily available, because it is an adoption, it can still sometimes take a long time to match with an embryo.
3. There are no guarantees that an embryo transfer will be successful and result in a pregnancy and delivery.

Which one is right for me?

The decision to use medical intervention to conceive a child or to go through an adoption agency to start a family is an extremely personal one. As you can see above, all paths come with their own set of unique challenges. The best thing you can do is become educated in all your options. Get second and third expert opinions. Seek out legal counsel and ask questions. No one but you can make this decision, but whatever decision you choose, know that you are not alone. Many have walked down these roads to have their family and none of them would have done it any other way.

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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Coming to terms that you need a donor egg to have a family can elicit all kinds of emotions. A major emotion that plays a big role during this process is grief. Grief is that deep, overwhelming sorrow that comes from loss. In this case, it is the anguish that comes from the death or loss of the dream - the dream of a genetic child. In this article, we’ll discuss grief and how it relates to being told you need an egg donor to conceive. 

What is egg donor grief?

In the late 60s, Dr. Kubler-Ross introduced a model for understanding the psychological reaction to loss. She described a cycle composed of denial, anger, bargaining, depression, and acceptance. This model can also be applied to understand the concept of donor egg grief.

For those told that they will require the use of donor eggs to procreate, many of the stages described by Dr. Kubler-Ross can occur not only simultaneously but also repeatedly. Unlike the image above, the stages are also not always linear and do not have a specified time period. 

The different stages of donor egg grief can occur during the initial diagnosis, during the decision-making process regarding moving forward or not and for some all the way until the baby is born. The good news is that grief is normal, it is expected, and it does pass. The clouds part and happiness and joy can once again take over. 

The good news is that grief is normal, it is expected, and it does pass.

Signs that you have donor egg grief

Shock

Unless you have always known that you will require assistance to have a child, when you first learn about needing donor eggs, there is shock.  That initial shock usually wears off pretty fast  because we easily slip into denial. 

Denial

Denial is a common defense mechanism used to protect oneself from the reality that a donor egg is needed. Some people are in such denial that they switch clinics thinking that they need a second opinion or that their clinic is incompetent. Denial is normal and can be important for processing difficult information. During this you need to really understand and educate yourself about why you need a donor egg. Find out about your diagnosis, Ask a lot of questions. And yes, it is okay to get a second opinion. Some find that delving into educating themselves serves as an escape from reality, which is natural. But when you start seeing that you cannot escape the fact, then anger begins to kick in. 

Anger

Anger can come in many different forms. There may be anger at self for waiting too long, for not understanding how fertility works. There may be anger at the partner who does not have to surrender his genetics. There may be anger at friends or family who seem to so easily get pregnant. Anger is also a normal and natural response. During this time having an outlet, be it creative or physical, or whatever,  is essential. Channeling that rage and letting it out allows you to walk the path toward healing.

Bargaining

In order to move on from anger and to get a semblance of control, many move into bargaining. This can look like, “I will focus solely on treatment and 100% on clean eating and living, and I will donate money to fertility causes, if I can try IVF one more time. I know this time it will work, this time will be different.” The truth is that bargaining is really a way to protect oneself from the painful reality of that lost genetic connection, to not want to believe that this diagnosis is true. So thoughts such as, “I probably wasn’t doing the hormone injections right. My doctor wasn’t giving me strong enough hormones.” are also part of the process.  

Depression

If you start to feel persistent feelings of sadness, a loss of interest in things you once enjoyed, hopelessness, issues with sleep, and fatigue, you are entering the stage of depression. Now is the time for self-compassion which is the process of turning compassion inward.  Now is the time to be kind and understanding and to give ourselves support and encouragement. Research shows that self-compassion can be a powerful source of coping and resilience as it can radically improve mental and physical wellbeing. 

Acceptance

The last and final stage of donor egg grief is acceptance. This is recognizing the reality that if you are to have a family, a donor egg will be required. This is when the longing to be a parent outweighs the need to procreate and have a genetic link to a child. This is when you no longer struggle with the loss of that genetic tie and instead decide to focus on what it will be like to finally be a parent. This is when the old expectations of how you saw yourself becomes redefined.  The definition of mothering, nurturing and family also changes and you start seeing a happy future once again. You start to realize that perhaps the best parts of you are not genetic, but things that were learned, nurtured and taught. And those are things you can and will pass down to your child. 

We are here for you

Whether you choose to match with an egg donor through Cofertility or elsewhere, it’s important to find a reputable and compassionate agency that will treat you with respect and provide you with the resources and support you need throughout the process. Remember that you are not alone, and that there is hope for building the family of your dreams, even if it looks different than what you imagined.

Read more:

• How Can I Come to Terms with Using Donor Eggs?
• The Parent-Child Relationship in Families Created Using Egg Donation
• Will I Regret Using Donor Eggs?

Premature ovarian failure (POF) is a condition in which your ovaries stop functioning properly before the age of 40. POF affects about 1% of females, and is also known as premature ovarian insufficiency (POI) or premature menopause. In this article, we'll discuss the causes, symptoms, diagnosis, treatment options for POF, and how it can affect your mental and emotional well-being.

What causes premature ovarian failure?

POF is a complex and multifactorial condition, with the exact cause remaining unknown in the vast majority (90%) of cases. However, research suggests that the problem is often related to issues with the follicles (the small sacs in the ovaries where the eggs mature). Some people with POF may run out of functional follicles earlier than expected, while others may have follicles that are not functioning properly. 

While the cause is often unknown, there are several factors that have been linked to POF. These include genetic disorders such as Fragile X syndrome and Turner syndrome, autoimmune diseases such as thyroiditis and Addison disease, exposure to toxins like cigarette smoke, chemicals, and pesticides, as well as certain metabolic disorders. Additionally, treatments such as chemotherapy or radiation therapy can also increase the risk of developing POF.

Symptoms of premature ovarian failure

The symptoms of POF are similar to those of menopause, and include irregular periods, hot flashes, vaginal dryness, and mood changes. Those with POF may also experience infertility or difficulty getting pregnant. In addition, POF can increase the risk of osteoporosis and heart disease. POF can also lead to a decrease in libido and sexual function, as well as depression and anxiety.

How do I know if I have premature ovarian failure? 

POF is diagnosed based on symptoms, medical history, and blood tests that measure levels of certain hormones. Females with POF typically have low levels of estrogen and high levels of follicle-stimulating hormone (FSH), which stimulates the ovaries to produce eggs. A pelvic exam and ultrasound may also be performed to evaluate the ovaries and determine if there are any structural abnormalities.

Premature ovarian failure and estrogen levels

POF can lead to low estrogen levels, which can cause a range of symptoms. Estrogen plays a vital role in the reproductive system and overall health. It helps regulate the menstrual cycle, maintains bone density, and supports vaginal and urinary health. When estrogen levels drop, you may experience symptoms like hot flashes, night sweats, vaginal dryness, mood changes, and difficulty sleeping. All of these are generally a result of lower estrogen levels.

Premature ovarian failure and FSH levels

Follicle-stimulating hormone (FSH) is a hormone that stimulates the growth of ovarian follicles and the production of estrogen. In those with premature ovarian failure, FSH levels are typically high due to the lack of viable follicles in the ovaries. High levels of FSH can be a useful tool in diagnosing POF.

Premature ovarian failure and AMH levels

Anti-Mullerian hormone (AMH) is a hormone that is produced by the ovarian follicles. Low levels of AMH can be a sign of a low ovarian reserve, which is a common characteristic of premature ovarian failure. While AMH levels can be useful in diagnosing POF, they are not always a reliable indicator of fertility potential.

Do you still have eggs with premature ovarian failure?

Premature ovarian failure is usually characterized by a decline in the number of eggs you have. However, some individuals with premature ovarian failure may still have a small number of eggs in their ovaries, especially early in the diagnosis. 

This can be determined through an ovarian reserve test, which measures the number of follicles (fluid-filled sacs that contain immature eggs) present in the ovaries.

However, for most individuals with premature ovarian failure, the number of eggs left may be too low for successful fertility treatment using their own eggs. In these cases, donor eggs may be a viable option for achieving a healthy pregnancy.

Can premature ovarian failure be cured?

There is no cure for POF, but there are several treatment options available. Hormone replacement therapy (HRT) can help alleviate symptoms of menopause and reduce the risk of osteoporosis and heart disease. Those with POF who wish to conceive can also explore fertility treatments like in vitro fertilization (IVF) with donor eggs. This can be a successful option for those with POF since the donor eggs come from women who are more likely to produce healthy embryos.

Can someone with premature ovarian failure get pregnant?

While premature ovarian failure can make it difficult to conceive unassisted, it is still possible for some people to get pregnant with the help of assisted reproductive technologies, like donor egg IVF.  In some cases, patients with POF may even be able to use their own eggs if they have enough viable follicles remaining. However, the success rates of these treatments are generally lower than for people without POF.

The good news, though,  is that people with POF are generally able to carry a healthy pregnancy!

Can you do IVF with premature ovarian failure?

Yes! IVF may be an option for those with premature ovarian failure who still have a small number of eggs in their ovaries. In some cases, these eggs can be retrieved and used for IVF. But it may take higher doses of medications, and more cycles to achieve success.

However, if you have very few or no eggs remaining, IVF with donor eggs may be recommended instead. 

Mental and emotional well-being, and coping strategies

POF can have a significant impact on your mental and emotional well-being. The diagnosis of POF can be devastating, and you may experience a range of emotions, including grief, anger, and depression. It is so important to seek support from a mental health professional and to connect with others who have experienced POF. 

There are several coping strategies to manage your symptoms and improve your quality of life. Focus on maintaining a healthy lifestyle by eating a balanced diet, getting regular exercise, and reducing stress. Those with POF can also explore alternative therapies such as yoga, meditation, or massage to help manage symptoms and gain a sense of inner peace. Those with POF should also be proactive about their healthcare by staying up to date on their medical appointments and advocating for themselves.

Bottom line

Premature ovarian failure can be a challenging condition to manage, but there are options available to help alleviate symptoms and increase the chances of starting a family. If you suspect you may have POF, it's important to speak with your doctor to start an evaluation.

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! 

First comes love, then comes marriage, then comes… how does that song go again? Our world has so many cultural rules and norms in place that we forget that in reality everyone’s experiences, needs, and realities are very different. We say we are open and tolerant to difference yet, we let society dictate how we live, love, and feel. So when a woman is diagnosed with infertility and told that donor eggs are required to have a baby, instead of being grateful for the opportunity to be a parent, different fears can kick in. One of the fears includes not being supported by family or friends. But what happens when that non-support comes from your partner? And what if despite his not wanting to use donor eggs, you still do? What happens then?

Understanding your options: the pros and cons of using donor eggs

The positives are obvious: you get to be a parent. And for some, another positive can be that  the husband's sperm can be used, thereby keeping some genetic connection. Negatives can include cost and finding the ‘right’ donor may take time. And in this scenario, conflicts with your partner about moving forward with donor eggs. 

Read more: I'm Considering Using Donor Eggs. What are the Pros and Cons?

Communicating with your partner: how to have a productive conversation

When this topic first came up, you both most likely had your own private reactions. You both may have needed time to truly digest and process the situation. But sometimes, one partner moves through the process a lot quicker and immediately decides what to do while the other partner needs more time to figure things out. 

So if you want to move forward with donor eggs and he doesn’t, what comes next? First, he needs the opportunity to spend time really digesting and processing this on his own terms.  He needs to sit and put himself in both situations (using a donor vs. not using a donor) and being honest about how that would look and feel. Has he had time to talk to someone without you? Maybe a friend, the REI, or even a therapist? He needs to talk to someone about his biggest worries, his biggest concerns, and his biggest issues with using a donor and sometimes that person is not you. 

You can’t force anyone to get on board just because that is something you really want. You also can’t let your feelings invalidate his feelings either. But what you can do is both get educated on the process, you can both speak with a therapist, you can both read the literature, and/or attend groups with other couples in your exact same situation. These are things that can help you make informed decisions, decisions that you can feel good about, even 20 years from now. 

Can I pursue donor eggs without my husband knowing? 

Surprisingly, this isn’t a joke. This question has been asked -  a few times. If you have this thought, then you need to work with a couples therapist. Starting a family is a huge endeavor, regardless if you use a third party or not. It is a life changing event that triggers a lot of stress and can be very challenging. If you are not on the same page regarding donor eggs you need to find a therapist who specializes in fertility. This is important so you aren’t spending time explaining the details of infertility, they will already understand and be able to flush out the issues with you.  

A fertility psychologist can help you  explore different parenting options. Options such as adoption, fostering, or maybe even living child free. It gives you the opportunity to create a safe space for you both to voice your feelings but also a safe space to learn more about each other's feelings, needs and wants. It can open space for understanding and a deeper connection. 

Coping strategies and how to manage your emotions during this time.

You can’t change the past and you can’t control the future. But you can learn how to be in the here and now by practicing mindfulness. Mindfulness can help regulate emotions, decrease stress, anxiety and depression. Practice self-care by doing things you enjoy and being with people you love. Talk to someone. Find a therapist, a friend or join a group, don’t bottle it up.

Conclusion

At the end of the day, there is no wrong decision. Navigating the complex world of infertility and exploring options like using donor eggs is a journey filled with challenges and emotions, particularly if you and your partner are not on the same page. It is essential to maintain open, honest, and compassionate communication throughout the process, granting each other the space to process feelings and come to a decision at your own pace. This is not a decision to rush, and sometimes the assistance of a fertility specialist or therapist may be needed to guide you both through this journey.

Remember, your feelings are valid and it is okay to feel a multitude of emotions. You are not alone in this journey and there are many resources available to you – from literature on the subject to support groups for couples facing the same situation. Lastly, self-care is vital during this time. Practice mindfulness, enjoy activities that you love and surround yourself with supportive individuals. Most importantly, no matter the outcome, it can lead to a deeper understanding of each other and potentially a stronger connection as you face these decisions. Together as a couple, you need to make a decision that is right for you and your family.

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!

As a reproductive endocrinologist (aka a fertility doctor), every day I witness firsthand the profound yearning to build a family. For many individuals and couples, the path to parenthood may not be a straightforward one. Fortunately, advancements in assisted reproductive technologies (ART) have opened doors to alternative family-building options. Third-party reproduction (TPR) can offer hope for those facing fertility challenges or seeking alternative means to complete their families. But what is it?

In this article, I'll dive into the world of TPR, exploring its various facets, the science behind it, and the unique considerations involved. Whether you're a couple struggling with infertility, a single parent by choice, or an LGBTQ+ individual seeking to build a family, understanding TPR can empower you to make informed decisions about your fertility journey.

What is third-party reproduction?

When you hear the term third-party reproduction, it’s referring to a range of techniques that involve using genetic material or gestational services from a third party, someone who is not the intended parent, to achieve pregnancy. 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. Here's a breakdown of the types of TPR:

• Sperm donation: Viable sperm from a carefully screened donor is used to fertilize eggs through intrauterine insemination (IUI) or in vitro fertilization (IVF).
• Egg donation: Donor eggs, retrieved from a healthy egg donor who has undergone rigorous medical and psychological evaluation, are fertilized with the intended father's sperm or donor sperm for implantation in the uterus via IVF.
• Embryo donation: Frozen embryos created by another family undergoing IVF are donated to another couple or individual for implantation. 
• Gestational surrogacy: A gestational carrier, also known as a surrogate, carries a pregnancy for the intended parents using an embryo created either through the intended parents' own gametes or donated sperm and eggs. The gestational carrier has no genetic link to the baby.
• Double donor: Both donor sperm and donor egg come together in IVF. 

More and more families are turning to third-party reproduction to build their families. Third-party reproduction is part science and medicine, and part generosity from someone else who wants to help you build your family. There is a lot of coordination and legal work involved to protect all parties, and if you work with a group like Cofertility, we will help you all along the way. 

What types of families use third-party reproduction?

Third-party reproduction (TPR) opens doors for a diverse range of individuals and couples who may not be able to conceive unassisted or carry a pregnancy to term. I have worked with so many different types of families, who come to me for various reasons. Here's a closer look at some of the families who find hope and fulfillment through TPR:

• Couples facing infertility:  Infertility, the inability to conceive after one year of unprotected intercourse, affects millions of couples worldwide. TPR can offer hope for those struggling with infertility due to various factors including low sperm count, blocked fallopian tubes, or hormonal imbalances.  For these couples, TPR, whether through sperm donation, egg donation, or even embryo donation, allows them to experience the joy of parenthood and build their families.
• Single parents by choice:  An increasing number of single intended parents are opting for TPR to build their families. They can utilize sperm donation, egg donation, and/or surrogacy to create their dream families.  
• LGBTQ+ families: TPR plays a significant role in expanding family-building options for LGBTQ+ individuals and couples. Same-sex male couples can utilize egg donation and surrogacy to have a biological child within their family. Lesbian couples have the option of using sperm donation, either from a known or anonymous donor, and either partner can carry the pregnancy or utilize a gestational carrier.  Transgender individuals can also explore TPR options to complete their families.
• Individuals with medical conditions:  Certain medical conditions may render pregnancy unsafe or even impossible. Uterine fibroids, endometriosis, or a history of complex medical procedures or births are just some examples.  TPR, through gestational surrogacy, allows these women to experience parenthood by having a genetically related child (through egg donation and sperm from their partner) or by adopting an embryo.
• People with genetic concerns:  For couples at risk of passing on a known genetic condition to their biological children, TPR offers a path toward a healthy family.  Preimplantation genetic diagnosis (PGD) can be performed on embryos created through IVF, allowing for the selection of embryos free from the identified genetic condition.  This can give couples peace of mind and increase their chances of having a healthy child.

Regardless of the specific route taken through TPR, the common thread is the unwavering desire to build a loving family.  While genetics play a role, the emotional bonds cultivated through love, nurturing, and shared experiences are the true cornerstones of a family. Studies have shown that children born through TPR thrive in loving environments and develop strong attachments to their intended parents.

The emotional journey of TPR

The decision to pursue TPR is rarely made lightly. It's often born out of a deep longing for parenthood and may be accompanied by a spectrum of emotions. Intended parents may experience a mix of hope, excitement, anxiety, and sometimes even a sense of grief if facing infertility or the inability to use their own genetic material. Open communication is absolutely vital – between intended parents, with any known donors or gestational carrier, with your agency, and within oneself.  Exploring personal feelings and expectations throughout the process  is essential for ensuring everyone is emotionally aligned.

Donors and gestational carriers also carry complex emotional feelings throughout the process.  Donors may derive a sense of altruism and fulfillment from helping others build families.  Gestational carriers often express feelings of deep satisfaction from carrying a child for intended parents who cannot do so themselves.  However, feelings of uncertainty, potential vulnerability, and even moments of hesitation are also natural parts of the experience.

Psychological support in the form of counseling provides a safe space to unpack these emotions for everyone involved.  It can help intended parents cope with potential setbacks, foster healthy communication with stakeholders, and build a strong emotional foundation as they navigate their unique path to parenthood.

If you work with Cofertility, we have a fertility psychologist on our team who supports all parties involved. 

Do I need a doctor who specializes in third-party reproduction?

The short answer is yes! Building a family through third-party reproduction involves a mix of medical, legal, and emotional considerations. While seeking guidance from any fertility doctor is a good starting point, partnering with a board-certified reproductive endocrinologist who specializes in TPR will go a long way. These specialists possess in-depth knowledge of the various TPR techniques, from sperm and egg donation to embryo donation and gestational surrogacy. Their expertise allows them to create tailored treatment plans that perfectly align with your unique circumstances – whether that means selecting the right donor, navigating IVF procedures, or understanding complex legal agreements.

A fertility doctor with TPR experience understands the potential risks and necessary medical monitoring throughout the process. They ensure your safety and well-being, always keeping your best interests in mind. Perhaps just as importantly, they offer compassionate support throughout your emotional journey, answering any questions and providing a safe space to process the complex feelings that may arise.  Building a trusting relationship with your doctor is important when making personal decisions that affect your ability to build a family.

Finding the right specialist takes a little research. Look for board-certified reproductive endocrinologists affiliated with reputable fertility clinics that offer comprehensive TPR services. Ask for recommendations from trusted sources or schedule consultations with a few specialists to find a provider whose approach aligns with your needs. Ask them about their experience with TPR, and how they approach treatment differently. Ultimately, a specialist in TPR will be your invaluable guide, increasing your chances of a positive outcome on your path to creating the family you've always dreamed of.

Summing it up

Third-party reproduction (TPR) is a powerful testament to where science and compassion meet. It expands our horizons of possibility, offering alternative paths to parenthood for many individuals and couples. Whether it's sperm donation, egg donation, embryo donation, or working with a gestational carrier – the techniques behind TPR are ever-evolving, giving more people the chance to fulfill their dreams of family.

While the science is complex, the heart of TPR is simple: it's about love, determination, and the generosity of those who offer the incredible gift of helping others build their families. Naturally, navigating the medical, emotional, and legal aspects of TPR necessitates a guiding hand. That's where a specialized reproductive endocrinologist, a team like Cofertility, and a strong support system are invaluable, turning what can seem daunting into a well-supported, empowering journey.

If this is a path calling to you, know that you're not alone. Seek out the knowledge and support that will enable you to make informed choices and feel confident at every step along the way.  The joy of parenthood, experienced through whichever means resonate with you, is a beautiful path of unwavering love.

Find an amazing egg donor at Cofertility

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 of 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!

Read more:

• Double Donor IVF: Making Embryos with Donor Eggs and Sperm
• Reciprocal IVF: What Should My Partner and I Consider?
• Gay Men Having Babies: Four Genetic Options with Donor Eggs

Diminished Ovarian Reserve (DOR) is a condition that affects many women, often catching them off guard as they embark on their journey to parenthood. While receiving a DOR diagnosis can be challenging, understanding the condition is the first step in navigating your reproductive options. This article aims to demystify DOR, explore its prevalence, discuss the chances of conception, and outline the available options for those diagnosed with this condition.

What is diminished ovarian reserve (DOR?)

Diminished ovarian reserve refers to a reduction in the quantity of your remaining eggs. Every female is born with all the eggs she'll ever have, and this number naturally declines with age. However, some experience a faster decline than expected for their age, leading to a diagnosis of DOR.

DOR is not the same as infertility. While it can make conception more challenging, it doesn't necessarily mean pregnancy is impossible. Instead, think of DOR as a warning sign that your reproductive window may be shorter than anticipated. The sooner you get a DOR diagnosis. The sooner you can begin to explore your reproductive options, including treatments like in vitro fertilization (IVF) or egg freezing, and potentially increase your chances of achieving a successful pregnancy.

How common is diminished ovarian reserve?

The prevalence of DOR increases with age, but it can affect women of all ages. According to one study, approximately 10% of women seeking fertility treatment are diagnosed with DOR. However, this number may not accurately represent the general population, as many women with DOR may not seek fertility treatment or may remain undiagnosed.

Age is the most significant risk factor for DOR. As women approach their late 30s and early 40s, the likelihood of experiencing DOR increases significantly. However, DOR can also occur in younger women too, sometimes due to genetic factors, medical treatments like chemotherapy, or unknown causes.

Some lifestyle factors have also been known to contribute to a diminished ovarian reserve. Smoking is one of the most significant factors, as a history of heavy smoking can accelerate the loss of eggs and may lead to earlier menopause. 

Diagnosing diminished ovarian reserve

Diagnosis of DOR typically involves a combination of blood tests and ultrasound imaging. The most common blood tests measure levels of follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH). High FSH levels or low AMH levels can indicate DOR. Additionally, an ultrasound to count antral follicles (small follicles in the ovaries) can provide further insight into ovarian reserve.

It's worth noting that these tests provide a snapshot of your current ovarian reserve, not a prediction of your ability to conceive. A low ovarian reserve doesn't necessarily mean you can't get pregnant, just as a high reserve doesn't guarantee conception.

Chances of getting pregnant with diminished ovarian reserve

The probability of achieving pregnancy without assistance (meaning “the old fashioned way”) when diagnosed with DOR varies widely depending on individual factors, including age, the severity of the condition, and overall health. A study published in JAMA found that women aged 30-44 with low AMH (an indicator of DOR) did not have a significantly different probability of conceiving after six months of trying.

However, these statistics don't tell the whole story. Some women with DOR do conceive unassisted, while others may require IVF or donor egg IVF. Every woman's fertility journey is unique, and statistics can't predict individual outcomes.

Options for women diagnosed with DOR

If you are facing infertility due to DOR or other reasons, the good news is that there are options. Here are some paths you might consider:

1. Fertility treatments

For women with DOR who wish to conceive using their own eggs, fertility treatments can potentially improve the chances of pregnancy. These may include:

• Ovulation Induction: Medications to stimulate egg production
• Intrauterine Insemination (IUI): A procedure where sperm is placed directly into the uterus
• In Vitro Fertilization (IVF): A process where eggs are fertilized outside the body and then transferred to the uterus

It's worth noting that success rates for these treatments may be lower in women with DOR compared to those with normal ovarian reserve. A fertility doctor can give you a better idea of your chances of success based on your unique health history. 

2. Egg donation

For some women with DOR, using donor eggs may offer the best chance of achieving pregnancy. This option allows for the experience of pregnancy and childbirth, even if the child isn't genetically related to the mother. Success rates with egg donation are generally higher than when using your own eggs

3. Adoption

Adoption is another path to parenthood for those diagnosed with DOR. While it doesn't involve a genetic connection or the experience of pregnancy, it offers the opportunity to provide a loving home to a child in need.

Conclusion

DOR is a challenging diagnosis, but it doesn't have to mean the end of your dreams of parenthood. By understanding your condition, exploring your options, and working closely with healthcare providers, you can make informed decisions about your fertility journey.

Remember, DOR is a medical condition, not a personal failing. It's okay to feel frustrated, sad, or anxious about this diagnosis. Many women find it helpful to seek emotional support, whether through counseling, support groups, or open conversations with loved ones.

Ultimately, the path you choose will depend on your personal circumstances, values, and goals. Whether you decide to pursue fertility treatments, consider egg donation, explore adoption, or take a different route entirely, know that there are multiple ways to build a family and experience the joys of parenthood.

Your fertility journey may not look exactly as you imagined, but with perseverance, support, and the right medical guidance, you can navigate the challenges of DOR and move forward with hope and determination.

Find an amazing egg donor at Cofertility

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 of 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!

For those struggling with infertility, the holiday season can intensify emotional challenges as celebrations often center around family and children. This guide explores practical strategies for managing holiday-related stress, understanding your emotional responses, and building resilience during this sensitive time.

Holiday-related anxiety and depression can be particularly high for those facing fertility challenges, as the season often emphasizes themes of family, children, and togetherness, potentially creating feelings of inadequacy, sadness, and envy. Holiday cards, pregnancy announcements, or events centered around children may serve as triggers, amplifying feelings of loss or grief. The societal expectation to feel and display happiness and joy during the holidays can exacerbate feelings of isolation and sadness when one is privately struggling.

How stress affects the brain

Social triggers that evoke strong emotional responses can have not only psychological impacts but also significant neurological impacts. One of the first areas of the brain that gets impacted during stress is the limbic system. The limbic system detects and processes emotional stimuli - especially stimuli perceived as threatening. This activation heightens emotional arousal and contributes to feelings of fear, anger, or shame. The prefrontal cortex (PFC), responsible for executive functions like decision-making and emotion regulation, attempts to interpret and manage the emotional response to triggers. It may struggle to regulate the limbic system’s response effectively in stressful or triggering situations, especially if the trigger is deeply personal or recurrent. Because the prefrontal cortex is struggling, the Hypothalamus-Pituitary-Adrenal (HPA) Axis is activated, releasing cortisol, the stress hormone, which prepares the body for a fight-or-flight reaction. Chronic exposure to triggers can dysregulate the HPA axis, leading to prolonged stress and health issues such as fatigue, anxiety, and depression.

Building emotional resilience through reframing

By addressing the psychological dimensions of social triggers, individuals can build emotional resilience, which is the ability to adapt and recover from stress while maintaining psychological well-being. The ability to reframe negative experiences and see challenges as opportunities for growth is central to resilience. Reframing involves identifying negative thought patterns and replacing them with more balanced or constructive perspectives. With fertility challenges, reframing helps shift the focus from loss and longing to aspects of life that can still bring fulfillment, allowing space for gratitude, flexibility, and self-compassion during a difficult time.

An example of how reframing may be used: 

“I can’t enjoy the holidays because they remind me of what I don’t have—a family with children." 

That thought might be reframed as: 

“This year may look different than I hoped, but it gives me the chance to focus on what I can enjoy and appreciate right now, such as spending time with my loved ones and creating traditions for myself. Building a family may take longer than expected, but that doesn’t diminish my worth or my ability to find moments of joy."

Using mindfulness to prevent anxiety spirals

Sometimes it can be difficult to reframe a thought when the mind is racing. Anxiety is such a fast-paced emotion that it can be hard to not jump from thought to thought to thought and end up spiraling. Spiraling can be prevented by using mindfulness to stay present in the moment, to be aware enough of our thoughts that we can catch them, reframe them, and be intentional with our reactions. Neurologically, mindfulness reduces activity in the limbic system, thereby strengthening PFC regulation and reducing cortisol levels. Lower cortisol levels protect the brain from stress-related damage in parts of the brain vital for emotional regulation.

An example of how mindfulness may be used: 

You are at a holiday gathering and someone makes an insensitive comment about when you’ll have kids.

Mindful response may include S.T.O.P:

• Stop
• Take a 4 - 7 - 8 breath
• Observe (your emotions, physical sensations, and thoughts without judgment) and ground yourself
• Proceed by calmly and saying, “That’s a sensitive topic for me right now.”  

The role of self-compassion in emotional healing

Even if we are being mindful and reframing our thoughts, we may still hear that self-critical voice that loves to self-punish. This is where practicing self-compassion comes in. Neurologically, self-compassion has shown to reduce the limbic systems hyperactivity, helping us feel less overwhelmed by negative emotions. It also strengthens the PFC allowing for better regulation of the limbic system’s responses, leading to greater emotional stability.
An example of how self-compassion may be used: 

You feel overwhelmed seeing social media posts of friends celebrating the holidays with their children.
A self-compassionate response may include:

• Recognizing your feelings with kindness: “It’s okay to feel this way. This is really hard, and I’m not alone in this struggle.”
• Reassuring yourself as you would a friend: “I’m doing the best I can, and it’s okay to focus on my healing during this season.”
• Engaging in an act of self-care, like taking a walk, or treating yourself to a comforting activity.

Understanding trauma responses to fertility challenges

Fertility challenges can be deeply traumatic. While the experience varies from person to person, infertility often involves a profound sense of loss, unmet expectations, and challenges to one’s identity and future. During the holiday season, trauma responses to fertility challenges can manifest in emotional, physical, and behavioral reactions. It is not unusual to feel profound sorrow when seeing children, pregnant family members, or holiday traditions centered on family and children. Anger, irritability, shame, guilt, hopelessness and even detaching from feelings altogether are all very common and normal trauma responses. 

It is also not unusual to experience physical symptoms such as a racing heart, shallow breathing, or sweating when confronted with triggers (e.g., a holiday card featuring a family with children). Feeling drained and developing headaches, stomachaches, or other physical discomforts are also typical. On top of the emotional and physical responses, we have cognitive responses such as “I will never have children” or “I don’t belong here” play on a loop and only exacerbate the other symptoms. All of these things combined then create our behavioral responses. Meaning the things we do in response. For example, skipping holiday gatherings to avoid potential triggers. Engaging in perfectionist behaviors to "prove" worth in other areas, such as hosting the perfect holiday event. Using food, alcohol, or other substances as a coping mechanism to regain a sense of control.
Some ways to cope with these types of trauma responses include:

• Grounding techniques, such as 4 - 7 - 8 breathing or naming objects in the room, to stay present during triggering moments.
• Setting boundaries by politely declining invitations 
• Leaning on trusted friends, family or partner
• Reminding yourself that your feelings are valid and that it’s okay to prioritize your needs.

Finding your own path through the holidays

The holidays can be an emotional minefield for individuals with fertility challenges as it often brings heightened emotions, societal pressures, and reminders of what you may feel is missing. The contrast between the joy others seem to experience and the sadness or grief you may be feeling can amplify the sense of loss. Therefore, emotional resilience is crucial during the holiday season. 

Reframing helps shift the focus from loss and longing to aspects of life that can still bring fulfillment. Mindfulness helps you become aware of your emotions, while self-compassion allows you to address those emotions with kindness and care. Together, these tools enhance the brain's capacity to regulate emotions, foster positive self-reflection, and reduce the harmful effects of stress. Over time, these neurological changes make it easier to approach challenges with kindness and emotional strength.

Understand that the magic of the season doesn’t have to look like everyone else’s. It's okay to experience the holidays differently this year or frankly any year. Even though you might be experiencing a difficult journey, it’s possible to find moments of beauty and peace. Whether it's the peaceful quiet of a winter morning, the sound of holiday music, or the taste of a comforting food, small moments of magic exist. Focus on those moments of beauty and allow them to fill your heart, even if just for a brief moment.