IVF

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

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

Issues facing egg donation and reproductive healthcare access

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

Understanding state-level implications for donor egg IVF

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

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

Insurance gaps and high costs

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

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

Impact on LGBTQ+ intended parents

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

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

Access to egg donation and donor egg IVF amid political changes

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

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

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

Key election topics to watch this season

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

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

How Cofertility can support your family-building journey

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

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

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

This article was last updated on March 1, 2024. The Alabama Supreme Court ruling is a quickly unfolding situation. Be sure to consult official news sources or legal experts for the most up-to-date information and guidance. 

On February 16th, 2024, the Alabama Supreme Court ruled that frozen embryos can be considered children under state law, a ruling that sent shockwaves through the reproductive health community and raised widespread concerns regarding its potential impact on fertility care. Several of the state’s in vitro fertilization (IVF) clinics have since paused services, and lawmakers, doctors, and patients are raising concerns about the far-ranging impacts of the ruling on healthcare and reproductive technology.

While there’s still a great degree of uncertainty, in this article, we'll delve deeper into the implications of this significant legal shift, exploring how it specifically impacts donor egg IVF procedures. Additionally, we'll explore what resources may be available to those affected by this ruling and provide insights on how you can engage in advocacy efforts to address these challenges.

What is the Alabama court case about?

The recent ruling by the Alabama Supreme Court was the result of a lawsuit filed by three couples who underwent IVF treatment at a fertility clinic in Alabama. Following successful IVF procedures that resulted in the birth of healthy babies, the couples, like many undergoing such treatments, had additional embryos preserved by the clinic which was located inside of a hospital.

However, in December 2020, a patient at the hospital gained unauthorized access to the fertility clinic's cryo-preservation unit and mishandled the frozen embryos, resulting in their destruction. This tragic incident led the plaintiffs to file lawsuits against both the fertility clinic and the hospital where it was located.

One of the lawsuits centered around the application of Alabama's Wrongful Death of a Minor Act. Initially dismissed by the trial court, which ruled that embryos in vitro did not qualify as minors under the act, the case was escalated to the Supreme Court of Alabama. The Alabama Supreme Court diverged from the trial court's stance. They asserted that the Wrongful Death of a Minor Act applied to all unborn children, regardless of their location—in utero or in vitro—at the time of the incident. By deeming the in vitro embryos as persons under the law, the court allowed the couples to proceed with their lawsuit, seeking punitive damages for what they perceived as the wrongful death of their children.

What are the implications for Alabama fertility patients?

The recent ruling by the Alabama Supreme Court does not explicitly impose any bans or restrictions on IVF procedures. However, legal experts suggest – and we’re already seeing in practice – that the decision may create confusion regarding the legality of certain aspects of IVF within Alabama.

For context, data from the Centers for Disease Control and Prevention indicates that approximately 2% of babies in the United States are conceived using assisted reproductive technology. Among the various treatments available, IVF stands out as the most commonly utilized method. IVF is a complex procedure that begins with a stimulated cycle wherein a woman undergoes hormone injections to prompt her ovaries to produce numerous eggs. These eggs are then harvested and united with sperm, giving rise to embryos that undergo incubation for development.

After a few days, the embryos undergo assessment, with only the most viable ones selected for transfer into the woman's uterus. The goal is for the transferred embryo to implant successfully, leading to a healthy pregnancy and ultimately the birth of a child. Any surplus high-quality embryos from the stimulated cycle are typically cryopreserved for potential future use. Not all harvested eggs are suitable for fertilization and not all embryos may be deemed suitable for transfer. Subpar-quality eggs, abnormally fertilized embryos, and embryos displaying poor quality are routinely discarded as part of the process.

The crux of the matter in the recent ruling lies in the classification of embryos as persons under Alabama law. This designation has already raised significant questions regarding the permissible usage and storage of embryos by fertility clinics. In essence, the interpretation of Alabama law equates the legal protection of frozen embryos to that of living children. Under this interpretation, individuals who inadvertently or intentionally destroy a frozen embryo in Alabama could potentially face severe penalties, including manslaughter or murder charges.

This ruling has the potential to significantly disrupt access to fertility care as it may introduce additional regulatory burdens in an already complex medical landscape and could potentially drive up procedural costs. Although the extreme of the financial implications remains unclear, factors such as additional storage fees and liability expenses may further contribute to the rise in expenses.

On top of existing clinics closing, the ruling might lead to a reduction in IVF providers in the state. Even if clinics reopen, fertility doctors may be hesitant to practice in or relocate to Alabama. In light of the perceived risks tied to freezing or destroying embryos within this legal framework, fertility clinics across the state are already proceeding with caution, opting to restrict their IVF services, including retrievals and cryopreservation. Consequently, patients are already finding themselves compelled to seek treatment outside of Alabama, a situation that might intensify if clinics can’t get back to operating at full capacity.

How does this affect donor egg IVF?

Egg donation itself is not in as much legal limbo as eggs are not considered fetuses under current law. However, given the end goal of fertilizing and transferring the donor eggs, the ruling of course affects the donor egg IVF process.

Donor egg IVF encompasses several stages, including egg retrieval, fertilization, and subsequent embryo transfer to the intended parent's or surrogate's uterus. This ruling may necessitate procedural changes in IVF, potentially influencing the number of embryos created and transferred per cycle. Moreover, frozen embryo transfers are commonly utilized in donor egg IVF for preimplantation genetic screening. The ruling could introduce additional regulations or restrictions on the use of frozen embryos.

Many individuals and couples pursuing donor egg IVF have already been through lengthy, challenging, and expensive fertility journeys. This is particularly true for LGBTQIA+ individuals and couples who often depend on donor egg IVF to grow their families. In short, the Alabama Supreme Court only introduces more complexity and potential hardship to a landscape that’s already fraught with challenges. Regardless of where someone is in this family-building journey, this ruling has the potential to alter their trajectory.

What resources are available to those impacted and how can I get involved?

In response to these challenges, several organizations have stepped up to support individuals and families in Alabama. 

Cofertility's storage partner, TMRW Life Sciences, is offering one year of free cryostorage for frozen eggs and embryos to patients who live in Alabama and who wish to move their embryos to TMRW’s biorepository in NYC. 

Conceive is offering a free one-month membership to Conceive Premium for anyone in Alabama. Conceive Premium provides invaluable assistance and guidance throughout your fertility journey by offering 24/7 support from fertility nurses, peer coaching, community forums, and more.

Furthermore, there are various ways individuals can get involved with advocacy efforts aimed at supporting  Alabama families and protecting IVF access across the country. You can show your support for organizations that fight to uphold reproductive rights and ensure equitable access to fertility treatments like the American Society for Reproductive Medicine (ASRM) and RESOLVE, the National Infertility Association. To stay in the loop, sign up for alerts from RESOLVE’s Advocacy Network and follow @resolveorg on Instagram.

Sharing personal stories through public channels like social media can help raise awareness and amplify the voices of those affected. You can also use easily-accessible, online forms to send a letter to Congress and encourage them to address the issue. Lastly, local support groups, such as RESOLVE peer-led support groups in Alabama, provide a supportive environment for individuals to connect with others facing similar challenges.

Cofertility’s position

We at Cofertility are deeply concerned about the recent verdict and have been monitoring the situation closely. Our team is diligently tracking developments and working with our legal and professional advisors in order to navigate any potential implications side by side with our members. We understand the importance of safeguarding the rights and interests of donors and intended parents alike.

We believe the decision to seek medical support in family planning is profoundly personal and should be guided solely by patients and their healthcare providers. We believe that access to safe and effective medical care should be available to all individuals on their journey to parenthood, regardless of their location.

As a proactive measure until the law becomes clearer, we are temporarily suspending the facilitation of retrievals in Alabama where legislative uncertainty or restrictions pose potential risks to our members. We are also actively engaging with any intended parents in Alabama to assess their specific situations and explore potential paths forward. We’re focused on providing these members of our community with comprehensive support and guidance as they navigate these challenging times. If you are a Cofertility member and have any questions, concerns, or would like to get in contact with our team to talk through the specifics of your situation and how we may be able to help, please don’t hesitate to reach out.

If you’ve decided you’re ready to use donor eggs to have a baby, but you’re still unsure whether fresh donor eggs or frozen eggs are the right choice, it’s likely you have a lot of questions about the difference between the two options. After all, picking an egg donor is overwhelming enough; deciding between whether to use fresh or frozen donor eggs shouldn’t add another layer of confusion to the process. 

We’ll break down exactly what you need to know about the two different methods and how to choose which one is right for you. 

Fresh donor eggs: pros and cons

When talking about the difference between fresh donor eggs and frozen donor eggs, it’s important to remember that one of the key points is that “fresh” donor eggs haven’t yet been retrieved. Using fresh donor eggs means that the oocytes (eggs) are retrieved only after you match with a donor.

There are several reasons some intended parents choose to use fresh donor eggs, especially if both your budget and timing are flexible. 

First, you may have access to a higher number of eggs from a fresh donor cycle compared to a frozen egg batch. When using a fresh egg donor, she will go through an IVF cycle. This means that there is the potential to have more eggs available from a fresh egg donor cycle than you would receive in a frozen donor egg “batch”. With Family by Co, our egg donors split the yield of retrieved eggs and freeze their half for their own reproductive future — while donating half to your family.

Frozen donor eggs: pros and cons

If you are using frozen donor eggs, the retrieval process has already taken place (so you may be skipping a waiting period), and you can begin the fertilization and implantation process shortly after selecting your donor. This method can possibly cut time from your process and make becoming a parent all that much closer to becoming a reality.

Because a frozen donor has completed most or all of her medical screening in advance of matching, it can bring a little more certainty to the process. With screening results in hand, you’ll have more certainty over whether a donor is the right fit for your family-building goals from the outset. 

However, if you’re hoping to have more than one child, you may not have access to as many frozen eggs as you’d like. Typically, when frozen donor eggs are used they are released in batches of around six—with the option to use multiple batches if they are available. 

Fresh donor eggs vs frozen donor eggs: which is right for you?

Ultimately, for many intended parents, the choice between a fresh or frozen egg donor often comes down to finding the right donor. Both options have their merits, and the best choice for you will depend on your specific circumstances, preferences, and the connection you feel with potential donors.

If you're open to either journey, we recommend exploring both options. Consider your priorities:

• Is time a critical factor for you? If so, frozen egg donation might be your best bet.
• Do you feel strongly about using fresh eggs? Then fresh egg donation could be the way to go.
• Is the ability to meet your donor before the retrieval important to you? With donors in our  fresh egg donation program, you could have this opportunity.
• Are you looking for the highest level of financial protection? The Frozen Baby Guarantee might be particularly appealing.
  

At Cofertility, we're committed to supporting you through every step of your journey, regardless of which program you choose. Our team is here to answer your questions, address your concerns, and help you navigate this important decision.

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Roughly 20% of single-parent households are single fathers, a group that has grown substantially in the past few decades. This translates to over 2.2 million single-parent households being led by dads (unfortunately the census doesn't ask how many of those men are single dads by choice). Research shows that single fathers provide healthy and supportive environments for their children, and actually spend more time with their children than do fathers in any other family structure.

How to have a child as a single dad by choice

There are a few options for building your family as a single dad by choice. Adoption and foster care are available domestically, and some international countries allow single-parent adoption. A single man who wants to be genetically related to their child can pursue egg donation, coupled with a gestational carrier (often called a “surrogate”) who carries the pregnancy but does not have shared genetics with the child. Both of these options take time and money, but are well worth the effort.

As egg donation and surrogacy become more widely available, the number of single fathers by choice is increasing – and we are proud to serve this incredible group of intended parents! 

Considerations for anyone considering parenthood

There are two major considerations that any parent – single or coupled – must think about on their path to parenthood.

The first is the financial costs of having and raising a child. These costs vary widely depending on location and preferences. The Brookings Institution found that the cost to raise a child from birth is $310,605 per child (for a middle-class family with two children). Of course, if you live in a major city like San Francisco or New York City, expect that number to at least double. This also does not include the cost of college, an expense that continues to increase. 

The second consideration is support. Parenting, especially in the early days, is a full-time role. Think about your village, and what you need to fully support your future family. Do you live near family members who are willing to help? If you work, will the child attend daycare or will you hire a nanny? Think about the day-to-day and how you will juggle parenthood with everything else in your life. 

Advice from the daughter of a single dad

I was raised by a single father (albeit by divorce and not by choice). I had a happy upbringing, and am very close to my father to this day. One of my fondest memories is when we fixed up a vintage car together. My dad shared his life passions with me (namely cars) and I had plenty of family and friends to round out my exposure to other interests. The best part of our relationship had nothing to do with his status as a single dad. In fact, I don’t even think about him that way. He’s just my dad – a loving, supportive, dorky parent who helped shape me into the person I am today. 

Resources

• Men Having Babies is a non-profit dedicated to providing gay men with educational and financial support to achieve parenthood; we love their events and attend their annual conference!
• The National Council for Adoption has great resources for pursuing single parent adoption
• The Single Parents Alliance of America (SPAA) is comprised of information resources, programs and savings for single parents across the United States
• The Single Fathers By Choice Facebook group is an online support community of over 1,000 people who have decided to become parents on their own
• SoloParent.org is a site run by a single-dad to support solo parents of faith. They also offer online and in-person support groups
• Single Parent Advocate is a non-profit committed to educating, equipping and empowering single parents with resources, practical assistance, emotional encouragement and social networking to better their lives, and those of their children
• Parents Without Partners (PWP) is a non-profit providing single parents and their children with an opportunity for enhancing personal growth, self-confidence, and sensitivity towards others by offering an environment for support, friendship and the exchange of parenting techniques
• Fatherly is the leading digital media brand for dads
• Fatherhood.gov is a site for dads looking for tips, hints, and even deals for dads and kids
• Nathan Chan is the single dad and influencer behind the lifestyle blog Single Daddy By Choice

At Cofertility, we honor your choice to pursue egg donation and support many single fathers. Our donors aren’t doing it for the cash – they keep half the eggs retrieved for their own future use, and donate half to your family. 

As someone raised by a single father, I know first hand that single dads are more than capable of raising happy, healthy children. If we can help you build your family, please reach out!

Your doctor told you that donor eggs are your best option for starting (or growing) your family. Now, you may be curious to know what the success rates are. Donor egg success rates can look high, which can be confusing when you compare them to some of the other numbers at play.

We broke down some of the numbers you’re likely to come across when looking at the different types of success rates. We explained what they mean and where they come from.

What are donor egg success rates?

What are your chances of having a baby with donor eggs? Depending on your individual circumstances, the chances of having a baby using a donor egg may be significantly higher than the chances of having a baby with In Vitro Fertilization (IVF) using your own eggs.

IVF success rates are impacted by things like age, genetics, and other medical conditions that impact egg quality. Donor eggs may eliminate these factors. That doesn’t mean that IVF can’t be successful on its own (it can!); but, some people, especially those with low egg quality or quantity, will experience a higher rate of success if they undergo IVF with the aid of donor eggs.

Success rates at the beginning and end of the process

IVF is a multistep process, and each step along the way has its own specific success rate. It’s hard to account for all the variables that are possible with each donor and recipient; however, there are some consistencies. Please note: while these figures are well established, success is not guaranteed when it comes to donor eggs or IVF.

Frozen eggs retrieved from women under the age of 36 have a 95 percent survival rate after being thawed. This figure can present a huge relief for hopeful parents who are worried about the cost associated with obtaining eggs and fearful of the disappointment that could come along with not even getting past the first stage of the process. While those numbers are strong, they drop slightly to 85 percent when accounting for eggs that were retrieved from women over the age of 36.

And that’s not the only good news. Around 53 percent of all donor egg cycles will result in a little bundle (or in some cases, bundles) of joy that you’ve been dreaming of.

How are these numbers reported?

A division of the Centers for Disease Control and Prevention (CDC) that tracks Assisted Reproductive Technology (ART) collects these statistics. ART covers all fertility treatments where eggs or embryos are used.

Most fertility clinics in the United States report their ART numbers to the CDC, which they then review and report. The CDC's most recent report was 2019’s Fertility Clinic Success Rates Report. This found that 2.1% of babies born in America each year are the result of ART. You can check out the Society For Assisted Reproductive Technology (SART)’s website; there, search for your clinic to find out how their numbers stack up.

Success rates 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.

In 2023, Cofertility was named one of the Best Egg Donor Programs by Egg Donor Connect. That’s because we’re shaking things up and doing things differently around here. Our unique model has landed us features in FastCompany, Fortune, Women’s Health, TechCrunch, Business Insider, and more.

We take our jobs seriously, and would be honored to work with you on this journey.

How using an egg donor increases your rate of success

There are several reasons why you might find yourself considering an egg donor as you plan your family.

Poor ovarian reserve or low egg quality

If your doctor told you that you have a low egg count (diminished ovarian reserve) or poor egg quality, using donor eggs may help increase your chances of having a baby with IVF. This is because egg donors are generally young with a high egg count and quality. A reproductive endocrinologist (REI) also screens and approves donors.

Age

A woman’s chance of success with IVF is highly correlated with her age. This means, using a donor egg from a younger woman could increase your chances of success. According to the Society For Assisted Reproductive Technology, the most important factor for success when doing IVF, is the age of the woman.

• Women under the age of 30 have the highest success rate, at around 50 percent per IVF cycle.
• Women over the age of 40 have success rates that range from five to 20 percent per IVF cycle.
• When the oocytes—which are the eggs that will eventually be fertilized and become embryos—are retrieved from an egg donor (under the age of 33), those success rates trend towards the higher end of the spectrum.

Genetic disorders

Some couples carry a genetic disorder that they do not want to pass down to their children. If you’ve been diagnosed with such a disorder, you can use a donor egg to avoid having a child with that condition.

Premature Ovarian Insufficiency

Some women have something called premature ovarian insufficiency (sometimes called primary ovarian insufficiency) which causes the ovaries to stop releasing eggs and producing estrogen. Doctors may diagnose this condition in women under the age of 40.

Surgical or cancer interventions

If you’ve received chemotherapy for cancer you may have a lower than expected egg supply for your age. If you have had your ovaries removed surgically, donor eggs may be the only way you’re able to proceed on your reproductive journey.

Get more information

Just by doing this research, you’re already on the right path towards starting (or growing) your family. To browse our platform of incredible egg donors, click here.

When you decide to build your family with donor eggs, you’re forced to contend with a lot of unknowns. You may be asking yourself questions like, “what if she doesn’t pass her screening,” or “what if the cycle doesn’t yield any healthy embryos?”

These concerns are compounded by the fact that any fertility treatment comes with a hefty price tag. We know that IVF and egg donation are huge expenses for families because we’ve been there. While we can’t promise perfection, we have devised the most parent-friendly guarantee on the market. We hope this brings you peace of mind and shows you how committed we are to helping you build your family. 

Cofertility’s baby guarantee

While some agencies require you to pay extra to receive any form of a guarantee, Cofertility’s baby guarantee is built into our pricing. We want to help you bring your baby home, and we’ll re-match you for free until that happens.

What does this mean? If the donor doesn’t clear her screening… we’ll rematch you. If the cycle doesn’t lead to any blastocysts… we’ll rematch you. If none of the blastocysts turn into a pregnancy… we’ll rematch you.

In short, if at any point along your egg donation journey, something out of your control prevents you from bringing your baby home, we’ll re-match you for free or we’ll offer you a full or partial refund if you do not move forward with another donor. 

How our guarantee applies to fresh egg donation

When you match with a donor in our fresh egg donation program, you’ll put down a $500 deposit that places a five day hold on the match. After your kickoff call, you’ll sign a formal agreement with Cofertility and pay the Cofertility Coordination Fee. Both the deposit and the Coordination Fee come with our Baby Guarantee. 

The guarantee is detailed in your contract, but covers the following scenarios:

• The donor does not pass her initial screening, which may include her AMH being too low, failing a genetic screen or psychological evaluation, or just generally not passing your clinic’s donor criteria 
• The egg retrieval fails or is canceled, which includes your doctor canceling the round or no mature eggs being retrieved
• No pregnancy is achieved, which extends from the eggs failing to fertilize through to no embryos transferring or no pregnancies making it to a live birth

If the Baby Guarantee comes into effect with a fresh donor cycle, you’ll be required to pay the clinic expenses associated with your new donor’s screening and retrieval.

If you’re using a gestational carrier, this guarantee will also extend to her as applicable (e.g., the embryo transfer).

Why we don’t guarantee a number of eggs in our fresh donation program

Cofertility’s egg sharing model allows women to freeze their eggs for free when they donate half of the eggs retrieved in the cycle to your family. With Cofertility’s model, you’ll never pay the donor any cash compensation and you’ll benefit from a more collaborative, empathy-driven experience.

On top of this, very few organizations offer guarantee programs for fresh egg donation. And when there is a guarantee, it is typically a premium package that’s based on a specific number of eggs retrieved or embryos created.

At Cofertility, we understand that the number of eggs that you’ll need depends on you and your family-planning goals. For some, one cycle may yield enough eggs to grow the family of your dreams. Others may be interested in completing a second cycle, either with the same or a different donor.

Because of this, we wanted to rightsize our guarantee to fit all family-building plans. Our commitment to you is the same regardless of how you envision your family.

How our guarantee applies to frozen egg donation

When you match with a donor in our frozen egg donation program, the entire cost of your match comes with our Baby Guarantee. This goes above and beyond what you’ll find with any other frozen donation offering, which is nearly always limited to guaranteeing a single blastocyst or a single euploid embryo.

With Cofertility’s frozen program you are always guaranteed a minimum of 6 frozen eggs, though the number could be higher depending on the donor’s retrieval outcomes.

What’s more, if for any reason outside your control the frozen eggs that you receive do not lead to a live birth, we’ll rematch you with a new donor with an equivalent number of eggs for $0.

In this case, the only costs you’d need to pay are the additional shipping and fertilization expenses at the clinic. Put another way, if you received 8 frozen eggs that did not lead to a live birth, we’ll match you with a donor with at least 8 frozen eggs until you achieve the desired outcome.

If you rematch with a donor who has more frozen eggs available, you will be responsible for covering the difference in cost.

If you prefer to match with a donor in the fresh program, your Coordination Fee will be waived but you'll be responsible for the administrative and medical costs associated with her fresh donation cycle. Importantly, any administrative, medical or cycle-related fees paid to third parties or scheduled for payment (e.g., the donor’s genetic screening, donor’s travel to clinic) are not refundable once incurred.

Summing up our commitment to you

Building your family through donor eggs should be a beautiful experience, but that doesn’t mean that it will come without stressors. While we can’t control every outcome, we’ve worked hard to ensure that our guarantee protects you through every twist and turn. If you have any questions about our pricing or guarantee, please don’t hesitate to reach out. 

IVF with donor eggs has a much higher success rate than IVF with a patients' own eggs. However, it’s still not 100%. In this article, we will go over the reasons for using donor eggs, how long it takes to use donor eggs, the chances of it working, and why donor egg cycles sometimes fail.

Reasons for egg donation

According to the CDC, a substantial 12% of all IVF cycles in the U.S., over 16,000 a year, involve eggs retrieved from a donor. And donor-egg IVF has the highest success rate of any fertility treatment. 

There are myriad reasons families turn to donor eggs to build their family. For heterosexual couples, the reason is usually due to poor egg quality or quantity, recurrent miscarriages, genetic mutations, or repeated IVF failure.

Read more in Seven Reasons Families Use Donor Eggs

How long does it take to get pregnant with donor eggs?

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

The time to match with a donor can be just days (we have hundreds of pre-qualified donors ready to match with your family). After that, a donor cycle with fresh eggs can take 60-90 days from match to completion of the cycle whereas a donor cycle with frozen eggs can be quicker.

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

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

How many donor eggs do I need?

One 2015 study of 647 frozen donor eggs found that:

• 97.1% survived thawing
• 85.3% of the eggs fertilized
• 59.1% made it to blastocyst
• 84.2% of blastocysts were euploid (genetically normal)

So three donor eggs would yield a little over one genetically normal embryo on average while nine donor eggs would be expected to yield three to four euploid embryos on average. Keep in mind that this will vary depending on a lot of factors other than the egg, including the quality of the sperm and the quality of the clinic.

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Another study found the average number of eggs retrieved from donors aged 25-29 was 18 eggs, and for ages 30-35 was 16 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.

Does donor egg IVF work for the first time?

IVF cycles using donor eggs certainly have a higher success rate than using a patient’s own eggs, especially for patients who have had failed cycles or recurrent miscarriages. So while for many families, donor eggs work the first time, for others it does not work on the first try. 

Why do donor egg cycles fail?

It can be very frustrating when a donor egg cycle fails, either due to fertilization, implantation failure, chemical pregnancy, or miscarriage. And unfortunately, most of the time, it’s hard to know exactly why. 

We know that sperm plays a huge role in fertilization and embryo quality, but there’s so much we still don’t know about sperm. Even sperm that passes sperm quality and fragmentation tests with flying colors can be the cause of poor fertilization or even miscarriage.

There could also be implantation failure or miscarriage due to uterine lining issues, endometrial receptivity, or immunological factors. We still don't completely understand implantation, and unfortunately many patients never find out why they miscarried a genetically normal embryo.

Failure could also be due to the quality of the clinic you are working with. We know that IVF success rates vary from clinic to clinic. You can find the success rates of your clinic on the CDC’s SART website – however, keep in mind that some clinics have better success rates because they turn away patients with low chance of success, and other clinics have worse success rates because they work with anyone.

And sometimes, a donor egg cycle can fail simply due to bad luck. Even with improved chances of success with a transfer of a euploid embryo from donor eggs, pregnancy is not a 100% guarantee. 

Cofertility’s Baby Guarantee

When you decide to build your family with donor eggs, you’re forced to contend with a lot of unknowns. You may be asking yourself questions like, “what if she doesn’t pass her screening,” or “what if the cycle doesn’t yield any healthy embryos?” 

These concerns are compounded by the fact that any fertility treatment comes with a hefty price tag. While some agencies require you to pay extra to receive any form of a guarantee, Cofertility’s Baby Guarantee is built into our pricing. We want to help you bring your baby home, and we'll re-match you for free until that happens.

This means that if at any point along your egg donation journey, something out of your control prevents you from bringing your baby home, we'll re-match you for free or we'll offer you a full or partial refund if you do not move forward with another donor.

Read more about our Baby Guarantee.

Egg sharing programs exist worldwide to help make fertility care more accessible. Egg sharing generally describes when a donor undergoes an egg retrieval, and the resulting eggs are split between the donor and the intended parent(s). The family receiving the donor eggs pays for the egg retrieval and all associated expenses. 

In Cofertility’s Split program, donors can freeze their eggs for free when they donate half of the retrieved eggs to a family who can’t otherwise conceive. Families pursuing egg donation to build their family can match with an egg donor on our Family by Co platform.

Egg sharing programs provide an opportunity for egg donors to contribute to the fertility journey of others while also receiving a benefit for their own future family planning. In this guide, we will explore the concept of egg sharing and all the relevant information you need to know. 

What is egg donation sharing?

Egg donation sharing is a process when an egg donor agrees to donate half of her retrieved eggs to another couple or individual undergoing IVF. In traditional egg donation, the donor's eggs are exclusively given to the intended parents. However, in egg sharing, the donor has the opportunity to use some of the eggs retrieved for her own future family planning.

Egg sharing IVF

Egg sharing IVF is similar to traditional IVF in that the retrieved eggs are fertilized in a lab with the partner's or donor sperm, and then transferred to the intended mother's uterus. In egg sharing IVF, the donor's half of the retrieved eggs will be used for the intended parents, and the other half will be reserved for the donor's own use. Sometimes donors keep their eggs frozen for years, and other times they have them immediately fertilized and turned into embryos.

Egg sharing pros and cons

Pro: more affordable

One of the biggest advantages of egg sharing is that it allows for more affordable access to IVF for intended parents. Additionally, egg sharing can be a good option for egg donors who want to help others and also want to have the option to use some of their eggs for their own family planning in the future. 

Pro: less icky

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.

Why is cash compensation problematic? A 2021 Harvard study found that 62% of donor-conceived adults felt the exchange of money for donor gametes was wrong, and 41% were troubled by the fact that money was exchanged around their conception. By allowing our donors to freeze their eggs as part of the process, our unique model honors everyone involved.

Pro: better for everyone involved

Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.

Con: there are still risks

Egg freezing is considered a safe procedure. In a single egg freezing cycle, the risk of a serious adverse event is under 2.5%. Severe OHSS accounts for the majority of complications, occuring in 0.1-2% of cycles. The risk of other acute complications, including pelvic infection, intraperitoneal hemorrhage, or ovarian torsion, is small (<0.5%).

That being said, many women do experience minor side effects – like bloating, constipation, nausea – from the medications and egg retrieval. 

Egg sharing criteria

Our team screens donors through a rigorous, multi-step process to ensure each person is qualified and prepared to become an egg donor, going above and beyond FDA and ASRM-recommended screening guidelines. Before donors can be listed on our platform, we review their personal and family medical history and collect information on their lifestyle and behavioral habits. Most importantly, we meet 1:1 with every donor to get at the core of who she is as a person — her values, her goals, her personality. This allows us to provide you with the most thoughtful match possible.

Once you move forward with a match, the donor will undergo a physical examination, psychological evaluation, and full genetic screen. Your doctor will review these results and give us the green light to move forward. We will also ensure that donors are screened for background and education checks. 

What are the costs of egg sharing? 

The cost of egg sharing can vary based on whether you opt for a fresh or frozen donation cycle as well as other factors like the fertility clinic or donor's location. Unlike traditional egg donation, donors in egg sharing programs do not receive cash compensation, which can reduce your overall expenses.

For a more detailed breakdown of Cofertility's pricing, including estimates, you can visit our pricing page. All of our pricing also includes our Baby Guarantee, our promise that if for any reason outside your control your initial match does not lead to a live birth, we’ll re-match you for free until that happens.

What the data says about egg sharing

There is limited data on the success rates of egg sharing compared to traditional egg donation. However, some studies have suggested that egg sharing may result in higher success rates because the donor's eggs are being used in her own treatment cycle, meaning she may be more invested in the outcome. 

This study of 276 egg-sharing cycles concluded that egg sharing “provides a good opportunity for recipients and egg-sharing donors to achieve a live birth”. Specifically, the study found that by sharing (donating) their eggs with another family, the egg sharers did not reduce their chances of pregnancy and live birth.

“Those patients participating in an egg-sharing programme are providing a valuable resource of donor eggs,” the authors noted, “while not compromising their own treatment outcome or putting themselves at any additional risk of complications”.

At Cofertility, the average number of mature eggs a family receives and fertilizes is 12. Some intended parents want to do two egg retrievals with the donor which is definitely possible. We also ask each of our donors whether they are open to a second cycle as part of the initial application — many report that they are!

You can see how many eggs are retrieved in the first cycle and go from there. If, for any reason, the eggs retrieved in that round do not lead to a live birth, our baby guarantee will kick in and we’ll re-match you at no additional match deposit or Cofertility coordination fee.

Will I regret egg sharing?

Egg donors

While some egg donors report feeling a sense of pride and fulfillment from helping others build their families, others may experience feelings of regret or sadness. We have found that people who donate their eggs as part of an egg sharing program are less likely to feel regret. 

In fact, egg share donors usually feel that egg sharing was a win-win solution for donors and recipients alike. One study found egg share donors are happy with their decision, and 83.3% would donate again. Only 2.1% regretted their decision to participate.

Donor egg recipients

Ask anyone who has had a child, born with or without some type of assistance, and they will all tell you the same thing: parenting is the greatest - yet hardest - thing they have ever done. It doesn’t matter how the child came into their lives, the role and relationship of parent and child is the same. 

When working with parents who had donor conceived children, we have found their only real regret was they wished they had done this sooner. They wished they had let go of their preconceived notions that a baby who looks like them or who shares their genes is the only way to be a parent. That bringing a child into their lives using alternative methods means the child won’t see them as their real parent, or that they will not bond. 

Egg sharing programs near me

We work with families and egg donors around the world! Cofertility is unique in that we are clinic-agnostic, as long as the clinic reports outcomes to SART and has a CAP certified lab. Some clinics have specific requirements related to working with outside donors and have policies in place for how they handle those cases. If you already have a clinic in mind, reach out to our team and we can send a list of questions that we recommend you ask them before getting started. 

Best egg sharing program

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!

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

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

What is donor egg IVF?

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

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

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

What are the odds of getting pregnant with donor eggs?

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

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

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

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

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

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

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

Chances of twins with donor eggs

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

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

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

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

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

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

Can I transfer two donor egg embryos?

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

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

Risk of pregnancy with multiples

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

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

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

The bottom line

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

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

Learn about egg sharing

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

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

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

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

We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account to get started today!

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!

In vitro fertilization (IVF) using donor eggs has become an increasingly popular option for couples struggling with infertility as well as LGBTQ+ families. One question that often arises is whether it is possible to choose the gender (sex) of the baby when doing donor egg IVF. In this article, we will explore the answer to this question.

First off, let’s understand gender vs. sex

Gender and sex are two distinct concepts that are often used interchangeably, but they refer to different aspects of a person's identity. 

Sex refers to the biological and physiological characteristics that define a person as male, female, or intersex. This includes chromosomes, hormones, and reproductive organs. In most cases, a person's sex is determined at birth based on their physical anatomy. 

Gender, on the other hand, refers to the socially constructed roles, behaviors, and expectations that are associated with being male, female, or non-binary. Gender is often expressed through a person's appearance, clothing, interests, and personality traits. It is a complex and multifaceted aspect of identity that can vary widely between cultures and over time. 

It's important to note that gender and sex are not always aligned, and it's possible for a person's gender identity to differ from their biological sex. While “gender selection” is the term traditional used, it’s actually “sex selection” of the embryo. 

What is gender selection and how does it work?

To answer this question, it’s important to understand the IVF process. During IVF, eggs are extracted from a woman's ovaries and fertilized with sperm in a laboratory. Once fertilized, the resulting embryos are monitored for development before being transferred to the uterus of the intended mother or a gestational carrier. In donor egg IVF, the eggs used for fertilization come from a donor, rather than the intended mother.

Gender selection with IVF is a process in which a family finds out the sex of the embryos before the embryo is transferred. This is typically done using preimplantation genetic testing (PGT), a procedure in which a small number of cells are taken from the embryos during their development in the laboratory, and their DNA is analyzed to determine their sex.

There are various reasons why someone may want to use gender selection through IVF. One common reason is “family balancing”, where a parent may want to have a child of a particular gender to balance out the gender distribution in their family. For example, a couple with three daughters may want to try for a son.

Another reason is related to genetic disorders that are linked to a specific gender. Some genetic disorders, such as hemophilia, are more common in males, and parents who are carriers of the gene may want to select a female embryo to reduce the risk of passing on the disorder to their child.

Can I select my baby’s gender when doing donor egg IVF?

When it comes to choosing the gender of the baby in IVF, it is possible to do so through PGT. As stated above, PGT is a procedure in which a small number of cells are taken from the embryos during their development in the laboratory, and their DNA is analyzed to determine their sex. The embryos of the desired sex can then be selected for transfer.

However, it's important to note that PGT is not 100% accurate. The technology used to analyze the embryos is highly sophisticated, but it is not perfect. There is still a small margin of error (<1%) that can result in the wrong gender being selected for transfer.

Some fertility clinics have guidelines around gender selection, and will only transfer the best quality embryo based on morphology. Furthermore, PGT testing for sex selection can add time and cost to your journey.  

Is gender selection ethical?

Gender selection for non-medical reasons raises some ethical concerns, and some countries even have laws that prohibit it for non-medical reasons.

Some argue that gender selection perpetuates gender stereotypes and reinforces the idea that one gender is preferred over another.  Other critics argue that allowing gender selection could lead to a slippery slope of other forms of selective breeding, such as selecting for traits like intelligence or athleticism. Furthermore, gender selection is expensive and may only be available to those with the financial means to access it, creating a divide between those who can afford it and those who cannot. Overall, the ethical considerations of gender selection are complex and depend on individual circumstances. 

Conclusion

There are various reasons a family may want to choose a baby’s gender while undergoing donor egg IVF. From medical reasons to family balancing, it’s important to talk to your doctor if gender selection is important to you. Remember, gender selection of embryos is not always accurate, and there is a small margin of error that can result in the wrong sex being selected. Ultimately, the most important goal of any fertility treatment should be the health and well-being of the baby and the family.

Using donor eggs can be a life-changing experience for couples struggling with infertility. For many, it is the best way to achieve a successful pregnancy and start a family. However, using donor eggs can sometimes be an overwhelming process, and there are many things that you may not be aware of until you start the process. In this article, I will lay out some things that you should know about using donor eggs.

If you’ve done IVF before, you know the drill

IVF can be broken down into three phases: 

1. The retrieval phase, where the eggs are matured and extracted
2. The embryo phase, where eggs are fertilized and monitored in the lab
3. And the transfer phase, where an embryo is transferred to the uterus of the intended mother or gestational carrier

With donor eggs, the egg donor undergoes the retrieval and then her job is done. The eggs are then fertilized with the sperm of the intended father (or a sperm donor) and grown for three to seven days under the careful eye of a trained embryologist. At this point, some families opt to do genetic testing. Once the embryo is ready, the intended mother, or a gestational carrier, takes over to carry the pregnancy to term.

Unless your doctor has determined that it is impossible or dangerous for you to safely carry a pregnancy, you can absolutely undergo IVF and get pregnant with donor eggs. 

Choosing an egg donor is a huge decision

Finding an egg donor can be a challenging and time-consuming process, and rightfully so! You want to ensure that you find the right match that you feel good about. When choosing a donor, it's essential to consider factors such as physical traits, medical history, and personality. At Cofertility, we have hundreds of pre-qualified donors ready to be matched. You can create a free account to begin your search. 

Medical screening of the donor will help increase your chances of success

Donors are screened for various genetic and infectious diseases before they can donate their eggs. This screening process is designed to ensure that the donor is healthy and that there is minimal risk of passing on any genetic or infectious diseases to the recipient or the baby. Additionally, their ovarian reserve is tested to help ensure that they are likely to produce enough mature eggs. The screening definitely adds time to the process, but is intended to help increase your chances of success.  

You’ll need a lawyer who specializes in third-party reproduction

There are state-specific legal considerations to be aware of when using donor eggs. It's essential to have an iron-clad legal agreement in place that outlines the terms of the donation and the rights and responsibilities of all parties involved. No clinic will accept a patient and egg donor without this contract in place. If you work with Cofertility, we will help ensure you and your donor have expert lawyers drafting this contract.

Donor eggs can 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. 

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

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.

It might get emotional

Using donor eggs can be an emotional journey for intended parents. It can create feelings of loss, sadness, anger, and possibly even shame. You may feel a deep sense of grief over not having a genetically linked child. Give yourself space to express your feelings and time to process this loss. Avoidance and distraction can only be helpful for so long. Allow yourself to sit with your feelings. Give yourself permission to move forward at your own pace.

Remember, DNA is a small part of who we are. All human beings are 99.9 percent identical in their genetic makeup and nurture plays an enormous role in who we become and who we bond with.

It will be expensive

IVF alone is expensive, and then there’s donor eggs. The total cost can end up being tens of thousands of dollars, depending on the clinic, the egg donor, and if your insurance or employer covers any of it. 

Know this: our donors aren’t doing it for the money. At Cofertility, our donors freeze their eggs for free in exchange for donating half of the eggs to your family. This saves families tens of thousands of dollars on donor compensation. 

You won’t regret it

Ask anyone who has had a child, born with or without some type of assistance, and they will all tell you the same thing: parenting is the greatest - yet hardest - thing they have ever done. It doesn’t matter how the child came into their lives, the role and relationship of parent and child is the same. 

When working with parents who had donor conceived children, their only real regret was they wished they had done this sooner. They wished they had let go of their preconceived notions that a baby who looks like them or who shares their genes is the only way to be a parent. That bringing a child into their lives using alternative methods means the child won’t see them as their real parent, or that they will not bond.  Read more in Will I Regret Using Donor Eggs?

In summary

Using donor eggs can be an excellent option for couples struggling with infertility. It's important to be aware of the various factors involved, including finding a donor, medical screening, legal considerations, success rates, emotional impact, cost, and talking to your child. With the right support and information, using donor eggs can be a positive and fulfilling experience, leading to the creation of a loving and happy family.

If you're in your 40s or 50s and looking to grow your family, you may be considering IVF with donor eggs. In fact, according to the CDC, a substantial 12% of all IVF cycles in the U.S. involve eggs retrieved from a donor. Donor-egg IVF has the highest success rate of any fertility treatment. But is there an age limit for intended parents pursuing this path? Let's take a look:

Parent age and egg donor IVF

Age is one of the biggest factors in the ability to get pregnant. And even with IVF, the chances of success with our own eggs declines as we reach our 40s. The great part about IVF is that you can find out if an embryo is genetically normal (and thus less likely to miscarry) before you attempt a transfer. This can save time and heartache. 

Data from the Society for Assisted Reproductive Technology (SART) shows the following chances of a live singleton birth using your own eggs via IVF:

• 38.3% for women 35-37
• 25.1% for women age 38-40
• 12.7% for women age 41-42
• 4.1% for women over 42

It’s important to remember that your age when you (or your gestational carrier) get pregnant is not as important as the age of the eggs. That means your chances of success getting pregnant, no matter your age now, is better with younger eggs. But how do you get younger eggs? For some lucky women, they can use eggs they froze years ago. But for most of us, getting younger eggs means turning to egg donation. 

My age vs. my donor’s age: which is more important?

Studies show that your chances of success using donor eggs does not diminish in your 40s. So while getting pregnant with your own eggs may be unlikely, using donor eggs can greatly increase your chances of a successful and healthy baby well into your 40s and even 50s.  

Many women in their 40s and 50s can carry a pregnancy when using donor eggs, although some need to use a gestational carrier for a variety of reasons. 

Is there an age limit for IVF with donor eggs?

Technically, there is no age limit (legal or otherwise) in the United States for pursuing IVF with or without donor eggs.  But ASRM discourages IVF for women older than 55, and some clinics set their own age limits for patients they will treat. 

For women over 45 years old, ASRM advises:

• “Comprehensive” medical testing for cardiovascular and metabolic fitness to ensure the safety of the mother and baby during pregnancy 
• Psychosocial evaluation to determine if support is in place to raise a child to adulthood
• Counseling patients on potential increased medical risks related to pregnancy

For families using donor eggs and a surrogate, ASRM would advise that the family undergo psychological evaluation to ensure the parents are equipped to raise the child at an older-than-average age. 

Supporting mothers of all ages

There is no age limit for men having children and there is no maximum age for US domestic adoption – so why would we put an age restriction on mothers via egg donation? Generally, these restrictions are for her own health during pregnancy. 

All pregnancies have risks, and pregnancy after 50 is no exception. One small study followed 45 healthy mothers ages 50-63 who used donor eggs, and found that 35% experienced pregnancy-related hypertension (high blood pressure), 20% experienced gestational diabetes, and 78% had a cesarean section. These numbers are higher than the general population. 

But what if a gestational carrier (surrogate) carries the donor egg pregnancy? Then the argument turns to the ability to parent. 

ASRM lays out some compelling arguments in favor of donor egg IVF for women over 45:

• Older people (grandparents) raise children all the time in our society, and successfully at that. So there’s no reason to think older parents wouldn’t have the physical and psychological stamina for raising children.
• Older men often have children, and there is no set age limit for males in IVF. So why create limits for women?
• Our society respects the rights of individuals to make reproductive choices regardless of age or life expectancy. For example, we don’t ban someone with a terminal illness from becoming a parent. So why stop someone else because of their age?

Benefits of having children later

Becoming a parent at an older age certainly has pros and cons, and is different for everyone. But here are some benefits to having children in your 40s and 50s:

• Financial security: older parents tend to have more financial freedom and savings, making the financial commitment of parenting less daunting.
• Emotional maturity: Older parents feel more ready and mature. In a study of older parents, 72% of mothers and 57% of fathers expressed that the emotional maturity associated with age provided a clear advantage to having children later in life.
• Smoother parenting: One study found that older maternal age was associated with fewer behavioral, social and emotional difficulties
• More life experiences: People who start families later in life have had more opportunity to check things off their bucket list – travel, work accomplishments, hobbies – and may not feel like parenting is as much a compromise in their lives. Plus, they have more to teach their littles! 

Summing it up

There is no formal age limit for pursuing donor egg IVF, although ASRM discourages it for women over 55 and fertility clinics may set their own age limit. Anyone over 45 is recommended to undergo comprehensive medical testing, counseling, and a psychosocial evaluation. There are pros and cons to becoming a parent at any age, and these should be carefully considered when making the decision. 

FAQ

What is “advanced maternal age” (over 35) “advanced reproductive age” (over 45)

Advanced maternal age is a not-so-great term used by the medical community to describe a potential pregnancy for women over 35. Advanced reproductive age refers to women over 45.  Interestingly, there is no similar term for males trying to conceive at any age. 

Am I too old to become a parent?

This is a question only you can answer. How is your health? Do you have a support system that could help raise the child if anything were to happen to you? Are you financially ready? These are questions any parent, at any age, should ask before building a family. 

What is donor egg IVF?

Donor egg IVF is an IVF cycle that uses a young, medically-cleared woman's eggs, which are then fertilized and implanted into the uterus of the intended mother or gestational carrier. 

How can I find an egg donor?

Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. Create a free account today to get started!

Breastfeeding is a way of providing nourishment to newborns and infants. It has been widely recognized as the best form of nutrition for infants and has many benefits for both the mother and the baby. However, breastfeeding is not always easy and it's not for everyone. 

And if you are pursuing donor eggs to grow your family, you may be wondering if you will be able to breastfeed if the child is not genetically related to you. In this blog post, we will answer all your questions. Let’s dive in!

First off, what are the benefits of breastfeeding? 

There are loads of benefits to breastfeeding, including:

• Nutritional benefits: Breastmilk is the perfect food for infants as it contains all the necessary nutrients in the right proportions, including proteins, carbohydrates, fats, vitamins and minerals. Additionally, breastmilk changes to adapt to the baby's needs as they grow and develop.
• Health benefits: Breastfeeding can reduce the risk of certain illnesses and conditions in both the mother and the baby. For the baby, it can reduce the risk of infections, allergies, asthma, and obesity. For the mother, it can reduce the risk of breast and ovarian cancer, osteoporosis and postpartum depression.
• Bonding: Breastfeeding can create a special bond between the mother and the baby as it involves physical and emotional contact. Additionally, the release of the hormone oxytocin during breastfeeding can promote feelings of calm and well-being in both the mother and the baby.
• Convenience: Breastfeeding can be convenient as it does not require any preparation, bottles, or clean-up and it's always available and at the right temperature!

But – let’s not act like it’s easy. What are the challenges of breastfeeding?

Breastfeeding can be a wonderful experience for both the mother and the baby, but it can also be really hard, or even impossible. Here are a few common challenges that mothers may face when breastfeeding:

• Physical challenges: Breastfeeding can be physically challenging, especially in the first few weeks. Some mothers may experience sore nipples, engorgement, and mastitis. Additionally, some mothers may have difficulty producing enough milk or have a medical condition that makes breastfeeding difficult.
• Time-consuming: Breastfeeding can be time-consuming, especially for mothers who are working or have other responsibilities. It can be difficult to schedule feedings around other activities and it can be challenging to pump and store milk when away from the baby.
• Social and emotional challenges: Breastfeeding can be difficult in social situations and some mothers may feel self-conscious breastfeeding in public. Additionally, some mothers may experience emotional challenges such as postpartum depression or feelings of isolation.
• Limited flexibility: Breastfeeding can limit a mother's flexibility as it requires the baby to be close by and available for feedings. This can make it difficult to travel or have a night out without the baby.

So can I breastfeed a donor-conceived baby if they are not genetically related to me?

Yes – in general, most mothers are able to breastfeed their donor-conceived child. But, it depends on the individual case and the methods used to achieve the pregnancy. 

If you carry the pregnancy, your body will work the same way it would if you got pregnant any other way. Lactation is a biological, hormonal response that occurs during and after pregnancy. Whether your baby was conceived from your own eggs or donor eggs, your body will trigger specific hormones to initiate milk production. So if breastfeeding is easy or hard for you – know that it would be that way regardless of the genetics of the baby. 

Can I breastfeed if I use a surrogate?

Yes – it is possible for some women who did not get pregnant to breastfeed their child; but it’s  not easy. This process is known as induced lactation, a process in which a woman can stimulate milk production through a combination of techniques such as hormone therapy, breast pumping, and/or breast massage.

The process of induced lactation can take several weeks or months, and you’ll need to work closely with a lactation consultant to ensure the process is done safely and effectively. The amount and quality of milk production can vary greatly and in some cases, it might not be enough to fully sustain an infant, therefore the use of formula may be necessary (and that’s OK!).

Induced lactation is not an easy process and it may require a lot of time, effort, and dedication. You should also consider the emotional and psychological aspects of this process, as it may bring up feelings of sadness, disappointment, or loss, especially if the woman has a history of infertility or has gone through a difficult pregnancy.

Will breastfeeding pass on my DNA?

If you breastfeed a donor-conceived child, they will not receive your DNA through the breastmilk. DNA is the genetic material that is responsible for the inherited traits and characteristics of an individual. It is present in every cell of the body and is passed onto offspring through the egg and sperm cells. Breastmilk is produced by the mammary glands and contains a mix of different nutrients, antibodies, and hormones that are beneficial for the growth and development of a baby, but it does not contain DNA.

The benefits of breastfeeding your donor-conceived child

In addition to providing an important source of nutrition and immune support for your baby, breastfeeding can play a significant role in the bonding and attachment between a mother and her donor-conceived child. The act of breastfeeding can release hormones like oxytocin in both the mother and the child, which can help to promote feelings of love, calm and bonding. 

One study of mothers who breastfeed their children found that they exhibit more maternal sensitivity. Maternal sensitivity was defined as the synchronous timing of a mother’s responsiveness to her child, her emotional tone, her flexibility in her behavior and her ability to read her child’s cues. However, the effect sizes were small, so don’t stress out if breastfeeding isn’t possible.

Summing it up

If you have a baby through donor eggs, and you carry the pregnancy, you can breastfeed just as you would otherwise. Even if you use a gestational carrier (surrogate), breastfeeding is still possible, although more difficult, through induced lactation. This is a process in which you stimulate milk production through a combination of techniques such as hormone therapy, breast pumping, and/or breast massage. There are a lot of pros and cons to breastfeeding, and it’s best to work with your provider to determine what’s best for your family. We are wishing you all the best on your journey!

When it comes to starting or expanding a family, many couples and individuals may turn to assisted reproductive technologies (ART) such as in vitro fertilization (IVF) to help them achieve their goal. One aspect of IVF that many patients are offered– whether using their own eggs or donor eggs – is preimplantation genetic testing (PGT). But is it necessary to do PGT testing with embryos made from donor eggs? Let’s dive in and find out. 

What is PGT?

PGT is short for PGT-A, or “Preimplantation Genetic Testing for Aneuploidies,” and you may also hear it referred to as PGS (“Preimplantation Genetic Screening”) or PGD (“Preimplantation Genetic Diagnosis”) which are various forms of testing embryos. 

PGT testing looks at an embryo to see if it contains the correct amount of chromosomes. Embryos with the right number of chromosomes — 46 — are considered “euploid,” and those with extra chromosomes or chromosome deletions are considered “aneuploid.” PGT is a way to screen for genetic disorders in embryos created through IVF before they are transferred to the uterus. 

PGT testing and age

Here’s an annoying fact: the percentage of embryos that are euploid decreases as we get older. So not only do we have fewer eggs as we age, but the chances that any one egg turns into a healthy baby decreases too.

One study of over 15,000 embryos found that the lowest risk for embryonic aneuploidy was between ages 26 and 30, and that older age groups had the lowest chance of a genetically normal embryo. 

As you can see, chromosomal abnormalities of embryos are normally due to the age of the egg (or rather, the age of the mother or egg donor at the time the egg is retrieved). Since donors are under the age of 33 and healthy, embryos made with donor eggs have a good chance of being genetically normal. So, is it still worth PGT testing donor egg embryos? That leads us to the next section…  

The upside of PGT testing donor eggs

There are definitely some benefits to testing donor eggs:

• Gender selection. PGT testing allows for gender selection. Most clinics allow you to know each embryo’s gender, which can be helpful for families that have a preference.
• Rule out sperm issues. PGT testing of embryos made from donor eggs may also be suggested for couples with male infertility, especially if the sperm has shown chromosome translocations or abnormalities.
• Pick the healthiest embryos. PGT can detect genetic disorders such as cystic fibrosis, Tay-Sachs disease, and sickle cell anemia, allowing for the selection of embryos that do not carry these disorders.

The downside to PGT testing

However, a lot of fertility doctors will say it’s okay to pass on genetic testing with embryos made from donor eggs. Here’s why:

• It’s expensive.The cost of PGT can vary depending on the type of testing done and the clinic you're working with, but it can be thousands of dollars. 
• Added time. It can take some testing companies weeks to give you the results. Time goes so slowly during IVF, and adding additional time can be a major downer. 
• False positives or negatives. PGT can be prone to false positives or negatives, meaning an embryo that is genetically normal could be labeled as abnormal, or vice versa. 
• There’s a small risk to the embryo. The biopsy process, which removes cells from each embryo to be sent for testing, has a chance of damaging the embryo. Also because the embryo must be frozen in order to do PGT testing, there’s risk in having to be thawed and unthawed. 

But the biggest downside is that PGT might not even improve the chances of pregnancy for those using donor eggs! Remember that chart you saw above? If embryos are made from donor eggs, where the donor is under 35… the chances of each embryo being euploid is pretty high. 

Let’s look at the data. A 2020 study looked at 1,291 donor-egg cycles across 47 IVF clinics– 262 cycles with PGT testing and 1,029 without. Live birth rates occurred:

• 53.8% of donor-egg cycles with PGT testing 
• 55.8% of donor-egg cycles with without PGT testing

Yes, you read that right. The donor-egg cycles that skipped PGT actually had higher live birth rates than those who paid to have the embryos PGT tested. The researchers concluded that PGT testing in donor egg-recipient cycles does not improve the chance for live birth, nor does it decrease the risk for miscarriage. But it does increase cost and time for the patient. 

Summing it up

PGT can be a useful tool for patients who are at risk for passing on a genetic disorder or have a family history of a particular condition, however it may not be that useful for those using healthy donor eggs. The financial cost, time, false positives or negatives, and risks to the embryo are all important factors to consider. This is definitely a question and conversation you want to have with your doctor who can help you make the best decision. Good luck!

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.