IVF

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

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

What is carrier screening?

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

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

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

ASRM recommendations

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

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

How is carrier screening done? 

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

What does a positive carrier screen mean?

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

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

What does a negative carrier screen mean?

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

Are genetic carrier screens accurate?

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

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

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

How is carrier screening different from PGS testing?

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

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

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

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

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

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

Why is carrier screening important in donor egg IVF?

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

What do different panels mean?

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

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

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

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

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

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

What is PGT-M and how does it differ from PGT-A?

PGT-M testing (Preimplantation Genetic Testing for Monogenic disorders) is a form of genetic testing used to screen embryos for specific inherited genetic conditions. When the sperm source and egg donor are known to be carriers of the same condition, this test can be helpful in identifying which embryos have the genetic mutation associated with that condition and which do not.

Much like the PGT-A testing mentioned above, PGT-M works by testing embryos prior to embryo transfer. A small biopsy is taken from the embryo, and its DNA is analyzed. The difference between the two is that PGT-A testing looks for chromosomal abnormalities while PGT-M testing looks for the presence of the specific genetic mutation associated with the condition in question. 

While PGT-M provides invaluable information, it’s important to note that it only tests for specific known mutations. It cannot detect all genetic conditions, nor does it guarantee that a child will be free from all forms of genetic disease. Despite this, PGT-M testing can help in making informed decisions about embryo selection in preparation for embryo transfer.

The bottom line

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

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

References

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

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

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

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

The biological basis: egg quantity and quality

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

IVF and Age

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

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

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

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

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

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

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

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

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

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

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

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

Summing it up

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

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

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

Find an egg donor through Cofertility

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

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

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

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

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

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

Read more:

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

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

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

First consideration: your age

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

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

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

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

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

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

Second consideration: your ovarian reserve

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

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

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

Third consideration: the emotional impact of unsuccessful attempts

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

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

Fourth consideration: finances

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

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

Fifth consideration: time

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

When should I switch to donor eggs?

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

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

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

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

Finding your path to parenthood

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

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

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

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

Read more:

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

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

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

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

What are GLP-1 medications?

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

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

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

​​GLP-1 medications, obesity, and fertility

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

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

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

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

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

Can you take GLP-1 medications while pregnant?

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

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

Summing it up

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

Here are some key points to remember:

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

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

When embarking on the journey of building a family with the help of an egg donor, there are a lot of people trained and ready to help you. Understanding who these individuals are, their functions, and the right time to engage them can be pivotal in your path to parenthood.

Here, we delineate the various members of your fertility care team and the services they offer, providing clarity on who you will be collaborating with during your journey with an egg donor.

Obstetrician-Gynecologist (OBGYN)

An OBGYN, specializing in women's reproductive health, provides essential insights into fertility and hormonal health. While not directly involved in the egg donation process, their advice is a critical step towards more specialized treatment.

Reproductive Endocrinologist (REI)

An REI, an OBGYN with additional training in reproductive endocrinology, is pivotal in your journey. They specialize in the hormonal and medical aspects of fertility, overseeing the egg donation process, including the screening and preparation of the donor eggs.

Nurse Coordinator

Acting as a central figure in patient care, the Nurse Coordinator ensures smooth coordination of patient education, scheduling, and medication management, vital for synchronizing the efforts of the entire fertility team.

Embryologist

The Embryologist, based at the fertility clinic, plays a crucial role. They are responsible for the fertilization and cultivation of embryos, using the donated eggs, and ensuring their optimal development.

Egg Donation Agency

For additional guidance and support, agencies like Cofertility streamline your journey. We assist in finding the right clinic, connecting with egg donors, and filling in gaps beyond what a standard fertility clinic offers.

Surrogacy Agency

A Surrogacy Agency is helpful for intended parents who need a gestational carrier in their journey. Agencies can help handle various aspects, including legal agreements, surrogate screening, and coordination of the pregnancy journey, ensuring a smooth and supportive surrogacy process.

Read: Which Should I Find First: An Egg Donor or a Surrogate?

Financial Counselor

Understanding and navigating the financial aspects of egg donation is a significant concern. Financial Counselors, who are generally employed by a fertility clinic, specialize in clarifying this area, helping you explore insurance and financing options.

Fertility Courier

The Fertility Courier, though often unseen, is entrusted with the critical task of safely transporting frozen embryos from the egg donor’s clinic to yours, playing a vital role in the logistical aspect of your journey.

Cryostorage Facility

A cryostorage facility serves as the vault for your frozen tissue. Specializing in the preservation of biological material, these facilities are where your eggs and embryos reside when not in use. We have a partnership with TMRW where we have negotiated discounted rates for our members. 

Genetic Counselor

Being a carrier doesn't mean you have the condition, but it can still be concerning when your genetic testing reveals you have a genetic predispositions to certain conditions. Your genetic counselor helps you understand the implications of your carrier status. They can explain the risks, potential impacts on future children, and provide guidance on family planning.

Third-Party Reproductive (TPR) Care Coordinator

A clinic employee who works in the field of assisted reproductive technology (ART) and reproductive medicine. Their primary role is to facilitate and coordinate various aspects of third-party reproduction, which involves using donated eggs, sperm, or embryos, as well as gestational surrogacy.

If you work with Cofertility, there are even more people you will work with along the way.

Our Family by Co platform honors families and egg donors with a thoughtful, human-centered matching experience. Our unique model empowers women to take control of their own reproductive health while giving families the gift of a lifetime.

Member Advocate

At Cofertility, the Member Advocate serves as your personalized concierge, easing communication among all the parties above and ensuring a smooth journey  from start to finish. A Member Advocate plays a crucial role in supporting you through the complex and highly regulated process of egg freezing and donation, helping you navigate the medical, emotional, and logistical aspects of preserving your fertility with compassion, evidence-based research and trustworthy guidance.

Fertility Psychologist

Emotional support is invaluable. A Fertility Psychologist on the team offers therapeutic support, addressing the psychological and emotional dimensions of your journey.

Third-Party Reproduction Lawyer

Upon matching with a donor, a Fertility Lawyer ensures all agreements adhere to legal standards. We can help you find a lawyer with expertise in this space, or you can find your own. 

Each individual's journey is unique, and not everyone will need the same team or services. It's crucial to ask questions and advocate for your needs, as your path should be as unique as you are. The most important member of your fertility team is you.

Cofertility has a preferred network of partners nationwide, ready to assist in every aspect of your egg donation journey, from legal contracts to embryo storage. While this list might seem daunting, working with us ensures that most interactions are efficiently managed on your behalf.

One of the first things a woman may think about after learning that an egg donor is required in order to have a child, is the worry of attachment. Specifically, will I have issues attaching to my baby because we are not genetically related? The reason for this train of thought may stem from common misconceptions or stereotypes that all mother’s immediately bond and connect with their child and that a genetic relationship is required for that attachment to even take place.  

Social media definitely loves to show that “perfect” moment after a woman gives birth where the mother looks lovingly into her healthy child’s perfect round face - with her hair, makeup and lighting fully on point - proclaiming this to be her greatest love of all. But rarely do we get to peek at what is happening behind the curtain. 

Whether an egg donor is needed to create a baby or not, many parents do not immediately connect, attach or bond with their baby. This lack of attachment has nothing to do with a lack of genetic connection, but everything to do with this new found responsibility, the shock of a new identity and purpose, hormones, lack of family support, lack of sleep, and just trying to survive those first few months. The purpose of this article is to examine attachment between mother’s and their donor conceived babies and to give a better understanding of attachment and how it works. 

Attachment theory and parent-child bonding

Psychologist John Bowlby described attachment as the emotional connection between an infant and their primary caregiver. The parent-child attachment lays the foundation for the child's life choices, overall behavior, and the strength of the child’s social, physical, mental, and emotional health. According to Bowlby, attachment develops  through interactions between infant and caregiver that evolves and grows deeper over time. This attachment typically occurs when a child is about six months old. 

Research and findings: attachment in donor egg families

Evidence from the attachment literature focuses on the importance of parental responsiveness as to what differentiates the type of attachment formed between parent and child - not whether they are genetically related. From the perspective of attachment theory, what is important for secure attachment to occur is not genetics but the consistency, availability and love that is shown to the child by the caregiver. It is parental responsiveness, rather than biological relatedness, that is considered to be important for the development of secure attachment relationships between a parent and a child. Meaning genetics does not play a role in secure attachment. 

It is parental responsiveness, rather than biological relatedness, that is considered to be important for the development of secure attachment relationships between a parent and a child.

Further insights from the adoption literature suggest that overall, parents who adopted their children reported few differences in the attachment behaviors between them and their adopted children versus parents and non-adopted children. Further adopted children and adolescents did not report feeling less secure in their relationships with their parents compared to non-adopted children. 

It appears that the caregivers' behaviors played a more important role when it comes to attachment. For example, Bowlby found that children whose parents were sensitive and responsive were likely to view themselves as loveable and have a positive sense of self. Whereas children whose parents were emotionally unavailable or rejecting, were more likely to develop a lack of self-worth. 

So the question of “will I have attachment issues to my baby because we are not related?” is not the question to ask, rather, “am I ready to be emotionally available to a child? Am I ready to be a parent?”

Existing research on attachment in families with donor egg children found that families with no genetic link between mother and the child showed more positive outcomes than families where the mother was genetically related to the child. The authors posed the possible explanation that perhaps this was true because these parents took the extra steps required to intentionally choose to raise a child who was not genetically related to them. Since that strong desire for parenthood was more important to them than genetic relatedness and since they had to move mountains to become parents, they found parenting to be more satisfying than those who become parents through “traditional routes.” Remember, this is just a hypothesis and it is definitely not implying that genetically related parents love their children less than parents not genetically related to their children. It could mean that the parents using donor eggs were perhaps more prepared - as they may have spent years planning for this baby. And finally having that dream realized makes them not take having this baby for granted. 

What does genetics have to do with attachment? 

Not much. A longitudinal study compared 46 donor insemination families and 48 egg donation families, with 68 natural conception families on the child’s second birthday. The results showed gamete donation mothers to have more joy towards parenting and more positive maternal feelings towards their child by the time the child had reached two years of age. Adding further evidence to the growing body of literature that genetics do not play a role in  the development of a positive relationship between a gamete conceived child and its parent. 

Social perceptions and stigmas

Societal views on donor egg conception vary with differing social perceptions and stigmas. Depending on your culture, your religion, your sexual orientation, your age, your belief system, your fertility journey, your level of education and understanding of gamete donation, and even your socio-economic status, your views on egg donation will be very different.  So depending on all those different variables society's views may potentially impact a mother-child relationship in a negative or positive manner. 

It seems as though everyone has an opinion on how we should raise our children from what they should eat, watch on television, ipad or no ipad, which school they should attend, and how to get that constipation resolved. It really never ends. It is very easy to say “don’t let people’s opinions impact you and your relationship with your child.” But it is never that easy, is it? 

We have evolutionarily evolved to want to be a part of a tribe, a village if you will. And their opinion matters. Because guess what? If you fell out of favor with your tribe thousands of years ago, you wouldn’t be able to survive. Things are a little bit different today than our caveman times but people’s opinions and views of how we live our life, can still negatively impact us. This is where the role of a mental health professional and support groups can be of tremendous benefit. 

Counseling and support

A healthy attachment style starts from the day you take your first breath. But what if you did not have a healthy secure attachment with your own parents? How is that now informing your relationship with your child? What if you don’t have a positive sense of self? What if you don’t  feel cared for by others? What if you don’t have a sense of closeness with other people? These are just some possible indicators of not having had a secure attachment to your own caregivers. Working with a therapist to work on your own attachment issues can really inform how you end up attaching to your own children, regardless if they are genetically related to you or not. 

Working with a mental health professional, you can learn how to self regulate your emotions, build your self-esteem, learn how to effectively communicate your needs, and how to set boundaries. Learning some of these skills by working with a mental health professional can be an important way for you to learn how to become more self-aware, how to stop self-sabotage and even how to get over that imposter syndrome you may be feeling when it comes to parenting. And learn how to deepen and securely attach to those you love. 

Summing it up

To sum it up, do moms of donor egg babies have attachment issues? Sometimes. But then again so do most parents, regardless if they are genetically related to their child or not. Attachment can take time, it doesn’t happen overnight. If you don’t immediately fall in love with your baby the second you lay your eyes on them, you are not alone. Every single relationship in this world takes time. Learn to cut out the outside noise, learn to listen to your own voice, and just go with what feels right.

Read more:

• Nature vs. Nurture: What Parents Via Egg Donation Need to Know
• Five Parents Share What They Wish They Had Known Before Pursuing Donor Eggs
• How Do I Navigate Telling Others My Child Is Donor Conceived?
• The Parent-Child Relationship in Families Created Using Egg Donation

Gestational surrogacy involves a woman agreeing to carry and give birth to a baby for someone else. After the baby is born, the gestational carrier (GC) gives custody and guardianship to the intended parent or parents via a legal document. This document states that the baby is not hers and that she has zero claim over the baby and surrenders all rights. The baby may have all, partial or none of the DNA from the intended parents. Due to medical reasons, carrying your own baby may not be a possibility and that may create some very strong negative feelings. Feelings of guilt, anger, loss and failure are very common. 

The grief of not carrying your child

Grief is something that is experienced after a deep and meaningful loss. We usually think of grief in terms of a death. However, grief in surrogacy is also very real, as the death of the dream of having and carrying a child of your own, may no longer be a reality. 

During the surrogacy process, grief can be felt after failed IVF attempts or miscarriages. There may be grief about the loss of a biological connection if donor gametes need to be used. There may be grief about missing out on the pregnancy milestones such as feeling the baby kick. There may even be anticipatory grief of believing that one may be unable to bond with the baby after birth. 

Stages of grief and how they manifest

Grief during surrogacy can manifest itself in many ways. It doesn’t always manifest as sadness as we would expect. During surrogacy, the intended parent(s) may go through stages of denial, anger, depression, and even guilt. 

Denial

Denial is typically the first way grief manifests during surrogacy.  Unless you have always known that you will not be able to carry your own child, that realization that you will not be carrying and birthing your own child, can be a difficult pill to swallow. Because you may look or feel healthy, you may not believe what you are being told.  You may refuse to believe that this is true. 

Anger

Anger can be aimed at self, partners or doctors. Even at random pregnant women walking down the street. Since this all seems very unfair, you may be easily set off by the most minor things. Your reactions may vary from minor irritability to intense rage. 

Depression

When the sadness just doesn’t go away. When it becomes more and more difficult to engage with life, depression may be setting in. There may be a sense of hopelessness and a loss of interest in things that used to create joy and happiness. There may be sleep issues - too much sleep or not sleeping at all. There may be a lack of appetite and social isolation. 

Guilt

Surrogacy guilt is real. The feeling that it is your fault and that maybe you are a bad person or are doing something wrong can start to appear as you go through a surrogacy. It may manifest as embarrassment, shame or a sense of inferiority. 

It is important to understand that all these feelings and emotions are normal. It is also important to understand that with the right help, these feelings can be processed and managed. You can get to the other side. 

How to deal with questions from nosy people

Sometimes questions that we consider to be personal are unavoidable. If you are using a gestational carrier to have a baby and you ask for maternity leave or tell people you are expecting when you’re not visibly pregnant, you can only expect people to be curious.

Luckily you have options. You are never obligated to tell anyone anything. It is afterall a personal matter and you are in charge of who gets to know what information. You can decide to share and tell your story while leaving out some information. You can do this by crafting an answer that you feel comfortable with. Write out some answers and start testing them - how does it feel when you say it? 

Coping strategies

The path through grief is winding and often disorienting. But equipped with coping strategies and the validation that your emotions are to be honored, not ignored, you are better poised to traverse this emotional landscape. Here are some coping strategies to try:

Find support through counseling or support groups

Navigating the emotions when using a gestational carrier often necessitates external assistance for emotional equilibrium. The act of consulting a therapist or joining a support group can serve as a respite from the mental weight one is carrying. Therapeutic interventions have been shown to improve emotional well-being and reduce symptoms of depression and anxiety). In the company of a trained therapist or a community of people sharing similar experiences, you are granted the space to explore your emotions and thoughts candidly. The collective wisdom found in these gatherings might provide unanticipated insights or coping strategies that you hadn't previously considered.

Communicate with your partner, friends, or loved ones

Solitude might offer a temporary refuge, but enduring support often lies in meaningful dialogues with those who share your life. Quality communication fosters emotional intimacy and provides a backdrop against which you can more fully understand your own feelings and concerns. By confiding in someone you trust, you externalize your emotions, creating room for insight and understanding to settle in.

Spend time with people you love

In the abyss of grief, companionship can be a lifeline. While the impulse to isolate may be strong, seclusion seldom serves the healing process. Human interaction releases oxytocin, a hormone proven to reduce stress and create feelings of well-being. Time spent with loved ones offers a reprieve, however brief, from the emotional turmoil you're enduring.

Spend time doing things you love

When enshrouded in grief, it's all too easy to forget the activities that once elicited joy. Though it may require a conscious effort, engaging in a beloved pastime can redirect focus and uplift spirits. Whether it's reading a treasured book or painting a canvas, these activities serve as emotional anchors, grounding you in a reality that still contains elements of pleasure and fulfillment.

Listen to your body

Grief can be visceral, a physical ache that demands your attention. If you feel the urge to cry, let the tears come. Emotional tears have been found to contain stress hormones and are thought to be a way for the body to achieve emotional release. Denying your body's signals to grieve can delay healing, whereas acknowledging them can pave the way for emotional relief.

Give yourself compassion

Self-compassion is not merely an emotional indulgence but a psychological necessity. Self-compassion is often linked to better mental health outcomes and resilience. It provides you with the psychological space to accept your feelings without judgment. Offering yourself compassion means acknowledging that grief is an inherently human experience, worthy of patience and understanding.

Keep a journal

Writing down your thoughts and feelings is akin to speaking them out loud but in a more introspective manner. By committing your feelings to paper, you're not only creating an emotional release valve but also establishing a written record that can help you track your emotional journey and healing progress over time.

Maintain a healthy lifestyle

A robust mind is often housed in a robust body. Regular exercise, balanced nutrition, and adequate sleep can have a profound effect on emotional health. It may be tempting to neglect these basics when grief strikes, but maintaining a healthy lifestyle provides the physiological support needed to cope effectively with emotional strain.

As you journey through, remember, the path is not to be walked alone. Seek and extend support; empathy and understanding are companions you need not leave behind.

Conclusion

Surrogacy can be an emotionally challenging journey. One fraught with many ups and downs. Aside from the complex medical procedures and legalities and costs, there needs to be an acknowledgement of the grief that also accompanies the process. 

Seeking support and resources before embarking on the journey, during and even after are important to managing emotions and the psychological impact of surrogacy. So prioritizing support is vital for the well-being of everyone involved. Cofertility is here to guide you every step of the way. 

Read more:

• What Should I Know Before I Get Serious About Surrogacy?
• Can Someone Break Down the Costs of Surrogacy?
• What Do I Need to Know About Surrogacy Laws?

The embryo transfer is an exciting and pivotal time in the in vitro fertilization (IVF) process. It’s when the embryo is transferred to the uterus of the intended mother or a gestational carrier, in hopes that it snuggles in for nine months and becomes the child you’ve always dreamt of.

You may be wondering if you should transfer one (single embryo transfer, or SET) or two (double embryo transfer, or DET) embryos, to increase your chances of a happy, healthy baby.  

This article will dissect the complexities of this decision-making process, taking into consideration both personal choices, and also help answer this question to intended parents using donor eggs.

First off, what is an embryo transfer?

Understanding what an embryo transfer entails is important to appreciating the decision-making process between single or double embryo transfer.

After an egg, or eggs, are fertilized with sperm, an embryo develops in a controlled laboratory environment for a few days under the careful watch of a trained embryologist. If and when the embryo reaches a particular developmental stage (ie. blastocyst stage), it is suitable for transfer.

Now, at this point, some families opt to do PGT testing, which looks to see if the embryo 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. Read more about PGT testing.

All embryos are then “graded” by the embryologist to evaluate their quality and chances of developmental success into a healthy pregnancy. Based on this assessment, your fertility doctor will recommend the order and number of embryos to be transferred. This is the stage where the choice between a single embryo transfer or a double embryo transfer is usually made.

Finally, the selected embryo(s) is transferred to the uterus via a thin catheter, typically under ultrasound guidance. If the embryo implants in the uterine lining, it may lead to pregnancy.

Embryo transfers and the history of IVF

When IVF was in its infancy, following the birth of the first IVF baby, Louise Brown, in 1978, the process was distinctly different from what it is today. In the early days, IVF involved the transfer of fresh embryos, without the technological advancements available now. This is because we didn’t have the technology to freeze and preserve embryos for genetic testing or future transfer.

At the time, this approach was taken to increase the likelihood of pregnancy, compensating for the uncertainties around embryo viability. However, this practice led to a higher incidence of multiple pregnancies (pregnancies of twins, triplets, or more), with associated health risks for both mothers and children.

With the development of cryopreservation techniques, it became possible to freeze embryos for later use, allowing for more flexibility and planning in the transfer process. This technology also enabled better timing for embryo transfer, and gave patients a break between the egg retrieval and embryo transfer. 

Simultaneously, genetic testing of embryos significantly increased the success rates of IVF, even with the transfer of a single embryo.

Guided by these advancements, the American Society for Reproductive Medicine (ASRM) now recommends elective single embryo transfer (eSET) in most cases, especially for women under the age of 35 with a favorable prognosis. This shift towards eSET reflects a growing emphasis on minimizing the risks associated with multiple pregnancies without compromising success rates.

So how many embryos should I transfer?

The decision regarding the number of embryos to transfer should weight the potential success rate against the risks associated with multiple pregnancies. Factors such as age, the quality of the embryos, previous IVF attempts, and individual patient preferences play an important role in this decision.

Let’s go through the pros and cons of each option:

Elective single embryo transfer (eSET)

Pros:

• Reduced risk of multiple births: eSET almost eliminates the chance of a multiple pregnancy (twins, triplets, etc.), thus reducing the associated health risks for both the mother and the babies.

Cons:

• Possibly lower success rates: Some studies have shown that eSET may yield a slightly lower live birth rate compared to double embryo transfer.

Double embryo transfer (DET)

Pros:

• Potentially higher success rates: By transferring two embryos, DET may improve the chances of pregnancy, especially when there are concerns about embryo quality.
• Chance to have twins: If you always wanted twins, transferring two embryos gives you a better chance of that dream.

Cons:

• Riskier pregnancy and birth: DET significantly increases the risk of twins or higher-order multiples, leading to more complicated pregnancies and a higher chance of preterm births and low birth weight.

It’s important to discuss this with your fertility doctor and get their input. Because ASRM usually recommends a single embryo be transferred, in most cases fertility doctors will recommend just that.  

How many donor egg embryos should I transfer?

When donor eggs are utilized, a couple other factors need to be considered. Donor eggs are from younger women who have gone through extensive medical screening, and thus, embryo quality tends to be higher. Because of this, it increases the chances of success, even if the mother is older, or if she experienced failed IVF in the past. In donor egg cases, eSET is generally preferred to minimize the risk of multiple pregnancies while maintaining a satisfactory success rate.

Summing it up

If you are wondering if eSET or DET is right for you, talk to your fertility doctor. They can help talk you through the pros and cons, and help select an approach that best fits your needs.

For those using donor eggs, the generally higher quality might lean the decision towards eSET, while personal preferences and specific medical situations might suggest otherwise. By carefully considering the nuanced pros and cons, you can make a well-informed choice in your pursuit of parenthood. We wish you all the best!

Reproductive technology has opened up new horizons for individuals and couples hoping to bring new life into their world. Among these opportunities, the use of donor eggs stands as a beacon of hope for many. 

However, the reality of this life-changing treatment is often met with a stark reminder of its costs. Enter the landscape of employee benefits platforms - innovative companies that have stepped forward to revolutionize coverage for fertility treatments. But which ones cover donor eggs? In this article, we’ll provide insight into their services.

Carrot

Carrot takes a flexible approach to fertility benefits, allowing employers to customize coverage based on their budget and employees' needs. Carrot’s model is based on reimbursing members for care, with the overall budget set by the employer. As such, its comprehensive platform typically covers a range of fertility services, including donor egg treatments. Cofertility is also a preferred partner within Carrot’s network and all Carrot members will receive a discount off the Cofertility Coordination Fee. If you have Carrot benefits, reach out to our team to learn more!

Progyny

The largest benefits platform known for its patient-centric model, Progyny offers a comprehensive fertility benefits plan which can include coverage for donor egg treatments. Their Smart Cycle policy provides flexible coverage units that can be used across different treatment types, including IVF with donor eggs. The number of Smart Cycles as well as the specific treatment types covered varies by employer. For example: among those plans that do cover donor cycles, some exclusively cover frozen donor egg cycles, some cover fresh donor egg cycles, and some cover both. 

Win Fertility

Win Fertility partners with employers to offer fertility benefits, including personalized treatment management. Its coverage is comprehensive, typically encompassing a range of fertility treatments. Employers who partner with Win Fertility have the option to include donor egg treatments in their coverage plans.

Maven

Maven's platform offers a holistic approach to family benefits, encompassing fertility, maternity, and pediatrics. While its fertility coverage is extensive, whether or not it includes donor egg treatments may depend on the specific plan chosen by your employer.

Kindbody

Kindbody offers fertility benefits tied to Kindbody and other partner clinics. They take a similar approach to Progyny with “KindCycle” units that can be used across treatments, including IVF with donor eggs. 

Cleo

Cleo's strength lies in its integrated support system for families across reproductive health, fertility, and parenting. While they don’t offer direct fertility coverage, they provide on-demand support, personalized support plans, and research and expert-based answers to a variety of family-building questions, including donor egg IVF. 

Identifying donor egg coverage in your benefits program

As you can see from the descriptions above, whether or not your benefits program includes donor eggs has more to do with your employer than the platform. Most platforms have the ability to include donor eggs, but not all employers are willing to cover that cost.  

Understanding the specifics of your benefits program can be a daunting task, given the complex nature of health insurance policies and benefits packages. Here’s how to determine if your program includes donor egg coverage:

1. Start by thoroughly reviewing your benefits information. This is usually outlined in a document or an online portal provided by your employer or benefits provider. Look for sections that talk about 'fertility treatments', 'reproductive health', or 'family planning'. You might find explicit mention of egg donation or donor IVF.
2. If your benefits documentation is not clear or you have difficulty understanding the language used, do not hesitate to reach out to your benefits provider or HR department directly. They can provide clarity and guidance on what exactly is covered under your plan.
3. If applicable, take advantage of other employer-provided resources that can help you navigate your benefits. Benefit Bump and BenefitFocus are two companies that employers engage to help you understand your coverage and how to best use your available benefits. 
4. When inquiring about your coverage, be sure to ask direct and specific questions. For instance, "Does my plan cover the cost of donor eggs?" or "Is IVF with donor eggs included in my fertility benefits?" The more specific you are, the more accurate the information you'll receive.

Remember, benefits plans can change from year to year, so make sure to review your plan annually during the open enrollment period. Keep abreast of any changes or additions to your benefits, especially if you're considering fertility treatments using donor eggs.

Summing it up

While donor egg coverage specifics can depend on the individual plans chosen by employers, the trend is leaning towards a more inclusive approach, reflecting an increased understanding and empathy towards diverse fertility journeys.

Understanding your benefits program and whether it covers donor egg treatments is crucial in planning your fertility journey. Don't hesitate to seek assistance from professionals or directly ask your benefits provider to clarify your coverage. Being proactive about understanding your benefits will help you make informed decisions about your reproductive health.

Cofertility can help!

We started this company with the vision of serving all families, regardless of what brought them here. And we promise to provide you with the care we would want for our families. With our commitment to transparency, inclusivity, and innovation, we are striving to be the best in the industry.

Our unique egg sharing model empowers donors and enables families to find the perfect egg donor match quickly and easily, setting a new standard for excellence in our field. Whether you are just getting educated on egg donation or ready to move forward, we want to help you achieve your goals and build the family of your dreams.

Create a free account to get started today!

When planning for IVF with donor eggs, one of the first questions that comes up is whether health insurance will help cover the costs. The answer isn't straightforward – coverage varies widely between insurance plans, states, and employers. While some people have plans that cover parts of donor egg IVF, many find themselves paying out of pocket for most or all expenses.

In this article, we'll explain how insurance typically handles donor egg IVF, including what parts of treatment might be covered and what's usually excluded. We'll look at state laws that require fertility coverage, examine how employer-sponsored plans work, and outline your options if insurance won't cover your treatment. You'll also learn about alternative ways to manage the costs of donor egg IVF, from financing programs to clinic payment plans.

Understanding health insurance and ART

Before diving into specifics, let’s discuss the fundamental relationship between health insurance and assisted reproductive technology (ART). Health insurance policies vary significantly in their coverage of fertility treatments. Because most insurance plans are tied to your employer, it’s ultimately up to them what to cover when it comes to fertility treatments. 

Some plans offer generous, comprehensive coverage, while others might only cover diagnostic procedures, and others yet cover nothing at all. Some plans only kick in when you’ve spent a certain amount out of pocket and other plans will cover a small portion of the expenses and you are expected to pay for the rest. What’s more, some plans limit coverage to people facing infertility, leaving out same-sex couples and those pursuing IVF for genetic reasons. So an important first step is understanding the specifics of your individual insurance plan’s coverage of fertility treatment. From there, you can investigate potential coverage of procedures involving donor eggs.

Insurance coverage for donor eggs

If your insurance plan does cover IVF, it doesn't necessarily guarantee that it also covers procedures involving donor eggs. Those plans that do offer coverage for IVF using donor eggs can also vary - some may cover the medical procedures related to egg retrieval and embryo transfer but might not cover the costs associated with the donor herself. These costs can include compensation for the donor, legal fees, agency fees, and the donor's medical and psychological screenings, among others.

Your location can also significantly impact the extent of coverage you might have for fertility treatments involving donor eggs. Across the country, 17 states (and counting!) have laws requiring insurance companies to cover or offer coverage for infertility diagnosis and treatment. 

However, the specifics of these laws vary from state to state, and not all necessarily mandate coverage for procedures involving donor eggs. While most laws are vague without any mention of donor eggs, a few specifically require coverage of donor eggs. Let’s look at those:

Delaware 

The DE law states that “in vitro fertilization, including IVF using donor eggs, sperm, or embryos and IVF where the embryo is transferred to a gestational carrier or surrogate must be covered.”

Maine 

The ME law states that health plans must cover fertility diagnostics and treatment, without “any limitations on coverage for any fertility services based on an enrollee's use of donor gametes.” However, any nonmedical costs for using donor eggs can be excluded from coverage.

Massachusetts

The MA law requires insurance plans to cover treatment of infertility including donor egg procurement.

New Hampshire

The NH law states that health plans must provide coverage for medically necessary fertility treatment, including “treatments associated with the procurement of donor eggs.”

New Jersey

NJ law requires health plans to provide coverage for four egg retrievals per lifetime, and 

IVF using donor eggs.

New York
New York now requires all fully-insured employer groups to cover up to three cycles of IVF for people with a medical diagnosis of infertility.

An important note: Even if your state has infertility coverage laws in place, your specific health plan might not be required to comply. Self-insured or self-funded insurance plans are exempt from state law and employers do not have to follow the state insurance laws. Some states also exempt employers under a certain size from having to provide coverage. The best way to find out is to talk to your employer or health plan directly.

Other ways to pay for donor eggs

If your insurance plan does not cover procedures involving donor eggs, there are still options you can explore to help manage the costs. These can include employer-sponsored reimbursement options (like Carrot Fertility), fertility financing companies, grants and scholarships from non-profit organizations, and discounted treatment packages or refund programs from fertility clinics. It's worthwhile to explore these avenues and to discuss potential options with a financial counselor at your fertility clinic.

Read more in Eggonomics: Seven Options for Paying for Donor Egg IVF

Find an amazing egg donor at Cofertility

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

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

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

• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
• Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
• Diversity: We’re proud 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 at no additional Cofertility Coordination Fee 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!

Summing it up

Navigating health insurance coverage for procedures involving donor eggs can be overwhelming. Unfortunately, most plans do not cover any IVF, let alone donor egg IVF. 

Start by understanding your individual insurance plan, and don't hesitate to seek clarification from your insurance provider about the specifics of your coverage. Exploring other financing options can also help manage costs if insurance coverage is limited or non-existent. 

Importantly, remember that our team is here for you every step of the way, before and after matching. If you have questions about how an egg donor journey with Cofertility would be covered by your insurance, don’t hesitate to reach out. We wish you all the best!

Read more:

• Is Donor Egg IVF Tax-Deductible?
• Where Can I Find Help Paying for My Fertility Treatments?
• Eggonomics: Seven Options for Paying for Donor Egg IVF

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

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

What is meant by low response to ovarian stimulation?

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

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

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

How common is POR?

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

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

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

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

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

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

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

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

How IVF can fail

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

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

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

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

Is POR curable?

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

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

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

What comes next after POR

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

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

Get the emotional support you need

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

We are here to help you find the perfect egg donor

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

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

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

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

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

As families are built in different ways, it's essential to have age-appropriate books to help children understand the processes and the love that forms families. Below are children’s books that tackle infertility, egg donation, embryo donation, and surrogacy in ways that children can understand.

Best children’s books about infertility

"Wish" by Matthew Cordell

The book: Wish is about an elephant couple that embarks on a life together, with thoughts of children far away—at first. But as the desire for a child grows, so do unexpected challenges. And it's only after thwarted plans and bitter disappointment that their deepest wish miraculously comes true.

The author: Matthew Cordell is the acclaimed author and illustrator of the 2018 Caldecott winner Wolf in the Snow. He is also the author and illustrator of Trouble Gum and the illustrator of If the S in Moose Comes Loose, Toot Toot Zoom!, Mighty Casey, Righty and Lefty, and Toby and the Snowflakes, which was written by his wife.

Why we love it: Although this book does not specifically discuss egg donation, it beautifully illustrates the angst of waiting for a child, the fear that it may not happen, and the joy when the wish finally comes true. It will make any parent who struggled with infertility tear up!

"To the Moon and Back for You" by Emilia Bechrakis Serhant

The book: "To the Moon and Back for You" is a beautifully written and illustrated children's book that tells the story of a mother's journey through infertility, surrogacy, and the ultimate joy of becoming a parent.

The author: Emilia Bechrakis Serhant is a lawyer, philanthropist, and television personality, best known for her appearances on the Bravo reality television series "Million Dollar Listing New York." She wrote "To the Moon and Back for You" based on her own experiences with infertility and surrogacy, as a way to help other families who are going through similar struggles.

Why we love it: We love how "To the Moon and Back for You" offers a heartfelt and honest portrayal of the emotional journey that many families go through when facing infertility and surrogacy. The book's illustrations are gorgeous, and the message of love and perseverance is both uplifting and inspiring. It's a great resource for families who have gone through infertility and surrogacy or for those who want to teach their children about the many ways that families can be created.

I'm Very Ferris: A Child's Story about In Vitro Fertilization

The book: "I'm Very Ferris" is a heartwarming and informative children's book that follows the story of a little boy named Ferris who was conceived through in vitro fertilization (IVF). It explores the journey of Ferris' parents as they went through the process of IVF and the joy they felt when they finally had their baby boy.

The author: Tess Kossow is a mom who went through the journey of IVF herself. She wrote "I'm Very Ferris" as a way to help families who are going through the same struggles, and to celebrate the love and joy that comes with building a family through IVF.

Why we love it: We love how "I'm Very Ferris" celebrates the beauty of IVF and the strength and resilience of families who go through infertility. The illustrations are bright and colorful, and the writing is heartfelt and relatable, making it a great read for both children and adults. The message of hope and perseverance is both uplifting and inspiring, and the book is a great resource for families who want to teach their children about the many ways that families can be created.

Miracle by Jason Pinter

The book: When rabbits Merle and Pearl meet on one beautiful day, they know that they have found true joy. Yet while they couldn’t be happier with each other, there’s one teeny, tiny thing missing...a child of their own. Merle and Pearl dream of expanding their nest by bringing a baby bunny into the world, but they face unforeseen challenges along the way. Determined to make their dreams come true, Merle and Pearl will do whatever it takes to find their Miracle—even if it means going deep under the sea, trekking across vast desert sands, or rocketing far out into the stars.

The author: Jason Pinter is the bestselling author of the Henry Parker series, which have over one million copies in print worldwide and have been published in over a dozen countries, as well as the Middle Grade adventure novel Zeke Bartholomew: SuperSpy. 

Why we love it: This book is a powerful testament to the power of unwavering love. This touching story is sure to resonate with many readers, making it a must-have and a must-read. After finishing this book, you'll find yourself holding your loved ones just a little tighter and cherishing each moment just a little more.

Best children’s books about egg donation

"A Tiny Itsy Bitsy Gift of Life, an Egg Donor Story" by Carmen Martinez Jover

The book: "A Tiny Itsy Bitsy Gift of Life" tells the story of a couple who are struggling to have a baby. They decide to use an egg donor, and the book explains the process in simple terms that children can understand. The book emphasizes the idea that even though the baby may not have the same genes as the parents, it will still be loved and cherished just as much.

The author: Carmen Martinez Jover is a clinical psychologist who specializes in infertility counseling. She has written several children's books about infertility and ART, including "A Tiny Itsy Bitsy Gift of Life." Jover is also the co-founder of a fertility clinic in Spain.

Why we love it: We love the colorful illustrations in this book, and the way it explains the egg donation process in a way that is easy for children to understand. The book emphasizes the importance of love and family, regardless of genetic relatedness, and it is a great resource for parents who are considering egg donation as a way to build their family.

"The Pea That Was Me: An Egg-Donation Story" by Kim Kluger-Bell

The book: "The Pea That Was Me" is a story about a couple who want to have a baby but cannot do so without the help of an egg donor. The book uses simple language and colorful illustrations to explain the egg donation process. It also emphasizes the importance of love and family, regardless of genetic relatedness.

The author: Kim Kluger-Bell is a clinical social worker who specializes in infertility counseling. She has written several children's books about infertility and ART, including "The Pea That Was Me." Kluger-Bell is also the co-founder of a support group for families who have used egg donation to conceive.

Why we love it: We love how this book explains the egg donation process in simple terms that children can understand. The illustrations are beautiful, and the book emphasizes the idea that love is what makes a family, regardless of genetics. It is a great resource for parents who are considering egg donation as a way to build their family.

"You Were Meant For Me" by Sheri Sturniolo

The book: You Were Meant For Me: Mom*Dad*Donor shows how the love and generosity of others can grow into the most wonderful gift. This book is a kid-friendly look into the unique ways that some families are grown and the journey of love that brings them together.

The author: Sheri Sturniolo is a Pediatric Registered Nurse and mother to a son and daughter—both born through the awesome gift of donors. Through her personal journey and experiences, Sheri hopes to offer a valuable tool to families searching for ways to make sense of their unique creation story. Sheri lives with her husband, son and daughter (both conceived through embryo adoption) in the San Diego area.

Why we love it: Using symbolism and sweet rhyming lyrics, You Were Meant For Me introduces the complicated topic of being born from sperm, egg or embryo donation, to a young child. By giving children the “pieces of the puzzle,” this book sparks their imagination and stimulates them to ask questions.

"Happy Together: an egg donation story" by Julie Marie

The book: Happy Together, an egg donation story uses clear language and cheerful illustrations to join Mommy and Daddy bear on the journey to fulfill their greatest wish of becoming parents. With help from a doctor, an egg from a special lady called a donor and Daddy’s seed, a baby grew in Mommy’s tummy and was welcomed with great joy.

The author: As a mother through egg donation, author Julie Marie found various paths to parenthood were underrepresented in children's literature. Julie wrote Happy Together to help parents share their special family building story with their child.

Why we love it: This tender book is a favorite amongst donor-egg parents, and it’s no surprise. The story is simple enough for even young kids to understand, yet it explains the process of donor eggs well. 

“Daddy, What Is An Embryo?: A Tale of Egg Donation” by J.D. Quarles

The book: When Ruthie discovers frog eggs in their pond, her father finds the perfect moment to tell her the story of how she was conceived with the help of an egg donor, and how this amazing process helped bring her parents' dreams to life. 

The author: After having his daughter at 46 years old, using both a surrogate and egg donor, J.D. Quarles wrote books in an effort to help his daughter understand the amazing process that brought her into this world. While watching his daughter's comprehension of this process develop, he decided to publish the books to help others in similar situations.

Why we love it: We love how "Daddy, What Is An Embryo?" takes a complex medical process and explains it in a way that is easy for young children to understand. The illustrations are beautiful, and the story emphasizes the idea that families come in all shapes and sizes. It's a great resource for families who have used or are considering using egg donation to conceive, as well as for families who want to teach their children about different ways of building a family.

Best children’s books about surrogacy

"The Very Kind Koala: A Surrogacy Story for Children" by Kimberly Kluger-Bell

The book: "The Very Kind Koala" tells the story of a kind koala who agrees to carry a baby for a couple who cannot do so on their own. The book explains the process of surrogacy in a way that is easy for children to understand. It emphasizes the idea that families come in all shapes and sizes and that what

The author: Kimberly Kluger-Bell is a clinical social worker who specializes in infertility counseling. She has written several children's books about infertility and ART, including "The Very Kind Koala." Kluger-Bell is also the co-founder of a support group for families who have used surrogacy to conceive.

Why we love it: We love the cute and colorful illustrations in this book, and the way it explains the surrogacy process in a way that is easy for children to understand. The book emphasizes the idea that love and family come in all shapes and sizes and that what matters most is the love that a family shares.

“The Kangaroo Pouch: A story about surrogacy for young children” by Sarah A. Phillips

The book: Oliver, a young kangaroo whose mother becomes a surrogate for the Bouncing-Hopalots and delivers their baby to them, narrates this heartwarming tale and shows what the gestational surrogacy process is all about from start to finish.

The author: Sarah A. Phillips is an author living in Illinois with her family and dog. She writes for children (and the young at heart) from picture books on up to young adult novels. Her first picture book, "The Kangaroo Pouch," was published in 2007 and due to its popularity worldwide, has gone on to be published in both French and Spanish.

Why we love it: The Kangaroo Pouch" is a beautifully written and illustrated book that celebrates the love and joy that comes with surrogacy. It's a great addition to any family's library and a must-read for anyone who wants to teach their children about surrogacy in a way that is compassionate and easy to understand.

"Sophia's Broken Crayons: A Story of Surrogacy from a Young Child's Perspective" by Crystal A. Falk

The book: "Sophia's Broken Crayons: A Story of Surrogacy from a Young Child's Perspective" tells a story of surrogacy from a young child’s perspective in a practical way that children can understand and grasp. A little girl by the name of Sophia is heartbroken after she discovers all of her crayons are broken. Sophia’s friend’s share their crayons with her as she experiences seeing her parents choose to give the gift of surrogacy to their friends. 

The author: Crystal A. Falk is an attorney and mother of two children, both of whom were born via surrogacy. She wrote "Sophia's Broken Crayons" to help children understand and normalize the surrogacy process.

Why we love it: We love how "Sophia's Broken Crayons" handles the topic of surrogacy in a gentle and accessible way. The story is relatable and easy to follow, making it a great conversation starter for families who are navigating the complexities of assisted reproduction. The book also includes a helpful Q&A section at the end, which answers common questions that children may have about surrogacy. Overall, "Sophia's Broken Crayons" is a beautiful book that celebrates the love and connection between families, regardless of how they come to be.

Best children’s books about embryo donation

"Hope & Will Have a Baby: The Gift of Embryo Donation" by Irene Celcer

The book: "Hope & Will Have a Baby" is a heartwarming story of a couple named Hope and Will who want to have a baby but are having trouble getting pregnant. The book explains the process of egg donation in simple, child-friendly terms, and emphasizes that all families are different and that love is what makes a family.

The author: Irene Celcer is a clinical psychologist who specializes in infertility counseling. She has written several children's books about infertility and ART, including "Hope & Will Have a Baby." Celcer is also the founder of a support group for families who have used egg donation to conceive.

Why we love it: We love how this book explains the concept of egg donation in a way that is easy for children to understand. The illustrations are beautiful, and the book has a reassuring tone that emphasizes the importance of love and family. It is a great resource for parents who are considering egg donation as a way to build their family.

“Made With Love: The sweetest allegory for embryo donation and adoption” by Whitney Williams

The book: "Made with Love" is a beautiful and heartwarming allegory that explains the concept of embryo donation and adoption through the story of two cookie families as they go through the trials and tribulations of infertility on one side and the decision to donate extra embryos on the other. 

The author: Whitney Williams is a Christian wife and mother to three boys, the youngest two of whom she and her husband adopted as embryos. She works from home for WORLD Magazine. She graduated from Baylor University in 2008 with a bachelor's in journalism. 

Why we love it: We love how "Made with Love" presents the concept of embryo donation and adoption in a way that is easy for children to understand. The illustrations are beautiful, and the story emphasizes the idea that families are built on love and the desire to care for one another. It's a great resource for families who have used or are considering using embryo donation or adoption to build their families, as well as for families who want to teach their children about different ways of building a family.

“Remy's Blueprints: A (Double) Donor Conception Story for Mom/Dad Families” by Sharon Leya 

The book: “Remy's Blueprints” is about an adorable kid named Remy who adores her Mommy and Daddy who are architects. It follows her adventure as she discovers how she was brought into the world. 

The author: Sharon Leya is the author of the My Donor Story series, a series of children's books that lovingly explains donor conception, and uses simple language to illustrate the basic concepts of genetics. 

Why we love it: Sharon Leya's book gently and lyrically explains the complex concepts of donor conception, genetics, and pregnancy in a way that helps children appreciate and love their unique origins. Through metaphors and a message of love, Leya guides young readers through a journey of understanding their conception and family building, offering a valuable resource for families who have used donor conception or for those who want to teach their children about different ways of building a family. Overall, Leya's book is a touching and informative read that helps children embrace the beauty of their own unique story.

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

‍Create a free account today!

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

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

Actively listen

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

Ask questions

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

Attend appointments

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

Create a safe space

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

Educate yourself

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

Respect your partner’s decisions

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

Show tangible support

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

Seek professional help 

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

Skip baby-oriented events

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

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

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For many, infertility treatment — whether or not you pursue egg donation — can be a costly process, even if it provides an incredible opportunity for people who want to achieve their dreams of parenthood. Fortunately, there are several ways to finance infertility costs (including the cost of using an egg donor) with loans that can make the process more accessible, a mission of ours here at Family by Co. 

Egg donation financing options to consider

Here are some options to consider when financing the use of an egg donor:

Financing programs

Some fertility clinics offer financing programs that allow individuals and couples to pay for egg donation services over time, often with little to no interest. These programs can make the cost of egg donation more manageable by breaking it down into smaller, more affordable payments. However, it's essential to understand the terms and conditions of the financing program, including any fees or penalties that may apply.

If you’ve decided you want to go the loan route, you have many options to choose from. There are general lending companies as well as companies that specialize in loans just for fertility treatments. 

Sunfish

Sunfish makes fertility treatment attainable for all types of families. If you’re pursuing egg donation and are interested in working with Family by Co to find your perfect match, we've partnered with Sunfish to offer you fertility financial resources and support throughout your journey. Sunfish offers the most comprehensive marketplace of financial options for IVF, egg freezing, embryo preservations, gestational surrogacy, egg donations, and more, up to $100,000 at industry-low rates. 

Sunfish has also waived their application and membership fees for all intended parents who are working with Cofertility. To take advantage of Cofertility’s infertility loan partnership with Sunfish, click here.

Ally

Ally’s loans offer solutions to cover the cost of infertility treatment at select partner clinics. Fill out a form to see your lending options and choose from 24-84-month loan options with annual percentage rates (APRs) starting at 3.99%.

FutureFamily

FutureFamily offers IVF loans (including egg donation), and they handle paying all your bills so you have just one easy payment. Loans start at $150/month* for 60 months based on your clinic, credit score, and approved infertility-related expenses. While you can apply individually, the rates are better (0% APR) if you are freezing with one of their partner clinics.

Lending Club 

Lending Club offers infertility loans that cover things like genetic testing, medications, and medical procedures at select partner clinics. They forward payment directly to the providers within three business days. Monthly payments are as low as $263/month to finance $15,000 with a 7.99% APR for 72 months.

Personal loans

Personal loans can be an option to finance the cost of egg donation, but they often come with high-interest rates and fees. It's essential to compare multiple loan options, understand the terms and conditions, and consider the long-term impact of taking on debt.

Other ways to save

Tax credits

The IRS offers a tax credit of up to $13,360 for qualifying expenses related to infertility treatments, including egg donation. This credit can significantly reduce the cost of using an egg donor, but it's important to consult with a tax professional to ensure that you qualify and understand the application process.

Infertility grants

In addition to financing the process with a loan, you may want to consider applying for infertility grants. There are many programs out there with shared goals of making family-building dreams come true. We also recommend checking out your state’s mandated fertility insurance coverage to see what you may be entitled to. 

What to know about taking out a loan

When taking out a loan, you’ll want to understand the terms and conditions of the loan, as well as the responsibilities that come with borrowing a large sum of money. A lot of the websites listed above will have online calculators to help you get a sense for the terms and fees you can expect. 

Loan amount: Consider how much you want to finance and whether they finance that amount. You could finance part, or all, of the egg freezing expenses. 

Loan terms: Loan terms are the length of time you have to repay the loan, and they can range from a few months to several years. Shorter loan terms generally result in higher monthly payments, while longer loan terms result in lower monthly payments but a higher total cost over the life of the loan.

Interest rates: Interest rates are the fees charged by the lender for borrowing money, and they can have a significant impact on the total cost of the loan. Find out the current interest rate being charged, and if that interest rate will stay the same or change over time. 

Loan fees: Of course, these lending groups need to make money, and they do this through loan fees. Loan fees are the additional charges associated with taking out a loan, including origination fees, application fees, late-payment fees, or prepayment penalties. You can use the annual percentage rate (APR) to compare average yearly fee and interest-rate expenses over the term of the loan. It's important to carefully review all loan fees and to make sure you understand the total cost of the loan.

Repayment options: Repayment options are the ways in which you can pay back the loan, including monthly payments, lump sum payments, or a combination of both.

Loan security: Loan security is the collateral that you provide to the lender to secure the loan, such as a home or a car. If you fail to repay the loan, the lender may take possession of the collateral. If you're taking out a secured loan, it's important to carefully consider the risks and responsibilities associated with putting up collateral.

Finally, if you’re quoted a monthly payment, remember to look beyond the monthly payment.  Think about how long you will pay, and what fees and costs have been added. 

In summary

Infertility loans are a great option to consider when financing your path to parenthood. We’re all about making the family-building process — especially via egg donation — more accessible. Through our platform, we’re able to reduce costs for intended parents and help make sure donors aren’t put between a rock and a hard place. 

How do we do it? With Family by Co, all of the egg donors on our platform give half of their eggs retrieved to intended parents, just like you, 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.

We’re thrilled to continue our mission to make egg donation a more accessible family-building option, while providing an empowering opportunity for women who want to preserve some of their reproductive future. 

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!