Demystifying The Donor Egg IVF & Embryo Adoption Process
By Kristyn Hodgdon
For IVF patients, having a doctor suggest donor eggs as a next step in the process can be an incredibly daunting and emotional experience. I recently had the pleasure of chatting with Meagan Chan, Nurse Practitioner & Third-Party Clinic Coordinator at Laurel Fertility Care in the Bay Area, all about how Donor Egg IVF and embryo donation works. She helps demystify the process and shares what intended parent(s) can expect when pursuing Donor Egg IVF or embryo adoption to grow their families.
Q: Meagan, you are in charge of third party reproduction at Laurel Fertility Care. Can you tell us a little bit more about your role and how you help couples through Donor Egg IVF and embryo adoption?
A: Hi! My name is Meagan, and as the Third Party Coordinator at Laurel Fertility Care, I assist in the donation process from start to finish. I coordinate with intended parents, agencies, and the donors themselves, making sure all parties are kept in the loop throughout the process. I assist with the medical screening and ultrasound monitoring appointments as well!
Q: What can intended parent(s) expect when embarking on the Donor Egg IVF process?
A: Once the intended parent(s) decide they would like to pursue using donor eggs, they have the opportunity to chat with me about the process and what to expect. I discuss my role in active communication with the donor agency and donor, reviewing any past records of donation, scheduling for donor medical screening clearance, completing a one-time psychological consultation for both intended parent(s) and the donor, completing legal contracts, and then planning for the stimulation treatment cycle leading to egg retrieval.
Q: What does the donor screening process entail?
A: The screening process involves checking labwork for both ovarian reserve and infectious disease labs as per FDA regulations, and a comprehensive history intake as well as a physical exam with transvaginal ultrasound to get an antral follicle count. All of these items in screening help to determine if someone is a good candidate for egg donation.
Q: Does the process take longer than a 'typical' IVF cycle?
A: Donor IVF treatment cycles can range. Donors with a higher ovarian reserve or antimullerian hormone (AMH) may respond quicker to the medication and only need to be on the stimulation medications for only 8-9 days compared to the typical 10-12 days. But generally, aside from the screening process, it doesn't take much longer than a 'typical' IVF cycle.
Q: Who are the donors? Does Laurel Fertility Care work with a donor egg bank, or do they have their own pool of donors?
A: Here at Laurel Fertility Care, we work with many egg banks! We provide our patients with a list of banks that we have worked with closely in the past and those that our patients have had good success with. We have a list of both fresh egg donor agencies as well as frozen egg banks. Patients can also choose donors from banks not on our list, and even individuals that they know (friends, family members, coworkers, etc). Regardless of where donors are from, we go through the same exact screening process to ensure they are a good candidate before proceeding.
Q: How do you counsel couples through the process of selecting an egg donor? What does the selection process entail?
A: We essentially go through ASRM (American Society for Reproductive Medicine) guidelines for egg donation. We recommend that donors are between the ages of 21-35 years, have no past medical history of substance abuse or untreated mental health issues, and have an adequate support system.
Q: Moving forward with Donor Egg IVF can be an incredibly difficult decision, and choosing a donor a very personal one. Do you offer your patients any guidance for how to cope with these complicated emotions?
A: Agreed, going the donor egg route can be incredibly overwhelming and emotional! I definitely emphasize that I am here for my patients every step of the way. Families come in all different shapes and sizes!
Q: What are the success rates with Donor Egg IVF?
A: The success rates for live birth from donor eggs would be determined by the age of the donor, ovarian reserve evaluation, as well as whether the embryos from donor eggs are PGS tested or not. In general, the success rates for those aged 20-35 years old can range from 45-50%, and with PGS testing of embryos, this can increase chances of success to 60-80%.
Q: Does Laurel Fertility Care usually recommend that those pursuing Donor Egg IVF have their embryos genetically tested?
A: The choice is ultimately up to the donor egg recipients! Generally, if the donor is a good candidate and has a good ovarian reserve, there is no specific need to do genetic testing on the embryos with the idea that the eggs are of good mature quality and would yield quality embryos. However, if donor egg recipients are interested in being very sure about chromosomal makeup before embryo transfer, or if they want to choose a specific gender to transfer, then testing can definitely be done.
Q: Who is the best candidate for Embryo Adoption? Is it typically couples with both female and male factor infertility?
A: Most of our patients who choose the embryo donor route are those who have both female and male factor infertility. We also have same-sex male couples and single individuals who choose to use donated embryos.
Q: How does the Embryo Adoption process typically work? Can you walk us through it?
A: Patients interested in using donated embryos will meet with one of our doctors for an initial consultation. Then, I get the opportunity to chat and go over what the process will entail. I set the patient(s) up with an embryo recipient profile online, and they can view our donor profiles online (which may include information about age at the time of donation, educational background, occupation, medical history, baby pictures, etc). Once they find a profile that they like, they’ll click “reserve,” and I’ll get notified.
During this process, we’ll also have the embryo recipient (if going to be undergoing treatment for the embryo transfer) start the process of medical screening with labs and saline sonogram. A psychological consultation will also be recommended for recipients to discuss the emotional highs and lows that come with using donated embryos and starting a family. Consents will be signed and we’ll prepare for the embryo transfer cycle!
Q: Do you typically do ‘anonymous’ embryo adoptions or ‘known’ embryo adoptions? How does that work with the donor family and the recipient family?
A: Here at Laurel, we currently work with anonymous embryo donations. Donors are able to share as little or as much information about themselves as well to be uploaded in the profile for recipients to browse through.
Q: We were so inspired by the amazing story of the couple in Tennessee that adopted a 27-year old frozen embryo! How long do you typically hold on to embryos that have been ‘left behind'?
A: It is amazing what science can do! Fertility medicine continues to grow and we can’t wait to see what else we can do for family planning. Every clinic has patients complete consent forms so that we know exactly what they want to do with their embryos. So they are kept frozen in the lab until they’re ready to be thawed for a transfer.
Here at Laurel, we freeze for up to 5 years, and then at that point, we have our patients sign consents to let us know if they would like for us to discard, donate them to another couple or to research, or transfer them to a long term storage facility.
Q: How can a couple go about donating their remaining embryos if they have completed their family-building journey?
A: I love receiving messages from patients who have completed their family-building journey and are looking to donate their remaining embryos! It’s such a great way to help another individual or couple looking to start a family of their own. I review their medical records to ensure that the embryos created passed infectious disease testing and have patients sign consents to designate how many or all embryos to be donated.
They will also have the opportunity to fill out a profile to share information regarding ethnicity, race, family history, personal medical history, age at the time of donation, pictures of themselves as babies, and any other notes they would like to share with the future recipients.
If you are interested in learning more about third-party reproduction, watch our IG Live discussion with Meagan on IGTV here.