Egg donation using frozen eggs – pros and cons

Diverse_Frozen_Egg_Donors

For the last 30 years egg donation has been performed almost exclusively using fresh eggs from young egg donors.

• The donors were chosen by a recipient couple and stimulated to produce multiple eggs.
• The eggs were retrieved and fertilized with the male partners sperm with the resulting fresh embryos transferred to the recipient female.
• Remaining embryos would be frozen for future frozen embryo transfer procedures (if needed).

This is still the way the majority of egg donation is done in the United States and around the world. However, in recent years advances in egg freezing technology have allowed the option of using frozen instead of fresh eggs.

We now offer egg donation using frozen (vitrified) donor eggs. We have been providing fresh donor egg treatments since 1997. Now we do egg donation using either fresh or frozen eggs.

Egg Banks

Egg freezing has improved significantly over the past several years due to fine-tuning of freezing and thawing protocols. Thawed egg survival and viability is much better than it was in the past. These improvements now should allow for reasonable pregnancy and live birth success rates using frozen donor eggs.

Recently there has been a proliferation of “egg banks” that recruit egg donors, have their eggs frozen and then sell them to recipient couples for their egg donation cycles. Some of these businesses are claiming to have high success rates from the thawed donor egg cycles.

However, buyer beware – egg banks are not required by law to report success rate data to the government like fertility clinics are. Their claims are not currently subject to on site inspection and validation. I believe many of the claims of high success rates made by donor egg banks are misleading and therefore untrue.

Egg freezing is far from perfect but using frozen donor eggs instead of fresh donor eggs can have some potential advantages for the recipient couples.

• Synchronization of the cycle between the donor and recipient becomes a non issue
• The complexities of ovarian stimulation for the donor and any problems that may result during the stimulation were already dealt with and a now done deal
• There can be a shorter time frame from choosing a donor until having embryo transfer when eggs are already frozen
• Costs per treatment cycle can be reduced using frozen donor eggs compared to fresh
• However, the cost per baby born could be lower, the same, or higher – depending on the live birth rate per embryo transfer procedure
  • This will need to be determined when sufficient verifiable live birth data using frozen donor eggs becomes publicly available

Success Rates

The live birth success rates using frozen frozen donor eggs at this time are lower than the success rates with fresh donor eggs. This is true regardless of the untrue statements made by some donor egg banks.

One problem with the current situation using frozen donor eggs is that there is far less live birth data available for cycles using frozen donor eggs as compared to fresh donor eggs.

Success rates using frozen donor eggs are dependent on several factors:

• The quality of the donor eggs
• The ability of the clinic to perform effective freezing and thawing of the eggs
• The number of eggs thawed
• The number of embryos transferred to the uterus
• The expertise and quality of the IVF program
  • Success rates with donor eggs vary greatly between clinics
  • See any clinic’s IVF and donor egg success rates on the SART or CDC sites

The cost per cycle will certainly be lower with frozen donor eggs. At this time a reasonable estimate (for our clinic) is about 50% for a live birth rate if 2 embryos are transferred after thawing frozen eggs, compared to 85% in our fresh donor egg program when 2 are transferred.

The Society for Assisted Reproductive Technology (SART) has the data on egg freezing outcomes from clinics that have been doing it. However, they are not reporting it publicly at this time. Apparently, the powers that be at SART have not yet (as of December 2013) been able to decide on how to report outcome data for frozen egg treatment cycles. It seems this would be simple. However, maybe nothing is simple with the politics of dealing with hundreds of fertility clinics.

So for now, accurate and validated pregnancy and live birth success rates for frozen egg treatment cycles using the patient’s own frozen eggs or using frozen donor eggs are an unknown.

• In the meantime, claims by individual clinics and frozen donor egg banks are potentially suspect due to the inability to compare the claims to the reported pregnancy and live birth data.
• Some success rate claims that are currently posted on donor egg bank websites are clearly misleading and very likely exaggerated and untrue.

Frozen Donor Eggs at ACME Fertility