“The chances of you using your own eggs are very slim,” Carli , of Long Beach, Calif. remembers her doctor explaining. Carli and her husband had already tried for a year on their own to get pregnant. Then, at just 30 years old, she underwent multiple in-vitro fertilization (IVF) cycles, which were also unsuccessful.
They knew her husband’s sperm count was low but now they were faced with a new reality. Carli’s eggs were immature and they had a hard outer shell— known as “thickened zona” in medical terms.
The couple considered adoption but Carli feared it would fall through at the last minute. They started saving for a fresh egg donor cycle until their doctor explained that using frozen eggs from a donor was about half the cost.
With this process, Carli wouldn’t have to worry that the donor was following the medication protocol, if her eggs were growing, or how many eggs would be retrieved. She knew the process was quicker, there would be fewer doctors’ visits and she’d have less medication to take as well.
“More importantly for me, it seemed less emotional,” she said.
Carli used My Egg Bank, one of only a handful of frozen egg banks in the U.S. She was able to access information about the donor’s medical history, genetic disorders, and if the donor had other children (she did).
She could also find out the donor’s SAT scores, if she graduated college, the degree she obtained, her employment status and even her music preferences. She could view photos and read a handwritten note from the donor explaining her decision.
“It was a really easy process,” Carli said. “It was definitely emotional but I felt more in control and much more positive about it.”
Another option for infertility
As more couples struggle with infertility, using frozen egg donors is becoming a more viable option. Within the past two years alone, it has grown in popularity as the science has been perfected, said Dr. Hal Danzer, co-founder of the Southern California Reproductive Center.
In 2012, there were 1,012 thawed donor egg cycles started, according to the Society for Assisted Reproductive Technology.
Women who choose to use frozen egg donors are usually in their early to mid-30s and don’t have partners. Or they don’t expect to have one and be pregnant when they’re in their late 30’s, when fertility has already declined and the risk for miscarriage and genetic abnormalities is higher.
Other women who choose this technology do so after learning that their anti-Müllerian hormone (AMH) levels are low, which indicates they have a diminished ovarian reserve. About 10 percent of 35-year-old women fall into this category, Danzer said.
Some women who have rheumatoid arthritis, lupus or immunological problems with their ovaries, a tubal infection or blockage, an IUD infection, or a ruptured appendix, may also consider using a frozen egg donor, but this is less common, Danzer said.
The pros and cons
Unlike fresh donor egg cycles where women could wait up to a year for a donor, frozen egg donors are more readily available. Plus, the recipient doesn’t have to be synchronized with the donor and take as many hormones. Instead, the eggs are thawed, fertilized and transferred to the woman’s prepared uterus.
“She can be transferring the embryo four weeks later, once they make the decision,” Danzer said.
Cost, however, is perhaps one of the most compelling reasons to choose frozen. A fresh egg donor cycle could run upwards of $28,000, which includes the agency fee, medication and IVF. A frozen egg donor cycle costs about $12,000 to $14,000. Insurance may cover medications or a portion of the IVF, but the patient is responsible for the rest.
Despite these benefits, frozen egg donor cycles do not have as high a success rate as fresh eggs for embryos.
“They’re about 80 percent effective as using fresh eggs,” said Dr. Marcy Maguire, a board-certified obstetrician and gynecologist and reproductive endocrinologist at Reproductive Medicine Associates of New Jersey. “So if you were going to get 10 embryos from fresh eggs, you would get 8 from frozen eggs.”
Once the embryos are created and transferred, however, the chance of having a live birth is the same.
What’s more, vitrification, or the process by which the eggs are frozen, may not be understood by all clinics so if it’s new to them, it may not be done as well as more experienced ones, Maguire cautioned.
Women purchase frozen eggs in allotments of six, compared to fresh where the woman receives as many as the donor produces. Five will usually thaw, four will fertilize and only one or two will grow into high-quality embryos. Donors are usually women in their 20s so the success rate is usually high.
“But you never know—sometimes it doesn’t work out as we expect it to,” Maguire said.
Since there are only a few egg banks in the U.S., the pool of donors for frozen is less than for fresh. Depending on the bank, there may not be as much ethnic diversity either.
Donors are tested for a host of sexually transmitted diseases, medical conditions and carrier status for genetic disorders like Cystic Fibrosis, Tay-Sachs and Fragile X Syndrome. Recipients can also find out information about the donor’s health and family medical history, learning disabilities, lifestyle habits and employment. Most banks show baby pictures, and some also include childhood or teenage photos.
If the recipient wants to have another child, she can reserve eggs for the future, but freezing an embryo is more ideal.
“Embryos offer a much higher chance of leading to a pregnancy down the road,” Maguire said .
Carli and her husband purchased six eggs and also used donor sperm. Four embryos were created and two were implanted. Four months ago, Carli gave birth to a healthy baby boy. Her other two embryos are still frozen should she choose to have them implanted.
Carli’s son can never contact the donor but when he gets older and is able to understand, she will tell him how he came to be.
“We’re very lucky that the technology is where it’s at,” she said. “I think we’re also very lucky that there are individuals out there that are willing to share a little bit of themselves to let a couple experience what we experienced.”