Unlocking Hope: Navigating the Donor Egg IVF Process Step-by-Step

One of the most challenging issues I deal with as a fertility doctor are egg quality issues and/or very low ovarian reserve which limit a patient’s ability to ovulate or undergo a successful egg retrieval. A transformative development in the field of assisted reproduction is the advent of in vitro fertilization (IVF) using donor eggs. For many people who have struggled with infertility, donor egg IVF represents a beacon of hope, a chance to realize their dreams of becoming parents. This guide aims to help you understand the process, and what you can expect at each step along the way.

1. Initial Consultation and Counseling

The first step in the IVF process with egg donation is the initial consultation. This meeting with your fertility specialist is crucial to understanding your individual fertility situation, the donor egg IVF process, and to discuss your priorities and concerns. Counseling is also an important aspect of this phase. The implications – emotional, ethical, and legal – of using donor eggs are profound, and it’s essential to explore these facets before embarking on this journey. At the practice I work, we have a clinical psychologist who meets with every individual/couple considering using an egg donor. Our clinical psychologist also vets and evaluates prospective egg donors. 

2. Selection of the Egg Donor

Choosing an egg donor is an intensely personal process and typically involves considering various factors, including the donor’s physical characteristics, health history, and educational background. An important thing to note is that the way genetics work, not all traits of the donor are guaranteed to be inherited by your child. There are many factors, such as genetic recombination, which introduce variation into the gene pool and heritable traits. Epigenetics, or the environment surrounding the DNA backbone inherited from the donor egg, can have an impact on which genes are expressed, amplified or suppressed. Whether using sperm from a partner or a donor, genetic carrier screening should be done to identify the risk of conceiving a child with a major medical issue.

There are two types of donors: known donors, often a friend or relative, and “anonymous” donors, sourced through an egg donation agency or fertility clinic. Each type of donor comes with its own set of considerations, and your fertility clinic can guide you through this critical decision.

3. Synchronization of Menstrual Cycles

The next step involves synchronizing the menstrual cycles of the donor and the recipient. This is achieved through the use of hormonal medications, which allow the clinical team to control the timing of egg maturation and the recipient’s uterine preparation for embryo implantation. If embryos are frozen, then we do not need to synchronize the recipient and donor cycle. We can do a frozen embryo transfer cycle in the recipient similar to a standard protocol (~3 weeks of hormonal preparation followed by embryo transfer).

4. Ovarian Stimulation and Egg Retrieval from the Donor

The egg donor undergoes ovarian stimulation using fertility drugs, which matures multiple eggs which can be retrieved. Once the eggs have matured, they are retrieved in a minor surgical procedure called an egg retrieval. This procedure is typically done under sedation to ensure the comfort of the donor.

5. Fertilization and Embryo Culture

Post-retrieval, the eggs are immediately fertilized in a laboratory using the partner’s or donor’s sperm. The fertilized eggs, now embryos, are cultured in the lab for several days. During this time, embryologists closely monitor their development, assessing their quality and selecting the best for transfer. You do have the option of using PGT to genetically test the embryos. Most egg donors are 20-30 years old and we anticipate approximately 20-25% of embryos coming from those eggs may have genetic errors. Because the majority of embryos are likely to be normal, PGT is not a “must” with donor egg derived embryos.

6. Embryo Transfer

The final step in the IVF process with egg donation is the embryo transfer. A single embryo is carefully transferred into the recipient’s uterus, typically using a small catheter. The procedure is painless and does not require anesthesia.

7. Pregnancy Test and Follow-Up

About two weeks after the embryo transfer, a blood test is taken to detect the presence of the pregnancy hormone, hCG. If the test is positive, the fertility clinic will schedule an ultrasound ~1.5 weeks later to confirm a healthy, progressing pregnancy.

The process of IVF with egg donation is a carefully coordinated series of steps, each one important to the overall success of the procedure. While it may seem daunting at first, it’s important to remember that you are not alone. Your fertility team is there to guide you, provide answers to your questions, and support you throughout this journey. A journey that holds the potential for an immense reward – the chance to create a family of your own.