Egg Donation and Gestational Carrier IVF
There are many different paths to parenthood, but if you’re experiencing infertility, you may feel frustrated, isolated, or a whole range of emotions. Maybe you’re wondering why this is happening and worrying about how you’re going to build your family. But you’re certainly not alone, and there are treatments to help.
Infertility affects millions of individuals around the world — the World Health Organization estimates 1 in 6 people experiences infertility in their lifetime.
Rachel Ashby, MD, is a Mass General Brigham reproductive endocrinology and infertility doctor who cares for patients at the Center for Infertility and Reproductive Surgery at Brigham and Women's Hospital.
In this article, Dr. Ashby discusses infertility and shares promising medical solutions that help parents build families: egg donation and gestational carrier IVF.
Treating infertility with egg donation or surrogacy
Infertility is the inability to conceive a successful pregnancy.
"It's important to remember that infertility is a common and treatable medical condition, much like hypertension," says Dr. Ashby. "Infertility does not have a higher meaning, and we have effective treatments available."
If you wish to start a family but are unable to get pregnant, talk to your primary care provider (PCP) or obstetrician-gynecologist (OB/GYN). They can help you find the best infertility treatment options for you.
Some people can’t use their own eggs for pregnancy. In those cases, patients may qualify for egg donation. Sperm donation is a similar option for people such as same-sex female couples, single women, and couples where the male partner can’t produce sperm.
For those patients who can’t carry a pregnancy due to medical issues, gestational carriers (called surrogates) can help.
How does the egg donation process work?
The first step in egg donation is meeting with your doctor. They help you find out if this option is right for you.
Next, it’s time to meet with an egg donor team. Your team teaches you more about donor egg fertility treatment and helps you select a donor.
Usually, donor eggs come from one of two sources:
1. An egg bank that supplies frozen eggs
2. A fresh donation cycle, where a donor goes through an in-vitro fertilization (IVF) cycle and all their eggs are used for you.
Your team guides you to the best choice for your case.
Why choose egg donation for fertility treatment
The most common reasons patients choose egg donation are:
- Early menopause
- Advanced age (over 35 years old)
- Persistent poor embryo quality
- Repeated treatment cycle failure
- Genetic defects
People in the LGBTQ+ community also may use egg donation to build their family.
How do you find an egg donor?
“Egg donors can be friends or family members,” explains Dr. Ashby. “They also may be anonymous volunteers.”
You work with fertility clinics or egg donation agencies to receive donor eggs. There are two types of egg donor:
- Directed egg donor. You know who the egg donor is, as they’re often a friend or family member. A specialist puts the donor through an IVF cycle and retrieves eggs. They then make the eggs into embryos and either use them immediately or freeze them for future use. Most commonly, specialists use an embryo immediately to establish a pregnancy after they place the embryo into the uterus of the intended parent.
- Anonymous egg donor. You don’t know who the egg donor is. Anonymous egg donors are usually between 21 and 34 years old and undergo the same process as directed donors. However, they never meet the intended parents and are paid by egg donation programs or agencies, who keep their identities anonymous. These donors undergo a rigorous screening process to be approved to act as an egg donor.
Specialized teams screen both directed and anonymous egg donors for genetic and medical disorders. They also look at the number of healthy eggs in their ovaries (called ovarian reserve). In addition, egg donors meet with social workers to confirm their general wellness.
How are donor eggs used to create an embryo?
Doctors create embryos using the partner’s sperm and the egg from the donor. They implant healthy embryos in the birthing parent's uterus.
How does gestational carrier IVF (surrogacy) work?
If you're unable to carry a pregnancy, you may be able to work with a gestational carrier, also known as a surrogate. A gestational carrier is a healthy person who agrees to carry a pregnancy for intended parents.
Like egg donors, gestational carriers undergo intensive medical and psychological testing. They must also have a history of uncomplicated pregnancy.
Gestational carrier vs. traditional surrogacy
There are two types of surrogacy:
- Gestational carrier IVF is when the surrogate doesn’t have a genetic connection to the child. The intended parents or a donor undergo IVF to provide eggs and sperm, which together make embryos. Doctors take the embryos and implant them into the surrogate to create a pregnancy.
- Traditional surrogacy is when the surrogate has a genetic connection to the child. Through a process called intrauterine insemination, a doctor takes the sperm of an intended parent and places it in the surrogate to create a pregnancy. This is much less common than gestational surrogacy and is illegal in some states. This practice is largely not used in the U.S.
How to find a gestational carrier
If you want to find a surrogate, you’re not alone in your search. Fertility clinics, surrogacy agencies, and matching professionals can help connect you with a surrogate. Your surrogate can also be a friend or family member.
Are there any legal concerns about egg donation or surrogacy?
A reproductive attorney gets involved with each gestational carrier case. They work to establish legal parentage.
In the U.S., surrogacy laws are different in each state. It’s important to make sure you work with a reproductive attorney familiar with the law of the state in which you live.
Doctors encourage parents to be honest with their children about egg donation and surrogacy when they feel the time is right.
