Egg and embryo donation

What do egg and embryo donation involve?

Egg and embryo donations are ways to help you conceive, using donors. They are both types of assisted reproductive technology (ART).

Egg donation is when eggs from another woman are fertilised with sperm from your partner or a donor in a laboratory. The resulting embryos are then transferred to your uterus (womb).

Embryo donation is when another couple’s embryo is implanted in your uterus during IVF. This is an option if you and your partner need both egg and sperm donation, or you’re a single woman who can't use your own eggs.

How might egg or embryo donation benefit us?

Your doctor may recommend egg donation if:

• You have no ovaries, produce low-quality eggs, or no eggs at all. This may be due to premature menopause, an inherited condition such as Turner syndrome, surgery to remove your ovaries, or treatment for cancer using chemotherapy or radiotherapy.
• You're over a certain age (usually about 45).
• You and your partner have been unsuccessful with other treatments, such as IVF.
• You’re at risk of passing on an inherited disorder or chromosomal abnormality.
  (NCCWCH 2013, VARTA nde)

Your doctor may recommend embryo donation if:

• You and your partner are unlikely to conceive using your own eggs and sperm for fertility treatment.
• Both you and your partner are at risk of passing on a genetic disorder to a child.
• You’re single and have gone through the menopause.
  (VARTA nde)

How do egg and embryo donations work?

The process starts with finding a donor, which your fertility clinic can help you with. You can use an unknown donor recruited by your clinic or a known donor, such as a friend, relative or someone you recruit through advertising or an online forum.

Egg donations can be from egg donors or egg sharers:

• Egg donors are women who aren't receiving fertility treatment themselves, but who choose to donate their eggs to help other women, or a particular woman they know.
• Egg sharers are women undergoing fertility treatment, who donate some of their eggs as part of their IVF cycle.
  (HFEA 2014)

Embryos are usually donated by couples or women who've successfully had their baby or babies from IVF and who want to help other parents-to-be (HFEA 2014).

In Australia, donors aren't paid, apart from direct expenses, so they give their eggs or embryos as a gift (NHMRC 2017).

If you want to use an unknown donor recruited by your clinic, you may have to wait months or even years, because there are more people wanting the treatment than there are donors (AA 2011, VARTA ndc). It may be worth contacting several clinics to find out what their waiting times are (HFEA 2018). Some clinics have access to overseas egg banks, which usually shortens the wait.

It’s recommended that egg donors are under 38 years of age (AA 2011), because fertility treatment is more successful with younger eggs. But there can be exceptions to this, such as when a woman is donating eggs to friends or family.

All egg donors are screened for infectious diseases such as HIV, hepatitis B, hepatitis C, and some genetic conditions such as cystic fibrosis, before their eggs are used (AA 2011, NCCWCH 2013, NHMRC 2017).

There are caps on how many families can be created using a donor's eggs or embryos (NHMRC 2017). Depending on where you live and the clinic you use, this may be up to 10 families, including the donor's own (VARTA 2017). Donors can also specify a smaller number of families when they donate (NHMRC 2017).

If you're using an unknown donor's egg or embryo, your clinic will give you information about potential donors to help you select one (NHMRC 2017). This information may include donors' physical characteristics, medical and family history, and the number of families who have already used eggs or embryos from each donor.

What are the legal implications of egg and embryo donations?

In both egg and embryo donations, you and your partner, if you have one, are the legal parents of your child and will be named on the birth certificate (AA 2011, VARTA 2017). The egg donor or embryo donors have no legal rights or obligations to your child (AA 2011, VARTA 2017).

Your child can find out information about the donor or donors once he’s 18 years old. He'll just need to apply to the donation register in the state or territory he was conceived, or go through the clinic you used (NHMRC 2017, VARTA 2017). In some circumstances, he may be able to apply at a younger age (NHMRC 2017, VARTA 2017). He'll be offered counselling before any information is shared with him (NHMRC 2017).

Depending on your state or territory, you may also be able apply for information on your child's behalf before he turns 18, but the donor or donors must consent before their information is released to you (VARTA 2017).

Clinics must try to notify the donor or donors before they give your child any identifying information (such as his name and address) (NHMRC 2017). If the donation was made before 2005, the donor or donors may not have consented to their identifying information being released, and you may not be able to access it (NHMRC 2017).

Your child can also apply for non-identifying information about other people created using your donor's eggs or embryos (donor siblings) (NHMRC 2017, VARTA nda). He may do this out of curiosity, or if he's worried that he may be in a relationship with a half-sibling (VARTA nda).

If your child does have a donor sibling and that sibling has consented for her information to be released, your child will be given her identifying information (NHMRC 2017). If she hasn't consented for her information to be shared, though, your child may still be able to get non-identifying information, such as his donor sibling's sex, and year and month of birth (NHMRC 2017, VARTA nda).

This information may be enough to determine that your child's partner isn't his donor sibling. If it's not, though, your child should encourage his partner to investigate her donor's information (VARTA nda).

How are egg and embryo donations done?

Embryo donation
In vitro fertilisation (IVF) sometimes produces extra embryos that may be used if the woman's first treatment cycle fails, or if she wants to have more children in the future (VARTA nde).

These embryos are usually frozen and kept in storage for a number of years. Sometimes women (and their partners) decide that they don’t want to attempt to have more children, and agree to donate the embryos to another couple (VARTA ndd).

If you’re the recipient, your doctor will monitor when you're ovulating. In the two to five days after ovulation, she'll transfer one or two of these embryos into your uterus through your cervix with a thin catheter (tube) (AA 2013, VARTA ndd).

Many clinics will only transfer one embryo per treatment cycle, because there's a risk of having a multiple pregnancy if two embryos are transferred (AA 2013, VARTA nde). Your doctor will counsel you on the number of embryos you should transfer, balancing the chances of success against the risk of multiple pregnancy.

If all goes well, at least one of the embryos will stick to your uterine wall and continue to grow. You can take a pregnancy test in about two weeks. If you do become pregnant through donation, you’ll have careful monitoring.

Egg donation
If you're using a known donor, the process is usually coordinated so that you and the egg donor have synchronised fertility cycles (HFEA 2018). You'll both be given hormones to make sure this happens. So at around the time that your uterus lining is able to support an embryo, your donor needs to be ovulating.

Your egg donor will also be given fertility drugs to help her develop several mature eggs for fertilisation (AA 2011). When the eggs are ready, a doctor will remove them using a fine, hollow needle.

If you're using your partner's sperm, he'll need to provide a semen sample on the same day as the eggs are collected from your donor (AA 2013). The eggs will then be mixed with his sperm, or a donor's if you're using donor sperm. This will happen in a laboratory if you’re having standard IVF (AA 2013). Or if you’re having ICSI, one sperm is injected into each egg (AA 2013). One day later, any fertilised eggs become a ball of cells called an embryo (HFEA 2018).

The embryo is then transferred into your uterus through your cervix with a thin catheter (tube) (AA 2013). This happens between two and five days after fertilisation (AA 2013, VARTA ndd). It’s usually recommended that only one embryo is transferred in order to avoid a multiple pregnancy (VARTA ndd).

In some cases, the fertilised donor eggs and the resulting embryos are frozen to allow for embryo transfer to take place on another day. This means your menstrual cycle doesn't need to be synchronised with the donor. This may make your treatment cycle less stressful (HFEA 2018).

Improvements in freezing technology mean it’s also possible for donor eggs to be frozen until selected for treatment. The thawed eggs are then fertilised with the sperm and the resulting embryos are transferred to your uterus. This approach doesn’t require synchronisation with your menstrual cycle either.

How long does treatment with donated eggs or embryos take?

The waiting lists for treatment using donated eggs and embryos vary, but can be very long. You can find a clinic that offers treatment using donated eggs and embryos on the Access Australia websiteOpens a new window.

If you want to shorten the wait, you could consider advertising for a donor or talking to a friend or relative who is willing to help. Depending on which state or territory you live in, there may be restrictions on advertising for egg and embryo donors, so check with your clinic.

Once treatment begins, one cycle of IVF or ICSI can take up to six weeks to complete (HFEA nd).

What are the success rates of egg and embryo donation?

In Australia and New Zealand, about 21 per cent of all assisted reproductive treatment (ART) cycles using donated eggs or embryos resulted in the birth of a baby in 2017 (Newman et al 2019). It can depend on your age and, if you're using donor eggs, whether the eggs are fresh or thawed from frozen (Newman et al 2019).

The percentage of babies born per ART cycle in 2017, were:

• about 10 per cent using fresh donor eggs
• about 29 per cent using frozen donor eggs
• nearly 24 per cent using donor embryos
  (Newman et al 2019)

If you're using donor eggs, your likelihood of success may be higher if the sperm used to fertilise the egg is also donated (HFEA 2019b).

What are the advantages of egg and embryo donation?

If you’re unable to produce healthy eggs, using donated eggs or embryos gives you the chance to conceive.

Success rates for donor egg and embryo ART can be higher than with regular ART (HFEA 2019b) because donor eggs are almost always from young women.

What are the disadvantages of egg and embryo donation?

The shortage of donors can make it a lengthy process. It's possible to use donated eggs from overseas, but only some clinics are able to offer this. And very few, if any, offer donated embryos from overseas. All overseas donations must meet the same strict legal, medical and ethical standards as Australian clinics (NHMRC 2017).

Egg donation from a known donor can be more stressful than regular IVF, because of uncertainty over whether the donor will produce enough eggs.

You and your partner will need to talk through the difficult issues raised by donation. In the case of egg donation, you won’t be the biological parent of your child. With embryo donation, it’s possible that neither of you will be genetically related to the child. So it may take time for you both to come to terms with that (VARTA ndb).

You and your partner will also need to consider how you'll tell your child about his genetic origins. Experts say that talking about it openly and honestly during childhood is usually the best course (DCN nd, HFEA 2019a, NHMRC 2017).

If you conceived by donation rather than conceiving naturally, you may be more likely to develop pregnancy-related high blood pressure conditions, such as pre-eclampsia (Masoudian et al 2016, Storgaard et al 2017). Experts believe this is because your immune system is reacting to the implanted embryo, which is genetically foreign to your body (Masoudian et al 2016). It’s important to go to all your antenatal appointments, as your midwife or doctor will check for high blood pressure as part of your routine care.

The Australian Donor Conception NetworkOpens a new window and Access AustraliaOpens a new window offer information, local support groups and online forums that may help if you’re thinking about treatment.

More information and support:

• Talk to others about egg and embryo donation in our assisted conception community.
• Learn more about IVF.
• Discover what's involved in sperm donation.
• Find out how surrogacy works.