Embryo donation is an option that is open to our IVF patients who have embryos that they do not wish to use themselves. They can “donate” or make their embryos available to other couples who are attempting pregnancy. The “recipient” couple uses the donated embryos instead of their own to attempt pregnancy. Embryo donation can be accomplished in two ways :
- At the time of the original IVF cycle
- At a later time using embryos previously frozen for a couple’s own use
Embryo donation versus Embryo adoption
Some religiously based organizations have used the term embryo donation rather than the accepted term embryo adoption. There is essentially no difference between the two concepts. At least in Illinois, couples who wish to attempt pregnancy with embryos donated from another couple do not have to go through a legal adoption process. Some agencies that provide donated embryos may have their own requirements, however. The agency requirements may be as stringent as adoption requirements. In some cases, these requirements exist because the couples who have donated these embryos requested them in order to make their embryos available. At IVF1, we do not have any of these requirements.
Known versus Anonymous Embryo Donation
Couples can donate their embryos anonymously or make their identities known to potential recipient couples. Couples who are potential recipients of donated embryos can make their identities known or remain anonymous. Thus, there are several different combinations possible. At IVF 1, embryo donation is performed so that both the donor couple and the recipient couple maintain anonymity. As stated above, some agencies may require that a couple remain known. In some cases, the donating couple may require the potential recipients to meet with them and be “interviewed” before they will release their embryos to them. They may also request that they be allowed to maintain a relationship with any children born using their embryos.
New Embryo Donation Requirements
As of May 25, 2005, new regulations from the Food and Drug Administration are going to make embryo donation much more difficult and expensive. At that time, if a couple wants to donate their embryos or even if they think they might want to donate their embryos at some point in the future, each partner who contributes to the formation of the embryos is going to be required to:
- Provide additional extensive medical history
- Undergo a detailed physical exam
- Undergo additional testing for transmissible diseases.
This includes blood tests, vaginal cultures for females and semen cultures for men.
These rules do not apply to embryos that were produced before May 25, 2005.
How does embryo donation work?
We have had the capability for many years to perform embryo freezing. It is possible, once an embryo is frozen, to store it for long periods of time before it is thawed and used to attempt pregnancy. It is also possible to safely transport frozen embryos to anywhere in the world. Once thawed, embryos can be placed into the uterus of the same woman who provided the eggs for their creation or into the uterus of any other woman. When we place embryos into a different woman, it is called embryo donation.
Couples who donate embryos have typically gone through an in vitro fertilization (IVF) process for their own infertility. They designated that any viable embryos that are not placed into the uterus of the female partner should then be frozen and made available to other infertile couples through ivf embryo transfer. Couples who make their embryos available for embryo donation may have had problems other than infertility. For example, it is possible that they had recurrent miscarriage or were having IVF for the purpose of having PGD.
Embryo donation success
The success of embryo donation depends in large part on the original center involved in the embryo freezing. Some centers are very proficient at freezing embryos and have high survival rates when thawing the embryos and high pregnancy rates using frozen embryos. Some centers do not do as well. The survival of frozen embryos is critically reliant on the program that froze them and less so with the center that thaws them. There are many other variables such as:
- The age of the woman providing the eggs
- The cause of the donating couple’s infertility
- The “quality” of the embryos when they were frozen
- The developmental stage of the embryos when they were frozen
- The number of frozen embryos available for donation
Generally speaking, embryo donation success rates will be lower if the female who provided the eggs is older, and if there were “egg” issues that contributed to her infertility. If there are fewer embryos available after the thaw there will be fewer for transfer and embryo donation pregnancy rates will be lower.
Babies that are conceived from embryo donation do not appear to be at any greater risks for birth defects or other problems than babies born from “fresh” in vitro fertilization (IVF) treatments.
Embryo Donation Protocol
The treatment used in embryo donation is the same that is used for women receiving their own frozen embryos. The uterus is prepared using hormones to mimic the natural menstrual cycle. These are the same hormones produced by the ovaries: estrogen and progesterone. One additional medication is also frequently used: Lupron. Lupron is used to suppress the pituitary gland to prevent the patient from ovulating during the preparation of the uterus. One the pituitary gland is suppressed, the estrogen begins. Estrogen thickens the uterine lining. Estrogen can be given as pills, patches, or even injections. The uterine lining is monitored with transvaginal ultrasound. Once the thickness of the lining reaches 7 mm or more, progesterone supplementation can begin. Progesterone can be given as a vaginal suppository or gel or as injections. Oral progesterone is not recommended. The number of days progesterone is given before the transfer must match the stage of embryo development. This “synchronization” is very important in embryo donation cycles.
Unlike other types of “transplants” the recipient of donor embryos does NOT need to take medications to suppress her immune system.
Once the uterine lining has been prepared, the frozen embryos are thawed and placed into the uterus. The embryo donation recipient continues to take estrogen and progesterone until a pregnancy test is done. If she is pregnant, she continues both the estrogen and progesterone until the 11th week of pregnancy.
Embryo Donation Costs
Embryo donation is less costly than IVF or IVF with donor eggs. Many of the most expensive parts of an IVF cycle: the fertility medications, the egg retrieval and the fertilization and culture of the embryos does not need to be performed.
Embryo donation can be a successful method for couples to achieve pregnancy on one or both of the partners have problems which lower their chances using their own eggs or sperm. It is an easy procedure and less costly than many other forms of treatment. Obtaining the embryos themselves is the biggest challenge. Because of the new FDA regulations, it is expected that there will be far fewer embryo to donate.