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    Should you choose Fresh or Frozen Eggs for your IVF treatment?

    Fresh eggs were the preferred source used in assisted reproductive technology until recently and are still the most prevalent method used around the world. Recent advances in the freezing and vitrification process have led to frozen egg donation becoming a more viable option. This has also led to the creation of Egg Donor Banks that offer a nationwide database of frozen donor eggs. The results of using frozen eggs are more consistent and predictable than they have been in the past with reports of successful pregnancies and live births.

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    Advantages of Using Frozen Eggs

    There are several advantages of choosing frozen eggs over fresh. Some of them include:

    • Synchronization of cycles between the egg donor and the embryo recipient is unnecessary with the use of frozen eggs.
    • Any complication that may have come up during ovarian stimulation has already been resolved, so at least one area of stress is reduced.
    • The cost for each cycle is greatly reduced by using frozen eggs over fresh eggs.
    • With frozen eggs, the treatment can begin right away and is not dependent on the egg donor’s availability.
    • Additional frozen eggs may be available without the donor completing a new cycle.

    Earlier attempts towards the development of frozen egg donation were met with challenges.  A slow-freeze method was used, which did not produce reliable results. After the discovery of flash freezing, also known as vitrification, the success rates improved greatly, and freezing eggs finally become a viable solution. With the option of egg freezing finally becoming available, women who weren’t ready to start a family in their more fertile years were able to freeze their eggs and then thaw them at the time of their choosing.

    In 2012, the American Society for Reproductive Medicine recognized that the process of egg freezing did result in an acceptable percentage of births. With current technological advances, there is an equal chance of a successful pregnancy using frozen eggs as there is with fresh eggs.

    The Choice Between Fresh Eggs vs Frozen Eggs

    The basic question for egg donor recipients is: fresh or frozen? The decision involves the determination of which process would be the best fit for each individual. A cycle with frozen eggs is less complicated and has a range of advantages that run the gamut between physical, psychological, legal and financial. The timing is also greatly shortened using frozen eggs and the recipients have more flexibility in terms of scheduling each step of the procedure.

    While on the other hand, the process for fresh eggs is increasingly unpredictable as it involves two separate individuals – the egg donor and the egg recipient. And as two individuals are involved, the risks are also doubled. The greatest risk doing a fresh egg donation cycle is that the donor becomes disqualified to move forward. Extensive testing needs to be performed in accordance with the Federal Drug Administration requirements. Every donor with a negative result is disqualified from moving forward. Potential donors also go through a psychological evaluation during the screening process.

    Some programs require genetic testing and visits with a physician which includes blood work and a physical exam. At any point in time, if the donor changes her mind, she is free to leave the process. Typically, the recipients bear the financial burden of the donation process.

    The process for frozen egg donation is less risky because the eggs have already been retrieved and there are nearly zero risks of disqualification. Removing the risk associated with the donor’s cycle minimizes the time between donor choice and treatment by four to nine months.

    How much do fresh and frozen donor eggs cost?

    The complete process with frozen eggs can be half the cost of a fresh donor egg cycle. The total cost of a fresh egg donor cycle can be as high as $30-$40k with donor recruitment, screening, treatment, and medication. On the contrary, the cost with frozen egg cycle is in the range of $14 – $20K. There are many differences between the two processes which accounts for such a significant difference in the cost.

    IVF with Fresh Donor Eggs: The Process

    Search for an Egg Donor

    Most individuals prefer to work with an agency which can cost anywhere between $5000 to $8000 each cycle to recruit an egg donor. Depending upon the unique requirements this process could take anywhere from a month to several months.

    Egg Donor Testing

    Once the donor has been accepted in a program, she will begin her evaluation and hormonal testing to determine suitability to be a donor. She will have to undergo psychological and psychological screening and genetic testing. This also includes infectious disease testing according to FDA guidelines.  If the donor is disqualified at any point the recipient may have to start again.

    Contracts and Attorney visit

    A contract needs to be created between the individual and the donor, once the egg donor has completed their screening.  This is to ensure the rights of the recipient and relinquish the eggs from the donor. This step involves drafting the contract through an attorney. Some agencies, such as Reproductive Science Medical Center, will provide an attorney. 

    Recipient Workup

    The recipient will receive a full medical evaluation to determine any risk factors.  The tests can include a cervical culture, hysteroscopy, and a saline sonogram to assess uterine health. The workup can take up to three months to complete and maybe more if the process is followed more leisurely.

    Prep Cycle

    The cycle consists of a trail transfer and hormonal therapy to ensure the treatment will achieve the desired blood levels and endometrial effects. Some physicians might also elect to perform an endometrial biopsy during this cycle. The trail transfer is used to determine the uterine depth and to ensure that the physician can navigate the catheter to the right spot.

    Suppression and Stimulation

    The donor is given birth control pills to suppress and synchronize her menstrual cycle with the recipient. The egg donor will also have to self-administer hormone injections on a daily basis to stimulate egg production and it will be monitored through 

    Endometrial Lining Development 

    While the donor is preparing for the retrieval, the recipient takes a combination of estrogen and progesterone to prepare her uterus for successful implantation. In certain cases where autoimmune issues occur, additional medications may be required.

    Triggering Ovulation and Retrieval 

    Once the ultrasound determines the eggs are ready, the donor will receive an injection of hCG, which is also known as the trigger shot. Within 36 hours of that trigger shot, the egg retrieval process is initiated through an aspiration needle guided by ultrasound under the effect of mild aesthetic.

    Fertilization and Embryo Transfer

    Once the eggs are retrieved, they are fertilized with the partner’s or donor’s sperm in a laboratory. The resulting embryos are incubated and then implanted in the recipient. This happens approximately 5 days after the retrieval.  

    Post-implantation Check-up

    Recipients will have a pregnancy test usually on day 14 or 15 after implantation. This is accomplished with a blood test. Once the pregnancy is confirmed from the blood test, an ultrasound is used to look for the baby’s heartbeat.

    IVF with Frozen Donor Eggs: The Process

    The process with frozen eggs is less complicated, as the egg donor has already completed half of the process before the cycle ever begins. 

    Search for an Egg Donor 

    To search for frozen eggs Intended Parents can use an agency such as Reproductive Sciences Medical Center.  You can browse through the donor profiles. There are no fees associated with this step. 

    Full Medical Evaluation

    This step is only for recipients. The intended mother will undergo a complete physical and psychological screening to determine any risk factors. The tests may include cervical culture, hysteroscopy and a saline sonogram to assess uterine health.

    Prep Cycle

    It’s an optional course of hormone therapy which can assure that the treatment will achieve the desired results. The prep cycle may include an endometrial biopsy to measure the thickness of the endometrial lining. 

    Endometrial Lining Development

    The recipient takes a combination of estrogen and progesterone to prepare her uterus for a successful implantation. In certain cases where autoimmune issues occur, additional medications are required

    Fertilization and Embryo Transfer

    Eggs are thawed and then fertilized with the partner’s sperm, and  the resulting embryos are incubated and then implanted in the recipient usually on day 5 after the retrieval.

    Post-implantation Check-up

    The recipient will have a pregnancy test usually on day 14 or 15 after implantation. Once the pregnancy is confirmed from the blood test, an ultrasound is used to look for the baby’s heartbeat.

    Legal Issues with Donated Eggs

    Fresh egg donation has a higher range of legal implications and more risks as compared to frozen eggs.

    Frozen eggs usually come from anonymous donors, thus virtually eliminating the need for legal counsel as the donor has already completed her cycle and relinquished her eggs. 

    Reproductive Sciences Medical Center is a leading egg donation agency in San Diego. If you want to learn  more about the egg donation process, you can visit us at www.fertile.com or call us at  858-436-7186 to schedule a free consultation.

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