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Embryo donation is an exciting new option in modern infertility treatment. While most couples would initially prefer to have children using their own eggs or sperm, due to numerous factors beyond their control many couples find that this is not possible. For couples where both the wife and the husband have significant fertility factors decreasing their chances for conception, this is a wonderful alternative in addition to traditional adoption. Many couples consider embryo donation a very early adoption.
A good example of an ideal couple would be a husband who has no sperm (azoospermia) due to lack of sperm production (sertoli cell only syndrome, testicular cancer, chemotherapy, etc) and the wife has poor egg quality due to advancing reproductive age or premature menopause. Prior to the initiation of donor embryo programs, traditional adoption was the only option this couple would have. Donor embryo allows the couple to experience the wonder and joy of pregnancy, labor and delivery while allowing the wife to carefully control the pregnancy environment (taking prenatal vitamins, good diet, avoiding alcohol, tobacco or unnecessary drugs).
A frequently asked questions is, “Where do donor embryos come from?” Donated embryos can come from a variety of sources. Most frequently other infertile couples who have undergone IVF treatment and achieved the family of their desired size chose to donate embryos rather than have them discarded. Couples who chose to donate find that this is a much more difficult and time-consuming option for them compared to discarding the embryos.
The couples are requested to provide extensive information regarding their personal and family medical and genetic information. The couples also are asked to provide updated infectious disease testing such as HIV, hepatitis B and hepatitis C. If they have not been testing previously, donating couples are also requested to undergo testing for ethnic specific genetic risks such as cystic fibrosis for Caucasian and sickle cell disease for Black couples. The fertility center staff which often includes a geneticist carefully review their medical information. Regretfully some embryos need to be eliminated from donation due to infectious or genetic disease risk issues. Donating couples are not paid for their embryos but some may receive compensation for their time and efforts in completing the required screening process. Couples who donate tend to want to help other infertile couples who are going through the same often-frustrating process that they went through.
Embryos that are donated have been frozen at the time of the initial fresh IVF cycle. They could have been stored for several months or even several years depending on the circumstances. Most programs encourage couples not to donate extra embryos until after the baby has been delivered and is doing well. Many couples prefer to wait until the child is 1-2 years old before making the decision to donate. Couples usually incur storage charges during this time which remind them to make a decision regarding management.
Pregnancy rates with the use of donated embryos are highly dependent on the age of the woman who donated the eggs, the quality of the donated embryos, and the number of embryos that the recipient couple is willing to transfer. The younger the age of the donating woman, the higher the pregnancy rate. The higher the quality of the embryos based on embryology scoring systems, the higher the pregnancy rate. Frequently couples will choose to transfer between 2 and 3 thawed donated embryos.
Typically pregnancy implantation rates between 5-15% per embryo transferred or 30% per embryo transfer can be expected. While at GIVF, Dr. Blauer had extensive experience working with couples who both donated and couples who received donated embryos. Many recipient couples had undergone extensive infertility treatments of their own including IVF before opting for donated embryos.
Once a couple have decided to pursue the use of donated embryos, the first step is to find embryos that would be acceptable for their use. Like many other centers, the Reproductive Care Center has a list of our currently available donated embryos but most programs also have a waiting list of couples who are interested in the donated embryos. Couples should also be encouraged to contact other agencies to determine if they have embryos that could be used.
The following web sites for further general information:
A Creative Option: Embryo Adoption
http://www.bioethix.org/newsletter/992/992bevington.htm
Choosing Embryo Adoption
http://www.perspectivespress.com/carembryo.html
Embryo Adoption FAQ
http://www.snowflakes.org/faqs.htm
Conceptual Options
http://www.conceptualoptions.com
mailto:maryann@conceptualoptions.com
A center for surrogacy, egg donation and embryo adoption.
10650 Treena Street, Suite 103
San Diego CA 92131
phone: 1-858-577-0358
fax: 1-858-577-0355
Creating Families, Inc.
http://www.eggdonorfertilitybank.com
Online data base registry for egg donation,
surrogate parenting and embryo adoption.
1395 Bellaire Street
Denver CO 80220
phone: 1-303-355-2107
fax: 1-303-355-1132
Embryo Donation/Adoption
The Iowa Women's Health Center
Advanced Reproductive Care, 2 Boyd Tower
The University of Iowa Hospitals and Clinics
200 Hawkins Drive
Iowa City IA 52242-1009
phone: 1-319-356-UIVF (8483)
fax: 1-319-353-6659
Genesis Family Services
Egg Donation, Embryo Donation
http://www.GenesisFamilyServices.com/
mailto:info@genesisfamilyservices.com
185 County Road 1801
Holly Pond AL 35083
phone: 1-888-517-8401
Genetics & IVF Institute
www.GIVF.com
3020 Javier Road
Fairfax, VA 22031
703-698-7255
GIVF@GIVF.com
Contact Nurse – Jennifer Machovina
National Embryo Donation Center
www.embryodonation.org
Baptist Hospital for Women
10810 Parkside Drive - Suite 304
Knoxville, TN 37922
Toll Free: 866-585-8549
Telephone: 865-218-6600
Fax: 865-218-6666
E-mail: info@embryodonation.org
Reproductive Specialty Medical Center
http://www.drary.com
mailto:info@drary.com
1441 Avocado Avenue Suite 203
Newport Beach CA 92660
phone: 1-949-640-7200, 1-800-414-7299
fax: 1-949-720-0203
Egg donors with photo as adults and as children, diverse choice of ethnic heritage and occupations available gestational surrogacy and donor sperm available
Snowflakes Embryo Adoption Program
Christian Adoption & Family Services
http://www.snowflakes.org/
mailto:info@snowflakes.org
801 East Chapman, Suite 106
Fullerton CA 92831
phone: 1-714-278-1020
fax: 1-714-278-1063
Once embryos have been identified the medical staff at the assisting fertility center can review the embryo transfer process with the couple. Recipient couples will need to undergo appropriate medical, infectious disease and psychological screening tests just prior to the embryo transfer. Couples should be encouraged to consult with a psychologist who has experience dealing with couples undergoing third party reproduction.
During the actual treatment cycle the wife is usually started on oral contraceptives. After taking the pills for 2 weeks, daily subcutaneous injections of leuprolide acetate (Lupron®) are started. After one week on leuprolide acetate, the pills are stopped. The Lupron is continued and menses usually begins within 7 days. Blood tests and transvaginal ultrasound are performed near the end of menses. If appropriate (estrogen level is low and there are no cysts on the ovaries), the wife is started on estrogen (oral, transvaginal, patch or injections) to help develop the lining of the uterus (endometrium).
The wife is then carefully monitored to makes sure that the lining of the uterus is appropriately prepared (an endometrial thickness more than 6 mm is essential for success). Once the lining is of the appropriate thickness, which usually required 14-15 days of estrogen, the wife stops leuprolide acetate, continues the estrogen and starts to take progesterone to prepare for implantation of the embryos.
The embryo transfer usually is performed 3-5 days later. The wife then continues the estrogen and progesterone until the pregnancy test is obtained 2 weeks later. Pregnancy rates with the use of donated embryos range from 10-40% per treatment cycle. The cost of a treatment cycle with the transfer of donated embryos is usually less than half what it would cost for a fresh IVF cycle.
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