Choosing Between Fresh Donor Eggs and Frozen Donor Eggs

Donor eggs help many couples with infertility conceive successfully and make their dreams of building a family come true. Trying to conceive with the help of an egg donor is an exciting but multi-step process. One of the first decisions you will have to make is whether to use fresh or frozen donor eggs. Both of these options have advantages and disadvantages. The best choice for you will depend on your individual medical and personal circumstances and priorities, including your age, medical history, and preferences. You will want to discuss your options with an experienced fertility specialist who can provide guidance on your unique situation.

There are many reasons a couple or individual may choose to use an egg donor to overcome infertility and conceive successfully. These reasons include:

• Diminished ovarian reserve
• Ovarian insufficiency
• Absence of the ovaries as a result of surgery
• Advanced reproductive age
• A history of poor oocyte or embryo quality
• Prevention of passing along a genetic disease
• Need for an egg because you are single or a same-sex male couple

Prospective parents considering donor eggs for in vitro fertilization (IVF) need to consider the benefits of fresh donor eggs vs. frozen ones. This blog will discuss the pros and cons of each option. 

The Fresh Donor Egg Process

The use of fresh donor eggs allows the oocytes to be fertilized by sperm on the day of egg retrieval. A fresh egg donor might be chosen from the patient’s own fertility program or selected from a donor egg agency.

Once selected, an egg donor undergoes stimulation and monitoring in an IVF program. Her resulting eggs are fertilized with sperm via conventional insemination (sperm and eggs are placed together in a petri dish) or by intracytoplasmic sperm injections (a single sperm is injected directly into each egg).

The Frozen Donor Egg Process

With the advances in egg freezing, using frozen donor eggs has become a popular alternative to fresh eggs.

As with fresh egg donors, frozen egg donors are screened and undergo stimulation and monitoring in an IVF program. Their eggs are retrieved and immediately frozen.

Patients who choose to use frozen donor eggs typically have access to a cohort of eggs (typically 6-12 eggs) from their selected donor,  The frozen eggs are shipped to the recipient’s local IVF program where they are thawed and fertilized. One of the developing embryos is then transferred to the intended parent’s uterus.

Pros and Cons of Fresh vs. Frozen Donor Eggs

There are several pros and cons to consider when choosing between fresh or frozen donor eggs.

Using Fresh Donor Eggs

Pros:

1. Higher Success Rates: Fresh donor eggs typically have slightly better success rates in terms of fertilization and implantation rates compared to frozen eggs. This may be due to the fact that fresh eggs are not subject to the freezing and thawing process, which can sometimes affect egg quality.
2. More eggs available: Fresh cycles typically retrieve a larger number of eggs, increasing the number of embryos for transfer or freezing.
3. Fewer eggs may be needed to achieve pregnancy: Because fresh eggs have a slightly higher likelihood of successful pregnancies, the process may require fewer eggs to achieve pregnancy.
4. ICSI not always required: Fresh eggs may be strong enough to fertilize without intracytoplasmic sperm injection (ICSI), a procedure where sperm is directly injected into the egg.

Cons:

1. Timing Constraints: Choosing a fresh egg donor can take longer as the donor has to undergo an egg donation cycle. The IVF clinic will need to coordinate with the donor’s schedule. Sometimes matching with a fresh donor can take months due to cycle synchronization requirements.
2. Cost: Fresh donor egg cycles are generally more expensive than receiving frozen eggs due to the medication needed to cycle, along with the additional coordination and monitoring involved.
3. Donors of certain ethnic groups may be limited depending on location.
4. Number of eggs retrieved and ready for transfer can be unpredictable.

Using Frozen Donor Eggs

The choice to use frozen donor eggs also presents certain advantages and disadvantages.

Pros:

1. Immediate Availability: Frozen eggs are ready when a recipient is ready as they can be stored until needed, allowing immediacy or flexibility in timing for the recipient.
2. Lower Cost: Frozen eggs are often less expensive than fresh eggs. The cost of stimulation medications, lab testing, and standard genetic screen are all typically included in the price of the cohort of eggs.
3. Wider Donor Pool: Frozen eggs can be shipped, allowing for a wider geographic area to select from. This is often advantageous if a local pool does not offer the ethnicity a recipient is seeking.

Cons:

1. The Thawing Process: Not all eggs survive the thawing process, and the process can sometimes affect egg quality, although advancements in vitrification have minimized this concern.
2. Slightly Lower Success Rates: While success rates are catching up to fresh eggs, frozen eggs may have a slightly lower chance of resulting in a live birth compared to fresh eggs.
3. Intracytoplasmic injection of sperm is required: This is because the freezing and thawing of an oocyte makes the shell surrounding the egg (the zona pellucida) more difficult for sperm to penetrate on its own.

Success Rates: Fresh vs. Frozen Donor Eggs

Research indicates that both fresh and frozen donor eggs yield excellent outcomes.

Fresh Donor Eggs: The success rate of using fresh donor eggs is, on average, around a 50% success rate per cycle. Most donors are young, which contributes to healthy eggs and better outcomes.

Frozen Donor Eggs: The success rate of using frozen donor eggs is, on average, just slightly lower than the success rate of fresh eggs. Here again, most donors are young, which means their eggs are healthy. The slight difference in success is due to the thawing process which in  some cases can lead to the egg failing to survive or to slightly lower quality eggs.

The Importance of Discussing Your Options with Your Specialist

The decision to use an egg donor to conceive a pregnancy is sometimes a hard one. Both fresh and frozen donor eggs offer very hopeful paths to parenthood. 

In addition to counseling with your physician, it is wise to research the many resources available to better understand the process and your options. The American Society for Reproductive Medicine has many helpful articles for patients considering donor eggs:  https://www.reproductivefacts.org.  

Counseling with a psychologist can also be very helpful to patients. 

Ultimately, the decision to use fresh or frozen donor eggs will depend on your unique circumstances, including your medical history and current medical condition, your budget, timing, ethnic preference for your child, and more. It is, therefore, very important to consult with an experienced fertility specialist to determine the best approach for your unique situation.

The ASB Difference

Atlantic Shared Beginnings offers both fresh and frozen donor egg options as well as donor embryos. Atlantic Shared Beginning’s partnership with Atlantic Reproductive Medicine makes this clinic uniquely positioned to offer the best in pregnancy and family-building programs to those needing donor eggs to grow their families with the highest screening criteria for egg donors and the best medical services for donors and recipients.

All egg donors undergo their donor stimulation and retrieval cycles at Atlantic Reproductive Medicine under the supervision of the clinic’s highly qualified and experienced physicians.

All Atlantic Shared Beginnings embryos are created in the clinic’s state-of-the-art embryology lab at Atlantic Reproductive Medicine with the expertise of highly experienced embryologists.

Atlantic Shared Beginnings is located in Raleigh, North Carolina, and serves patients from all over the state, region, country, and world.