Fresh or Frozen Donor Eggs? The Better Question May Be: What Fits Your Family Vision?

When you begin considering donor eggs, one of the first choices you may encounter is fresh or frozen?

Both can work well. And neither is automatically the right choice for every family.

Each approach offers something different: fresh eggs may provide greater biological efficiency, frozen eggs provide flexibility, and sharing can make donor eggs more accessible.

Frozen donor eggs offer flexibility. Eggs can be available when you are ready, without coordinating your treatment with a donor's cycle. They can also travel between fertility centers and across geographic distances.

Fresh donor eggs offer something different. Because the eggs do not go through freezing and warming, more of the eggs allocated to you may ultimately become embryos.

Our recent research at Shared Beginnings and Atlantic Fertility is helping us understand that tradeoff more clearly. And it reinforces something we have long believed about donor egg care:

The goal isn’t to take the same approach for every patient. It is to help each patient find the right-sized path toward the family they hope to build.

Why does fresh versus frozen matter?

Every step between a donor egg and an embryo matters. Frozen eggs must survive warming before fertilization and embryo development can occur. Fresh eggs do not undergo that additional step.

That does not make frozen eggs unsuccessful. Frozen donor eggs have made treatment significantly more flexible, allowing eggs to be available across time and geography.

Our research suggests that seven fresh donor eggs would be expected to provide approximately one additional viable blastocyst compared with seven frozen-thawed eggs.

This is not a guarantee that seven eggs will produce a particular number of embryos, pregnancies, or children. Biology is not that predictable. Instead, it gives us another piece of information for planning.

We should consider how efficiently the eggs allocated to a patient may translate into embryos and future transfer opportunities. That becomes especially important when deciding how many donor eggs may be appropriate for the family someone hopes to build.

Why wouldn't everyone simply choose fresh eggs?

Because biological efficiency is only one part of the decision.

A donor egg plan has to fit your life as well as your biology.

For some patients, the flexibility of frozen eggs may be especially valuable. Frozen eggs can be available without waiting to coordinate a fresh donor cycle and can be transported and used across time and location. They may also preserve access to a particular donor who is no longer available or able to complete another fresh stimulation cycle.

For another patient, maximizing the number of embryos created from each donor egg may matter more, particularly when hoping to build a larger family.

And cost matters. The upfront price of a donor egg option does not necessarily tell the whole story. We also consider what that investment may provide in terms of embryos and potential future transfer opportunities.

These considerations don't tell an individual patient which option to choose. They help us understand the tradeoffs.

There is another option: sharing

The choice also doesn't have to be simply "fresh" or "frozen."

A donor retrieval can be used in several ways.

One recipient can receive the entire fresh retrieval. Two recipients can share fresh eggs from the same retrieval. One recipient can receive fresh eggs while additional eggs are frozen for another recipient. Or eggs can be frozen and made available to recipients later.

Sharing allows us to divide a limited and valuable donor resource in ways that can improve affordability and expand access. It also allows us to combine the strengths of fresh and frozen eggs: eggs can be used fresh for one or more recipients while additional eggs are preserved for future families.

That creates many more possibilities than a one-size-fits-all egg lot or a full fresh retrieval.

So what is the right donor egg strategy for your family?

The answer isn't simply fresh or frozen. It includes how many eggs you need, how they are provided, and what tradeoffs matter most to you.

Someone hoping for one child may make a different decision than someone hoping for two or three children.

We start by asking about your family vision:

How many children do you hope to have? Will you use one sperm provider or more than one?

Then we consider your constraints:

How important is timing? What is your budget? Are there sperm factors that could affect embryo development? Are you planning to carry every embryo you create?

Only then do we talk about the donor egg strategy.

For one patient, that might mean a smaller frozen egg cohort that offers convenience and flexibility. For another, it might mean a shared fresh cycle. For someone hoping to create embryos for several future children, a larger fresh cohort may make more sense.

The goal is not to give everyone the most eggs. It is to right-size the number and type of eggs to the family they hope to build.

Fresh and frozen are complementary, not competing

Frozen donor eggs work and provide tremendous flexibility. Fresh eggs offer different advantages.

Fresh eggs can offer greater biological efficiency. Frozen eggs offer flexibility across time and place. Sharing can make donor eggs more accessible and allow one donation to help more families.

When a donor program can offer fresh, frozen, and different ways of sharing them, the conversation can start somewhere different:

What does your family look like in your imagination?

Then we can work backward together to right-size a donor egg strategy for that vision.

And as we continue to learn from our outcomes, we will keep measuring, learning, and refining how we combine real-time fresh egg sharing with selective freezing so that donor egg care becomes more efficient, flexible, accessible, and responsive to the families we serve.

About the author

Susannah Copland, MD, MSCR, MBA is co-founder of Shared Beginnings and a board-certified reproductive endocrinologist. She also co-founded Atlantic Fertility, Shared Beginnings' partner fertility clinic in Raleigh, North Carolina. She previously directed clinical research and the fertility preservation and third-party reproduction programs at Duke University.

Dr. Copland will present “Fresh donor oocyte sharing is associated with higher blastocyst efficiency and lower cost per embryo than frozen-thawed oocyte cycles” at the ASRM 2026 Scientific Congress & Expo in Baltimore on October 27.