The process of egg donation is a relatively new concept. It started in the early 1980s and, interestingly enough, was more an act of altruism than a compensated business deal. If one woman undergoing in vitro fertilization with her own eggs had a few left over, she'd donate them to a woman who had none. Generosity at its finest -- the eggs was a pure donation.
This exchange did not last for long. Today, egg donation is both a legal and business interaction where the woman desiring pregnancy pays a hefty price--around $20,000--to use eggs from younger, perkier ovaries.
If you are arriving at this decision yourself or with a loved one, by now you have realized that there is a lot to consider, financially, logistically and emotionally.
WHO
Women who use egg donors cannot be easily summed into one group. They are women who may be too old to use their own eggs (which deteriorate in number and quality as we age); women who have poor egg quality at a younger age (due to illness, genetic disorders, chemoradiation or other unknown reasons); women with premature ovarian failure or early menopause; and women whose ovaries just don't respond well to hormonal stimulation.
WHEN
Deciding to use donor eggs can happen at any time in a woman's reproductive lifespan. Egg donor recipients are not all older women and sometimes have previous children from their own eggs.
HOW
The two main categories of egg donations are from known (friend or family) and unknown/anonymous donors. Sometimes using a known donor can significantly decrease the price of the procedure, but there are unique social and emotional considerations for that type of arrangement as well.
The process of egg donation involves syncing the donor's menstrual cycle to that of the recipient's through a number of hormonal medications and doctor's visits. Once the donor's eggs are ready for surgical retrieval, the recipient switches medications from a uterine priming regimen to progesterone only so that her uterus can support the pregnancy.
Almost simultaneously, an embryologist mixes the retrieved donor eggs with the father's sperm and then prepares the now fertilized embryos for transfer into the recipient's uterus.
SUCCESS/RISKS
Keep in mind that fertility centers list success rates in terms of "pregnancies achieved." For most centers, this rate is around 50 percent with donor eggs. This value does not take into consideration however, the number of naturally occurring miscarriages that happen with any pregnancy, including one from donor eggs.
According to The Guttmacher Institute, 15 percent of all pregnancies will end naturally in miscarriage. This is just how biology works, owing to the fact that it takes several green lights in a complicated traffic jam of biologic pathways for a pregnancy to come together successfully.
Lastly, risks of using donor eggs are the exact same as using IVF and embryo transfer with a woman's own eggs if she could. The American Pregnancy Association estimates that there is a 20 to 25-percent chance of multiples, and the same three to five percent chance of birth defects as in any natural pregnancy.