This is going to be a tough blog to write. Many have asked, when should I say goodbye to using my eggs and switch to a donor’s eggs? This of course assumes that you would consider using a donor’s eggs. Donor egg: It’s not for everyone. But for those who are interested it can be a very real way to become pregnant and have a child.

Every woman and man has a different threshold for getting to donor egg (DE). If you are in menopause and would consider donor egg, your decision is made for you. For everyone else, choices need to be made. For some people, decision-making in general is very easy, for others it is almost impossible, and most fall in between.

No one else knows what’s best for you. No doctor, lawyer, friend can tell you which direction to turn. A little advice from any available source you feel comfortable tapping into may not be a bad idea. But no one really knows how you feel; no one has had your unique life experiences that you go back to as you make your choices.

Before you even face the decision, you need to feel good that you are at the crossroads. You need to understand the advice of your doctor and you need to feel that you have received correct the information about your ability to produce eggs of reasonable quality.

Stories of the average woman going to donor egg did not inspire me to write this blog. Rather, it was the stories of a smaller group of women who were told they needed to go to donor egg, maybe a little prematurely. Over the years I have seen a few too many women who were told they needed donor egg when in fact they would have been better served using their own eggs.

To be clear, I am not talking about most of the women going to DE, including women who we would say have a “very reduced” chance of becoming pregnant with their own eggs. All of these cases can be debated, but in the end DE may be the better option mostof the time.

What I am talking about here is the woman who is 39, makes 11 eggs, gets 2 fair embryos back, no frozens, and at her post cycle visit the doctor brings up donor egg. The doctor may talk about doing another IVF cycle, but for some reason he/she has a real need to start planting the seeds of egg donation. This happens way too often, and I don’t really know why.

One failed cycle of IVF is not completely predictive of future cycles. Yes many women are consistent in their response to meds and embryo quality, and not every woman at 39 will become pregnant with IVF even with multiple attempts. However, women get pregnant with marginal quality embryos every day. Women get pregnant on their 2nd or 3rd IVF cycle every day, and 39 year olds get pregnant every day.

I said this would be a hard blog to write. The reason is that I am trying to avoid upsetting any of you (especially my own patients). Every case is different so it is impossible for me to say who needs what. I do want to state for the record, however, that there are too many women with reasonable chances at getting pregnant using their own eggs being offered donor egg.

So if you cant really understand why your doctor is bringing up donor egg after one failed IVF cycle, you need to entertain the option of getting another opinion. Who knows, maybe your doctor is absolutely correct. Or maybe you would much rather go with 50% using donor vs. 25% with your eggs. If that’s ok with you, it’s ok with me.

What I don’t like is when the doctor almost shames you into donor egg by stabbing you with the bad embryo quality speech. Embryo quality cannot be accurately assessed after 1 IVF cycle. If you have done more than one cycle and you are being told your embryos grow poorly, show the pictures to someone else. If you are of a reasonable age and you make nice looking embryos, but are told they are not good, get another opinion.

Donor egg is a great way to get a family started, or expand the family you may already have. Just be as sure as you can that DE is really the next step for you.
Thank you and please read disclaimer 5/17/06.

Dr. Licciardi

References:

  • Reh A, Amarosa A, Licciardi F, Krey L, Berkeley AS, Kump L. Evaluating the necessity for universal screening of prospective oocyte donors using enhanced genetic and psychological testing. Hum Reprod. 2010 Sep; 25(9):2298-304.
  • Mullin CM, Fino ME, Talebian S, Keegan D, Grifo JA, Licciardi F. Comparison of pregnancy outcomes in anonymous shared versus exclusive donor oocyte in vitro fertilization cycles. Fertil Steril. 2010 Feb; 93(2):574-8.
  • Noyes N, Hampton BS, Berkeley A, Licciardi F, Grifo J, Krey L. Factors useful in predicting the success of oocyte donation: a 3-year retrospective analysis. Fertil Steril. 2001 Jul; 76(1):92-7.