Embryo Donation

When a couple goes through fertility treatments, such as in vitro fertilization (IVF), there are usually extra fertilized eggs that are frozen and stored for later use. Sometimes a couple will decide that their family is complete when they still have embryos available. In such cases, they may choose to donate their remaining embryos, allowing other infertile couples to carry, give birth to and raise a child of their own. This is known as embryo donation.

A well-established and successful form of assisted reproductive technology (ART), embryo donation offers hope for thousands of couples who previously thought they would be unable to conceive. If, for example, a woman is unable to produce or use eggs of her own and her partner has a low sperm count, embryo donation can offer a solution to their combined fertility problems.

The embryo donation process usually costs less and has fewer medical complications than IVF, and the rates of success compare with those of egg donation. However, according to the American Society of Reproductive Medicine, the estimated number of human embryos in frozen storage in the United States is more than 400,000. Of this number, approximately 88 percent are still being used by the genetic parents of the embryos to build their own families, while the other 22 percent are ready and waiting for an infertile couple to "adopt" them.

Embryo donation vs. embryo adoption

Embryo donation and embryo adoption both refer to the giving and receiving of fertilized eggs that are created during an IVF cycle. Typically, embryo donating parents tend to use the term "donation," while receiving couples tend to use the term "adoption." According to the official Web site of the Embryo Adoption Awareness Campaign, the basis for this is more psychological than practical.

Donation, it states, is used in the sense of "giving a gift" and offers a genetic couple an emotional separation from the embryos. For a couple wanting to raise the child born from the embryo, on the other hand, the term "adoption" both legally and socially explains the transfer of parental rights associated with traditional adoption. It also suggests that referring to receiving an embryo as adopting it may also help the couple explain to the their child in the future how they became a family.

Legally, however, "adoption" implies that a child has already been born and is then placed into a family. With embryo donation, even though you and your baby are not genetically connected, he or she is born into your family and you and your partner are named as parents on the birth certificate. According to a recent poll conducted by Harris Interactive, an overwhelming number of respondents said the term 'embryo donation,' as opposed to 'embryo adoption,' best describes the process.

Types of embryo donation

There are two types of embryo donation: known embryo donation and anonymous embryo donation. In a known embryo donation, both the donors and the recipients exchange their full names and other personal information, and they come to a mutual agreement regarding the donation of embryos. An anonymous embryo donation is when the donors and the recipients do not know each other's identities and no contact will be made between the couples during the donation process or in the future. While some donors wish to be involved in the selection of the couple who will receive their frozen embryo, others are satisfied just knowing they have helped another infertile couple.

In addition, there are two types of embryos that can be donated: frozen embryos and created embryos. Frozen embryos come from infertile couples who have used IVF and have spare embryos to give to other infertile couples. In a typical IVF treatment, approximately 12 embryos are created, but only three of them are implanted at once. Considering there are more than 100,000 IVF treatments done each year in the U.S., there are a lot of excess embryos. Embryo creation, on the other hand, involves using both a donated egg and donated sperm by mixing them together to create an embryo.

All donated embryos undergo diagnostic screening before they are transferred. They are frozen and quarantined for six months to ensure they test negative for infectious diseases, such as hepatitis and HIV. They also undergo genetic testing to reduce the chances of genetic diseases or chromosomal defects. The embryo transfer procedure is considered extremely safe.

Good candidates

You and your partner may be good candidates for receiving a donor embryo if: * You are both infertile - You have a uterus, but your ovaries do not produce eggs due to premature menopause; you have had your ovaries removed as a result of cancer, endometriosis or pelvic infection; your ovaries have been damaged by chemotherapy or radiation as treatment for cancer; you were born without functioning ovaries or your ovaries are resistant to hormones. Your partner has either a very low sperm count or no sperm due to vasectomy, testicular damage by chemotherapy or radiation as treatment for cancer or has been born without functioning testicles.

You are at a high risk of passing on genetic disorders to your children - You have a sex-linked disease, such as hemophilia, or you have had recurrent pregnancy loss due to chromosomal abnormalities.

• You have been unsuccessful with other forms of ART - Several cycles have failed due to poor response to fertility drug stimulation or poor egg quality. If you are over 35 and you have poorly functioning ovaries with a slim chance of achieving pregnancy using your own eggs, you may be a good candidate for receiving a donated embryo if your partner is infertile.
• You might also consider embryo donation if you cannot afford or pursue adoption, or if you cannot afford more expensive fertility treatments.

Finding a donor

Many fertility clinics offer embryo donation for a registration fee of around $200. After you sign up, your doctor will review your medical and family history and perform a physical exam to be sure your body is prepared to support a pregnancy.

Once you have been evaluated and accepted into the program, you and your partner will meet with a counselor to discuss the psychological issues that go along with embryo donation. The counselor will want to make sure you and your partner understand that you will be the legal parents of the child although you will not be genetically related. You will also discuss the cost of treatment and the decision as to whether to tell your child how he or she was conceived. You should consider the possible outcome of the treatment and the likelihood that you may not get pregnant, as well as the possibility of a multiple pregnancy and the side effects of medication.

Once you have completed the counseling process, you will be matched with a suitable donor from the clinic's list of registered donors according to your ethnic background and physical characteristics. You will likely be asked to choose more than one donor so that you have at least six possible embryos to use during transfer.

Frozen embryo transfer

After you find a donor, you will be given fertility medications to strengthen and prepare your uterine lining for implantation. Your reproductive endocrinologist will monitor you frequently using ultrasound scans and blood tests in order to determine proper development of your endometrium. Once you are physically ready, you will undergo a procedure called frozen embryo transfer (FET), which is very similar to the IVF procedure in that your body is carefully monitored and embryos are implanted in your uterus.

Typically, FET takes place about two days after ovulation and the donor embryos will be thawed the day before your procedure is scheduled. The actual procedure only lasts about 15 minutes and anesthetic is not usually needed. First, your doctor will insert a vaginal speculum to expose your cervix and gently insert a catheter. The embryos are carefully injected into the catheter and placed in your uterus. Sometimes an ultrasound is used for guidance. Many clinics recommend the transfer of only two embryos because of the increased risk of multiple pregnancy. Your doctor will ask you to lie still for a few minutes following the procedure to allow the embryos time to settle into the lining of your uterus.

After the transfer, you will continue taking the fertility medications you have been using and will return to the clinic approximately two weeks later for a pregnancy test. Success Rates

Success rates of embryo donation are somewhat lower than those associated with egg donation due to several factors. Embryos are frozen for long periods of time before they are donated, which compromises the quality of the embryo. They also go through a thawing process before they are transferred, which not all embryos survive. One more reason for lower success rates may be because embryos are taken from infertile couples, so they may not be the best of quality to begin with.

Embryo donation success rates vary depending on a number of factors including the quality of the embryo being used, the stage of the embryo when it was frozen and how well it survives the thawing process, but he typical rate of success is about 20 percent.

Cost

Embryo donation costs less than other types of ART procedures. Your donors will not receive any money for their embryo, but you will be responsible for paying the clinic for storage, testing and the transfer procedure. The cost of one embryo donation transfer can range anywhere from $2,000 to $3,000.