After you have gotten over the shock and grief of learning that your egg supply is depleted, you must decide if you want to pursue getting pregnant. For some, the journey ends there, but for those who want to experience the birth of their child, the voyage has just begun. Finding a good supply of eggs becomes the next task and there are several reliable sources.
The traditional source is an egg donor who goes through IVF cycle and gives away all of the eggs to the recipient-or “intended parents “. The donor is identified either by a donor agency, by the clinic providing the care, or you can bring in your own, known donor. The advantage of going the “egg donor” route is that you get the largest number of eggs and you have the greatest degree of freedom to choose the source of the eggs. The biggest disadvantage of this is cost. You have the cost of finding and vetting out the egg donor (the donor agency fee), psychological testing, legal fees, and infectious disease testing. If the donor has to travel then you can add those in as well. You also have to pay for the IVF cycle to collect the eggs and then, of course, there is the cost of preparing your own body for the embryo transfer. Oh… And let’s not forget about administrative fees which vary greatly from clinic to clinic. All in all the cost can go from the range of $18,000-$50,000 depending on the donor and where you are located in the country (in major cities the prices go up). Here in St. Peters, Missouri we try to keep it under 20 K.
Another way to procure eggs is by going to an “egg bank”. Unlike sperm, it was once very difficult to reliably freeze a human egg and thaw it safely. Newer technology, namely “vitrification”, has made the freezing of mature human eggs a routine and reliable process. Ever since September 2012 when the American Society of Reproductive Medicine declared that the freezing of oocytes is “no longer experimental”, egg banks have sprung up and function now like sperm banks. That is to say, you can go through a catalog and try to identify a source for eggs that best suits your wishes.
But there is another way to obtain donor eggs- at Fertility Partnership we call it a Shared Cycle. This when is when a couple with an excellent egg supply goes through the IVF process and shares half of the mature eggs retrieved with a couple that is in need of eggs. Typically it is a younger couple and need IVF but cannot afford it. Perhaps her tubes are blocked or “tied” or her husband’s sperm is extremely low. The price tag of IVF is just too much for the younger, less established couple and so the donor couple agrees to anonymously share her eggs with the couple in need. At Fertility Partnership we ask that the recipient couple cover half the price of the IVF of the donor cycle, the medications, and any laboratory expenses. The donor gets vetted and worked up like any other donor. The woman must be 32 years old and have ample ovarian reserve based on ultrasound and blood test parameters to increase the likelihood that both couples will have a good number of mature oocytes to work with. The couples remain anonymous to each other just as it is done with the vast majority of donor egg situation. The on the day of the retrieval the eggs are evenly divided and the couple who needs eggs receives half. If there’s an odd number we typically give the extra egg to the recipient couple. At Fertility Partnership we require that at least six mature eggs be available to give to the recipient couple in order for the process to be completed.
There are several major advantages to doing shared cycles. The first is cost. The actual financial burden to the recipient couple is probably one 3rd to 1/2 of a typical donor cycle and also usually less and more successful than using an egg bank. The success rate with fresh donor eggs is significantly higher than with frozen donor eggs. Shared cycles also provide an opportunity for the younger, less financially established couple to access the IVF technology. The out of pocket costs for the donor couples are typically less than $6,000. It is a process that, because of the sharing of cost, we have created a situation where two couples actually have an opportunity to build their families.
Another advantage is the more efficient use of the younger woman’s eggs. So often the younger couple goes through IVF and has a large number of frozen embryos that they may never use and will sit frozen either to be destroyed at a later date or donated. Another word it’s a very economical way to use the resources, both biological and financial of both couples.
So what is the downside? Well, the most important negative aspect of this process is that the recipient couple does not really have a lot of choices. In other words, if they were to have gone to a donor agency or an egg bang they would be able to choose from any number of various donors. At Fertility Partnership we often have donors and recipients waiting for us to call to say that we have matched them. We do our best to match the two couples as best as possible. Both the recipients and the donors can stipulate requirements to us in writing. Eventually, most couples are matched and great care is taken that they are not at the facility at the same time and anonymity is ensured.
The reason why the Shared cycle is such a great opportunity is that the although recipient couples typically are older and likely more financially stable, they are able to obtain eggs at a much more reasonable cost. By paying them for a significant portion of the process for the younger couples, they enable them to do IVF and start their family. It is a win-win situation.
So why is it that most clinics don’t offer shared cycles? Well, the fact of the matter is that the clinic typically will earn far less money from a shared cycle. There is no financial incentive to do the cycles, and very often they are complicated from an administrative standpoint. But, if the goal is to help as many couples as possible, then, at Fertility Partnership will continue to offer them to those who are interested.