Many couples that struggle with male infertility turn to embryo donation as a potential way to build their family. This unique high-tech family building option is attractive to many couples because it allows them to “give birth to their adopted child.
What is Embryo Donation?
During a typical IVF cycle multiple eggs are collected and fertilized. Embryos are grown over the period of something around 5 days and usually 1 or 2 top candidates are selected for implantation. Often there are several viable embryos left over which are frozen for future use or in case the IVF cycle fails. Once a couple determines that their family is complete, they may be faced with a dilemma for what to do with the remaining frozen embryos. This is of course a very personal, ethical decision.
Embryo donation is one option. A couple may elect to donate their frozen embryos to another couple struggling with infertility as a means for building their family. The couple receiving the embryo will have it transferred to the female partner’s uterus where hopefully it implants and grows into a healthy baby that she delivers 9 months later.
A bit of history
While embryo donation has only recently begun to gain popularity as a form of family building, the first embryo donation actually happened over 30 years ago. Interestingly, the donated embryo was actually created for the recipient at the same time that four embryos were made for the donor couple’s own use. The menstrual cycles of the donor and recipient women were synchronized using medications, and the transfers occurred on the same day.
These days, most embryos are cryopreserved, aka frozen and donated to recipients months, years and even decades after they were created.
The Embyro Donation Process
Nearly all fertility clinics offer the ability for couples to donate left-over embryos to other couples who are struggling with infertility. Increasingly, national organizations are facilitating the process. The process of receiving an embryo is highly dependent on the organization that you go through. Here are some of the most common steps:
Selecting a donor
There are a lot of questions to think about when selecting a donor. The first is to consider what type of arrangement will work best for your family. As with sperm donation and adoption, there are a range of situations for how connected you may be with the donating family. On one extreme, they can become a sort of extended family where siblings know and relate to each other on a fairly regular basis. On the other extreme, you could know nothing about the parents, their medical or biological history. As you work through this decision, it is important to think about your family and your child as they grow. Some questions to think about
- How much would you like to know about the donor couple?
- How much contact would you like to have with them?
- Should the donor couple know if a pregnancy occurs?
- If the donor couple has children, will they be told?
- If the donation is successful will you tell your child?
- Should the children have contact with each other in the future?
Although legally, there are huge differences between traditional adoption and embryo donation, many of the national organizations refer to embryo donation as adoption. As such, they add layer of protection to both the donors and the recipients of embryos and may require any of the following:
- Mental health evaluation
- Adoption education
- Background or health checks
- Home Study
- Court certification of adoption eligibility
Because embryo donation is still in its infancy, there is still quite a bit of variation in state laws that govern the process. At the core, there are few primary things that both sides need to agree to:
- The rights and obligations that each couple has to each other in respect to the embryos and future offspring
- Issues around future contact
- Terms of reimbursement (couples cannot be compensated for donating but can be reimbursed for medical expenses)
Before proceeding with an embryo donation, it is a good idea (and often a requirement) to go through a medical evaluation on both sides.
Often, both parties are screened for infectious diseases such as hepatitis and HIV. The donating couple may additionally be screened for blood type, Rh factor and /or genetic screening for Tay Sachs, Canavans disease, thalassemia, sickle cell anemia and cystic fibrosis.
The female recipient usually undergoes a series of screenings to test the health of her uterus to carry a baby. The first of these is a hysterosalpingogram or hysteroscopy which provides an image of the uterine shape and can warn doctors if there is something that might prevent the embryos from implanting. Second, a “mock transfer” is also often recommended. This procedure allows doctors to measure the thickness of the uterine lining prior to transfer, again to get an idea of how likely implantation is.
Preparing for a Frozen Embryo Transfer (FET)
After you received your embryos and medical evaluations that give you the green light, it will finally be time to prepare for the transfer. For your partner, this means making her body as ready for implantation as possible. She will need to eat a healthy, balanced diet, as well as a folic acid supplement. She’ll also take medication to regulate her hormones and her cycle. There are two options for prepping for the procedure: natural and controlled.
When prepping for a natural cycle frozen embryo transfer (FET), your partner will go through blood tests to determine when she’s ovulating. When she gets closer to ovulation, an ultrasound will be taken to make sure her uterus is healthy and ready for implantation. If her body is ready for the implantation, the procedure will get scheduled for a few days after her ovulation.
A controlled cycle FET, your partner is given medication to prep her uterus for implantation. She goes through a series of ultrasounds to make sure the medicine is working. When it looks like the uterus is ready, she receives an injection to trigger ovulation and further prep her uterine lining. With this technique, medication has to be continued for up to 10 weeks after the FET.
Alright guys, Game day. It’s time for the embryo to be transferred to your partner’s uterus. The process itself is pretty simple, and anesthesia is rarely needed. A catheter is inserted into her cervix, and the embryos are placed through the tube into the womb. And that’s it. Now it’s a waiting game.
It’s recommended that your partner take it easy for a few days after FET. The more she takes care of herself, the better the chance of implantation occurring. About two weeks after the procedure, a blood test will be taken to see if your partner is pregnant. If the blood test is negative, you’re faced with the choice of undergoing another cycle or looking at other options. If you choose to undergo another cycle, you’ll stop medication, wait through two of your partner’s cycles and repeat the process. If the test says she’s pregnant, she’ll go through an ultrasound to examine the embryo. If it all checks out, congratulations! You’re pregnant.
One advantage of embryo donation is that is possibly lower costs than some of the other options for family building. Here is a breakdown of potential costs
Infectious disease screening – $200 – $1,000
Legal $500 – $1,500
Embryo shipping (if not local) $200 – $500
Medical screening for female recipient $500 – $2,000
Prescription drugs (depending on cycle type) $500 – $2,000
Frozen Embryo Transfer $1,000 – $4,000
Total $2,400 – $11,000
Taking the first step
If you think that embryo donation may be a viable option for you to build your family, the first step is working through the decision with your partner.
Things to talk about
- Why do you want to become parents?
- What are your hopes and dreams for your future children?
- What are the painful points of facing infertility for him / for her? Are they the same or different?
- Why are you pursuing an alternative form of family building?
- How do you each feel about different methods of family building?
- How do you each feel about embryo donation? What is appealing? What are the downsides?
- What are your religious / ethical views on embryos, adoption, donation, assisted reproduction and abortion?
- What if embryo donation doesn’t work? Are you prepared for the risk?
- How do you feel about giving birth to a child that isn’t biologically related to you?
- How do you feel about the idea that your child might have biological siblings out there?
- How much contact / information would you like on donors?
Talking through questions this heavy may present emotional challenges and challenge your relationship. There are a number of great resources that specialize in helping couples navigate infertility and alternative forms of family building. You may find it helpful to work through some of these tough questions with a professional.