Donor Eggs: Fresh vs Frozen

If a woman cannot become pregnant using her own eggs, either by sexual intercourse, artificial insemination or IVF, she may choose to use eggs donated by another woman.

A women has the choice between fresh or frozen eggs. Frozen eggs eliminate the need for cycle coordination, as the egg retrieval process is already complete. Fresh and frozen donor eggs have about the same pregnancy success rate of 55-63%. Listen as Dr Martinez discusses donor eggs, fresh vs frozen.
Donor Eggs: Fresh vs Frozen
Featured Speaker:
Alan Martinez, MD
Dr. Alan Martinez is a specialist in reproductive endocrinology and infertility. He was drawn to this specialty because it is an ever-evolving field of medicine that allows him to partner with patients and provide personalized treatment plans. He also appreciates that the field is filled with the latest laboratory technology, which continues to advance success rates.

After graduating with distinction with a B.S in biology and B.A. in psychology from San Diego State University, Dr. Martinez received his medical degree from the David Geffen School of Medicine at the University of California, Los Angeles. He completed his obstetrics and gynecology residency training at Saint Barnabas Medical Center, an affiliate teaching institution with Rutgers New Jersey Medical School. He completed his fellowship training at the University of Cincinnati Medical Center.

Learn more about Dr. Alan Martinez
Transcription:
Donor Eggs: Fresh vs Frozen

Melanie Cole (Host): If a woman cannot become pregnant using her own eggs, she may choose to use eggs donated by another woman, but are fresh and frozen eggs the same? My guest today, Dr. Alan Martinez, is a specialist in Reproductive Endocrinology and Fertility at the Reproductive Science Center of New Jersey. Welcome to the show, Dr. Martinez. First of all, speak about egg donation, just a little bit, and what’s involved in either donating or receiving donated eggs?

Dr. Alan Martinez (Guest): Well, thank you for having me on the show today, Melanie. I appreciate it. I’m always happy to speak with you. So yes, the donor egg process, first, involves actually having – usually a young female of reproductive age, usually less than 30 years of age through agencies, known donors -- there’s many different facets.

What the patient actually will do is they will agree, sign a contract, undergo screening, and then they will ultimately undergo the first part of an in vitro fertilization cycle. They will use injections of medicine to recruit a certain number of eggs. Those eggs are ultimately retrieved from them through the egg retrieval process. Those eggs are then handed off to the intended parent – the woman who has elected to be the recipient of the eggs, whether fresh or frozen. Her cycle, and wherever the sperm source is from, they can be used – the sperm – to make embryos. The embryos are grown out in the laboratory setting, and then the woman’s uterus is prepared via a specific sequence of hormones, to be receptive, and to take an embryo. They usually transfer one embryo back into the recipient, and then the pregnancy is carried, and people move from there.

Melanie: While they’re doing their research and homework on egg donors, they see fresh, and they see frozen eggs. What is the difference between these two?

Dr. Martinez: Historically, when we proceeded with third party reproduction using the donor eggs, it was primarily done in the fresh setting. The difference is that you – the intended parent chooses from a selection – a pool, a fresh donor. That intended parent can see details of the egg donor. It’s correlated in that egg donor goes through a fresh cycle and simultaneously when those eggs are retrieved, and while that donor is going through that fresh stimulation cycle to get the group of eggs, the intended parent will actually prepare the uterus, and things will be timed out. That way, when you collect the eggs, and you make embryos, you grow out an embryo, and you transfer in fresh. You do not freeze any of the embryos for later use – well, you can, but a fresh transfer is done.

In a frozen donor egg cycle, that donor has already gone through a cycle, the eggs have been collected, and those eggs are frozen. That intended parent is purchasing a certain number of eggs that then are thawed out; embryos are made, grown out in the same manner as fresh, and transferred into the uterus at a later date.

Melanie: How long are fresh eggs viable? What’s that time period between the retrieval of the eggs and the implantation?

Dr. Martinez: In an ideal scenario, the embryos should be transferred on day five of life. The retrieval is done. On that same day, the sperm are brought together with the eggs, and then the next day – the day after retrieval is considered day one. Those embryos are grown out for five days, and on day five, in an ideal world a day five, blastocyst embryo is then transferred in. So, six days after the retrieval process is generally when the transfer is done.

Melanie: And how long can frozen eggs stay viable?

Dr. Martinez: Frozen eggs are essentially frozen in time. The evidence shows that these – at least a number of years. We counsel our patients that once they’re frozen, they’re in a state that they can be used five years, seven years later – ten years later. Generally, it’s indefinite according to the information at this point, and most of our patients that go through this, they use the eggs within, I would say, a one to three, at most a five-year period.

Melanie: Is there data, Dr. Martinez between fresh and frozen? Are fresh eggs more efficient at generating viable embryos? Is there a difference?

Dr. Martinez: They are both very effective, and the pregnancy rates overall, nationally, throughout all of the fertility centers in the United States, are around 50, 55% for the most part. In some situations, depending upon the characteristics of the sperm that you’re using, as well as the uterus that you’re transferring the embryo into, those rates may be a little higher or lower in some cases.

In 2012, the experimental label came off of freezing eggs, and now it’s standard of care. The main difference – the success rates are quite similar. The main difference is that with a fresh donor, you may end up with purchasing and having a larger number of eggs to work with, whereas the frozen is usually – you’re limited to a certain amount. Usually around six eggs by all of the frozen egg donor agencies. And fresh, you can end up with many different embryos. But overall, the success rates are very similar and highly successful in these types of cycles.

Melanie: And what about the waiting game? If there’s a – working with fresh donor eggs, and then you described the menstrual cycle needs to be synchronized with the recipients’ – so that waiting game, is that something that people take into consideration when they are considering fresh versus frozen?

Dr. Martinez: Absolutely, there are several aspects. One is a financial aspect. Generally, the fresh egg donors are more expensive. The intended parents may pay for a donor that is cycling through, and they may pay for their travel, to the fertility center near them to retrieve the eggs. It’s generally a little pricier.

A frozen donor egg has cost savings. In addition, the frozen donor eggs, once you purchase those eggs, they can be thawed out at any time and correlated – used at the schedule of the intended parent. The fresh donors, you have to make sure that that patient is available. You have to make sure that they are willing to cycle at the time point that you would like them to, and it’s generally more expensive.

Melanie: How do you counsel your patients on how to make this decision?

Dr. Martinez: We review all aspects of both processes, fresh and frozen. We discuss the possibility that with a fresh cycle, you may indeed end up with a larger number of eggs and thus, more embryos to culture in the laboratory, and ultimately more of a selection process because you may have more embryos. We discuss with them the cost and time differences in how you’re relying on the egg donor to take her medications correct – in a live setting. Whereas, the frozen donors, you are coordinating it, scheduling it completely on your own choice. There’s less variables involved. It’s a cheaper process. It’s a limited number of eggs, but in either case, it is essentially two different paths to a high chance of pregnancy in most individuals.

Melanie: And you mentioned that you’re hoping that the – if you’re doing fresh that the donor is taking their meds and doing everything properly. In the frozen situation, Dr. Martinez, are these already – these have already been checked out? These are already high quality – everything’s been done already, right? There’s not that risk or possibility that it’s not going to happen?

Dr. Martinez: Correct, because if that frozen donor, when they went through the fresh cycle – however long ago it was – they have already retrieved a certain number of eggs, and that company is selling you a product. They’re saying, “Yes, I’m selling you six mature eggs,” and you already know what you’re getting. Whereas, there are some variables with the fresh donors.

With that being said, the fresh donor was historically done, and it was coordinated quite well, and in the majority of cases, the fresh donor cycles did work out to the intended parents’ advantage. But now, we have an opportunity for a couple of different options, which is why we’re discussing this today.

Melanie: Wrap it up for us, Dr. Martinez -- as we’re speaking about screened egg donors, and the recipients, and the timing, and the waiting, and the cost -- just wrap it up, with your best advice about educating themselves when making this decision between fresh and frozen egg donation.

Dr. Martinez: Yes, first, absolutely talk with the Reproductive Endocrinologist about your options. It’s so important to get all of your information, all of your questions answered, both avenues – the fresh and the frozen – have their advantages and disadvantages. You have to ultimately decide what’s best for you. Your physician will talk with you about the sperm source, about how many eggs you’re purchasing, about what your ultimate goals are, and then make a coordinated decision with you. At the Reproductive Science Center of New Jersey, that’s what we lead our patients down that path -- through education, empowerment, and working with our patients to their ultimate goal of growing their family.

Melanie: Thank you, so much, for being with us today. You’re listening to Fertility Talk with the Reproductive Science Center of New Jersey. For more information, you can go to FertilityNJ.com, that’s FertilityNJ.com. This is Melanie Cole. Thanks, so much, for listening.