Frozen donor egg technology provides a fantastic opportunity for many hopeful parents to build their families. The lower costs combined with the reduced uncertainty about the stimulation cycles make frozen donor egg cycles a good alternative to fresh donor cycles for many patients. If this is the route you have chosen to build your family, here are some things you will want to keep in mind as you prepare for your cycle:
SELECTION OF IVF CLINIC
SUFFICIENT EGG LOTS: Does your preferred IVF clinic have a sufficient selection of available frozen eggs–either through their in-house program or through an affiliation with an egg bank?
DONOR POOL: Are there available frozen egg lots from donors who meet your match criteria, such as having certain physical characteristics, talents, or educational backgrounds? The challenge is that many programs provide you with limited or no information about their donor pool prior to formally signing up (and paying) for the program.
SUCCESS RATES: Are the clinic’s success rates acceptable to you? Make sure to compare apples to apples:
- You want to understand the success rates for frozen donor egg cycles specifically.
- What counts as “success”? Would a pregnancy resulting in an early miscarriage qualify as successful completion of the program?
- How many of the cycles are elective single embryo transfers (eSETs)?
- Are the rates based upon multiple attempts from one batch of eggs?
ANONYMITY: Does the clinic or egg bank offer semi-open donations, if that is important to you? Most frozen donor egg programs are completely anonymous, but there is a recent trend toward permitting open identity donations. However, to my knowledge, no frozen donor egg program currently permits the kind of customized contact arrangements available through many egg donor agencies (learn more about anonymous egg donation).
If your current clinic doesn’t have a large or diverse enough pool of frozen eggs available, if the success rates are not acceptable to you, or if the anonymity requirements don’t match up with your own preferences, it might be worthwhile to look at the pools available through other clinics before signing on to a particular program.
EVALUATION OF FINANCIAL PACKAGES
Many IVF clinics and egg banks offer several financial packages for frozen donor egg cycles. You may have a choice of refund plans, guarantee plans, multi-cycle plans, and so forth. Here’s an example of how the financial plans are structured by one frozen donor egg bank.
COMPARISON: It may be helpful to prepare a spreadsheet to compare the various financial implications of these plans over multiple cycles. Typically, paying per cycle is cheapest if you succeed on the first cycle, and refund plans are better deals if you require three or more cycles. The challenge is that it is impossible to predict the results of your cycle in advance, so the decision does hinge upon your own risk tolerance.
EXCLUSIONS: Make sure you understand what additional costs you can expect. With some plans, these extra costs can be thousands of dollars per cycle.
REFUNDS/FUTURE ATTEMPTS: Consider whether the circumstances under which you would receive a refund or another attempt sufficiently protect your financial investment. For example, do you lose the opportunity to undergo a repeat cycle or receive another lot of eggs if you deliver a premature baby who is alive at birth but subsequently dies? I know this is the kind of stuff that no one wants to think about, but it’s necessary to sufficiently understand your financial investment (and there’s no question that, for most people, a donor egg cycle is a significant financial investment). You might want to have your lawyer look over the financial plan contract to make sure that you understand these kinds of nuances that are unique to frozen donor egg cycles.
- Multi-cycle discounts typically require that patients have a favorable prognosis. You may not qualify if you have had repeated donor egg cycle failures, are unable to produce a sufficient uterine lining, or have severe male factor infertility. Be sure to read the qualifications carefully to understand the prerequisites for the program.
- Equally important is under what circumstances the program can disqualify you once you have started treatment.
- Some programs require you to transfer a minimum of two embryos, if available. While this may increase your odds of pregnancy, it also increases your odds of complications, and double embryo transfers have fallen into disfavor in the medical community.
EGG BANK PARTICIPATION AGREEMENTS
Typically , these documents outline what the egg bank will do on your behalf and also address your rights and obligations under the arrangement. For example, you may be required to promise that you will not attempt to locate or contact the egg donor. Or you may have to promise not to bring a lawsuit against the egg bank if something bad happens–like if UPS loses your eggs. You may wish to have your lawyer review this document with you to ensure you are comfortable with all the provisions.
IVF CLINIC CONSENT FORMS
As with any IVF treatment, it’s important to read and fully understand the clinic consent forms before you sign them. Among other things, these forms often contain provisions limiting the clinic’s liability to you should something go wrong and may also contain “indemnification” type clauses. Again, your lawyer can provide invaluable advice in helping you understand exactly what you are signing.