By Sheryl Steinberg, East Coast Regional Manager, The Donor SOURCE of New England, a division of Fertility SOURCE Companies and speaker at RESOLVE New England’s upcoming 20th Annual Fertility Treatment, Donor Choices, and Adoption Conference on Saturday, November 2, 2013

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For those of us involved in the world of Donor Egg, fresh donor egg cycles vs. frozen egg cycles are the talk of the town. What to do? Which one gets better results? What exactly is the difference between fresh vs. frozen?

Let’s first be clear on the difference. A fresh donor egg cycle is when you are working with a live donor that you picked just for you. You get the entire yield of her cycle, good or bad. If they retrieve 26 eggs from the donor, all those eggs are yours to use now or in the future. If the cycle only yields 8 eggs, then you get only those 8 to work with.

A frozen egg cycle is different from a frozen embryo cycle or thaw cycle. A thaw cycle is when you freeze embryos from a fresh cycle and either use those embryos (fertilized eggs) for another biological sibling in the future or to try again if the first cycle was unsuccessful. Your frozen embryos are thawed for another transfer, thus, a thaw cycle.

A frozen egg cycle is when you work with an egg bank and only get a lot of eggs, unfertilized eggs, not embryos, from the egg bank. You then fertilize these eggs. You only get a lot of 6(usually) no matter how many were retrieved from the donor. If there were 24 eggs retrieved, these eggs will be divided into 4 lots of 6 eggs each and each lot goes to a different recipient.

Whether one way to go is better or not is really a very individual decision. It depends on your circumstances and what your particular needs are.  Do you want only one child? Are you going to try for siblings or biological siblings? Do you have insurance? Are you an international recipient? Is your time very limited? Are you trying to match with a particular ethnicity? You can read SART stats and ASRM stats and this stat and that stat. Stats will be stats will be stats. I am not debating success rates here. I want to give you other things to think about as stats can be different depending on who you are speaking to. Is either guaranteed, no. Do we all want you pregnant, yes.

Some things to consider when making this decision:

Most people think doing a frozen egg cycle from an egg bank works out to be cheaper, well it depends. A single transfer frozen egg cycle is cheaper, yes, but there are many things you must take into account before making this choice. If you choose the one cycle option, you will receive a lot of about 6 eggs, from the egg bank. Out of these 6 eggs, you hope at least 4 fertilize, it may be less. You will most likely transfer two. Hopefully it will work and you will get pregnant. It is unlikely that the remaining two will freeze for another cycle. It is possible but unlikely. If you do not get pregnant, you have nothing left and need to pay for another donor egg bank cycle. Many say, well there is another guaranteed option. Yes, there is, but this is very expensive, more than a fresh cycle.  If you do not get pregnant on the first try you can try and try again, up to 6 times. Something to consider, do you really want to go through this 6 times? Once you have done it once, you will see that this prospect is far from appealing. Secondly, if it does work the first or second try, you have now paid a fortune for a guaranteed option that you did not need to use. This does not mean you got pregnant on the first cycle and now you want a sibling and get to do it again, at no cost. You got pregnant. If you want a sibling, you pay for a complete new lot of eggs and it is very unlikely the same donor eggs will still be available for a biological sibling cycle.

If you do a fresh donor egg cycle, you pick your donor and this donor is only doing this cycle for you. All her eggs go to you. They are not shared with 4 other couples all over the country. If the cycle yields 26 eggs and even just 15 fertilize, you transfer 2 and have let’s say have  6 frozen, well, those are 6, healthy, good quality, fertilized embryos. You can try again and do a thaw cycle if it does not work the first time or save them for a biological sibling in the future at no extra cost to an agency or egg bank.

Some other things to consider when making this decision:

  • As of now, insurance will only cover fresh donor cycles. If you are insured, doing a frozen egg cycle should be taken out of the equation all together.
  • Egg banks have a very low number of donors. Their donors match very quickly. If you are looking for a particular donor, their selection is very limited. You must make a fast decision or the donor you liked may be gone.
  • You will not have the option of meeting the donor or negotiating with the donor in any way. You cannot ask more questions or get more photos.
  • You do not know how many other couples were or will be successful with this donor and there may be several live, half siblings.
  • Frozen egg cycles are much faster so if time is a concern, doing frozen eggs may be the best option for you.Most frozen eggs are prescreened so you are not taking the risks of working with a fresh donor, certainly if you are working with a repeat donor. No medical surprises. Although using a repeat fresh donor offers the same benefits.
  • With frozen eggs you do not have to sync your cycle with the donor’s therefore, the cycle is quick and easy. You do not have to stress and worry if the donor’s retrieval will go well. That part is already done.

It used to be that once you made a decision to do donor egg, the decision was made. Now, you have to decide on what type of donor eggs you will use.

I wish you all the best luck in making the best choice for you and that no matter how you do it, you are successful in the final result, a baby.