Recently I’ve been asked on several occasions about how the frozen donor embryo programs abroad compare to what is available in the US. So, I thought I would share a bit more about the similarities and differences.
Generally speaking, the embryo donation (sometimes called embryo adoption) programs in Europe have shorter waiting times, and in some cases may be less expensive than the programs in the US. In the US, you have the chance of having information and sometimes even ongoing contact with the families who are donating the embryos.
In European countries where donors are legally mandated to be anonymous, you will find that most donor embryos available are only from a double donor IVF cycle (meaning a donor egg and donor sperm). The end result is that the vast majority of these embryos are from women who passed ASRM screening to be a donor (age, genetic screening, family history, etc.). You will generally be matched by the clinic and receive the limited information about the egg and sperm donor, such as blood type, age, eye/hair color characteristics, but no identifying information. Most of these programs allow you to select the number of embryos to transfer (1 or 2).
Some European clinics have a wait list for donor embryos, others do not. The wait lists there are usually a few months at the most (depending on the clinic and when embryos become available). In the US, wait lists can be very short, but in general tend to be a bit longer – up to 3 or more years is reported in some geographic areas.
In the US, it is common that the embryos are donated from couples who have done IVF (with some combination of their own eggs, donor egg, own egg/donor sperm, or donor egg/donor sperm) and had a surplus of embryos that were frozen. They are now done with their family building and they have decided to generously relinquish them to help another family achieve their dreams of having a baby. For embryos donated from an own egg IVF cycle, it means the woman providing the eggs may not meet the standards that would be required for a donor: genetic screening, family history screening, age limitations, etc. Or, in other cases, you may hit the embryo lottery so to speak and be so fortunate as to be offered embryos that have been through genetic screening tests (PGD or CGH) so that you already know that there were no chromosomal abnormalities present.
Most US clinics will provide a minimum amount of information about the quality of embryos and type of freezing, age of the person providing the eggs & sperm, and in some cases they will share whether the other embryos from the same cycle resulted in a pregnancy (this is often the case). However, some US clinics decline to provide any information about the embryos citing the privacy of the family donating the embryos.
In the US, you have the possibility of getting genetic data about the embryos, although practically speaking, it seems that most donor embryos and donated anonymously. The two common ways to be matched with donor embryos are:
- through a service where the families donating embryos may choose to select who will receive the embryos (for example through Miracles Waiting) and the donating family can specify the level of contact or information they would like to share, at the time of donation or if a baby results from the donation. (Additionally, there are also several organizations that offer donor embryo adoption – which requires home studies and various other aspects similar to traditional adoption)
- through a clinic that does the matching of embryos that are available and/or have been relinquished to the clinic for them to select the recipients (these are more often anonymous)
When the US clinics or donating families are doing the matching, they may also have additional criteria for the recipients. In some cases, the clinics will limit their donor embryo program to prior IVF clients of the clinic, or only to recipients who meet certain health criteria, or in some cases only to patients who otherwise would not be able to adopt or get pregnant (due to age, egg/sperm quality, etc.).
The European clinics tend not to have the same types of limitations, and generally are only concerned with the overall health of the recipient, ensuring that she is healthy enough to carry a pregnancy.
A benefit to the US programs is that often the recipient will receive all remaining embryos from a cycle. This offers the potential of multiple FET (frozen embryo transfer) treatments and as a result, the potential for full genetic siblings. Whereas in Europe, you are generally receiving a set number of embryos (1 or 2) just enough for 1 transfer.
Overall costs in the US vary widely. Generally, a recipient can expect to pay the clinic’s frozen embryo transfer fee (maybe with an added management fee for handling the case), plus psychological evaluation fees, and any required ultrasounds or tests prior to being cleared for treatment. The recipient of donor embryos also is generally responsible for the legal fees (for the donating family if necessary and the contracts for the recipient), the recipient’s medications for the cycle, and any travel (if the embryos are not at your local clinic). There is generally no fee for the embryos, although you may be asked to reimburse the freezing or storage fees. In total, a typical donor embryo cycle in the US may range in cost from $5000 – $15000 not including any travel costs.
Overall costs in Europe for a transfer of two double donor embryos is generally between $2000 – $2500 for the embryos and actual procedure to transfer the embryos, plus the recipients medications (usually around $200 – $300), your local monitoring ultrasound, plus your travel (plan to be there 2 – 3 days), and maybe $500 – $600 coordinator fees for someone like me to help you find the clinic & embryos and assist you with all aspects of coordinating your cycle, medications and travel. In total, expect a budget of $2500 – $3500 not including any travel costs.
Keep in mind that a fresh egg donor IVF cycle in the Czech Republic only costs an affordable $6500 – $7500 plus travel. Since the clinical pregnancy success rates are higher for a fresh transfer, I often find clients initially considering frozen embryos may instead decide to proceed with a fresh donor (or double donor) cycle instead.
Donor embryos are also quite popular for the 40+ year old single mothers by choice (SMC) who need donor eggs and would also be using donor sperm to conceive or for same sex female couples who may require donor eggs and would be using donor sperm. However, unlike the US, not all countries and clinics currently provide fertility treatments for single patients or same sex couples, so it is important to select clinics that are amenable to providing those treatments if that is your situation.
Overall, there are pros and cons to donor embryo treatments regardless of whether you pursue treatment in the US or abroad. However, donor embryos provide many families a lower cost option to traditional IVF and donor IVF treatments, and allow them to fulfill their dreams of having a baby.
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