Sometimes, a patient may need help from another person to have a baby. Often called “third-party reproduction,” it describes a situation when an individual or couple uses someone outside their personal relationship to have a child, such as using donor eggs, sperm or embryos, or even using another woman’s uterus to carry your pregnancy.
Third- party reproduction is not easy – not the decision to go there, the decision to volunteer to help, nor the process itself. Deciding to use donor eggs, embryos, sperm or a gestational surrogacy can be a difficult crossroads that opens up a host of emotional and legal issues. Usually, you make this decision because of need. One or both of you has a fertility issue that can be fixed. Or you make the choice because you are part of a same sex couple or single parent.
Third-party reproduction allows successful conception and a healthy pregnancy in situations such as:
- Advanced maternal age
- Premature ovarian failure
- Severe male factor
- Specific diseases
- Single patients or same sex couples
The different options for third party reproduction include the following, and are sometimes used in combination, based upon a patient’s needs and wishes, are described below. Except for donor sperm (in some cases), all third-party reproduction options require using assisted reproduction techniques, such as in vitro fertilization.
Donor Egg (Oocytes)
Using donor eggs is accomplished in one of three ways – either with previously frozen eggs that are obtained from a frozen egg bank or using “fresh” eggs from a woman known to you or from someone you do not know (de-identified*) but selected by you from a third-party company’s profile. All three sources require an IVF cycle to obtain the oocytes.
Frozen eggs that are purchased will be thawed and combined with the sperm to create embryos; these can then be frozen for a future frozen embryo transfer or used during the same cycle in a fresh embryo transfer.
For known or de-identified egg donor cycles, the oocytes can be used to create embryos, and these can be transferred in “fresh” cycle, which is a treatment cycle when the egg donor undergoes an egg retrieval, and the intended mother undergoes an embryo transfer. An alternative is to freeze the embryos created from the donor eggs and then use the embryos in a later frozen embryo transfer cycle.
There are several options for obtaining fresh donor oocytes. A friend or relative can agree to undergo IVF and donate the oocytes to the intended parents. Alternatively, numerous broker companies exist locally, nationally, and internationally to recruit woman to donate their eggs. RFC maintains a list of available brokers and they can also be found on the Internet by using a search engine, under “donor eggs.” Using a broker is a common form of egg donation as many clinics, such as RFC, do not recruit their own egg donors. The advantage of brokers is that they provide more choice of donors; the disadvantage is that they add considerable cost. Also, it is of value to know if a cycle from a donor’s eggs resulted in pregnancy that went beyond the first trimester.
Donor sperm insemination can be done in natural cycles, in cycles using oral medication, or in IVF cycles. The donated sperm may be either from someone known to you or de-identified and selected from a sperm bank. In the case of a known sperm donor, infectious disease testing and perhaps a quarantine period may be needed prior to use. De-identified frozen sperm may be purchased from a sperm bank and RFC recommends only using sperm banks that are certified by the American Association of Tissue Banks, which adds an additional level of safety by setting standards.
Some patients may decide to use frozen embryos that have been created by other patients or couples who have completed their families and wish to donate their remaining embryos to help others have a family. These embryos can come from friend or family, or (most often) are selected from embryo banks who store and match the embryos with prospective parents. Using donated frozen embryos requires infectious disease screening of the intended parents and the donating parents, as well as independent legal counseling and signed legal documents.
Also referred to as gestationally surrogacy, this type of third-party reproduction includes a woman who has agreed to attempt and carry a pregnancy with embryos created by the intended parents. The gestational host may be a friend or family member or may be someone that you find through a third-party company that specializes in gestational host arrangements. These arrangements always include a through medical evaluation and infectious disease screening for the gestational host, psychological education and counseling for the gestational host and the intended parents, infectious disease screening for the intended parents, and independent legal counseling and signed legal documents.
Most often, the gestational host will undergo a frozen embryo transfer; however, sometimes a fresh transfer may occur if the intended mother is providing the eggs.
Whatever the circumstance, third party reproduction is a wonderful means of starting or growing your family! Your third-party journey starts with talking with Dr. Rinehart and our clinical staff to map out your treatment plan and guide you through the selection, review, financial and legal questions that arise.
* A word about anonymous donors. Simply stated, anonymity cannot be guaranteed. “De-identified” is the current accepted term for what was previously named an “anonymous” sperm or egg donor. With the widespread use of genetic testing and genetic ancestry tracing. There is no longer any guarantee that the identity of the egg or sperm donor, or a child born of a donor egg or donor sperm, will remain anonymous. Intended parents should be aware that future disclosure is a real possibility and that