Embryo Donation and Adoption: A Complete Guide from a Reproductive Medicine Specialist

Embryo donation offers hope to couples who cannot conceive using their own genetic material. This comprehensive guide explains everything you need to know about embryo donation, from the medical process to emotional considerations, success rates, and costs. As a fertility specialist, I'll walk you through this important family-building option with honest, evidence-based information.

Embryo donation has grown significantly in recent years, with over 21,000 cycles performed in the United States between 2004-2019, resulting in more than 8,400 live births [1]. However, many people still have questions about how it works and whether it's right for them.

What Is Embryo Donation and How Does It Differ from Adoption?

Embryo donation is a fertility treatment where embryos created from donor eggs and donor sperm are transferred to a recipient woman's uterus. In such countries as the US, embryos are typically excess embryos from other couples' IVF cycles who have completed their families and choose to donate rather than discard their remaining embryos. In Russia the treatment functions completely differently: donor embryos are instead created using donor egg and donor sperm, cryopreserved, PGT-tested and offered to patients via an online database.

Where Do Donated Embryos Come From?

In NGC, donated embryos originate from Donor Gamete Cycles: Embryos created specifically for donation using screened donor eggs and sperm

All donor embryos undergo rigorous screening for genetic conditions and infectious diseases before being made available for donation.

Who Is a Candidate for Embryo Donation?

Embryo donation may be recommended in several circumstances:

Medical Indications

Combined Male and Female Infertility: When both partners have fertility issues that make conception with their own gametes unlikely or impossible.

Genetic Disorders: Couples with high risk of passing hereditary diseases to their children, including:

Cystic fibrosis carriers
Huntington's disease
Chromosomal translocations
Multiple genetic risk factors

Repeated IVF Failures: After 3-4 unsuccessful IVF attempts with own eggs, even with donor sperm.

Premature Ovarian Insufficiency: When ovaries stop functioning before age 40 and no eggs can be retrieved.

Severe Male Factor Infertility: When no viable sperm can be obtained even through surgical procedures.

Cancer Survivors: Patients whose fertility was damaged by chemotherapy or radiation treatment.

Age-Related Considerations

Embryo donation can be particularly beneficial for women over 42, where success rates with own eggs are very low (less than 5% per cycle), but embryo donation maintains success rates of over 50% regardless of recipient age [3].

The Embryo Donation Process: Step-by-Step Guide

Step 1: Initial Consultation and Evaluation

Medical Assessment:

Comprehensive fertility evaluation for both partners
Uterine evaluation
Infectious disease screening (HIV, Hepatitis B/C, syphilis), general health check-up

Timeline: 1 week for complete evaluation

Step 2: Embryo Selection and Matching

Quality Assessment:

All embryos are typically Day 5-6 blastocysts
Top morphological grades (AA, AB, BA, BB quality)
Genetic testing results if available (PGT-A)

Matching Criteria Often Include:

Blood type compatibility (optional)
Physical characteristics (via child and adult photos)
Educational background
Medical history
Ethnicity preferences

Step 3: Legal and Consent Procedures

Legal Documentation:

Embryo donation agreements
Relinquishment of parental rights by donors
Recipient consent forms
Clinic policies and procedures

Important: Unlike child adoption, there is no "cooling-off" period, and donors cannot change their minds once embryos have been transferred.

Step 4: Preparing for Transfer

Endometrial Preparation:

Hormone medications to prepare uterine lining
Estrogen supplementation (~3 weeks)
Progesterone support
Monitoring appointments

Timeline: 3 weeks from start of medications to transfer

Step 5: Embryo Transfer and Follow-Up

Overall Outcomes per Embryo Transfer [4]:

Outpatient procedure, no anesthesia needed
Takes 10-15 minutes
Single embryo transfer (SET) for safety
Bed rest not required

Post-Transfer Care:

Continued progesterone support
Pregnancy test 10-14 days after transfer
Early pregnancy monitoring if successful

Success Rates and Realistic Expectations

Understanding success rates helps set appropriate expectations for embryo donation cycles.

National Success Rates

Endometrial Preparation:

Clinical pregnancy rate: 53.4%
Live birth rate: 43.5%
Miscarriage rate: 17.4%
Singleton birth rate: 84.4% of live births

Factors Affecting Success

Positive Factors:

High-quality blastocyst embryos
Eggs from younger donors (under 30)
Genetically tested (PGT-A normal) embryos
Good uterine receptivity
No significant medical comorbidities

Potential Challenges:

Advanced recipient age (over 45)
Uterine abnormalities (fibroids, polyps)
Thin endometrial lining
Previous pregnancy complications
Medical conditions affecting pregnancy

"While embryo donation has excellent success rates, I always remind patients that each transfer gives you about a 50% chance of pregnancy - similar to natural conception rates in healthy young couples," explains Dr. Diana Lobzeva. "Most patients achieve pregnancy within 1-3 transfers."

Dr. Diana Lobzeva

Costs and Financial Considerations

Embryo donation is typically the most cost-effective third-party reproduction option.

Comprehensive Cost Breakdown (NGC)

Component	Typical Cost Range (USD)	Notes
Initial Consultation & Testing	€425	One-time evaluation, ultrasounds, blood work
Embryo Selection & Matching	free	Embryos can be selected online
Legal Fees	free	Since embryos come strictly from certified egg and sperm donors, there is no need to pay any additional fees
Medications (FET cycle)	~€700	Estrogen, progesterone, post-transfer support medicines etc.
Monitoring Appointments	€500	2-3 ultrasound appointments are scheduled in your home clinic
Embryo Transfer Procedure	€3,850	Including PGT-tested embryo thawing and transfer
Total per Attempt	€5,500-5,700	Varies by location

Cost Comparison with Other Options

Own egg IVF with PGT-A: ~€7,000 per full cycle
Donor egg IVF with PGT-A: ~€10,000 per full cycle
Embryo donation with PGT-A: ~€5,700 per full cycle

Advantages and Challenges: An Honest Assessment

Benefits of Embryo Donation in NGC

Medical Advantages:

High success rates (>50% per transfer)
Lower cost than other donor options
Shorter waiting periods than double donation
Experience of pregnancy and childbirth
Control over prenatal care and environment

Emotional Benefits:

Pregnancy and birth experience creates bonding
Privacy - no obligation to maintain relationships

Challenges and Considerations

Medical Limitations:

Possible need for multiple transfers
Standard pregnancy risks still apply
Age-related pregnancy complications for older recipients

Emotional Considerations:

Questions about telling children about their origins
Limited or no medical history beyond screening
Potential future contact questions from children

Practical Challenges:

Limited embryo availability in some areas
Insurance rarely covers treatment
Possible travel required for specialized programs
Legal variations between states/countries

Real Patient Stories: Experiences with Embryo Donation

Jennifer's Story (Age 42, Single Mother by Choice)

As a single woman over 40, Jennifer faced very low success rates with her own eggs. "Embryo donation made financial and medical sense," she explains. "The success rates were so much better than using my own eggs at 42."

Jennifer's first transfer was unsuccessful, but her second transfer resulted in the birth of her son. "The hardest part was accepting that my child wouldn't be genetically related to me, but once I held him, those concerns melted away."

Outcome: Healthy son after two transfers

David and Maria's Experience (Ages 38 and 35)

This couple carries genetic mutations for cystic fibrosis. Rather than risk passing the condition to their children, they chose embryo donation. "We wanted to focus on being parents, not managing a genetic condition," Maria explains.

They were fortunate to find embryos where egg and sperm donors underwent genetic testing, ensuring their children would not have cystic fibrosis. "It was the right choice for our family," David reflects.

Outcome: A healthy baby from one transfer

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FAQs

How do I know the embryo quality is good?

All embryos in donation programs are typically high-grade blastocysts that have survived the freezing and thawing process. Many undergo genetic testing (PGT-A) to confirm normal chromosome numbers. The success rates of >50% demonstrate good embryo quality.

Will my child look like me?

While there's no genetic connection, NGC’s programs provide physical matching based on pictures. However, environmental factors, nutrition, and upbringing significantly influence a child's development and characteristics. The baby will be influenced by your personality traits during the upbringing. They will take leads from you while developing their character.

What if the embryo transfer doesn't work?

About 40% of transfers don't result in pregnancy. Most patients try 2-3 transfers before considering other options. Your clinic will review your case and may adjust medication protocols or investigate other factors.

Are children from embryo donation healthy?

Yes, children born from donated embryos have the same health outcomes as children born from standard IVF. All donors undergo extensive medical and genetic screening to minimize health risks.

How many embryos will be transferred?

Most clinics transfer only one embryo (single embryo transfer/SET) to avoid twin pregnancy risks. Twins carry higher risks for both mother and babies, including premature birth and low birth weight. NGC follows the single ET strategy to be in line with the global treatment standards as published by ASRM.

What are the legal implications?

Once you receive donated embryos and they result in pregnancy, you are the legal parents. Donors have no parental rights or responsibilities. Legal documentation is completed before any medical procedures begin.

Should we tell our child about embryo donation?

This is a personal decision. Many mental health professionals recommend age-appropriate honesty. Consider counseling to help navigate these conversations and prepare for questions as your child grows.

Can we meet the donor family?

In Russia it is impossible to meet the donor or their family.

How long do we have to wait?

An embryo donation program typically takes 1 month from consultation to transfer.

How to Begin Your Journey with NGC Clinic

Making the decision to pursue embryo donation is significant, and having the right support team makes all the difference.

Our Comprehensive Approach

Expert Medical Care: Our reproductive endocrinologists have extensive experience in third-party reproduction and will guide you through every step of the process.

Extensive Donor Database: We maintain a large database of high-quality frozen embryos from thoroughly screened donors, with options to match your preferences.

Personalized Treatment: Every patient receives individualized treatment protocols optimized for their specific situation and medical needs.

Your Next Steps

Initial Consultation: Schedule a comprehensive consultation to discuss your situation and determine if embryo donation is right for you
Medical Evaluation: Complete necessary testing and screening to prepare for treatment
Database Access: Review available embryo options and begin the matching process
Treatment Planning: Work with your care team to develop your personalized treatment timeline

The journey to parenthood through embryo donation requires careful consideration of medical, emotional, financial, and ethical factors. With proper guidance and realistic expectations, it can be a successful path to building your family.

References

[1] Lee JC, DeSantis CE, Boulet SL, Kawwass JF. Embryo donation: national trends and outcomes, 2004-2019. Am J Obstet Gynecol. 2023;228(3):318.e1-318.e7. Available at: https://pubmed.ncbi.nlm.nih.gov/36368430/

[2] Ethics Committee of the American Society for Reproductive Medicine. Defining embryo donation: an Ethics Committee opinion (2023). Fertil Steril. 2023;119:944-47. Available at: https://www.asrm.org/practice-guidance/ethics-opinions/defining-embryo-donation-an-ethics-committee-opinion-2023/

[3] Centers for Disease Control and Prevention. ART Success Rates. Available at: https://www.cdc.gov/art/success-rates/index.html

[4] Lee JC, et al. Embryo donation: national trends and outcomes, 2004–2019. PMC. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9975076/

[5] American Society for Reproductive Medicine. Gamete and embryo donation guidance (2024). Available at: https://www.asrm.org/practice-guidance/practice-committee-documents/guidance-regarding-gamete-and-embryo-donation/

[6] Embryo Adoption Awareness Center. Success Rates in Embryo Donation and Adoption. Available at: https://embryoadoption.org/2013/11/success-rates-in-embryo-donation-and-adoption/

[7] Progyny. Embryo Donation and Associated Costs. Available at: https://progyny.com/education/ivf-facts/embryo-donation-costs/

[8] Finger R, Sommerfelt C, Freeman M, et al. A cost-effectiveness comparison of embryo donation with oocyte donation. Fertil Steril. 2010;93:379–81.

[9] Practice Committee of the American Society for Reproductive Medicine. Guidelines for embryo donation. Fertil Steril. 2021;116:56-66.

[10] Braun CB, DeSantis CE, Lee JC, et al. Embryo donation trends and perinatal outcomes in the United States, 2008-2020. Fertil Steril. 2024;122(5):844-855.