The prospect of using an egg donor can feel overwhelming and daunting, often leaving patients full of questions and concerns. It’s not an easy choice to make, from the emotional mourning of fertility to the practical decisions on finding a donor and clinic. However, as intimidating as it might appear, for many women egg donation is the reality, providing the best option of being able to carry a child and create a much longed for family.
Egg donation UK and NHS
Oocyte (egg) donation is an established standard of practice for the treatment of female related infertility and is associated with increased rates of pregnancy success. However, even though it’s a widely accepted procedure, the NHS offers no funding. With individuals covering all costs privately, it’s no surprise that patients are widening their searches to find the best treatment, wherever in the world they are prepared to travel.
IVF is an incredibly frightening road to embark upon, even when seeking treatment close to home, and many women decide a UK based clinic is more appealing.
I had formed a close relationship with the staff (at my clinic) and trusted them after so many years together. I wanted the comfort of familiarity.
However, with the popularity of fertility treatments in Europe rising, patients are looking past the assumed complex logistics, raising the question; just how much of a comparable, realistic alternative is egg donation IVF overseas?
Egg donation UK – Legal requirements by HFEA
All fertility treatments carried out in the UK are regulated by the HFEA. This independent governing body is responsible for overseeing the use of all eggs, sperm and embryos, whether donated, or own, for treatment and / or research. This is to ensure that anyone who either undergoes treatment, or is born as a result of it, will receive a high quality of respect and care. The HFEA inspects and monitors all UK based licensed clinics, collecting data to provide free and impartial information about all aspects of infertility and treatment.
In order to undergo egg donation IVF treatment, in the UK, full consent must be received by both the donor and recipient, ensuring all parties involved are fully aware of what could lie ahead. The HFEA states that these consent forms should be filled in with clinical staff present, allowing an opportunity for any questions to be raised and answered. The HFEA also advises that clinics must offer an opportunity for implications counselling.
It was compulsory for both us, and our donor, to see the counsellor before starting the cycle. Our counsellor had to provide a letter to the clinic to confirm we had attended.
Non anonymous donors only in the UK
Since April 1st 2005, it is a UK legal requirement that all egg, sperm and embryo donors agree to be identifiable to any person/s conceived as a result of their donation. This means clinics are legally required to submit personal information, to the HFEA, about the identity of anyone who donates. Currently, at age 16, any person/s conceived, via gamete donation, has the right to apply to the HFEA to receive non-identifying information. At 18, UK donor conceived individuals are legally entitled access to all the information, submitted by the donor, at the time of the donation. The transparency of donor information is an extremely important issue for some mothers conceiving with donated eggs.
We wanted the chance for our child to know who her donor was in the future, as per the rules here. We felt it wouldn’t be fair for her to have no idea of where she was from genetically.
Donors are permitted to find out whether they have genetic children but, if donor egg treatment takes place at a licensed UK clinic, have no legal rights or obligations. This means a donor cannot be named on the birth certificate, voice opinions over how the child is raised, or be required to provide any financial support to children produced from their donation/s. Donors can change or withdraw their consent at any point until the gametes are used. They are also entitled to decide how many families can be created, from donated eggs, up to a maximum of ten.
Who are egg donors in the United Kingdom?
Healthy women between the ages of 18 and 35 can donate eggs, in the UK. It is a legal requirement that donors must undergo screening and some clinics also specify additional eligibility, such as a minimum or maximum BMI calculation.
Following the changes to donor anonymity the recruitment of egg donors can be challenging. The HFEA lists 71 IVF clinics, across the UK, currently offering UK recruited egg donation treatment. Waiting times vary.
“We were expecting 12-18 months and, in the end, had our first donor offer four months after going on the list”. But there are no guarantees, with some cases taking a minimum of eight months just to find a match. Patients should also check what service clinics provide.
In our consultation we were told that lots of donors were ready to go, but later told it might take a while, despite very basic physical match requirements. They got us in by saying they had no wait list and we could start immediately, which was based on frozen eggs.
A small number of private agencies are available and usually result in less of a delay.
Egg donors in the United Kingdom
Choosing a donor is typically clinic led, with donors and recipients matched on basic phenotypes (hair and eye colour, shape, height) and ethnicity. Patients often don’t have a choice on additional factors, such as personality type or education;
“We didn’t have a choice, the donor was chosen for us based key characteristics i.e. the lady had similar skin tone, hair colour and height to me”.
This may differ if donors are selected via a private agency. There are two main types of egg donors; women participating in egg sharing schemes whilst undergoing IVF and women who donate altruistically. In the UK donors can only legally be paid a maximum of £750, in expenses.
When using a UK recruited egg donor, clinics often perform a synchronised, fresh transfer cycle, meaning that treatment for the donor and recipient runs simultaneously. The usual protocol for retrieving the donated oocytes is normally the same as with any standard IVF cycle; the donor undergoes ovarian stimulation, by injecting gonadotrophins, the eggs are then surgically collected and fertilised with the sperm of the recipient’s partner, or a donor. Any subsequent embryos are either transferred, or frozen, depending on quality and quantity. Meanwhile, the clinic prepares the recipient for receiving the embryo.
Egg donation cost in the UK
As previously mentioned, donor egg IVF is not covered by the NHS and, as with all fertility treatments, is a costly procedure. Clinics may offer egg sharing, which is a more cost-effective alternative, but obviously results in fewer eggs for the recipient. As the oocytes are retrieved from women undergoing IVF themselves, there could be risk in terms of the quality, when compared to those of a potential, younger donor, not requiring fertility treatments. Some clinics provide a fee reduction if the male partner is eligible for, and goes ahead with, sperm donation. It’s worth speaking to individual clinics to determine what options are available.
Within the UK, egg donation IVF treatment starts at circa £5,000, per cycle. This price doesn’t always include additional costs, such as; donor expenses, donor waiting list fees, embryo cultivation, some medications, and / or required blood, uterine and sperm analysis tests. It’s easy to see how patients can end up with a final bill in the region of £12,000. Before deciding on a clinic, patients should confirm what is included. Treatment prices don’t appear to differ depending on location within the UK. The average advertised rate, for donor egg IVF, in top London, Manchester and Edinburgh clinics, are all in a similar range of around £8,000 per cycle, when everything is included. However, do remember that every case is unique and, as with any fertility treatment in the UK or overseas, prices may differ depending on individual patient circumstances.
The HFEA’s latest IVF trends and figures research published in March 2018, reports 3,000 cases of egg donor IVF with the use of partner sperm, totalling 4% of all UK IVF treatments. Women over 44 years of age accounted for 29%, of the donor egg cycles, with 12% representing women under 35. In 2016 the HFEA reported a 30% live birth rate per embryo transfer (PET) from fresh cycles, and 24% from frozen, when donor eggs were used in the UK.
Egg donation in the UK or overseas?
Whilst cost implications may influence patients to seek treatment in Europe it’s not the only determinant. European donor databases are much larger, when compared to their UK counterparts, meaning less waiting time to find a match.
On the advice of our consultant, in a UK clinic, we went to Spain, due to their large egg bank.
There is also a wider range of donor choice.
Where can patients from the UK go for treatment?
Currently the most popular destinations, in Europe, for women seeking IVF with donated oocytes, are Spain, Czech Republic, Cyprus, Greece, Poland, Latvia, Ukraine and Russia. Some patients do travel to the USA; however, treatment is notoriously costly, at least double what would be paid in Spain. As per UK law, most European egg donation legislation restricts the age of recipients. This can vary, depending on the destination and clinic, but the age limit is usually capped at between 50-52 years. For older patients it’s worth investigating what options are available within Ukraine, Cyprus, Latvia, Russia and Poland.
How are egg donors selected abroad?
Unlike the UK, in all the locations listed, national law restricts access to egg donors. This means it is a legal requirement all donors are 100% anonymous. Whilst some patients may prefer their donor/s to be traceable to any potential children, for many women the anonymity of an egg donor is more appealing.
We’re his parents and it doesn’t matter to him where he genetically came from.
The matching of donor and recipient phenotypes is obligatory, so, just as in the UK, donors must have matching eye, hair and skin colour. Some clinics in Ukraine and Russia are prepared to offer a more patient led approach, to donor selection.
Despite legally remaining anonymous, basic donor information is passed on to recipients, aligning with HFEA, ESHRE (European Society of Human Reproduction and Embryology) and ASRM (American Society for Reproductive Medicine) guidelines. In Ukraine, Cyprus and Russia, international recipients may be entitled to additional donor information, such as photos and extended donor characteristics (skills, education, etc.). Individual country laws can differ, but donor screening is widely legislated across Europe and, other than expenses, donations should be altruistic. The lack of a European independent regulator can be worrying.
I didn’t know if treatment abroad was legitimate or safe.
However, clinics are required to adhere to their country’s legislation.
Due to larger donor pools a greater selection is usually offered, in Europe, with Caucasian donors currently dominating the databases. Recipients requiring a match with women of other ethnic origins should look for a donor in Spain, Cyprus, Greece and the USA. Spain, the USA and some parts of Russia present higher availability for Asian donors, and those requiring a more unique ethic match.
Choosing an IVF clinic abroad and customer service
Whilst visiting local clinics is perhaps logistically easier, clinics abroad typically offer introductory video calls and / or facility visits. As overseas clients constitute up to 50% of all patients in European clinics, Doctors are fully fluent in English, and customer service is high. Clinics will often offer a range of services including airport transfers, online consultations and an emergency contact.
The average cost of IVF with donor eggs in Europe
The cost of treatment across Europe is more favourable when compared to the UK. In Poland prices start at circa €4,500 per donor egg cycle. The most expensive country, included in the list, is Spain where treatment averages at just over €6,000. International patients in the USA pay around €18,000, for the same treatment. Whilst there may be additional costs the average price, per cycle, does tend to be lower. Some clinics offer a guaranteed number of oocytes and / or blastocyst service too, however, it’s ultimately quality, over quantity, which matters.
You may be interested in reading: 9 most popular destinations – IVF Egg donation abroad
IVF with egg donor success rates in Europe
When choosing a clinic, it’s crucial to find one which has a wealth of experience. Good clinics should perform between 300-400 egg donation cycles per year, have a solid embryology team and a respected reputation for recruiting and qualifying egg donors. If a clinic matches these criteria then success rates should be comparable, to those within the UK. Some European clinics specialise in egg donation IVF and higher levels of success can be achieved at those. Unfortunately, with no European authority verifying the clinic produced statistics, it becomes incredibly difficult for patients to compare success rates.
All clinics are fully aware that patients are influenced by statistics, which is why it’s hugely important to research and fully comprehend any data. This is especially important when looking at success rates; achieving a pregnancy and having a live birth are two very different outcomes.
The same caution should be applied when researching cumulative pregnancy / live birth rates. These usually reflect the average effectiveness of treatment but do not show the results of individual cycles of IVF. Cumulative results can also be misleading as frozen embryo transfers are often included.
From the patient’s point of view, clinic advertised IVF success rates should show the probability of a positive IVF treatment outcome which resulted in a live birth. However, most clinics present theirs based on the percentage of patients who become pregnant, with the probability calculated on embryo transfers completed, rather than cycles of IVF started. As with anything fertility related; If there is any uncertainty, ask clinics for clarification.
IVF success rates in all destinations vary from clinic to clinic. In a professional, well run, and established European medical centre, patients should expect a live birth rate of between 60-70% per single cycle, and 70-90% cumulatively, based on three cycles. Whether seeking treatment in the UK or overseas, it is imperative to remember that every patient is an individual and outcomes are likely to differ depending on the uniqueness of each situation.
You may be interested in reading: IVF with donor eggs success rates – the truth clinics don’t tell you