The Egg Question: Fresh vs Frozen Donor Eggs

Eran Amir

CEO and Founder of GoStork

When deciding whether to use fresh or frozen donor eggs, you’ll want to consider various factors. The choice is usually a very personal one and often depends on the reasons conception has been difficult in the first place. Before we get too far into the details, let’s first cover the basics:

What is egg donation?

Through egg donation, a woman donates her eggs, or oocytes, to another person to help achieve pregnancy. Egg donation is an integral part of assisted reproductive technology (ART), where a doctor removes eggs from a donor for use in implantation procedures, such as in vitro fertilization (IVF). Donor eggs are a solution when a woman’s own eggs are not viable, as well as for single individuals, and same sex couples. Egg donors can be anonymous or known.

According to a study published in the journal Fertility and Sterility, the use of donor eggs is most common among women over the age of 40: within this age group, IVF success rates increase dramatically when donor eggs are used (49%-50% vs 0%-24%).

When is egg donation necessary (or at least recommended)?

There are a number of scenarios which may lead intended parents to grow their family via donated eggs:

  1. Age – fertility naturally diminishes with age as changes start occurring in the ovaries
  2. Diminished Ovarian Reserve (DOR) – when the ovaries no longer produce quality eggs in good numbers. It occurs with ageing and menopause, but genetic abnormalities, medical treatments or injury can lead to an earlier DOR 
  3. Primary Ovarian Insufficiency (POI) – Women naturally experience reduced fertility around 40 years old but for those with POI, this starts earlier, in some cases even as early as the teenage years
  4. Absence of the ovaries – due to surgery or a congenital malformation
  5. Poor oocyte quality – an oocyte is an immature egg cell. During ovulation, the oocyte matures and becomes an egg. The number of oocytes decreases with age, as does their quality 
  6. Poor embryo quality – this could be due to a genetic abnormality in the egg or sperm of the male or female partner, or a genetic abnormality in the embryo
  7. Prevention of genetic diseases – if the intended parent is aware of a condition that could be passed on to the baby
  8. Previous IVF failure – when attempted using one’s own eggs
  9. Single individuals and same sex couples – need the help of donor eggs to conceive

And now let’s get into the pros and cons of each option. 

What are the advantages of using fresh donor eggs?

  1. Better odds of live birth – IVF with fresh donor eggs has been widely researched and found effective. A national study published in the journal Obstetrics and Gynecology found that the use of fresh donor eggs in IVF has a small advantage in birth outcomes. According to the study’s lead author, Jennifer L. Eaton, M.D., “the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference.”
  2. Larger number of eggs – A fresh egg donation cycle can potentially give intended parents anywhere from ten to twenty eggs – this is a good start if you plan on having more than one child. 

What are the disadvantages of fresh donor eggs?

  1. Time consuming – using fresh donor eggs is a longer process: it takes time to match a donor to the recipient and to then synchronize schedules and cycles.
  2. Less availability – the availability of donors can be limited, both geographically and in terms of preferred attributes.
  3. Greater cost – fresh donor egg IVF is typically more expensive than the frozen alternative: as noted by what to expect, at an average of $25,000, fresh donor eggs amount to around twice the cost of frozen eggs.
  4. Potential for cancellation – donation cycles can get cancelled due to poor medication response or issues, or because of an insufficient amount of eggs obtained. Medical issues more specifically may include uterine cysts or bleeding, which can have a negative impact on implantation, preventing the cycle’s success. 

What are the advantages of frozen donor eggs?

  1. Easier process – frozen eggs are a simpler option when compared to fresh eggs as there is no need to synchronize cycles
  2. Shorter timeframe – the waiting time is much less with frozen eggs as these are immediately available.
  3. Less expensive – costs per treatment cycle are lower, as mentioned above
  4. Comparable outcomes – advances in cryopreservation (freezing) have led to comparable success rates to fresh eggs.

What are the disadvantages of frozen donor eggs?

  1. Lower success rates – the national average of live births from frozen eggs is lower than that for fresh eggs (more on this, in the next section). That said, some clinics do report equal success rates with both fresh and frozen.
  2. Additional step in the process – with frozen eggs, an extra procedure known as intracytoplasmic sperm injection (ICSI) becomes a must (which also adds to the overall cost). The freezing and thawing process makes the shell surrounding the egg hard for the sperm to penetrate on its own. ICSI bypasses this as a single sperm is injected directly into the egg. 
  3. Smaller number of eggs – Intended parents will only get from six to eight eggs which may be insufficient for multiple pregnancies. 

What are the pregnancy success rates when using donor eggs?

Data from the Centers for Disease Control and Prevention (CDC) shows that, overall, and based on 2018 data, chances of a live birth with fresh embryos from fresh eggs is 57.1%, while that for fresh embryos from frozen eggs is 44.2%

Success rates depend on various factors. Age of the recipient is not one of them but specific diagnoses do slightly alter success rates. The table below, based on data from the CDC, breaks down the rate of live births using donor eggs, in relation to the intended parent’s diagnosis.

DiagnosisFresh eggs – fresh embryosFrozen eggs – fresh embryos
Male factor54.1%46.3%
Tubal factor49.0%38.3%
Ovulatory Dysfunction55.9%43.7%
Uterine factor45.6%44.4%
Diminished ovarian reserve57.1%47.7%
Recurrent pregnancy loss58.8%45.9%
Unexplained factor59.3%46.2%
Percentage of embryo transfers from fresh donor eggs and frozen donor eggs that resulted in live birth (National figures). Source: CDC, 2018.

Individual clinics will have their own specific success rates. The most recent report can be viewed here

It’s important for intended parents to understand the risks and benefits specific to themselves in analyzing whether to opt for frozen donor eggs or fresh – but national CDC data such as this offers a good indication to help intended parents weigh their options. 

So…  Fresh or frozen donor eggs: which is the best option?

As we’ve explored here, when it comes to choosing between fresh or frozen eggs, there is no easy answer as to which is best. Success rates can depend on each individual’s specific case, as well as the expertise of the clinic you’re working with. A doctor and the clinic can help you assess your options based on your medical history and specific circumstances.

Before closing, it’s worth taking a bigger step back and mentioning that the decision to use donor eggs in itself is one that may involve various considerations. We explore the factors to consider when selecting an egg donor in a recent article – if you’re just starting your consideration process around potential egg donors, it’s a helpful read. In the end, between our articles and our egg donor platform, our mission is simply to help intended parents start their journey.   

If you’re interested in beginning the search for an egg donor, on GoStork you can easily find, compare, and connect with more than 10,000 egg donors from various egg donor agencies across the US. Our innovative platform allows you to filter egg donors by personal attributes (age, height and eye color, ethnicity, education level, and more), provides detailed background information, including personal and family health and genetics history, as well as complete and transparent cost breakdowns.

Once you’ve identified your favorites, our unique comparison tool allows you to analyze your options side-by-side to help you make a more informed decision. You can then get connected with your preferred egg donor’s agency in just one simple click that you’re ‘Interested’! Explore our wide selection of egg donors today.