Most women and couples contemplating fertility treatment would choose to use their own eggs and sperm. However, there are lots of circumstances when having a baby the old fashioned way is impossible. Technologies and modern medicine can open new doors, allowing the dream of having a family to come true.
A single woman
As a single woman, there can come a time where the stressful decision arises. To have a child (or children) or to choose not to. For women, our biological age plays a big role in the decision making process. The cold hard facts are that if we do not act, we will run out of time. Young eggs can make babies. Older eggs can not. There is a grey zone, starting from the age of 35 where fertility with our own eggs is still possible but strategically becomes much, much harder. As it becomes the exceptional egg rather than the average egg that can make a baby, both natural fertility and IVF success rates decline. Miscarriages become more common. Because the IVF process is less successful at an older age, many more treatments are needed to achieve pregnancies.
Freezing eggs can buy you time, but ultimately, if they have not found a partner, many single women now feel comfortable making the choice to parent alone.
Donor sperm can be used to help a woman to conceive. This can be a known donor or a donor chosen from a sperm bank. Melbourne IVF, the lab we use at Women’s Health Melbourne, run our own in house sperm donor program.
Depending on a woman’s age, prognosis for success, long term family planning goals and preferences, different techniques can be used to assist conception using donor sperm.
IUI stands for Intra Uterine Insemination. Often IUI is combined with gentle ovarian stimulation (asking the body to produce 2 eggs in a cycle) to improve pregnancy success rates. Ovulation is tracked during a woman’s cycle and prepared donor sperm in injected inside her womb via a minor procedure that does not generally require any anaesthetic or sedation.
IVF (In Vitro Fertilisation) is a more complicated method to assist a woman to conceive using door sperm. After a two-week period of preparing the ovary using a series of hormonal injections, multiple eggs are collected outside of a woman’s body. In the IVF lab, her eggs are combined with sperm and embryos result. These embryos are nurtured until the day 5-6 stage of development, known as a blastocyst. If appropriate, one blastocyst may be returned to a woman’s womb in the same treatment cycle that embryos were created. Any other embryos can be frozen and used at a later date if needed. IVF success rates (measured by the chance that a transferred blastocyst will result in a baby’s birth) differ tremendously person to person. The most significant factor is a woman’s age. Laboratory factors also play a big role.
Genetic testing of embryos is a great tool to help older women find success more quickly, screening out embryos that have made age related DNA mistakes.
A same sex couple
Same sex female couples always need a sperm donor. Just like single women, this can be a known donor or a clinic recruited donor and the treatment options of IUI versus IVF are the same, with a twist.
Often same sex female couples planning a larger family wish to create babies using eggs from either partner, often sharing the same donor.
Some same sex couples make a plan where one or both women wish to carry a baby using their partner’s egg and donor sperm. This is called reciprocal IVF.
For same sex male couples, things get a little more complicated. A same sex male couple need to decide which partner will provide the sperm. They will then need to use a donated egg and a gestational carrier or surrogate. It is generally felt that the gestational carrier should not provide the egg (traditional surrogacy).
Severe male factor infertility
Many circumstances where there is male factor infertility can be overcome via IVF using a man’s sperm, injected directly into a woman’s egg (ICSI stands for intracytoplasmic sperm injection). There are some circumstances where a man no longer makes any sperm at all and all efforts to retrieve sperm from his testis have failed. This can happen for unexplained reasons or after chemotherapy for cancer treatment. Some men with male factor infertility have tried IVF with their own sperm and still had poor outcomes. These groups of men and their partners may choose to conceive using a sperm donor.
Older women face two separate but parallel problems in IVF: diminishing ovarian reserve and egg quality problems. Using a donor egg can overcome these barriers. In IVF there is strength in egg numbers and age related egg quality correlates strongly to a woman’s chance of achieving a healthy pregnancy. Changing from using a woman’s own eggs to that of a young fertile donor can radically improve her chance of conceiving via IVF.
Donor egg and donor sperm needed: Adopting a donor embryo
In the case of a woman needing both donor egg and donor sperm to conceive, either with a partner or as a solo parent, embryo donation can be a great answer.
Many families have been formed via IVF – worldwide more than 8 million births have occurred using IVF technology. Occasionally, a family has achieved their ideal number of babies and still have embryos in the freezer. Families can choose to donate their embryos to help others to conceive and have children.
Adopting a donor embryo can be a great option.
Whether a baby is born from your own eggs and a partners sperm or in other ways, you will still share every conscious experience with your child. That child will be yours to raise and love. Families come is all shapes and sizes. What they have in common is love. We are so lucky as a generation to have so many choices and options when it comes to having a family.
Women’s Health Melbourne is a boutique fertility and women’s health practice, led by Dr Raelia Lew who holds a CREI, the highest Australasian Qualification for a fertility specialist.
We offer a full range of fertility treatments including all aspects of donor sperm, donor egg and donor embryo conception, IVF and egg freezing.
Follow us @womenshealthmelbourne @drraelialew and @knockeduppodcast