This post was written by ORM Genomics Genetic Counselor, Gena Shepherd, MS, CGC.
Have you heard of embryo donation? Here’s how it works: individuals who create embryos with in vitro fertilization may altruistically donate their excess embryos to others with infertility. Embryo donation programs (like ORM’s) make donated embryos available to patients who have been unsuccessful with other fertility treatments.
Once you and your physician have decided that receiving a donated embryo is right for you, you will need to select a group of embryos. Each group of embryos has its own “story,” with varying amounts of information available. It may be difficult to decide what factors are most important to you, so we have compiled a set of five important questions to consider before moving forward.
1. How much will I know about the embryo donors?
Most donors provide information about their family history, physical characteristics, education, career, and personality. Some recipients may have requests—for example, that the gamete providers are a specific ethnicity, have a particular eye color, or have advanced educational degrees. You should connect with an embryo cohort and be able to envision the resulting child as a part your family; just keep in mind that the more specific your requests, the longer it may take to find donated embryos that meet your criteria. Individuals who have very precise requirements may find that egg or sperm donation is a better fit.
2. How old was the egg provider when the embryos were created and did the embryos have chromosome screening?
Some embryos have had comprehensive chromosome screening (CCS), also known as pre-implantation genetic screening (PGS). The purpose of this testing is to identify embryos with a normal number of chromosomes. It is common for embryos to have extra or missing chromosomes. This occurs more frequently as the age of the egg provider increases. These embryos have a lower implantation rate and a higher risk for miscarriage and/or fetal abnormalities. CCS is a helpful tool that may improve pregnancy rates and reduce miscarriage rates. However, untested embryos created with eggs from egg donors or women under the age of 35 still have high reproductive potential. At ORM, transfer of one such untested embryo would be expected to have a pregnancy rate of 50-60%. ORM provides each donor embryo recipient a consult with a genetic counselor to review the results of any chromosome screening, pregnancy rates, and prenatal screening options for their individual embryo cohort.
3. Did the embryo donors have any other genetic testing done, such as carrier screening?
Carrier screening is genetic testing performed on the egg and sperm providers, rather than on the embryos. This type of test screens for recessive genetic conditions, such as cystic fibrosis, where both the egg and sperm providers would need to be carriers in order for a child to develop the disease. While most patients at ORM now have an expanded carrier screening panel of over 175 diseases, just five years ago, many patients were screened for only 1 or 2 conditions, or perhaps none at all. You should be aware of the conditions that the egg and sperm providers were tested for (and whether they were a carrier of any of the conditions), for your future child’s medical records, and for your doctor’s information during a pregnancy.
4. Are there any serious health issues reported in the embryo donors’ family?
The family history is a surprisingly sophisticated medical screening tool. Reviewing the family history can detect increased risks for common health problems such as cancer, heart disease, diabetes, and risks for serious genetic conditions, like Huntington’s disease. Being aware of familial predispositions can guide our medical screening and help us reduce risks with lifestyle or environmental changes. The more family history available for your donor embryos, the better—this information will be incredibly useful for your child and their medical providers in the future. At ORM, a board-certified genetic counselor reviews the family history of all our embryo donors and assesses their eligibility according to published guidelines for gamete donor screening. The genetic counselor also helps to break down the family history for our recipients and interpret how the family history could affect the health of a future child.
5. What level of contact do the embryo donors want?
Some donated embryos were created with the donor couple’s own eggs/sperm, while others were created with eggs and/or sperm from an anonymous donor. Any children born from donated embryos will be a genetic, or biological, sibling to other children born from the same group of embryos. You should consider what level of contact, if any, you would like with the embryo donors to make sure that both parties’ wishes align. The options range from completely anonymous, to having the option of contact through the Donor Sibling Registry, to a known donation between you and the embryo donors. Open, or known donations, typically require the assistance of a lawyer to create legal agreements between yourself and the embryo donors.
ORM Genomics is proud to be part of ORM’s embryo donation program. We focus on providing all of our embryo donation recipients with clear and comprehensive genomic and family history information— for themselves, their medical team, and their future children. Ready to get started?