Our detailed course on the IVF process explains the key steps and major decisions that doctors and patients must make along the way. The IVF journey typically includes five to ten critical milestones, each influencing the number of viable eggs and embryos available for use. As shown in the sample chart, the process functions like a funnel—starting with many eggs and narrowing down to a few high-quality embryos suitable for transfer.
At each stage, important choices arise that affect outcomes, including medication protocols, fertilization methods, and embryo selection. When using donor eggs, certain decisions become especially significant, such as choosing between fresh or frozen eggs, assessing donor health, and managing fertilization timing. Our dedicated course explores each of these topics in depth, guiding intending parents through every stage of IVF to help them make informed decisions that align with their goals, values, and family-building plans.
In IVF, success rates generally rise with the number of eggs retrieved, though outcomes plateau after about 20 eggs. A similar trend appears in donor egg cycles. A study in Human Reproduction found that once a donor produced 15–20 eggs, success rates did not significantly improve. Some doctors use this to justify higher drug doses to boost egg yield, while others prefer a measured approach, since excessive stimulation increases the risk of ovarian hyperstimulation.
Typically, donors receive 150–250 IU of medication daily, though higher doses may be used for donors expected to respond less effectively—raising overall costs. Fertility medications can follow different protocols, most commonly the “antagonist” or “long agonist” approaches. The antagonist protocol is preferred for donors, as it reduces the risk of hyperstimulation and cycle cancellation. Each method has its advantages, and doctors select the most suitable option based on the donor’s health, response, and treatment goals.
After egg retrieval, fertilization is the next critical step in IVF. Clinics typically use one of two methods: ICSI (Intracytoplasmic Sperm Injection) or conventional insemination, each with distinct advantages. In ICSI, an andrologist selects a single healthy sperm and injects it directly into the egg, ensuring fertilization. In conventional insemination, multiple sperm are placed around the egg, allowing natural selection to determine which one fertilizes it.
ICSI is required for patients using frozen eggs, those facing severe male-factor infertility, or when embryos will undergo genetic testing to screen for hereditary conditions. For others, either method may be suitable depending on preferences and clinic recommendations. While ICSI offers greater control and higher fertilization certainty, conventional insemination allows for a more natural process and may reduce costs. Choosing the right technique depends on individual fertility factors, medical needs, and treatment goals. Our dedicated course explores both methods in depth.
After fertilization, embryos can be tested using PGT-A (Preimplantation Genetic Testing for Aneuploidy) to check for the correct number of chromosomes, helping identify embryos most likely to result in a successful pregnancy. Experts, however, differ on when PGT-A is most beneficial. Research across 34 clinics shows the greatest advantage when the egg provider is over 35, as chromosomal abnormalities rise with age. For younger donors—who make up most donor egg cases—the benefit appears minimal, leading many doctors to question its necessity and cost.
Still, PGT-A may be valuable in specific situations. Intended parents using both donor eggs and a surrogate may find the added reassurance worthwhile given the high coordination and cost involved. Those planning multiple children can use PGT-A to identify viable embryos for future use. Similarly, when using eggs from older or known donors over 35, PGT-A can provide added confidence in embryo selection and success.
Once embryos are created, the next key decision is how many to transfer. Donor egg recipients often have several embryos available and may feel eager to achieve success on the first attempt. However, because donor-egg embryos have a higher likelihood of implantation, transferring multiple embryos significantly raises the risk of twins or higher-order pregnancies. Multiple gestations are closely linked to premature birth and health complications for both the carrier and the babies.
Research, including a major Swedish study, shows that transferring two embryos at once does not increase overall success rates compared to transferring one embryo at a time with a second transfer if needed. The outcomes are equally positive, but single embryo transfer greatly reduces medical risks. While an additional transfer may slightly raise costs—about 5% of the total donor egg IVF cycle—the improved safety and lower risk of complications make it a preferred, evidence-based strategy.
Our job is to listen, to connect the dots between your needs, and to determine how we can best help you have your baby. If you’re asking how much does it cost for a surrogate, we’ll walk you through every step of the process to ensure there are no surprises.
To make an appointment with one of our counselors or physicians, please call (212) 661-7673 or email info@surrogacy4all.com. We look forward to hearing from you.
Surrogacy4All is a unique international surrogacy service targeted at providing state of the art IVF and surrogacy services to Intended Parents irrespective of age, sex or color, at the lowest possible cost in the world.
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