Intending parents must decide whether to use a donor’s freshly retrieved eggs or previously frozen eggs. Fresh eggs are retrieved specifically for the intended parents’ cycle, while frozen eggs have already been collected, preserved, and are ready for use. Each option has its own advantages and considerations. Fresh eggs may offer slightly higher success rates in some cases, but they require precise timing, coordination with the donor, and can involve more logistical challenges. Frozen eggs provide flexibility, allowing parents to plan the cycle without coordinating directly with the donor, and they can often be sourced more quickly from a donor bank.
Choosing between fresh and frozen eggs involves several nuanced factors, including the donor’s availability, geographic location, costs, and fertility clinic protocols. While these considerations can vary by region or individual circumstances, understanding the key differences helps intending parents make an informed decision tailored to their needs and goals.
Until the early 2000s, almost all egg donation used fresh eggs, as the slow-freezing method then available was considered less effective. Over the past 15–20 years, vitrification—a rapid freezing technique—has significantly improved egg survival and success rates after thawing. The HOPE study, which gathered data from over 16 fertility clinics, showed that vitrified eggs survived the warming process far better than slow-frozen eggs, resulting in higher overall success.
This distinction is important because some clinics still use slow freeze. When considering frozen eggs, ensure they were vitrified. Additionally, vitrification is a technique, not a guarantee. Both the freezing and warming clinics must be experienced, as errors at either stage can compromise outcomes.
Finally, published success rates often come from highly experienced clinics, so results may not generalize to all centers. When evaluating studies, look for data from multiple clinics to get a more accurate perspective on expected outcomes.
A common question is whether vitrified donor eggs are as effective as fresh eggs. Evidence suggests fresh eggs may be slightly more effective, though differences are modest. A Spanish study compared outcomes from donors providing the same number of eggs. After freezing and thawing, the number of viable eggs and the percentage of cycles yielding at least one high-quality embryo were similar between fresh and vitrified eggs. Pregnancy rates per cycle were also very close, highlighting the reliability of vitrification.
The main difference lies in total embryo yield: fresh cycles tended to produce more embryos, resulting in more surplus embryos available for storage. This can be important for intended parents considering multiple children or their comfort with creating embryos they may not use. Broader U.S. data from 2018 confirmed that fresh donor cycles generally produced more embryos and slightly higher success rates, giving fresh eggs a modest advantage, though vitrified eggs remain a highly effective option.
Frozen eggs are often immediately available, while fresh eggs require time for donor screening, cycle scheduling, and medical preparation. Using frozen eggs can save weeks or months and reduce the risk of a donor changing her mind or producing fewer eggs than expected. Costs vary by region, but for illustration, recruiting and retrieving a fresh donor may cost $18,000 for 18 eggs. In a fresh cycle, the intended parents pay the full cost and keep all eggs.
In contrast, frozen eggs are often sold in smaller batches—for example, six eggs for $16,000. While frozen eggs may appear cheaper upfront, the per-embryo cost can be higher, and the total number of embryos is usually lower. Fresh eggs may be preferable for parents seeking multiple children or wanting to minimize the risk of cycle failure. For those aiming for a single child and comfortable with fewer embryos, frozen eggs can be a practical choice. Some banks even offer thaw or success guarantees, often at an additional cost.
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