The effect of maternal age on a woman’s fertility is very real and predictable. Beginning at age 35 and rapidly accelerating at age 40, the ability to have a child with your own oocytes is quickly declining. At age 40 it is more than twice as hard to conceive and by age 43 this has become ten times as difficult as it was at age 30. This decline is almost exclusively related to your biological age and unrelated to factors like fitness, previous fertility, use of birth control pills, nutrition or other factors.

There are two primary factors responsible for the decline. First is a decline in the total number of eggs you have and secondly there is a decrease in the quality of the remaining eggs in your ovaries. This can be clearly seen in IVF procedures in women over age 40. Not only do we have fewer eggs retrieved but the resulting embryos have markedly diminished ability to make a child. These women have three options to have a child. First would be to beat the odds using their own oocytes. Second would be adoption and the third option is the use of donor oocytes.

Assuming that you haven’t beaten the odds, donor oocytes offer many advantages over adoption. With donor eggs you carry the pregnancy and are therefore legally the mother. You can use your husband’s sperm and go through the pregnancy and childbirth experience. This is something most women want to experience in their life. Because you carry the pregnancy, the bonding process with the baby cannot be duplicated. Adoption doesn’t give you this degree of bonding. Finally the donor oocyte procedure is much less expensive in almost all cases to adoption. The pregnancy rate with donor oocytes is controlled by the age of the donor and not the age of the recipient. When you read of celebrities in their late 40’s and 50’s giving birth through “IVF” what they really did was IVF with donor oocytes.

Finally, it is possible to have more than one child from a single donor oocyte procedure. For these reasons and many others, the donor oocyte procedure has become a very effective way to achieve a pregnancy. While the majority of women who use donor oocytes are over 40, it is also used in younger women that have lost their ovaries because of genetics, surgery, radiation or chemotherapy.

How are donors found and why would they donate their eggs?

Women are born with all of the oocytes they will ever have and at birth that is a very large number (over 400,000). If women lost only one egg per month, they would have eggs until they are several thousand years old. What really happens is that every month a large number of oocytes (50-100 or more) become activated in the ovary. Usually the body only allows one of these to fully develop and one egg is available for potential pregnancy. The other activated eggs are prevented from maturing and eventually die within the ovary (apoptosis).

In cycles where women are pregnant or on birth control pills, there is no stimulation in those cycles. The eggs that have activated get no stimulation and all of them break down and die. The eggs that are available in a single month are only available that month, and if they are not fertilized they die. If more stimulation than normal is used, multiple oocytes can fully develop and these can be removed from the ovary in the IVF procedure. This is the procedure used to obtain the donor oocytes. So, for the donor, the oocytes that are retrieved would have normally died that month if they were not used. Donating eggs does not use up any of their oocytes or damage their future fertility in any way.