IVF over 35 – Everything to know about donor egg selection, matching, and prepping for treatment

Egg donation IVF UK – the expert perspective

Editor’s note – Since this webinar took place, Apricity Fertility has ceased all operations, effective as of 1st January 2025. We’re keeping this page on our website in the hope that the content and information shared can still help those looking for answers.

Over 35 and looking into treatment with donor eggs? Watch our expert webinar on the egg donation IVF UK ins and outs, for the very latest.

Hear from Caroline Allen, former Head of Patient Enquiry Team and trained NHS midwife, and Debs Maguire, former Senior Fertility Nurse at Apricity Fertility Clinic.

Apricity was a trusted leader for high success rates in fertility, with an impressive 88% cumulative clinical pregnancy rate with donor eggs*.

Watch as we cover

• Why choose treatment with donor eggs in the UK, if you’re 35+
• 1:1 donation vs. batch buying
• Criteria and considerations to keep in mind
• Legal guidelines to know

We also get into the specifics of Apricity’s leading approach, including:

• How donor egg matching works at Apricity
• Top tips for prepping for treatment
• How else Apricity can support you
• And much more

Want more insight from Apricity? Jump here next: 20 key questions to ask your fertility specialist

*cumulative clinical pregnancy rate defined as up to three recipient embryo transfer events from one cohort of donor eggs.

Transcript

Eloise Edington

Hello, welcome to those who are joining us today. We have the pleasure of being joined by Apricity Fertility Clinic to discuss IVF over 35. We will be talking about everything you need to know about donor egg selection, matching, and preparing for treatment. Let’s start with some introductions. Caroline, please introduce yourself, and then you, Deborah.

Caroline Allen

Thank you. My name is Caroline Allen. I’m a midwife by background. I worked in the NHS for around six years as a clinical midwife. I then stepped away from the NHS and worked at GE Healthcare for a few years in their maternal infant care segment, and since then have joined Apricity. I now lead our patient inquiry team, which is a team of advisors, nurses, and midwives who onboard anyone considering treatment with Apricity and wanting to know more. We talk to a whole range of people, setting expectations about what we offer, costs, success rates, and how Apricity differs from other clinics. I lead that team, and if you ever speak to Apricity, it’s my team you’ll speak to. One of those team members is Deborah. I’ll hand over.

Debs Maguire

Thanks, Caroline. I’m Debs, a senior fertility nurse at Apricity. I’ve been a nurse for a long time now, working in fertility for about 15 years, mostly within women’s health. I’ve worked in various roles within fertility clinics, from clinical work to team management.

I’ve been with Apricity for over two years, and a fulfilling part of my role is helping people work out the best treatment options for them, signposting, and listening. It’s really nice to be on the webinar today. Thanks for having us.

Eloise Edington

Thank you for the introductions. 

Debs Maguire

We are the UK’s first virtual fertility clinic, and it’s worth explaining the virtual model of care. We’re not a bricks-and-mortar clinic in the traditional sense, but we partner with ultrasound scan clinics and fertility clinics across the UK, which means we have access to egg donors nationwide. Compared to traditional clinics where egg donor options might be geographically limited, our model provides more variety and availability. It also simplifies the process for both donors and recipients, with fewer appointments and less travel. Our team includes fertility advisors, nurses, midwives, fertility-specialist counselors, and doctors, all experienced in egg donation treatments. 

As an overview of egg donation in the UK, anyone who donates their eggs remains anonymous to the recipient. What that means is that you cannot find out identifying information about your donor. However, the law states that if a donor-conceived child turns 18, they have the right to find out identifying information about their donor through the HFEA, the governing body for all fertility treatments, including egg and sperm donations. This information includes the donor’s name, date of birth, and last known address. While donors have no obligation to respond to contact, the law is that the child has a right to know.

Egg donation in the UK is altruistic, though donors are compensated £750 per donation cycle to cover their time and expenses. The criteria for egg donors is that they must have a healthy ovarian reserve (an AMH test), a BMI below 35, and be aged between 18 and 35. 

Caroline Allen

They go through extensive screening, to ensure the eggs we collect from them are completely safe and of the best quality. This includes a full medical questionnaire covering both personal and family history to identify any known genetic conditions, AMH testing, and a scan of their uterus and ovaries to check that they are likely to produce a good number of eggs. We also do a number of screening tests to check that they are fully healthy and relevant genetic information can be checked. They receive counseling from an accredited counselor who specializes in genetics to ensure they completely understand the implications of donating eggs, and what it may mean for them in the future in terms of HFA guidelines as well as what the screening test can potentially uncover.

For the matching process, Apricity differs slightly from other clinics. Often, recipients receive only basic information about a donor. At Apricity, however, recipients receive two non-identifying childhood photos (up to age five), giving an idea of what their child could look like. We also ask donors to write a “pen portrait,” a personal profile answering questions about their motivations, hobbies, and personality, providing recipients with a fuller picture. Recipients also get details on physical characteristics like hair and eye color, height, and ethnicity so you can build up that image in your head. 

And then also we get um lots of information on their hobbies and interests. Some people are quite specific in what they would want in a donor. Some people want a donor that is educated to a certain level, that has proven fertility before, that has known that they’ve donated before, as well as wanting to know their motivation for donating. So these are all things that we’re able to share about our egg donors, obviously without revealing any identifying information. And then I think what this builds up is a real image of what your donor is like, what those eggs that you were going to be using are made up of, the personality this person may have, and what they may look like. This builds the package for you while keeping everything confidential.

Eloise Edington

Now, how long does it take to be matched to a donor? 

Caroline Allen

If you come to us now, or come to us in six months, the answers may be a little bit different. Even though we have a constant onboarding of donors they may all be different. This is because even though we have a constant onboarding of donors, we also have a continuous onboarding of donors from different ethnicities and backgrounds. At the moment, as we stand in July of 2024, we actually have a really low matching time for Black African donors. This was because, a short while ago, we had a big influx of Black African couples coming forward, looking for eggs of this ethnicity. So, we did a real marketing drive to try to access this community, and it worked well, with some amazing donors coming forward. We now have a really good community of Black African donors.

We say that our average matching time for this ethnicity is three to six months, which is similar for Caucasian donors. There tends to be a steadier stream of Caucasian donors most of the time, so we say three to six months. For other ethnicities, the wait can be a little longer simply because we don’t get as many donors from those backgrounds. These are all averages, and we have new donors coming in weekly. If you were to come to us, we do sometimes match people within days if we have the right donor available. This is sort of an average, and we like to set these expectations, but sometimes it can be much less.

Debs Maguire

I’m now going to talk about how long the process takes in general. As Caroline’s already mentioned, it’s never exactly set in stone because it depends on how long it takes to match you and which treatment route you decide to choose. Hopefully, this slide will explain a bit more about what the expected timelines might be from the point of matching up until you’re having your embryo transfer.

Once you’ve been matched with your donor, the donor will then, as soon as possible, start her stimulation medication. If anyone’s been through an IVF cycle, an egg donation cycle is similar: the donor will have medications, regular ultrasound scans to monitor her response to the medications, and then undergo the egg collection procedure. The donor is also required to have additional screening, and then the egg collection takes place. The section here about donor egg quarantine only applies if you’re using frozen eggs, and it depends on your clinic, which we can discuss in more detail if you go that route.

If you’re having a fresh embryo transfer—using the donor’s eggs once fertilized—you’ll also start your treatment medication. This usually involves two to three weeks of medication alongside regular ultrasound scans to prepare your body for the embryo transfer. Again, the timing of your embryo transfer will vary depending on whether you’re using a fresh or frozen embryo. The embryo transfer procedure itself is a short, 15-minute procedure. So overall, depending on whether you’re using fresh or frozen donor eggs and how quickly we can match you, we’re looking at a timeline of six months, though it can extend up to 12 months. We hope to get everyone matched and through treatment within those 12 months.

Caroline Allen

Deb’s touched on fresh and frozen eggs in the last slide, and I want to talk a bit more about the differences. Overall, when talking about fresh or frozen eggs, the clinical pregnancy and live birth success rates are relatively similar, regardless of fresh or frozen, because once an egg is thawed, it has the same success rate as a fresh egg. However, with frozen eggs, there is a chance that not all will survive the thaw.

With frozen eggs, you know upfront how many eggs you’ll receive when purchasing a treatment package, whether six, eight, or 10. They are all mature eggs and readily available, and the donor screening is complete. You can start immediately, as the three-month quarantine Deb’s mentioned would have already taken place. There’s no risk of the donor withdrawing or new medical issues arising since all screening is done. 

There is an 80% to 90% thaw survival rate. So, if you have 10 eggs, eight to nine are likely to survive. Frozen eggs usually come in packages up to about 11 eggs, depending on how many were collected from the donor at the time, so a package might have four or five eggs or up to 11. This is something to consider when offered a package: Is that enough eggs for you? Is it too many? Also, consider if the donor profile is right for you.

With fresh eggs, egg donation has been practiced longer, so we have large data sets on success rates. Success rates based on egg donation are typically based on fresh egg donation. There’s no risk of thaw, so you won’t have the 80% to 90% thaw risk, but not all eggs will be mature. The risk of mature fresh eggs is about 80% to 90%, so you may have 10 eggs from a donor, but only eight or nine will be mature enough to create embryos. With fresh eggs, if you opt for a one-to-one package where you obtain all the eggs the donor can donate, you might get more eggs. We say an average of around 16 for a one-to-one package. If you want genetically related siblings, this may be the best option for you as you’re likely to have more eggs, though there’s no guarantee as egg collection hasn’t taken place yet. Sometimes, there’s less flexibility with timing for fresh eggs because the donor is actively in treatment, and your cycle would need to align with hers.

There’s also a risk that the donor may withdraw or that we may find medical issues along the way. Egg donors have the legal right to withdraw at any point, even near the end. Apricity does all it can to minimize this by completing as many checks as possible before matching, though some final checks are right at the end. 

So, as you can see, there are pros and cons to both fresh and frozen eggs. It’s a choice up to you, and sometimes it also depends on the donor we have available. If we have a donor with fresh eggs, you might want to match with them if they’re the perfect donor for you. Similarly, if that donor has frozen eggs, you might choose them because their profile fits what you want. It’s worth discussing this with your clinic. Apricity nurses are very experienced in these conversations, so I’d recommend talking to them and explaining your circumstances. 

This example illustrates average survival rates for fresh and frozen eggs. I’ve used eight as an example, with stages through the journey: for fresh eggs, maturity rates, and for frozen, thaw rates. Success rates are similar, with about 60% fertilization and about 50% reaching blastocyst stage. You typically have around one to two quality embryos for transfer. So this is the average, but may differ from person to person.

Debs Maguire

So, based on thaw survival rates, the next question is, what are the overall success rates of using donor eggs?

Here, we’ve displayed success rates for women having an embryo transfer using a donor egg across all age groups: under 38 years old, over 38, and of all ages. Each time, Apricity success rates are above the HFEA average, which is great, and we’re really proud of that. When using donor eggs, all of our egg donors are aged under 35, eliminating the egg quality reduction that occurs as a natural part of aging into our late 30s and early 40s. Using an egg donor increases the chance of success by improving egg quality. Statistically, our success rate is 88% over three embryo transfers using donor eggs.

In terms of our pricing and packaging, at Apricity, we offer full cost inclusion with our packages. We have various donor egg packages and would be more than happy to discuss them. I believe we’ll include the link to book a consultation as well if you have further questions or wish to speak with myself or one of my colleagues in more detail. All of our packages cover everything you’ll need: donor screening, monitoring scans, blood tests, counseling, egg collection, hormone monitoring, doctor consultations, and supportive counseling, which is unlimited.

Our embryology services, sometimes considered add-ons at other clinics, are also included. This covers egg fertilization in the lab, ICSI if needed, embryo freezing, and storage for one year. For you as a recipient, it includes monitoring scans, medication, a pregnancy blood test, an early pregnancy ultrasound, and the HFEA fee. One of the biggest distinguishing factors with Apricity is that you have access to our app, which connects you to a personal fertility advisor available seven days a week. So, if you have questions late in the evening or feel unsure about something, you can send a quick message and get a response.

Our app is more than just a messaging tool. It’s a clinical tool to help you monitor medications and keep track of appointments. The app outlines your treatment plan, sends reminders for medications, and allows you to mark doses taken, ensuring you’re on track. It also provides access to medical records for both you and your partner, if applicable, along with a range of resources, such as how-to guides for injections, medication, and support resources.

Here’s a picture of some of our advisors. I’ve worked in various fertility clinics, both NHS and private, and one of the biggest challenges as a fertility nurse is managing multiple tasks. With our app, the instant communication streamlines everything. Any treatment changes are automatically uploaded, and we can send you messages about updates right away, easing communication on both sides. Of course, we’re also available by phone for calls or video calls if you prefer to speak with someone directly.

We’re proud of our app and the support we can offer through it. Your donors also have access to the app, ensuring they’re fully supported from their initial inquiry about egg donation through to egg collection. They receive the same support.

Eloise Edington

Thank you very much. That was thorough and informative. 

You’ve covered many of the questions we had sent in. One key question is about safety for recipients who might feel nervous about the process. Are there any risks to using donor eggs?

Debs Maguire

I would say any medical process has risks. We can never make it completely risk-free, but I think Caroline touched on all of the screening processes and tests that the donors have done. So, in terms of infection screening, genetic screening, genetic testing as well, and the HFEA are very strict in the guidelines that they put in place for egg donation. Those guidelines are in place to protect you as recipients, but also to protect the donors as well. I would say that having treatment with a donor egg is no more risky than having IVF with your own eggs. In fact, one of the biggest risks is the actual egg collection procedure because it’s a minor surgical procedure, whereas actually using a donor egg, you’re withdrawing that from yourself as a recipient. So, very, very mild risks.

In terms of the side effects of medication that you would have to take as an egg recipient, fairly similar to a contraceptive pill really. Usually, tiredness is one of the biggest things, or some headaches, maybe some mild tummy cramps. But overall, most people seem to cope very well just with resting, taking it a little bit, you know, on the easier side of normal. 

Caroline Allen

The only other thing that I would add, and I touched on it earlier, is that when you choose egg donation, we are bringing someone else into that treatment, and that is the donor. At Apricity, we call our donors angels because they are completely altruistic, lovely human beings who are doing this so selflessly. But as I mentioned, we have to give them the right to withdraw should something come up in their lives or they decide to change their mind. So that is the other risk, I would say, with an egg donation procedure over a standard IVF—that we have some reliance on a donor to also complete that journey. 

At Apricity, we try and support them the whole way through as if they were an actual patient of ours and we were caring for them, because they are a patient of ours and we rely on them so much. That’s the only other thing I would say is different between your own egg IVF cycle and a donor egg IVF cycle.

Eloise Edington

Is that the case? Would they have the right to withdraw should someone have embryos made and fertilized in storage?

Debs Maguire

They can, yeah. So, the donor always has the right to withdraw the use of their eggs even once embryos have been created. I don’t think I’ve ever known that to happen once, say, if you’ve had your embryo transferred to your womb as a recipient, the donor cannot stop that pregnancy. But, yes, they do always maintain that right to withdraw the use of their eggs being used. It’s pretty rare; I’ve not actually known it. 

Eloise Edington

You’ve gone into depth about the ethnicity and the diversity across your donors, which is fantastic, and it’s amazing that it is so diverse because I know that we’ve had lots of people in our community who have wanted Black donors and have not been able to have the opportunity of finding the same amount of donors to choose from as other ethnicities. So that’s really brilliant. I’m sure everyone watching this who’s interested would be delighted to know that Apricity can support them in that way.

If you’re married, does your partner need to legally adopt your child if they aren’t the birth partner? 

Debs Maguire

No, the UK has a really old-school law. So, if you’re married, when you give birth, your legal partner is automatically the legal parent of that child. If you’re not married, don’t worry; you still don’t need to adopt afterward. There’s a separate consent form that’s signed before you have treatment. So, there are lots of consent forms that are issued by the HFEA. But it’s basically saying that you give your consent to your partner being the legal parent of any child born as a result of your treatment.

Eloise Edington

You’ve mentioned this again because you’ve been very thorough with what you’ve gone through today. But counseling—is this the same for the donors, as well as the recipients throughout the process? 

Caroline Allen

Yeah, absolutely. One of the things about us being a virtual fertility clinic is there’s less of the actual face-to-face interaction. The way that we want to ensure that doesn’t impact people in a negative way is to provide even more support in every way possible. Deb’s mentioned the advisors. If you were at a normal clinic and you wanted to contact someone, you would go through to a receptionist potentially, and then someone may or may not phone you back a few hours later. 

Whereas with us, you have a fertility advisor in your pocket to contact all the time. Similarly, with counseling, I don’t know any other clinic that offers unlimited counseling, but Apricity does unlimited counseling for the recipient and the donor through that whole process. This is to make sure that they feel fully supported the whole way through, and they can access counseling as frequently or not as needed.

Eloise Edington

If it’s a couple who are recipients, do they both need to have the counseling? Because, as an example, I’m a mother to five sperm donor-conceived children, and my husband just said counseling wasn’t for him, whereas I found it really beneficial. 

Caroline Allen

Yeah, absolutely. We do encourage, in particular for the donors, their partners to attend counseling sessions so that they’re fully aware of the implications and the surroundings.

Debs, is it right that the recipients’ partners also need to attend the implication counseling session? 

Debs Maguire

I think it’s strongly encouraged. It doesn’t always have to be that you attend together. Sometimes people choose to; it could be schedules or they would rather explore something separately. So it can be individually as well. It doesn’t necessarily have to be as a couple at the same time. But it’s definitely encouraged for both partners to explore those thoughts around having donor egg IVF as well. No one can force you to have counseling, but it’s encouraged.

Eloise Edington

We’ve obviously mentioned IVF over 35 because we know that with age, egg quality decreases. Do you see many people using donor eggs who are younger for various other reasons? 

Debs Maguire

Yeah, really sadly we do. There are lots of reasons why. Sometimes it’s a genetic condition that they may have. They may have had to go through chemotherapy or some surgery, which means they’re not able to use their own eggs in treatment. 

For some people, they may have a condition called premature ovarian failure, which unfortunately means that they end up in menopause much earlier than anticipated. So, it’s not always just about the age of the female; there can be many reasons why someone might need to use a donor egg.

Eloise Edington

It’s an amazing success rate though, isn’t it? Especially for, I’m sure people who are watching can relate, but if you’ve had multiple cycles that haven’t worked with your own eggs, it’s obviously a really tough decision to go into yet another cycle of the unknown and using donor eggs. But to have a higher chance of success is obviously a positive step forward to creating the family that you want. 

Debs Maguire

I think it’s really hard, isn’t it, that you say with IVF, anyway, you’re handing over so much control to a clinic and to doctors, and then you add in a third party where you’re handing over even more control. But we’re here to support with that, and the success rates really change when you start to introduce a donor egg, so it can really help. But yes, it’s not an easy decision to make at all.

Eloise Edington

And this is a really good question. If the cycle fails, should someone look at using a new donor? 

Debs Maguire

I guess it’s hard to define fail. So if you have, say, three embryos frozen from your donor cycle and the first one isn’t successful, it doesn’t automatically mean at all that the remainder of those embryos would fail. So I wouldn’t automatically say, right, you need to go through another whole fresh cycle and be rematched with a new donor. 

If you’ve used all the embryos from a treatment cycle with a donor, we can, unfortunately, ask a donor to re-donate. So it would be likely, unless your donor is altruistically coming through to donate again and we can match you at that right time, or they have subsequent frozen eggs, it probably would be a case of matching you with a new donor.

Eloise Edington

And is that an easy process to do with Apricity?

Debs Maguire

Yeah, it is kind of starting the rematching process from scratch. It would just depend on the characteristics and criteria that you’re looking for in a donor and also our current donor availability, which, as Caroline said, can change. It changes throughout the day sometimes.

It doesn’t necessarily mean that it would be a whole six months again. It could be a matter of days or weeks, really, just depending on that criteria.

Eloise Edington

Do you see seasonal trends when more people are having IVF with donor eggs? Are there seasons or months? 

Caroline Allen

We definitely see a trend when people want to donate. It’s really interesting. You see at the start of the year, usually when people make New Year’s resolutions, they say, ‘I want to do something amazing this year,’ and that’s when they choose to donate their eggs. So we do get an influx in January, which we always look forward to. 

I think that’s the only trend that I would have noticed. Debs, would you say anything else? 

Debs Maguire

It’s really hard to predict sometimes. I guess sometimes in summer things go, you know, less people want treatment, but then also around Christmas time, often less people want treatment because of family and those sorts of things. 

But it really varies, because then often people who are teachers really like to have treatment in the summer holidays. So it kind of peaks and troughs really in like trends. 

Eloise Edington

Yeah, makes complete sense. And you’ve covered success rates, so thank you for that in your slides before. Really appreciate both of your time today and look forward to those watching back. For anyone who is looking into options, perhaps in the late 30s or 40s, or an egg donation, then please do reach out to the very friendly team at Apricity who would be happy to help you with whatever stage you’re at in your journey. 

There’s the phone number and website and we are also linking to the website through our bio. So thank you both very much for your time today. It’s been a delight to speak to you and thanks to those who have joined live. Thanks so much for having us. We look forward to chatting to you. Thank you very much. Thanks everyone. 

Debs Maguire

Thanks everyone! Bye bye. 

Caroline Allen

Bye bye.