What Are the Potential Disadvantages of Using Donor Eggs?

This post walks through seven considerations that can be considered disadvantages of using donor eggs, what the current research says about it, and what tends to help, and it closes with the questions we hear most often from intended parents.

What are the disadvantages of using donor eggs?

The seven disadvantages of using donor eggs fall into genetics, donor selection, disclosure, cost, pregnancy risk, emotional impact and timing, and the table below gives the short version of each before the full sections take them one at a time.

1. Will the child share my genetics?

No, not unless your donor is a relative, in which case the child will not inherit the birth mother's DNA. What you do keep is everything else about carrying a baby: the pregnancy itself, the delivery, and a measurable influence on how the child's genes are expressed through epigenetics.

For most intended parents this is the hardest part to sit with, and it usually arrives before any of the practical decisions do. Grieving the genetic link is a normal step, not a sign that donor eggs are wrong for you.

It also tends to recede. Research comparing families at the child's twelfth birthday found parent-child relationships in donor-conceived families to be as strong as in families who conceived without a donor, and parents in those studies consistently described the genetic question as far less significant than they had expected. If you want to read more on bonding and attachment, we cover it separately.

Victoria Niño, mother via donor eggs

2. How hard is it to choose an egg donor?

It is harder than most people expect, largely because there is no objectively correct answer. You are weighing physical characteristics, medical and family history, education, personality, and often ethnicity, and no single profile will rank first on all of them.

Two things make it manageable. The first is deciding, in writing and before you open a single profile, which two or three criteria are non-negotiable for you. Everything else becomes preference rather than pressure. The second is working with a program that has already done the medical, genetic, and psychological screening, so the profiles you are comparing have all cleared the same bar. Our guide to choosing an egg donor walks through the criteria in order.

3. How do you tell your child and your family?

Start early and keep it ordinary. The ASRM Ethics Committee strongly encourages telling donor-conceived people how they were conceived³, and it is blunt about the reason the old approach no longer holds: with consumer DNA testing as widespread as it is, no program can guarantee that a donor's identity stays private.

The research on the exact right age is mixed. A systematic review in Human Reproduction found the evidence on disclosure timing inconclusive⁴, with some studies showing a modest benefit to telling before age seven and others showing no difference. What we see in practice is that families who fold it into normal, age-appropriate conversation from the first few years never face a single big reveal, because the child cannot remember a time before knowing. Our post on talking to your child about donor conception has language you can borrow at each age.

4. Does insurance cover donor egg IVF?

Usually it does not, and the gap is wider than it is for IVF alone. Twenty-five states have some form of infertility insurance law and fifteen mandate IVF coverage, but only a handful, Delaware, Illinois, New Jersey and Washington D.C. among them, explicitly extend that coverage to donor eggs, sperm or embryos⁵. Everywhere else, donor gametes are billed on top of a cycle your plan may not cover either.

Because of that, published pricing matters more here than it does in most of medicine. Our own financial breakdown is public: frozen egg bank cohorts run $19,500 to $29,500 for six eggs, fresh matching starts at $29,600, and the donor embryo program is $9,400.⁷ Fertility clinic fees, medications and monitoring are billed separately by your clinic, so ask any program you talk to what its number does and does not include before you compare two of them.

If cost is the obstacle, start with three things: your clinic's financial counselor, fertility lending, and IVF grants, which are more numerous and less competitive than most people assume.

5. Does using donor eggs raise pregnancy risks?

Yes, mainly where blood pressure is concerned. A 2026 individual participant data meta-analysis in Human Reproduction Update pooled 2,747 donor egg pregnancies against 4,699 IVF or ICSI pregnancies and 33,323 naturally conceived pregnancies across 16 cohorts. It found about 2.4 times the odds of preeclampsia (adjusted OR 2.39, 95% CI 1.94 to 2.94, with no heterogeneity across cohorts and high certainty of evidence) and roughly 2.9 times the odds of hypertensive complications overall, and the difference held whether donor egg pregnancies were compared with IVF or with natural conception¹.

Two pieces of context matter alongside that number. Preeclampsia affects roughly 1 in 25 pregnancies in the United States⁶, so an increase of that size still describes a complication that most donor egg pregnancies do not develop. And it is a condition obstetricians screen for routinely, which means the single most useful thing you can do is tell your OB early that the pregnancy is donor-conceived, so blood pressure monitoring and preeclampsia screening are planned from the start rather than added later.

6. What is the emotional impact of using donor eggs?

The emotional weight is significant, and for most intended parents it lands hardest in the first few months. Alongside the genetic grief above, there is decision fatigue, the strain of a medical process with dates you do not control, and the question of who in your life you tell. Couples often arrive at acceptance on different timelines, which is its own kind of pressure.

Two resources help more than anything else we recommend. Counselors who specialize in third-party reproduction handle exactly this, and unlike general therapy they will already know the terrain. Reading stories from other intended parents tends to help for the same reason. And donor egg support groups put you in contact with people at every stage, including parents on the far side of it. At Donor Nexus, one case manager stays with you from your first call through your transfer, so you are not re-explaining your situation to a new person at every step.

7. How long does it take, and does it always work?

No, and planning around a single transfer is the most common mistake we see. SART's 2023 National Summary Report puts live birth per recipient cycle start at 38.5% for fresh donor eggs and 37.9% for frozen, figures with overlapping confidence intervals.² Donor eggs raise the odds substantially for most patients using them, and they still leave more than one transfer as the likely path rather than the exception.

What you can control is the timeline and how many eggs you start with, and it helps to see the donor egg IVF process laid out step by step before you commit to either route. Frozen donor eggs remove months of waiting because screening, stimulation and retrieval have already happened, so you are working backward from your own clinic's calendar. A fresh matching cycle takes longer but sends you every viable egg retrieved, which is what makes future genetic siblings possible. We compare the two in detail in fresh vs. frozen donor eggs.

Across our frozen egg bank from 2012 through 2025, 90.7% of eggs survived warming, 83.1% of surviving eggs fertilized with ICSI, 81.1% of patients obtained at least one blastocyst and 60.5% obtained two or more.⁷ You can see the full set on our success rates page.

Do people change their minds about donor eggs over time?

Frequently, yes. Patients who arrive certain that donor eggs are not for them often return after six months to a year of thinking it through, and the second conversation sounds nothing like the first. Nothing about the medicine changes in that window, so what accounts for the shift is usually that the loss has had time to settle into something they can live alongside.

Read next: Victoria's second baby via frozen donor eggs

Though using a donor egg might be a loss of one dream, it also can be the beginning of another with the embrace of a proven technology that has created thousands of babies and happy parents for over four decades.

- Dr. Daniel Potter, reproductive endocrinologist

Frequently asked questions

Is a child conceived with donor eggs genetically related to the mother who carries the pregnancy?

Not genetically, unless the donor is a relative. The birth mother provides the uterine environment and influences gene expression through epigenetics, but the child inherits DNA from the egg donor and the sperm source.

Are donor egg pregnancies higher risk?

The clearest difference is blood pressure. A 2026 individual participant data meta-analysis found about 2.4 times the odds of preeclampsia in donor egg pregnancies compared with IVF and naturally conceived pregnancies. Most donor egg pregnancies do not develop it, and it is screened for routinely, so tell your obstetrician early that the pregnancy is donor-conceived.

How much do donor eggs cost?

At Donor Nexus, a six-egg frozen cohort is $19,500 to $29,500, fresh matching starts at $29,600 and the donor embryo program is $9,400. Fertility clinic fees and medications are billed separately. Only fifteen states mandate IVF insurance coverage and few of those name donor gametes, so most families pay out of pocket or finance.

Should I tell my child they were donor-conceived?

The ASRM Ethics Committee strongly encourages it, and consumer DNA testing means the information is likely to surface eventually regardless. Families who start early, in ordinary age-appropriate conversation, avoid a single disclosure moment altogether.

How many transfers does donor egg IVF usually take?

Plan for more than one. National live birth rates per recipient cycle start sit near 38%, so a second or third transfer is common rather than a sign something has gone wrong.

Can you still miscarry with donor eggs?

Yes, though the odds are considerably better than they are for a patient using her own eggs at the same age. The eggs come from a screened donor in her twenties or early thirties, so fewer embryos carry the chromosomal errors behind most early losses, and miscarriage rates in donor cycles do not climb with the recipient's age the way they do in autologous IVF. A national analysis of 48,679 donor oocyte transfer cycles published in Fertility and Sterility found miscarriage in 14.3% of clinical pregnancies from fresh embryos created with fresh donor eggs, and in 18.5% of those from frozen embryos created with frozen donor eggs.⁸

Does my age still affect miscarriage risk if the eggs are not mine?

Egg age carries the chromosomal part of the risk, which is why donor egg outcomes hold steady for recipients well into their forties. The rest of the picture is still yours, since uterine anatomy, thyroid function, blood sugar control, clotting disorders and blood pressure all influence whether a pregnancy continues, and those are the things your clinic evaluates and treats before a transfer is scheduled.

Are frozen donor eggs more likely to end in miscarriage than fresh ones?

Slightly, and only in one of the two transfer scenarios. In that same national dataset, clinical pregnancies from fresh embryo transfers carried an 18% higher relative risk of miscarriage when the eggs had been frozen rather than fresh, at an adjusted relative risk of 1.18 with a 95% confidence interval of 1.04 to 1.32. Among frozen embryo transfers the difference was not statistically significant, at an adjusted relative risk of 1.07 with a 95% confidence interval of 0.99 to 1.15.⁸ Because that gap is narrow, cost, timing and donor availability usually weigh more heavily on the decision than this number does.

Why would a miscarriage happen when the embryo came from a young donor?

Donor screening lowers the chance of a chromosomal problem without removing it, and many losses in donor cycles trace back to something other than the embryo. Uterine polyps or fibroids, a thin or scarred lining, untreated thyroid disease, infection and clotting or immune conditions all turn up in workups after a donor egg loss, so most clinics order a full evaluation before scheduling another transfer rather than repeating the same protocol.

Keep reading

Should I use donor eggs? How to know when it is time → Will I regret using donor eggs? One mother answers → Grieving the genetic child I imagined →

Sources

1. van Bentem K. et al. The risk for the development of hypertensive complications in oocyte donation pregnancy: a systematic review and individual participant data meta-analysis (DONOR IPD). Human Reproduction Update, 2026.
2. Society for Assisted Reproductive Technology. National Summary Report, 2023 reporting year.
3. Ethics Committee of the American Society for Reproductive Medicine. Interests, obligations, and rights in gamete and embryo donation.
4. Pennings G. Disclosure of donor conception, age of disclosure and the well-being of donor offspring. Human Reproduction, 2017.
5. RESOLVE: The National Infertility Association. Insurance Coverage by State.
6. March of Dimes. Preeclampsia.
7. Donor Nexus. Success Rates and Donor Egg Costs, figures current as of September 2026.
8. Braun C.B. et al. Trends and outcomes of fresh and frozen donor oocyte cycles in the United States. Fertility and Sterility, 2024.