Research: Donor eggs no guarantee to help older women with infertility

New research confirms that women aged 49 or older will still struggle with pregnancy complications and infertility even if they use donor eggs in the IVF process.

Key Takeaways:

• Women are increasingly advised to freeze their eggs or use donor eggs so they can put off having children during prime childbearing years until they are older.

• A new study presented at a meeting for the European Society of Human Reproduction and Embryology (ESHRE) found that women 49 and older still struggle with infertility, even when using donor eggs.

• Aging was found to affect the uterus, making it more difficult for eggs to implant.

The Details:

The ESHRE study examined 2,760 single blastocyst transfers performed in 1,774 women, all of whom had received donor eggs, between March 2021 and December 2024. The goal was to determine what role the uterus plays in implantation and successful pregnancy. Researchers found that age 49 seemed to be the threshold at which fertility became more difficult, even when using donor eggs:

Compared with women aged 35–40, women 49 and older had significantly lower odds of achieving a live birth and more than double the odds of miscarriage. Cumulative live birth rates also declined substantially with age, from 80.0% among women age 35–40 to 62.5% among women age ≥49 who transferred all available embryos.

The study also found age-related changes in the lining of the uterus, known as the endometrium. While the thickness of the uterine lining remained similar across age groups, the proportion of women with a trilaminar endometrial pattern—a feature generally associated with a uterus that is receptive to embryo implantation—declined significantly with age, from 94.7% among women age 35–40 to 81.0% among women age ≥49.

Lead author Dr. Beatrice Crestani said that while this shouldn't discourage women from using donor eggs, the study proves that women can't reset their biological clock simply by using younger eggs.

"For many years, reproductive aging has been seen primarily as an ovarian issue, meaning that if you replace older eggs with donor oocytes, you essentially 'reset' the reproductive clock. Our findings suggest the picture is more complex," she said. "Donor eggs clearly overcome the problem of egg quality, and outcomes remain very good for many women even into their late 40s. However, beyond the age of 49, we observed lower live birth rates and higher miscarriage rates despite the use of donor eggs, suggesting that age-related changes in the uterine environment may also influence reproductive success."

Why It Matters:

In recent generations, children have largely been raised hearing that marriage and parenthood should be delayed until everything else in their lives is in place, focusing particularly on building a successful career before starting a family. Subsequently, young adults are increasingly saying they never plan to have children at all.

Still, most people plan to have children one day, and with the rise of assisted reproductive technologies (ART), assume that they can use donor eggs and sperm if they can't get pregnant naturally; in essence, the mindset is that freezing eggs, or using donor eggs from a younger person, will stop the effects of aging on fertility.

However, as Live Action News has previously explained, freezing one's eggs is not a guarantee of future fertility:

The study found that the chance of a live birth from frozen eggs is only 39%. Dr. Alan Penzias, a fertility doctor at Boston IVF Fertility Clinic and Beth Israel Deaconess Medical Center, told The New York Times that data from his center are consistent with the study. Women who freeze their eggs at his clinic have only a 33% chance of having a baby using those eggs.

“Counseling should be clear that there is no guarantee and that the value of delaying having a child must exceed the benefit of delay,” Dr. Penzias said.

National data on the success rates of having a baby after freezing your eggs remain unknown, Dr. Timothy Hickman, president of the society and medical director of CCRM Fertility in Houston, told The New York Times. Women are trying to buy time in hopes of having a baby in the future but there is no guarantee — and it could cost them tens of thousands of dollars. Once they have paid to retrieve, freeze, and store their eggs, there are still costs associated with the IVF process, which carries its own low success rate.

For women under 35, IVF has a success rate of just 44.5%, dropping to 2.8% for women ages 42 and over, according to data. Just seven percent of babies created through IVF survive to the newborn stage of life.

And now, another study is indicating that donor eggs don't solve the problem of age-based infertility, either.

Indeed, as Dr. Crestani said, the issue is far more complex, and as inconvenient as it may be, the reality is simply that women cannot delay childbearing indefinitely.

The Bottom Line:

The average age of parents in the United States is rising; for first-time mothers, it has risen to 26, while for fathers, it’s 31. For most people, pregnancy is still possible at those ages. But delaying parenthood into the 40s only creates more issues down the line.