IVF is a process where an egg is fertilized by sperm outside the body in a laboratory setting. For individuals without ovaries, either due to a medical condition or surgical removal, carrying a pregnancy may seem remote. However, modern reproductive medicine confirms that IVF is entirely possible, even without ovarian function. This achievement relies on two primary solutions: obtaining an egg from an external source and utilizing hormonal replacement therapy to prepare the uterus. The uterus remains capable of supporting a pregnancy, provided the proper biological environment is artificially created through a carefully managed protocol.
Addressing the Egg Source: Donor Eggs
The absence of ovaries means the body cannot produce eggs necessary for fertilization. The solution involves using donor eggs, which are retrieved from a separate, healthy individual. Donor candidates are typically young women who undergo extensive medical, genetic, and psychological screening to ensure a high-quality egg supply.
Once selected, the eggs are fertilized in the laboratory with sperm from the recipient’s partner or a sperm donor. The resulting embryos are cultured until they reach the blastocyst stage. Recipients may use fresh donor eggs, requiring coordination with the donor’s cycle, or use frozen donor eggs, which allows for a more flexible timeline.
The use of frozen eggs eliminates the need for cycle synchronization. Resulting embryos are often subjected to preimplantation genetic testing before transfer to ensure chromosomal normalcy. Since the eggs come from a young donor, their quality is high, contributing significantly to the overall success rates of this IVF cycle.
Hormonal Preparation of the Uterus
Preparing the uterus requires a precise hormonal regimen because the natural signals from the ovaries are missing. This process, Hormone Replacement Treatment (HRT), focuses on thickening the uterine lining, or endometrium, and making it receptive for implantation. The protocol relies on Estrogen and Progesterone.
Estrogen is administered first, typically for about two weeks, to stimulate endometrial tissue growth. This hormone is given via tablets, patches, or injections, aiming for a lining thickness between 7 and 14 millimeters. Monitoring is performed using transvaginal ultrasounds to ensure the environment is physically ready.
Once the lining is optimal, Progesterone is introduced. Progesterone makes the endometrium biologically receptive for the embryo to attach during the window of implantation. This hormone is administered vaginally or through intramuscular injections. The timing of the embryo transfer is scheduled precisely based on the number of days the recipient has been taking progesterone.
The Embryo Transfer Procedure
The embryo transfer places the embryo into the hormonally prepared uterus. If frozen, the embryo is thawed in the laboratory. The procedure is performed five or six days after fertilization, corresponding to the blastocyst stage. This timing is synchronized to occur approximately six days after the recipient began progesterone administration, mimicking natural biological timing.
The recipient is positioned similarly to a routine pelvic exam, and the physician uses ultrasound guidance to visualize the uterus. A thin, flexible catheter containing the embryo is gently passed through the cervix and into the uterine cavity. The embryo is expelled into the uterine lining, a process that is quick and does not require anesthesia.
Following the transfer, the catheter is removed and checked under a microscope to confirm the embryo is no longer inside. The recipient is advised to rest briefly before resuming light activity. The recipient must continue the prescribed Estrogen and Progesterone regimen without interruption, as these hormones are necessary to sustain the early stages of pregnancy.
Success Factors and Timeline Expectations
The timeline for IVF with donor eggs can be completed faster than cycles using one’s own eggs. From the initial consultation and donor selection to the start of hormonal preparation, the process takes a few weeks to a few months, depending on donor availability. The hormonal preparation itself typically lasts three to four weeks before the transfer is scheduled.
Success rates in this scenario are high because the egg quality is excellent, coming from a rigorously screened young donor. Live birth rates per embryo transfer cycle often exceed 50% and can reach 70% in some clinics. The recipient’s age does not negatively impact the success rate, as egg quality is the determining factor.
Factors influencing the outcome include the recipient’s uterine health, the quality of the sperm used, and the maintenance of hormonal support. Two weeks after the transfer, a blood test detects the pregnancy hormone, human chorionic gonadotropin (hCG). If positive, the recipient must continue Estrogen and Progesterone supplements until the placenta develops sufficiently to produce these hormones independently, typically around the tenth to twelfth week of gestation.