In Canada, Third-Party In Vitro Fertilization is a legal and safe practice that offers a viable option for patients seeking to start a family. As reproductive technology improves and becomes more widely available, it continues to gain popularity.
If you’re considering Third-Party IVF, we are here to help. Dr. Tanya Williams Fertility Centre guides many couples through this complex journey. We understand that you may feel excited, overwhelmed, scared, and everything in between as you figure out where to begin. Read the article below to learn what to expect and determine if this option might be right for you.
What is Third-Party IVF?
Third-Party In Vitro Fertilization (IVF) uses a third party’s eggs, sperm, or embryo to help a couple or individual have children. The treatment may also involve a surrogate, where a third party carries the fetus to term and gives birth to the recipient’s child. This third party has no interest in raising the child.
If the recipient knows the third-party donor or surrogate, they are usually a close friend or family member. Alternatively, you can find anonymous donors through various egg donation agencies and programs.
Reasons for Selecting Third-Party IVF Treatment
Patients choose Third-Party IVF treatment for various reasons, with the most common being:
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- Patients who are experiencing low quality of eggs or a low egg count
- Those who had their ovaries damaged or removed due to illness such as cancer or severe endometriosis
- Patients who are over 40
- Couples who do not want to pass down inheritable diseases or abnormalities
- LGBTQ2IA+ couples where either sperm or eggs are unavailable
- Single parents
- Couples experiencing male factor infertility, including people who don’t identify as male as well as those who suffer from urologic conditions and have abnormal sperm parameters
- Congenital or acquired conditions in which the uterus is either absent or malformed
- Medical conditions which suggest that a pregnancy would be dangerous for the woman and is therefore not advised
Gamete Donation
Gamete donation involves donating sperm and/or egg cells. The recipient will have a genetic connection to the child only if the donation is fertilized using sperm or eggs from the recipient.
The laboratory can thaw fresh or frozen eggs from a donor before fertilizing them with the male partner’s or donor’s sperm. If a female partner opts to use her own eggs and donor sperm, she can achieve this through intrauterine insemination or IVF.
During IVF, the laboratory performs fertilization before transferring the embryo to the recipient’s uterus.
Fertilization can occur by placing the sperm and egg together in a dish or through intracytoplasmic sperm injection (ICSI), where a single healthy sperm is injected directly into each healthy egg. The laboratory can also assist in embryo hatching by creating a small hole or thinning the outer membrane of the embryo just before transferring it to the uterus. This process helps the embryo attach to the uterine walls.
Fresh Eggs vs. Frozen Eggs
| Fresh Eggs | Frozen Eggs |
| The recipient and the donor must wait until their menstrual cycles line up or must be synchronized using hormones for the transfer to be done. | Only the recipient’s menstrual cycle needs to be taken into consideration. |
The recipient will need to take medication both before and after the IVF procedure to thicken the lining of the uterus and prevent uterine contractions during implantation. This medication includes estrogen and progesterone. These hormones may cause side effects such as irritability, fatigue, bloating, nausea, and breast tenderness, and rarely, they may increase the risk of blood clotting. In some cases, the procedure can use a natural or modified natural cycle.
Surplus embryos from an IVF treatment can be frozen and stored for later use. Alternatively, they may be donated or destroyed. Most clinics set the cut-off age for using Third-Party IVF treatment without a surrogate at 50, though this can vary.
Surrogacy
| Traditional Surrogacy | Gestational Carrier |
| The surrogate provides the egg and carries the pregnancy to term. They have genetic ties to the child. | The surrogate has the fertilized embryo provided to them, so there are no genetic ties to the child. |
The recipient may know the surrogate, often a friend or family member who volunteers to carry the pregnancy. Alternatively, surrogates can be found through agencies that specialize in recruiting eligible women.
Features to Look For in a Surrogate
If you decide to recruit your surrogate, here are a few features to look for which will ensure you select the best candidate:
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- A surrogate will ideally be between the ages of 21-42, an older surrogate can lead to potential health risks for both the surrogate and the child
- BMI should be under 35 (some clinics will say under 40 is also acceptable so long as the surrogate also has no metabolic disorders like diabetes or high blood pressure)
- Ideally, a surrogate has already gone through at least one birth
- No history of serious pregnancy/delivery/postpartum complications
- Hasn’t experienced premature births unless the surrogate’s most recent birth was at full term
- No serious health issues. The surrogate must be in excellent physical, mental and emotional health
- Must have a clean criminal record and be at least three years clean of any drug or alcohol abuse. The surrogate must have no history of smoking or is willing to abstain from smoking during the pregnancy
- A surrogate must be willing to commit to the time required for a successful pregnancy. This includes appointments, the time off that is required for the actual birth and postpartum recovery. A surrogate must be comfortable taking time away from work and family life
- Must be fully committed to their decision and ideally will enjoy being pregnant
- A surrogate should have a well-established support system of friends and family
Implications of IVF
Consult your physician when considering Third-Party IVF as an option in your fertility journey. You need to consider many social, psychological, legal, and ethical factors when selecting Third-Party IVF treatment.
Debate surrounds how this process affects the recipient, the child, the donor, and the surrogate, making it a controversial topic.
Psychological Counselling During IVF
The recipient, donor, and surrogate must undergo mandatory psychological counselling. Important topics to consider include:
- How and when to inform the child about the surrogate or gamete donor.
- Whether to disclose this information to extended family or the community, and under what circumstances.
- How the recipient feels about the biological connection, or lack thereof, to the pregnancy.
- The level of involvement the donor will have in the child’s life and the boundaries needed to protect the privacy of both the donor and the child.
- If the donor is anonymous, the implications of lacking important medical information.
If you choose to work with a surrogate, the surrogate and their partner (if applicable) should also receive counselling to discuss the psychological impacts of the pregnancy, feelings of attachment to the child, and the effects the pregnancy may have on other aspects of the surrogate’s life, such as their job, relationships, and friendships.
Legal Implications of IVF
In February 2020, Health Canada introduced new federal regulations to protect against the transmission of diseases from the donor to the recipient or child.
The Safety of Sperm and Ova Regulations requires donation programs to register with Health Canada and comply with these new guidelines to continue providing sperm and egg donations. Currently, some clinics are still assessing these regulations and may not yet be fully certified to offer donations.
Both the third party and the recipients must provide written consent, and it is advisable to consult a fertility lawyer to ensure both parties’ interests are accurately represented.
Whether you choose a surrogate who provides the egg and carries the child to term (a traditional surrogate) or a gestational carrier, the couple or female recipient must legally adopt the child after birth.
In Canada, a surrogate cannot be paid for carrying a pregnancy to term, as the act must be purely altruistic. However, the surrogate can be reimbursed for pregnancy-related expenses and may qualify for EI if they need time off. Additionally, giving gifts and tokens of appreciation to the surrogate is allowed and is common practice between surrogates and recipients, especially after the birth.
Start Your Fertility Journey
Third-Party IVF treatment can provide a rewarding and fulfilling experience for both donors and recipients.
Although the process may seem confusing, remember that you have resources and people available to assist you at every step. Feel free to contact Dr. Tanya Williams Fertility Centre anytime to discuss your Third-Party IVF treatment options.
Discover more related blogs from Dr. Tanya Williams Fertility Centre:
What to Expect During an IVF Cycle: Your Comprehensive Guide
Challenges of Third-Party Reproductive Donor Services for the Black Community
