Third-Party In Vitro Fertilization is a legal and safe practice in Canada that serves as a viable option for patients looking to start a family. As reproductive technology improves and becomes widely available, it has steadily gained in popularity.
If you’re considering Third-Party IVF, we’re here to help. At Dr. Tanya Williams Fertility Centre, we’ve assisted many couples as they navigate through this complicated journey. We understand that you may be feeling excited, overwhelmed, scared and everything in-between as you figure out where to begin. Read the article below to learn what to expect and if it might be right for you.
What is Third-Party IVF?
Third-Party In Vitro Fertilization (IVF) is the process of using a third party’s eggs, sperm, or embryo to assist a couple or individual in having children. Third-party IVF treatment may also involve the use of a surrogate, which means that a third party will carry the fetus to term and give birth to the recipient’s child. This third party has no expressed interest in raising the child.
If the third-party donor or surrogate is known to the recipient, it is most often a close friend or family member. Anonymous donors may also be found through a variety of egg donation agencies and programs.
Reasons for Selecting Third-Party IVF Treatment
Patients may select Third-Party IVF treatment for a variety of reasons, but the most common ones include:
- Patients who are experiencing low quality of eggs or a low egg count
- Patients 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 is the donation of sperm and or egg cells. The recipient will only have a genetic connection to the child if the donation is fertilized using sperm or eggs from the recipient. Fresh or frozen eggs from a donor can be thawed in a laboratory before being fertilized with the male partner’s or donor’s sperm. If a female partner chooses to use her own eggs and donor sperm, this may be done by intrauterine insemination or by IVF.
During IVF, fertilization takes place in the laboratory before the embryo is transferred to the recipient’s uterus.
Fertilization may occur through either placing the sperm and the egg in a dish together or through intracytoplasmic sperm injections (ICSI). ICSI is the process whereby a single healthy sperm is injected directly into each healthy egg. Laboratories can also assist in embryo hatching, which involves making a small hole or thinning the outer “membrane” of the embryo just before it is transferred to the uterus. This will assist the embryo in attaching to the walls of the uterus.
|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 be asked to take medication both before and after the IVF procedure, designed to thicken the lining of the uterus and to prevent uterine contractions during the implantation process. This involves taking estrogen and progesterone. These hormones may produce unwanted side effects such as irritability, fatigue, bloating, nausea, breast tenderness and rarely may increase the risk of blood clotting. In some cases, the procedure can be done using a natural or modified natural cycle.
Any surplus embryos from an IVF treatment may be frozen and stored for later use. They may also be donated or destroyed. The eligible cut-off age for using Third-Party IVF treatment without a surrogate is variable but most clinics designate a cut-off of age 50.
When considering Third-Party IVF treatment, surrogacy may also be required. Here are the two basic types of 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 surrogate may be known to the recipient, being either a friend or family member who volunteers to carry the pregnancy. Surrogates may also be found through agencies that specialize in recruiting eligible women.
If you decide to recruit your surrogate, here are a few features to look for which will ensure you select the best candidate:
- 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
- No history of 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
- A surrogate 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
The Implications of Third-Party IVF
It is important to consult your physician when considering Third-Party IVF as an option in your fertility journey. There are many social, psychological, legal, and ethical factors to consider when selecting Third-Party IVF treatment.
There is debate around how this process affects the recipient, the child, the donor and/or the surrogate, making it a controversial topic.
Psychological counselling is mandatory for the recipient, donor and surrogate. Topics that will need to be taken into consideration include:
- How and when to tell the child about the surrogate or gamete donor.
- Whether the extended family or community at large will be told, and under what circumstances
- How the recipient feels about the biological connection or lack thereof to the pregnancy
- How much involvement the donor will have in the child’s life and what boundaries need to be set in place in order to protect the privacy of the donor and the child
- If the donor is anonymous, the lack of important medical information also needs to be discussed
If you decide to get a surrogate, the surrogate and their partner (if there is one) should undergo counselling to discuss the psychological impacts of pregnancy, feelings of attachment towards the child, and the impact the pregnancy will have on other elements of the surrogate’s life (job, relationship, friends etc.)
Legal Factors of Third-Party IVF Treatment
In February of 2020, Health Canada released new federal regulations designed to protect against diseases being transmitted from the donor to the recipient or the child.
The Safety of Sperm and Ova Regulations requires donation programs to be registered with Health Canada and meet the new regulation guidelines in order to continue to provide recipients with sperm and egg donations. Currently, some clinics are still evaluating these new regulations and may not yet be fully certified to provide you with donations.
Written consent is required from both the third party and the recipients, and a fertility lawyer is recommended to ensure the interests of both parties are accurately represented.
Whether you decide to use a surrogate who provides the egg for the pregnancy as well as carries the child to term (a traditional surrogate), or you use a gestational carrier, the couple or female recipient must legally adopt the child after it is born.
A surrogate cannot be paid for carrying a pregnancy to term in Canada, the act must be purely altruistic. However, a surrogate can be reimbursed for the expenses of the pregnancy and may be eligible for EI if they require time off. Gifts and tokens of appreciation to the surrogate are permitted as well and are common practice between surrogates and recipients, especially after the birth.
Start Your Fertility Journey
Third-Party IVF treatment can be a rewarding and fulfilling experience both for the donors and the recipients.
Even though the process can be confusing, it is important to know that you have resources and people who can help you every step of the way. You can always contact Dr. Tanya Williams Fertility Centre anytime to discuss your Third-Party IVF treatment options.