Best Strategies for Egg Donor Preparation: A Retrospective Analysis of a Single-Center Cohort

Egg donation is a critical component of assisted reproductive technology, but its success hinges on optimal donor selection and stimulation protocols. This article summarizes a retrospective analysis of egg donor preparation strategies at a single fertility center. The study evaluated donor selection criteria, oocyte quantity and quality, the role of preimplantation genetic testing for aneuploidy (PGT-A), and the comparative efficacy and safety of different follitropin preparations. Key findings indicate that while age is a significant factor, anti-Müllerian hormone (AMH) is a more crucial marker for ovarian reserve. A substantial proportion of cycles experienced “unmet expectations”, highlighting the physiological variability of AMH and the importance of considering antral follicle count (AFC) in cases of discordance. The data suggest no statistically significant difference in oocyte quantity or quality in younger donor age groups (≤30 years). Furthermore, PGT-A did not improve live birth rates in this donor oocyte population, though it did prevent transfers in cycles with no euploid embryos. The use of follitropin delta demonstrated a higher safety profile in terms of ovarian hyperstimulation syndrome (OHSS) risk. These findings underscore the need for a personalized approach to donor stimulation, with AMH as the primary guide for selection and dose determination, while also acknowledging the value of other markers and protocols.