Infertility Infertility is usually defined as the inability to conceive after one year of unprotected intercourse. According to the American Pregnancy Association, infertility affects about 6.1 million Americans. In about one-third of cases, it's caused by problems with the woman (like congenital abnormalities of the reproductive system, ovulation disorders or blocked fallopian tubes). In another third, problems with the man cause infertility (like a low sperm count or poor sperm quality). The remaining cases are caused by a combination of factors in the woman and man. Sometimes the cause of infertility can't be found.

Assisted Reproduction About 85 to 90 percent of cases of infertility can be treated with medications or surgery to correct problems with the reproductive system. When conventional treatments don't help, a couple may try in vitro fertilization (IVF). In this procedure, the woman is usually given medication to increase the production of eggs. Then, the eggs are removed and united in a specially prepared Petri dish with sperm (either from the male partner or a donor). Some of the fertilized eggs (embryos) are placed back into the uterus. Ideally, the embryos will implant in the uterine lining and continue to grow, leading to a birth.

The American Society for Reproductive Medicine estimates more than 139,000 babies have been born in the U.S. through IVF. The average live birth rate after a single egg retrieval is about 29.9 percent.

Using Donor Eggs Another option for some infertile couples is donor eggs. Egg donation may be preferred by women who have poor quality eggs, have experienced premature menopause, have had their ovaries removed or may be carriers of a serious genetic disease.

Once a couple has agreed to the process, the recipient's menstrual cycle must be synchronized with that of the donor (to allow the recipient's uterus to accept the embryos at the right time during her menstrual cycle). The donor is given medication to increase the number of eggs produced during ovulation. When ready, the eggs are retrieved from the donor and mixed with sperm from the recipient couple. Then one or more embryos are placed into the recipient's uterus.

The American Pregnancy Association estimates about 3,000 babies are born each year through egg donation. Costs of the procedure vary widely, but are often between $15,000 and $20,000.

Frozen Egg Donation Using fresh eggs creates timing obstacles for the donor and recipient. In addition, both the donor and recipient must be geographically close to get the fresh eggs to the recipient. Now, another option is available for women - frozen donor eggs. In the past, doctors have not had good success with frozen donor eggs because the quality of eggs deteriorated during the freezing/thawing cycles. But refinements in technique are reducing egg degradation and improving the likelihood of fertilization.

Cryo Eggs International is a commercial company that offers frozen donor eggs. Donors, who are compensated for their eggs, must undergo rigorous medical testing (including screening for genetic and infectious diseases) and a psychological evaluation. The donated eggs are frozen for at least six months and released for sale only when the donor has been tested a second time for HIV and other infectious diseases.

Recipients don't meet the egg donors, but are given a medical profile and picture of possible donors. Diana Thomas, President and CEO of Cryo Eggs International, says some people think recipients want eggs from only the most intelligent and best looking donors. However, couples are more likely to choose eggs from donors who are most like themselves (i.e., have similar interests, looks and genetic history).

The recipient's menstrual cycle is monitored so doctors can insure the uterus is ready to accept an embryo. Once the timing is worked out, the frozen eggs are shipped to the recipient's physician. The eggs are thawed, fertilized and then place into the recipient's uterus.

Each frozen egg costs $2,500. A couple can choose to purchase one egg or several from the same donor. According to the company's data, about 60 percent of frozen eggs remain healthy after being thawed. Of those, 68 percent are successfully fertilized. The pregnancy rate is about 30 percent.

Cryo Eggs International recently celebrated its first successful outcome with commercially obtained frozen donor eggs. The baby girl, named Avery Lee Kennedy, was born at the University of Kentucky Chandler Medical Center on December 31, 2005.

For information on cryopreserved eggs: Cryo Eggs International, http://www.cryoeggsintl.com

For information on infertility: American Pregnancy Association, http://www.americanpregnancy.org American Society for Reproduction Medicine, http://www.asrm.org RESOLVE, http://www.resolve.org