Donor-Egg Birth Odds Drop After 49, With Live Births Falling to 31.7%

2 articles · Updated · Medscape · Jul 13

Women 49 and older using donor eggs had significantly lower live-birth odds and about double the miscarriage risk than those aged 35-40, according to research presented at ESHRE 2026.
Data from 1,774 women and 2,760 single blastocyst transfers showed pregnancy rates fell to 42.6% in the oldest group from 54% in the youngest, while live births dropped to 31.7% from 46.2%.
The study suggests donor eggs do not fully offset age-related changes in the uterus: trilaminar endometrial patterns declined to 81% in women 49 and older from 94.7% in those 35-40.
Researchers said paternal age was unlikely to explain the decline, but outside experts cautioned the single-center retrospective study cannot prove uterine aging caused the worse outcomes.
Clinicians said the findings should inform counseling rather than deter treatment, challenging the idea that donor eggs fully reset the reproductive clock beyond age 49.