Egg Donation

Egg donation is the process by which a woman provides one or several (usually 10-15) eggs (ova, oocytes) for purposes of assisted reproduction or biomedical research. For assisted reproduction purposes, egg donation involves the process of in vitro fertilization as the eggs are fertilized in the laboratory. After the eggs have been obtained, the role of the egg donor is complete. Egg donation is part of the process of third party reproduction as part of ART (Assisted Reproductive Technology).

Indication

A need for egg donation may arise for a number of reasons. Infertile couples may resort to acquiring eggs through egg donation when the female partner cannot have genetic children because she may not have eggs that can be successfully fertilized. This situation is often, but not always based on advanced reproductive age. Early onset of menopause which can occur in women as early as their 20's can require a woman to use donor eggs to grow her family. Some women are born without ovaries or other reproductive organs. Sometimes a woman's reproductive organs have been damaged due to disease or have been forced to have them surgically removed. Another indication would be a genetic disorder on part of the woman that can be circumvented by using eggs from another person. Many women have none of these issues, but continue to be unsuccessful using their own eggs.

If desired, (and if the egg donor agrees), the couple can personally get acquainted with the egg donor, her children and family members. More often, egg donations are anonymous.

Congenital absence of eggs

• Turner syndrome
• Gonadal dysgenesis

Acquired reduced egg quantity / quality

• Oophorectomy
• Premature menopause
• Chemotherapy
• Radiation therapy
• Autoimmunity
• Advanced maternal age
• Compromised ovarian reserve

Other

• Diseases of X-Sex linkage
• Repetitive fertilization or pregnancy failure
• Ovaries inaccessible for egg retrieval

Egg Donation Procedure

For the egg donor, the process is the following. First, it will be necessary for the donor to undergo a thorough medical examination, including a pelvic exam, blood draw to check hormone levels and to test for infectious diseases, and an ultrasound to examine her ovaries, uterus and other pelvic organs. These evaluations are necessary to ensure that the donor is fully prepared and capable of completing the donation cycle safely and successfully. These evaluations will be done at no cost to the donor.

Once the screening is complete and the contract signed, the donor will begin the donation cycle, which typically takes between 3-6 weeks. There are two parts to a successful egg retrieval procedure: the Egg Donor's Cycle and the Recipients' Cycle. The Egg Donation Cycle will begin with a few weeks of birth control pills (to synchronize the donor's cycle with the Recipient's), followed by a series of injections. There are different medical protocols currently used, but they will all include medication that makes the ovaries produce a number of eggs. At the doctor's office, the donor will be given instructions on how to properly administer the injections herself. These injections must be administered on a daily basis for one or more weeks (typically not more than 3 weeks.)

Egg Donation Results

Nationwide, egg donor cycles have a success rate of upwards of 60%. When a "fresh cycle" is followed by a "frozen cycle", the success rate with donor eggs goes up to approximately 80%. With egg donation, women who are past their reproductive years or menopause can become pregnant.

Babies born after egg donation are not genetically related to the recipient.

Throughout the cycle the donor is monitored often by the doctor. They will run blood tests and perform ultrasound exams to determine the donor's reaction to the hormones and the progress of follicle growth.

Once the doctor decides the follicles are mature, he/she will establish the date and time for the egg retrieval. Approximately 36 hours before retrieval, the donor must administer one more injection (of the hormone HCG) to ensure that her eggs are ready to be harvested. The Egg Retrieval is a minimally invasive surgical procedure that requires a light general anesthetic and lasts about 20-30 minutes. The doctor will use a small ultrasound-guided needle inserted through the vagina to aspirate the follicles in both ovaries. Immediately following the surgery the donor will rest in the recovery room for an hour or two. It can take one full day up to a week to fully recover, but generally Donors return to normal activities the next day.

First, you'll decide whether to use a friend or family member's eggs, an anonymous donor's eggs, or, if your partner's sperm aren't healthy, donor embryos - the combined sperm and eggs of known or anonymous donors.

If you decide on an anonymous egg donor, you can find her through your fertility clinic. You'll usually be able to choose based on her physical characteristics, ethnic background, educational record, and occupation. Most donors are between 21 and 29 years old and have undergone psychological, medical, and genetic screening. Ask how your clinic screens candidates - some do less extensive tests and background checks than others. If you choose to use donor embryos, you can either pick unrelated egg and sperm donors or use a frozen embryo donated by a couple that had extras.

Once you pick a donor, both you and she will take Lupron, a synthetic hormone, or birth control pills to get your reproductive cycles in sync - she needs to ovulate when your uterine lining can support an embryo. She'll also take a fertility drug to help her develop several mature eggs for fertilization, while you will receive estrogen and progesterone to prepare your uterus for pregnancy. Once her eggs are mature, your doctor will give her an anesthetic and remove her eggs from her ovaries by inserting a needle through her vaginal wall using an ultrasound for guidance.

From here on out, the procedure is just like that of in vitro fertilization (IVF). Your partner's sperm or a donor's sperm will be combined with your donor's eggs in a dish in a laboratory. Two to five days later, each of the fertilized eggs will be a ball of cells called an embryo. Your doctor will insert two to four embryos into your uterus through your cervix using a thin catheter. Although it's not a common practice, many experts say couples should consider transfer of a single embryo to avoid the risk of twins or triplets. Extra embryos, if there are any, may be frozen in case this cycle doesn't succeed. If the treatment does succeed, an embryo will implant in your uterine wall and continue to grow into a baby. In about 40 percent of ART pregnancies using donor eggs, more than one embryo implants itself and women give birth to multiples.

You'll be able to take a pregnancy test about two weeks after the embryos are placed in your uterus

Although the laws vary from state to state, donors usually sign away the rights to any children born as a result of the use of their eggs or sperm