Egg donation, also referred to as oocyte donation, makes pregnancy possiblefor women who might not otherwise be able to get pregnant using their owneggs.
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Who are candidates to use donor eggs?
The reality is that any woman desiring to become pregnant has the optionof pursuing donor eggs. Unfortunately, the majority of women who use donoreggs have significantly diminished egg quality. Women with the followingconditions or situations are typical candidates for donor eggs:
- Early menopause or premature ovarian failure (POF)
- Extremely poor egg quality
- History of genetic disease
- Ovaries do not respond to stimulation
- Hormonal imbalence
- Over the age of 40
What is the process for selecting an egg donor?
The first step is to decide the characteristics you prefer in an egg donor.The egg donor could be a family member, friend, or someone anonymous. Anypotential egg donor should be screened as follows:
- History of birth defects or hereditary diseases
- Medical and social history
- Physical examination
- Psychological screening
- Testing for sexually transmitted diseases
What is the process for the egg donor?
The egg donor will experience ovary stimulation using the same medicationsthat a woman would use to stimulate her own egg development in planningfor in vitro fertilization. Ovulation induction will be done using a combinationof drugs. These medications will help prevent ovulation from occuring tooealry and also help stimulate the productoon of multiple eggs in the ovary.The donor will be monitored through ultrasound and blood work to determinewhen her follicles have developed. The hormone hCG is then administeredand the eggs are retrieved about two days later.
What is the process for the recipient couple?
Ideally, the recipient’s cycle will be synchronized with the donor’scycle. This is accomplished by administering a combination of two or threehormonal medications. Lupron® is administered shortly before the periodis expected to start in order to suppress the natural cycle. Estrogen isadded shortly after the period starts and changed daily until the recipient’sand donor’s cycles match. Hormonal medications will be used to manipulatea regular 28-day menstrual cycle and keep the recipient and donor on thesame cycle. Being on the identical cycle offers the best chance of havingthe lining of the recipient’s uterus prepared to support the embryo.
The male partner will provide a semen sample on the same day that eggsare retrieved from the donor. The semen and eggs are fertilized in a laboratoryusing in vitro fertilization.
Progesterone treatment begins on the day after eggs are retrieved fromthe donor, and Lupron® injections are discontinued the day before theembryo transfer. The embryo transfer normallyoccurs two-five days after the eggs were initially retrieved. A blood testwill be performed 10 days later to determine if pregnancy has occurred.The recipient should also be aware of early signsand symptoms of pregnancy. Most donor recipients will also stay on bothprogesterone and estrogen until about 10 weeks into the pregnancy, whenthe placenta can provide these hormonal needs on its own.
What is the success rate of pregnancy using donor eggs?
The success rate will vary depending upon age of eggs, retrieval process,quality of semen, and the overall health of the women involved. In mostcases, younger eggs are preferable. Up to 48% of women using donor eggswill experience pregnancy. Unfortunately, approximately 15-20% of womenwill miscarry.
What are the risks related to egg donation?
Egg donation carries the same risks as in vitro fertilizationand embryo transfer and there is a 20-25%chance that the pregnancy will involve multiples. Pregnancies from donoreggs carry the same 3-5% risk of birth defect as natural pregnancy.
The medications involved may have side-effects. Some women experience hotflashes, feelings of depression, headaches, and sleeplessness.
In rare cases, donors may experience ovarian hyperstimulation syndromewhich involves a painful swelling of the ovaries. Other symptoms includenausea, vomiting, abdominal pain and shortness of breath. Contactyour healthcare provider immediately if you experience any of thesesymptoms.
Common Questions and Concerns:
How much does the process cost? Total costs typicallyrange from $15,000 to $20,000. It is important to find out what is includedand what is not included in the fee structure: donor fees, in vitro fertilization,embryo transfer, medications, embryo freezing, etc.
What are the legal concerns? Laws tend to vary from stateto state, but there should be little concern about parental rights. No matterwhether the donor is known or anonymous, legal contracts can be writtenthat remove all parental rights of the donor.
How many eggs should be retrieved, fertilized, and transferred?In most cases fertility specialists will remove as many eggs as possibleduring the retrieval process. This provides the opportunity for additionalprocedures if the first attempt is unsuccessful. The number of embryos thatshould be transferred during any single IVF cycle has been the subject ofmuch discussion and debate. Some experts believe that transferring no morethan four embryos per IVF cycle will yield optimal results in order to reducethe risk of multiple pregnancies and other complications. Transferring fourembryos instead of only one or two increases the probability of a successfulpregnancy. However, there is the possibility that all four embryos couldimplant. It is important to discuss these options with a fertility specialist.
Compiled using information from the following sources:
RESOLVE: The National Infertility Association, http://www.resolve.org
American Society for Reproductive Medicine (ASRM), http://www.asrm.org