Egg donorship, or as it is also called oocyte donorship (OD) aided in conception for the first time back in 1984.
When is an egg donor needed? Egg donorship is used with female infertility. A patient is implanted with embryos that have been obtained by using a husband's sperm to fertilize eggs that were given by another woman - an oocyte donor. Sometimes it is not a husband's sperm that is used but donor fertilization.
Egg donorship is the only hope for pregnancy for women, whose infertility is caused by ovarian failure or absence. This is when an oocyte donor is needed – when a patient has no eggs of her own or they are of poor quality. In those cases donor eggs are used.
Aside from that, an oocyte donor is needed if a woman has her own eggs that mature but additional negative factors exist:
- poor response to ovarian stimulation, when only 1-2 follicles mature, even though large doses of FSH were used, as well as inability to complete in vitro fertilization during a natural cycle; ;
- numerous unsuccessful IVF attempts, where poor quality eggs were obtained and thus it was impossible to get good embryos;
- a risk of transferring serious genetic disorders to an unborn child;
- numerous unsuccessful IVF attempts, causes of which could not be established, a patient's age is over 39, and FSH indices are marginal;
- individual indications. These might include repeated hyperproliferative processes inside the uterus, complicated ovarian hyperstimulation syndrome, contraindications for conducting ovarian stimulation with no contraindications for carrying pregnancy, etc.
The decision to use the services of an oocyte donor is not an easy one for a married couple to make. It is very important to take this seriously, all pros and cons must be carefully examined; they need to talk not only with their doctor, but also with other specialists at the infertility center. And if a couple did make a decision that an egg donor is needed, there should be no further doubts.
Practice shows that women, who conceived through this type of programme, never remember afterwards that the resulting child is genetically related only to their husbands. Once a woman, who undergoes IVF with the use of donor egg, realizes that a new life has begun inside her, she becomes filled with emotions that let her forget the fact that this baby is not hers by blood.
You have the right to conceal this problem from your friends and family. There is no need even to tell the doctor that will be performing your prenatal care at a local women's health clinic that you used the services of an egg donor. The only one who would know about it would be the specialist at the infertility treatment clinic, who performed the in vitro fertilization procedure. On a side note, it would be a good idea to keep in touch with that doctor even after you begin prenatal care in your own clinic. When your baby is born, tell this doctor the specifics of the delivery as well as information about the baby: its height, weight and other data.
An egg donor is typically a young, healthy woman, aged 20 and 35. Every woman that decides to become an egg donor undergoes thorough examination for presence of infections, she is consulted by a geneticist. Moreover, a sine qua non condition for a woman, who decided to become an oocyte donor, is to have at least one healthy child of her own. A woman that decided to become an egg donor is subjected to ovarian stimulation to obtain higher quantity of eggs. Donor oocytes are then given to female patients, who are suffering from infertility for a separate charge. So far no negative consequences of egg donorship for women, who decided to become egg donors, or risks to egg donor's reproductive health have been discovered. The cost of egg donorship, the price of an egg donor's biological material depends on a number of factors.
How does one find an egg donor?
If you need an oocyte donor, you may use the services of specialty clinics that have their own databases. Many infertility treatment centers that conduct artificial insemination procedures have their own egg donor banks. An egg donor undergoes stimulation in accordance with the patient's cycle. For that reason, the cost of in vitro fertilization is increased by a specific amount that would equal an oocyte donor's payment. How much an egg donor is paid depends on a clinic, where you conduct IVF. Every clinic has its own egg donors. Moscow, as it has been noted, experiences less of a deficit in donors. If it is medically necessary for a patient to use egg donorship, the cost of the procedure might increase due to the fact that artificial insemination with donor sperm might be needed as well.
Some centers pay a donor a sum that depends on the number of eggs that will be obtained. Specialists at in vitro fertilization clinics usually distribute gametes obtained from one oocyte donor between several patients. The drawback of this method is that a woman receives a small number of eggs. As a result, there are only enough embryos to make one transfer, and there is nothing left for cryopreservation. Another disadvantage is the lengthy wait for a free egg donor.
If you do not wish to wait, turn to a professional oocyte donorship and surrogacy programme operator. Such organizations generally have a large database of oocyte donors and maintain detailed records about each of them.
Occasionally a patient that undergoes IVF can also become an oocyte donor, if she conforms to all the requirements set for donors, of course. The only exception is the requirement with regards to having children of one's own. And a patient will have to undergo all the necessary tests prior to IVF regardless.
If a patient yields more than 10-12 high quality eggs, she will be given a discount for the IVF procedure if she agrees to share some of those eggs with another woman. This procedure will also be cheaper for a patient that uses those cells. The cost of dedicated oocyte donor services is much higher.
Generally, though, very few patients agree to become oocyte donors. Even if they obtain a large quantity of cells, the majority of them will prefer to leave those cells for cryopreservation, in order to use them later, should this attempt prove unsuccessful.
Some infertility treatment clinic specialists, as well as some married couples believe that only eggs from dedicated oocyte donors, in other words, healthy women, should be used for in vitro fertilization. Others are convinced that it is perfectly acceptable to use the gametes of other infertile patients. Different arguments are provided on both sides, but the final decision is up to you.
Every patient has a right to choose; it can be a relative or someone they know – this option is used more frequently by representatives from ethnic and racial minorities. This is also your choice, and yours alone. Some find it easier to consent to the use of anonymous genetic material, others prefer bringing in their own oocyte donor.
It is very important to make this decision consciously, without taking emotions into account; with a clear head, rather than at the peak of depression that might arise after several unsuccessful IVF attempts with the use of your own eggs. Furthermore, it is essential to discuss this problem with your husband. Should you decide favorably with regards to donorship, your spouse must choose a donor with you, help you prepare for the protocol.
Generally, most men have no problem using a donor gamete. This is due to the fact that this child will still be genetically related to the man. The fact that spouses want their wives to be happy is also an important factor.
How to Choose an Oocyte Donor
When making your selection, you will have to rely on general information only, as nobody will give you a donor's photograph. You may choose based on the following criteria:
- outward appearance (Slavic, Oriental type, etc.);
- height, weight;
- eye, hair color;
- facial features: eye size, nose and lip shape, etc. (not all infertility treatment centers provide this information);
- blood type, Rh factor.
The list of criteria depends on a specific medical institution – in some places it is more extensive, in others - less so. Doctors usually provide assistance to the patients by helping them choose an oocyte donor similar to them in appearance and blood type. It is easier for them to do so, as doctors actually know the donors personally.
Doctors at infertility treatment clinics can sometimes advise you to choose an oocyte donor that you do not particularly like based on the description – you might, for instance, think that the eye or hair color is wrong for you. But this might just be the woman who looks more like you, which is obvious to the doctors. Prior to conducting IV, you should keep in mind that the use of donor cells is not a guarantee that an IVF attempt will be successful. Experts recommend changing an oocyte donor after two unsuccessful attempts with the use of fresh embryos.
How Is an IVF Procedure with the Use of Donor Cells Conducted
The first thing that needs to be done is to synchronize the cycles of the patient and the oocyte donor, which is accomplished with the use of hormonal agents. Afterwards, the donor undergoes ovarian stimulation, the same as the one before IVF, only in some cases this procedure is performed with the help of cheaper medications. You should not be concerned that such medications are less effective or harmful to one's health.
During all this time the patient is taking medications that help prepare her endometrium for successful embryo implantation. She is most often prescribed Progynova or Estrofem.
The next stage: the oocyte donor undergoes follicular centesis under anesthesia. Egg fertilization is done with the use of husband's sperm. The resulting embryos – 2-3 – are transferred into the patient's uterine cavity, as during a regular IVF. Before the results are known, the woman will be receiving maintenance therapy; she will be prescribed oil solution of progesterone (1 and 2.5%) or utrogestan.
After 2 weeks the patient is given a pregnancy test. If the attempt was successful, HRT is used up to week 14. Dosage is selected on an individual basis and may vary, depending on the levels of progesterone and estradiol in the blood.
A patient that undergoes IVF with the use of donor cells has no corpus luteum. If she conceives, however, the chorion produces enough chorionic gonadotropin for normal fetal development. For that reason, a woman is not prescribed choracon injections. The number of successful attempts of IVF with the use of donor eggs reaches 30-40%.
Visitors to our website often ask about egg banks, similar to HYPERLINK "http://ma-rt.com/ru/services/34-uslugidonorovspermy.html" \t "_blank" sperm banks that exist in infertility treatment clinics. Unfortunately, it is very difficult to HYPERLINK "http://www.probirka.org/krioeco/krioecooocits.html"cryopreserve eggs and, in addition, their ability to fertilize decreases significantly after thawing, which has a negative impact on embryo development and implantation. That is why this procedure is not performed on a large scale and no egg banks are set up. Sometimes eggs are frozen, but that is done out of necessity.
Work continues, specialists are trying to develop cryoprotectants – special environments that would prevent damage to the eggs during cryopreservation.
Oocyte donorship is conducted only if an infertile couple have been fully informed about this infertility treatment method, as well as on the condition that a donor is also informed about the use of her eggs. When the procedure is conducted, relevant documents are drawn up for both parties. They are signed by the recipient and the egg donor. The cost and compensation depends on a number of factors. In certain countries, for instance, in Israel and Germany, oocyte donorship is prohibited for religious and ethical reasons. These restrictions are not valid in Russia, however there are no laws that fully govern this process either.
Oocyte donorship helps many infertile couple have a child. The popularity of this programme has, in turn, led to certain rather questionable and sometimes unacceptable actions on the part of representatives of infertility treatment clinics. So be alert!