For many couples, being infertile no longer means having to go through life without children. Modern science and continued research in this direction has helped millions of couples all over the world become parents to a healthy child. Even issues that were once thought to make it impossible to conceive a child can now be overcome. One such female fertility problem is having a lack of eggs available for fertilisation.
What is Egg Donation
So what is a woman to do if her eggs have been found to be of poor quality or low quantity? Using an egg donor can significantly increase your chances of pregnancy. Compared to a your own eggs, using donor eggs are typically a better option when you do not have a very good ovarian reserve.
Ovarian reserve is the quantity and quality of eggs present in a woman’s body and this number differs for from every woman. In some cases, in spite of a high number of follicles, a woman may not have her eggs mature due to issues like premature ovarian failure. Other women may have eggs that are incapable of being fertilised or implanting on the uterine wall due to structural defects.
On the whole, donor eggs may be a better option when:
- A woman has irregular periods
- Premature ovarian failure due to genetic or auto-immune disorders has been diagnosed or has occurred due to radiation therapy or artificial removal of the ovaries
- A woman is over 40 and is going through or has already gone through menopause
- There has been no not response to fertility drugs
- There is a high level of FSH in the blood (FSH is a hormone that stimulates follicles to mature into eggs. If its level is too high in the blood, it signifies fewer eggs present in the body.)
- A woman cannot conceive in spite of repeated IVF cycles
- There is a risk of transferring genetic disease, like haemophilia, to the child from the mother
Doctors recommend that if a couple is opting for donor eggs, the mother should undergo a detailed medical analysis to check whether her body is suitable for pregnancy or if she is at a health risk. This particularly becomes important for women aged 40 years or more.
The uterus is also checked for deformations such as fibroids and scarred tissues that may not allow the egg to implant.
The decision of using an egg that is not yours is a difficult one. The choice of the donor, her being known or anonymous, the ethical or religious aspects, the choice of telling the child, the involvement of relatives and friends and most importantly the parents’ firm will to use donor eggs are some aspects of the issue that have to be dealt with.
Psychological counselling can be very helpful for couples in this regard to make a concrete decision.
Selection of Donor
Choosing a donor is a crucial aspect. She might be a family friend, relative or a person known to you. There are also many organisations and online sites that provide a list of donors who are willing to donate eggs. If you are already attending a fertility clinic, they too may have a pool of egg donors from which you can choose. Some couples have also successfully advertised for donors, though this may not be a safe approach, as the person’s background cannot be sufficiently verified.
Depending on how you locate your donor, the donor may remain anonymous. For instance, if your infertility clinic offers an egg donor program, you will likely be able to read about a donor’s health history, physical traits, education level, possibly profession and other general information. However, you will not learn the donors name, address or any other information that will allow you to identify them.
In general, women between the ages of 18 and 35 who are physically healthy, non-smokers, with no hereditary or sexually transmitted diseases and who are psychologically fit are most suited to become donors.
In order to ensure that a donor is physically, genetically and psychologically healthy for the donation, she has to undergo a number of tests. These may include:
- Blood tests to know the blood group, blood count and check for any infectious diseases might be passed on to the child
- HIV tests
- Hepatitis B or C tests
- Test for syphilis
- Cystic fibrosis test
- Medical history of the donor and her family to ensure that no hereditary problems are present
- The level of hormones present to know how fertile she is and whether her eggs are healthy enough
Psychological counselling is also advised to know her better as well as prepare her for the process.
Once you have decided to use donor eggs, the first step involves consultation with a physician or an organisation providing the donors. This helps in identifying your needs better and also answers any queries you might have regarding the procedure. The consultant also tries to find out your physical characteristics, likes, and dislikes to best match you with a donor.
After the selection of the donor comes the evaluation cycle phase.
When the process of pregnancy takes place naturally, the uterus of the mother prepares itself by thickening the lining of the inner wall, while the body automatically produces an increase of hormones, like estrogen and progesterone, for the conception. But in the case of pregnancy with donor eggs, a mother’s body is not prepared for pregnancy and therefore the hormones have to be artificially induced.
A prospective mother will undergo an evaluation cycle to determine the correct amount of estrogen and other hormonal supplements to be administered prior to transferring a fertilised donor egg. This is done by measuring your blood estrogen level and through ultrasound check ups to observe the uterine lining. The doctor may also give oral or estrogen injections to raise your hormone levels, which you may continue to take for a period of 10 to 14 days.
In approximately three to four weeks the evaluation cycle is complete.
Egg Donation Cycle
This cycle is also known as the coordination cycle as the donor and the mother’s cycle are synchronized with the help of birth control pills. Once this has been done, the donor is given fertility drugs to promote a greater number of eggs being matured during her cycle. Meanwhile, you are given the appropriate dose of estrogen determined during the evaluation cycle to prepare your uterus for the embryo.
A day before your donor under goes egg retrieval, you are given progestrone vaginally or with an injection. When the donors egg are retrieved, your partner will provide a semen sample that day so that his sperm can be combined that day with the freshly retrieved eggs. After 3 to 5 days, once the embryos have formed, two to three embryos will be transferred to your uterus as it normally would during an IVF procedure.
You will continue to receive estrogen and progestrone doses to help encourage a pregnancy. 10 to 11 days after the embryo transfer, a pregnancy test is carried out to check the success of the procedure.
There are a number of benefits to using donor eggs:
- A donor egg from a younger woman increases the chances of conception to 50% as compared to 15% to 18% with your own eggs. This is because donor eggs are of better quality and there are more numbers of eggs available for fertilisation.
- As the donor egg provides a better chance of fertilisation, you may not have to undergo as many IVF cycles thereby saving yourself from the physical, mental, and financial anxieties associated with each cycle.
- Donor eggs provide an opportunity to conceive a child whose genetic make up resembles one of the parents.
- You are able to experience the process of giving birth when the fertilised egg is placed inside your uterus, which is not possible with an adopted child.
A common fear of parents is that their child will be born with a genetic defect. Donors, however, are usually extensively checked for any signs of physical and genetic abnormalities. As a result, the chances of your child being affected by genetic problems caused by a donor are significantly reduced. However, they cannot be completely eliminated.
Unlike donor sperm, which is frozen and quarantined for at least six months, donor eggs are not frozen. This is because the freezing technique for eggs has yet to be perfected; in fact, freezing eggs typically damages the egg making it unusable. Therefore, fresh eggs must be used when you opt for donor eggs. Some infections, like HIV, may not produce a positive result until months after the infection, which means, although a donor may be tested, there is still a chance that she, and her eggs, could have a serious infection.
Other risks associated with this procedure include those associated with the IVF process itself as well as the chance of miscarriage if your body does not respond to the embryo. Furthermore, because two to three embryos are transferred, your risk of a multiple pregnancy occurring is increased.
Research has shown that there is about a 48% to 50% chance of conceiving using donor eggs. For women above the age of 40, who in general have a lower quality and quantity of eggs, the chances of conceiving with a donor egg is 5 times more than with their own eggs.
In the UK, the Human Fertilisation and Embryology Association (HFEA) is the body that governs the working of fertility treatment centres and clinics. Because of the highly emotional situation that can arise when using a donor, the HFEA has outlined numerous strict rules regarding the use of donor eggs.
According to the HFEA, only licensed clinics can undertake egg donation. A donor has the right to remain anonymous and she does not have any parental right to any children conceived through her donated eggs. However, a child may know about the identity of the donor by contacting the HFEA. Apart from these, there are many other laws enforced by the HFEA to allow the donor as well as the recipient a safe donation process.
According to the HFEA, donors should not make any profit from their donation and therefore should just be compensated for their time and travel expenses. However, in the U.S., donors can be paid and may earn anywhere from $2500 to $5000 per donation.
If you are planning on using a donor, you should expect budget anywhere from ₤6,500 to ₤8,000 for your treatment. This will include your appointments and check-ups, tests, fertility drugs, cost for donor eggs, IVF, and follow-up.