The donation of eggs is a technique that allows a woman (donor) to provide her eggs to another woman (recipient) so that the latter can have a baby. To donate eggs, the donor must receive medication to stimulate the development of multiple eggs in a single cycle. Then, the eggs are extracted from the donor by placing a needle connected to an ultrasound probe through the vagina. The eggs are gently aspirated (suctioned) from the ovaries. Once extracted, the eggs are evaluated by an embryologist. Next, the sperm from the male partner or a sperm bank is injected into each egg or placed around them. This process is called in vitro fertilization (IVF).
How is the recipient prepared for embryo transfer?
The recipient's uterus (womb) must be synchronized with the donor's stimulation so that they are ready at the same time. There are several ways to achieve this. If the woman still has regular menstrual cycles, medication is often used to suppress ovarian activity and the menstrual cycle. Once the donor begins taking medication to stimulate her ovaries, the recipient starts taking estrogen to develop the endometrium (uterine lining). When the time for egg retrieval approaches, the recipient will start taking progesterone to allow for the implantation of the embryo (fertilized egg). The embryos are transferred to the recipient's uterus three to five days after fertilization. Hormones will continue to be administered until the time of the pregnancy test, and then, if the test is positive, during the first part of the resulting pregnancy's first trimester.
Who should consider using an egg donor?
Egg donation is recommended for women who want to have a child but cannot become pregnant with their eggs. This may be due to being born without ovaries, being in menopause, not responding adequately to ovarian hormonal stimulation in the past, or having poor egg or embryo quality in previous attempts of IVF. Women may also choose to use an egg donor if they have a genetic disease that they do not want to pass on to their children.
Who can be an egg donor?
Egg donors are women, usually between 21 and 34 years old, who are willing to donate their eggs to a recipient. They can be anonymous (unknown) or known to the intended parents. Anonymous donors are recruited through egg donation programs or agencies and are not known to the recipient. However, some couples find donors through advertisements. Recipients should exercise caution when recruiting donors without the use of an intermediary who selects the donors and should seriously consider seeking legal advice. Known donors (also referred to as directed donors) are usually a friend or close relative of the recipient.
What tests are conducted on the donor?
The donor undergoes screening tests for infections such as HIV, hepatitis B and C, gonorrhea, chlamydia, and syphilis. All donors must undergo a test to ensure they are not carriers of the cystic fibrosis gene. Other genetic tests should be performed based on the donor's medical history and ethnic origin. Some programs conduct chromosome analysis and fragile X chromosome syndrome tests; however, these tests are not necessary. Psychometric tests are often performed as part of the mental health evaluation.
How should the recipient be evaluated?
The evaluation of the recipient is similar to that of couples undergoing routine IVF. It should include a comprehensive medical history of both members of the couple, including blood type and Rh factor, and tests for sexually transmitted diseases such as HIV, hepatitis, gonorrhea, chlamydia, and syphilis. The couple should be advised by a mental health professional about the complexity of the decision to use an egg donor. The recipient should undergo a pelvic examination and an evaluation of the uterus. If she is over 45 years old, a more meticulous evaluation needs to include an evaluation of heart function and the risk of contracting pregnancy-related diseases,
Also, it's recommended to consult with a specialist in high-risk pregnancies. The male partner's semen should be analyzed, and appropriate genetic testing should be done based on their medical history and ethnic background.
What is the probability of a successful egg donation cycle resulting in pregnancy?
The success of an egg donation cycle depends on many factors but is not considered to be related to the age of the recipient. Success rates compiled by the Centers for Disease Control and Prevention (CDC) in 2010 showed an average birth rate per embryo transfer of 55% for all egg donation programs.
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