Egg donation, also called oocyte donation or egg cell donation, is a fertility treatment that aims to help the many women that are unable to use their own eggs for an in vitro fertilization (IVF) cycle. Also single men and male homosexual couples desiring to have a baby can now become parents through surrogacy.
The various sections of this article are assembled in the following table of contents.
What is egg donation?
The history of this treatment goes back to 1984, and was specially aimed to those women who have fertility problems due to early menopause, surgery for ovarian cysts, or malignant diseases, and until then saw themselves with the impossibility of becoming pregnant.
Generally, egg donors act altruistically. Nevertheless, it is allowed that egg donors are rewarded with an economic compensation for the potential risks and nuisances that might arise from the treatment. While in some countries the minimum egg donor compensation is addressed on the regulations governing this field, others leave flexibility regarding how much money should be paid to the donor.
Regarding the donor profile, policies vary from country to country. For example, while some have egg programs where the donor must remain completely anonymous, others allow that it is the recipient who chooses the donor profile or even gets to know her in person.
An advantage of using donor eggs is that the woman can go through the phases of being pregnant, having a baby and giving birth as if it was a natural pregnancy. Also, the baby has a male partner genetic connection.
As for the cons, the first one is that the child will not have any biological connection to the mother. Secondly, egg donation cycles are expensive, although it depends on the country.
Process for recipients
Using an egg donor may seem complicated, but the process every receiving woman should follow is almost the same to that followed in IVF. In fact, the treatment of choice when donor eggs are used is IVF.
The following is a guide to the donor egg IVF process step-by-step.
Egg donation locations
Single parents and infertile couples who decide to travel abroad for IVF with donor eggs should look for the clinic that best fits their personal needs. And the same applies in case they wish to undergo this treatment in their home country.
Do seek experienced doctors, nurses, and counselors willing to guide you through this procedure. Choosing the right fertility clinic is a key step to make the most out of your donor egg experience.
Make sure the center has good quality control, strong ethics, and ask them for their live birth success rates. Pay attention to the location, search for the testimonials of previous patients on different egg donation websites and/or forums, etc.
Timeline and approximate cost
The next step is all about cycle preparation. You may be ordered several tests to identify any potential abnormalities that may reduce your chances of success (e.g. fertilization and/or implantation failure).
Women in their 40s or even 50s may be required additional testing in order to ensure they are able to get pregnant in optimal conditions. Thanks to it, high-risk pregnancies can be prevented.
Ask your fertility clinic for the costs of your donor egg IVF cycle, what’s included and what’s not, what are the donor fees, etc. The cost of oocyte donation varies from country to country.
Egg donor database and profile
Choosing a donor is crucial, as well as a uniquely personal decision. In some cases, consulting with an experienced psychologist may be helpful in order for patients to make up their minds.
Although in most European countries, egg and sperm donors must remain anonymous (Spain, Cyprus, Greece, Czech Republic, France…), there are countries such as the USA where non-anonymous donors are acceptable as well.
Once you choose a donor, she will have to undergo extensive genetic and mental screening. It is not until your donor coordinator confirms she is healthy to go through the egg donation process when the cycle begins.
Donor eggs, fresh or frozen?
In case you prefer to use fresh donor eggs, then your cycles must be synchronized. This step is crucial, as it allows the recipient’s uterine lining (endometrium) to be prepared for implantation right after the retrieval of the donor’s eggs.
The hormone therapy for recipients can be administered either orally, vaginally or using patches. The aim is to reach the ideal endometrial thickness, which is the mucosal layer of the uterus where embryo implantation takes place.
The donor has to take stimulation of ovarian function medications that trigger the growth and maturation of a number of eggs. For 10 to 14 days, she will be monitored until the eggs are ready to be harvested.
Frozen cycles are easier from a procedural point of view. In this case, the patient works with an egg bank, from which she gets a certain amount of unfertilized eggs. After being fertilized with the husband’s or donor’s sperm, an embryo transfer is carried out.
IVF embryo transfer: the process
Once the donor’s eggs are retrieved, your partner or sperm donor has to provide a semen sample on the day of the ovum pick-up, so that the eggs are inseminated for the creation of human embryos.
The embryos are left in culture until they reach the proper stage for transfer, usually on day 3. That is the moment when recipients have to return to the clinic for transfer to the uterus.
Patients have to decide how many embryos to transfer in this very moment. Although experts typically recommend single embryo transfer (SET) to reduce the chances of multiple births, it is a topic for discussion with your doctor.
Once the endometrium acquires the ideal thickness, that is, trilaminar appearance and a 8 mm lining, the embryos will be transferred and their implantation will be awaited.
Embryo transfer (ET) is a simple, painless procedure after which the only thing left to do is waiting for embryo implantation. In other words, pregnancy is what every woman expects after performing an ET. You can find out whether you are pregnant within 10 days by means of a beta-hCG pregnancy test.
Risks to the recipient
The number of side effects recipients may experience during and after undergoing an IVF cycle with donor eggs is considerably lower than that expected for donors.
Having a multiple pregnancy is the principal risk of egg donation for the recipient. This may occur when multiple embryo transfers are carried out, because the fact that donors are young women increases the pregnancy success rate.
It should be kept in mind that the age of the recipient does not have an influence on the final outcome, even if she is 40 or over. Inversely, being pregnant with multiples increases the chances of:
- Premature birth
- Gestational diabetes
- Heart problems
- Placenta previa
- Iron deficiency anemia
For this reason, experts do recommend to limit the number of embryos to transfer, generally to no more than 2 or 3 for day 2-3 transfers. If the embryo is transferred on day 5 (blastocyst stage), a single or two embryo transfer.
When are donor eggs used?
In the case of single women, lesbian couples, and heterosexual couples, egg donation may become necessary due to many reasons. The following are the most common causes:
- Poor ovarian reserve
- Genetic alterations or diseases
- Advanced maternal age
Out of the causes mentioned above, poor or zero ovarian reserve is the most common one, either of natural origin or as a consequence of a medical treatment (e.g. especial medication, cancer treatments…) or a surgical intervention (e.g. having one or both ovaries removed).
Women at risk of transmitting a hereditary disease to their offspring may also need donor eggs even though they do not suffer from any female fertility problem related to her own eggs.
Attention should also be drawn to advanced maternal age. As a woman ages, the quality of her eggs becomes poorer, and her ovarian reserve keeps on diminishing. Delayed motherhood is therefore the reason why demand for donor eggs is increasing nowadays.
Donor eggs are from the highest quality, since they have been delivered from young, healthy women who do not suffer from any fertility problem. Besides, to be accepted as donors, they must undergo a series of thorough medical tests to ensure their optimum state of health.
Bearing this in mind, it is only logical that IVF cycles using donor eggs usually present higher success rates than those cycles that are performed using the patient’s own eggs.
Be it as it may, chances for success may vary as well according to other factors such as the recipient’s anatomy of the uterus, using frozen or fresh eggs, the ages of the donor and the recipient, what is causing infertility on the recipient…
Nevertheless, the following statistical data should be taken into account when deciding to use donor eggs:
- Recipients aged over 40 have lower implantation rates, live birth rates, and clinical pregnancy rates. Subsequently, the miscarriage rate is higher.
- Uterine receptivity declines with advanced maternal age, especially when pathological conditions in the uterus such as myomas or polyps have ever been suffered.
- Hypertension, as well as other systemic disorders, are more common in older women, something that may contribute to reduce the implantation potential, and therefore a successful pregnancy outcome.
If you want to find detailed information about success rates, you can read the following article: Pregnancy success rates with donor eggs.
Egg donation and surrogacy
Host or gestational surrogacy is the name given to the process of using donor eggs and a gestational carrier to have a baby. It is often the treatment of choice for single men and gay couples.
Because of their own anatomy, it is obvious that single men or gay couples are unable to naturally conceive a biological child without a female partner. This is the reason why they have no choice but to start a surrogacy treatment using their own genetic material (sperms) in combination with donor eggs.
Although it is considerably more expensive than traditional or straight surrogacy, in which the surrogate’s own eggs are used, this type of surrogacy is usually the preferred one, as it is less legally complex and become harder emotionally.
To make the dream of being a father come true, men can start an IVF cycle using their own sperm with donor eggs (either from an anonymous or known donor). Thus, the surrogate mother is genetically unrelated to the baby-to-be.
If conception occurs and the embryos develop, only those of the highest quality will implant into the gestational carrier’s uterus. It should be clear that the role of the surrogate is to rent her womb for the gestation of a child, but she won’t act as the child’s legal parent.
Should you need any further information, please visit the following post: Egg donation and surrogacy.
FAQs from users
Donor eggs or adoption?
Both donor assistance and adoption offer the pleasures of parenting, so it is up to you. Prospective parents should focus on long-term aspects such as how this decision could affect their family life.
I used donor eggs, when should I tell my child?
Deciding when to tell your child depends on your preferences, though experts are in favor of disclosure at some point in the child’s life. Telling earlier may help them absorb the information more easily over time.
How can recipients cope with grief and regret after using donor eggs?
The loss of one’s own genetics is a dramatic step in many women’s lives. The good news is that grieving the use of one’s own egg cells is a normal part of the process, and many women understand that parenting is not 100% about genetics after a few months.
Remember that the donor may be the genetic DNA source, but she is not the mother. You are the one who is going to be a mom, regardless of whether it is a donor-conceived or biological child.
More info here: Telling children about their conception by gamete or embryo donation.
What is the relationship between epigenetics and egg donation?
Epigenetics is the study of physiological phenotypic characteristics in babies that result from environmental factors. Such variations have an influence on how cells express genes.
In this sense, women who regret having used donor eggs because they do not share their genetic expression with the baby should know that, during pregnancy, the metabolism of the pregnant woman may have an influence on the baby’s future behavioral patterns.
Will my egg donor baby look like me?
Keeping in mind that egg donors should be compatible with recipients, so that they share certain characteristics such as the hair, eye, and skin color, ethnicity, height, etc., the donor-conceived baby will share certain physical traits with her.
What is the history of egg donation?
The first pregnancy with donor eggs was achieved thanks to the work of Dr. Alan Trounson. However, the first term pregnancy was achieved by Dr. Lutjen a year later, in 1984, in a woman who suffered from ovarian insufficiency. She could not have ever achieved her dream of having a baby without this technique.
All assisted reproduction techniques are relatively new, though egg donation is the most recent method. It all started with discretion, that is, reproduction centers did not make much room for it, since the ethic implications of such process are difficult to accept for many.
Over time, the relative change of mentality and the incorporation of the woman into working life have pushed motherhood into the background. Egg donation has slowly but surely gained ground and it has become one of the most widely used fertility treatments today.