When a woman or couple is going to undergo an in vitro fertilization (IVF) treatment with donated eggs, also known as ovodonation many doubts and questions usually arise. Some of them may deal with donor allocation, i.e. how the most suitable egg donor is chosen for the recipient woman.
When the oocytes come from an anonymous donor, the donor is chosen by the medical team. To guarantee the anonymity of the donation, the recipient woman or couple cannot personally choose the donor or her characteristics.
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How are egg donors selected?
The egg donation process is legally regulated in most countries by their legislation on Assisted Reproduction Techniques. Certain conditions that a woman must meet in order to be able to donate eggs. Among these requirements are:
- Be of legal age.
- Be healthy, both physically and psychologically, and have full capacity to act.
- Not suffer from genetic, hereditary or infectious diseases transmissible to offspring.
Therefore, when a woman decides that she wants to be an egg donor, she must pass certain medical and psychological tests to ensure that she is in good psychophysical health and that she meets these requirements.
Thus, not all women who intend to donate eggs can do so: only those who have passed each and every one of the stipulated tests will be accepted as donors.
You can find more information about the requirements and tests to be an egg donor in the following article: What are the requirements for egg donation?
How do you choose the most suitable donor for the recipient?
Once the woman is accepted as a donor, the actual egg donation can proceed. The oocytes obtained will be donated (either fresh or vitrified) to the recipient woman anonymously for both parties.
Therefore, the donor will not know the identity of the recipient and the recipient will not know the identity of her donor. However, the recipient does have the right to receive certain general information (such as age) from the donor. Of course, this information will not include identity.
This implies that the recipient woman or couple cannot choose the donor. The medical team will be in charge of the donor-recipient assignment, thus preserving the anonymity of the donation. To do so, they will be based on several criteria that we will explain below.
IVF with donor eggs is probably the most confusing of all fertility treatments, and oftentimes, a misleading one. Transparency is one of our strict selection criteria when it comes to recommending fertility clinics to our readers. You can create your Fertility Report now to filter clinics based on our selection criteria and get an individual report based on your preferences with answers to your queries and most importantly, to prevent potential frauds.
Phenotypic and immunological matching
The corresponding medical team should try to ensure the greatest possible phenotypic and immunological similarity of the available samples with the recipient woman.
This means that the medical team must compare the available donor profiles with the recipient to find the best match:
- Immunological: blood group and Rh factor.
- Phenotypic: physical characteristics such as height, build, eye color, hair color, skin color, etc.
In this way, the recipient woman will not be able to make any particular request regarding the donor's physical characteristics. However, she will be assigned the one that has similar characteristics to her own.
Genetic matching
Nowadays, more and more clinics are offering to perform a genetic compatibility test. This test checks whether the donor and the male sperm provider (the recipient's partner or, if applicable, a sperm donor) are "genetically compatible".
This means that it is analyzed if both share any mutation that could result in the birth of a child affected by one of the diseases studied in the test.
Therefore, in the event that the result of this genetic test does not show compatibility, the medical team will look for another donor who is compatible (or another sperm donor compatible with the donor, if applicable).
You can read more in depth about this test in the following link: Testing For Hereditary Diseases: Genetic Compatibility Test (GCT)
Biometric facial matching
Through this type of matching, the aim is to find the donor with the closest facial resemblance to the recipient. Biometrics-based technology is used for this purpose.
These systems measure and compare the distances between certain facial points from photographs. In this way, these programs can determine the degree of donor-recipient resemblance.
This is a novel technology that gives patients peace of mind when faced with the doubt as to whether the donor will really resemble the recipient woman. However, it is important to mention that not all clinics currently have this matching system in place.
Donor-recipient assignment video
Michelle Emblenton, biochemist at inviTRA, summarizes in this video how to choose the most suitable egg donor for the patient:
FAQs from users
Is it necessary to perform genetic matching on an egg donor?
Exactly. The recommendation of the Spanish Fertility Society (SEF) is to perform a genetic analysis on all donors. In this way, the most suitable donors can be chosen for each type of patient.
Read more
How do I know that I have been matched with the most compatible donor?
Donation in Spain is an anonymous and altruistic process. Under this concept, the recipient (in this case of oocytes) will not be able to know anything about the donor except her age and blood group. However, for donor selection and donor assignment, a phenotypic match/similarity is made on the basis of the physical characteristics provided by the recipient and confirmed in consultation with the attending physician.
In the same way, assisted reproduction centers use facial recognition programs that perform a phenotypic matching between the recipient and the assigned donor. This matching is performed in the laboratory by those in charge of the oocyte donation department.
Therefore, the phenotypic matching will be done according to the donor's phenotype, being mandatory that the blood group is the same or compatible with that of the parents. An attempt is made to adapt as much as possible to the height, eye color, hair color and skin color.
Genetic matching (Genetic Compatibility Test - Recessive Disease Carrier Test) is also advised to all couples in order to make a proper matching prior to donor assignment. This is a study performed on all donors as part of the studies prior to the start of treatment.
How much does the genetic compatibility test cost?
The genetic compatibility test may range from $100 up to $2000, depending on each type and complexity of the test and whether more than one test is necessary.
When a test is recommended by your doctor, your health care provider may take over the costs of the GCT.
Is the baby going to look like me in an ovodonation?
Those responsible for choosing the donor in a clinic first consider the blood group compatibility with the recipient. Next, phenotypic characteristics such as race, weight, height, hair and eye color are compared. Therefore, there are usually similarities between the mother and the future child.
In addition, although genetics is important in the development of the baby, education and environment also play a major role in the formation of personality and character.
What does matching with an egg donor mean?
The term matching refers to the matching that the medical team must do in order to assign the most suitable egg donor to the patient who will receive the donated eggs.
This matching process can be phenotypic (physical characteristics such as eye color, hair, etc.), immunological (blood group and Rh factor), genetic (through genetic compatibility testing with the male who will provide the sperm) and even facial (using biometry). However, genetic and facial matching, although increasingly used, are not always performed.
Recommended reading
If you are going to undergo an IVF treatment with donated eggs, we recommend reading this article: Donor-Egg IVF Procedure for Recipients - Protocol & Cost.
Alternatively, if you are interested in knowing more about the psychological controls performed on egg donors, you can access the following link: Psychological Assessment of Egg & Sperm Donors.
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References
Flores H, Lee J, Rodriguez-Purata J, Witkin G, Sandler B, Copperman AB. Beauty, brains or health: trends in ovum recipient preferences. J Womens Health (Larchmt). 2014 Oct;23(10):830-3. (See)
Gil-Arribas E, Herrer R, Serna J. Pros and cons of implementing a carrier genetic test in an infertility practice. Curr Opin Obstet Gynecol. 2016 Jun;28(3):172-7. (See)
Ley 14/2006, de 26 de mayo, sobre técnicas de reproducción humana asistida. Jefatura del Estado «BOE» núm. 126, de 27 de mayo de 2006 Referencia: BOE-A-2006-9292 (See)
Lindheim SR, Sauer MV. Expectations of recipient couples awaiting an anonymous oocyte donor match. J Assist Reprod Genet. 1998 Aug;15(7):444-6. (See)
Maung HH. Ethical problems with ethnic matching in gamete donation. J Med Ethics. 2019 Feb;45(2):112-116. (See)
Payne MR, Skytte AB, Harper JC. The use of expanded carrier screening of gamete donors. Hum Reprod. 2021 May 17;36(6):1702-1710. (See)
Zhang T, Madeira J, Lu Y, Sun Y, Mertes H, Pennings G, Lindheim SR. Expanded Preconception Carrier Screening in Clinical Practice: Review of Technology, Guidelines, Implementation Challenges, and Ethical Quandaries. Clin Obstet Gynecol. 2019 Jun;62(2):217-227. (See)
FAQs from users: 'Is the baby going to look like me when using donated eggs?', 'Is it necessary to perform genetic matching on an egg donor?', 'How are egg donors selected?', 'How is the most suitable donor chosen for the recipient?', 'What is phenotypic and inmunological matching with an egg donor?', 'How is genetic matching with an egg donor performed?', 'What is biometric facial matching with an egg donor?', 'How do I know that I have been matched with the most compatible donor?', 'How much does the genetic compatibility test cost?', 'Is the baby going to look like me in an ovodonation?', 'What is the price of genetic matching with the egg donor?' and 'What does matching with an egg donor mean?'.
Authors and contributors
More information about Michelle Lorraine Embleton
