Egg and sperm donation allows many couples with fertility problems to achieve the desired pregnancy through assisted reproduction techniques such as artificial insemination (AI) or in vitro fertilization (IVF).
Although the idea is to be able to perform these processes with one's own gametes (eggs and sperm), there are infertility situations that prevent this. Therefore, in these cases, resorting to gamete donation can be the definitive solution to fulfill the dream of achieving pregnancy.
Provided bellow is an index with the 11 points we are going to expand on in this article.
What is third-party reproduction?
Third-party reproduction, also referred to as donor-assisted reproduction, is defined as an alternative human reproduction technique in which DNA or pregnancy is provided by a third party, that is, a person other than the prospective parents, who will raise the resulting baby.
The ASRM (American Society for Reproductive Medicine) defines it as follows:
Arrangements in which intended parents collaborate with gamete donors and/or GCs (gestational carriers) is referred to as «third-party reproduction».
There are 4 different types of third-party reproduction arrangements, which at the same time allow combinations between them:
- Egg donation
- An egg donor provides eggs. It is indicated for women with a poor ovarian reserve or low egg quality.
- Sperm donation
- A sperm donor provides spermatozoa. It is an option for women without a male partner, as well as heterosexual couples in which the male has low or zero sperm count (azoospermia).
- Embryo donation/adoption
- A couple donates their unused embryos, either created with their gametes or by egg and/or sperm donation, for the use of a third party.
- An embryo created with the gametes of the intended parents or egg and/or sperm donors is transferred to another woman, who will carry the pregnancy and deliver the baby. It allows all family types to start a family, especially gay males, single men, and straight couples where the woman is unable to carry a pregnancy.
In the words of the ASRM, assisted reproductive technology (ART) third parties can be divided into three categories: physicians and collaborators participating in the medical process, gamete donors and/or GCs who help in another's reproduction, and agents and attorneys who formalize and monitor formal legal relationships between the parties.
The laws regarding third-party arrangements vary greatly from country to country. In this sense, we distinguish three different groups of countries according to how permissive the policies governing third-party reproduction are there:
- Non-permissive countries
- Surrogacy and donor conception are not permitted by law or, if allowed, with a great number of restrictions. Italy, France, Germany, Norway, Sweden and some Latin American countries are some examples.
- Semi-permissive countries
- We use this terminology to refer to those countries where the law permits some third-party reproductive procedures such as gamete and embryo donation but bans surrogacy, as in the case of Spain.
- Permissive countries
- Where the prevailing law allows all kinds of third-party conception arrangements. It is the case of the United States, Canada, Ukraine, Russia, the UK, etc.
The most common reasons behind the prohibition of these treatments or some of them include religious beliefs, ethical considerations, or historical background, among others.
Donor-assisted reproduction means giving up on your own genetic material, either totally, in case you use both donor eggs and sperm or embryo donation, or partially, if one of the two gametes has been delivered by one of the commissioning parents.
The fact that the children do not share the genetic material of both parents is seen as a challenge for the society in general. In fact, many couples need psychological support before, during, and/or even after treatment to cope with the fact that they need to use donor gametes.
Groups such as the Indian Society for Third Party Assisted Reproduction (INSTAR) work to promote ethical third-party arrangements. One of the aims to be pursued by the INSTAR is «to spread public awareness that surrogacy is a boon to mankind».
For that matter, it is important to expand the concepts of motherhood and fatherhood. Everyone having or about to have a child via donor-assisted reproduction should understand that, given their situation, maternity and paternity refer to the desire of bringing up, educating, and being responsible for a child, and are not dependent on any genetic links.
Who can use it to start a family?
Fertility problems may be caused either by female or male alterations. Likewise, sometimes both members of the couple have their fertilizing capacity affected due to anatomical or genetic problems or because their gamete production system does not work properly.
In those cases where infertility is caused by the absence or poor quality of the gametes, donor conception can be the only chance for intended parents to have a child. A couple may turn to reproductive medicine due to a wide range of fertility problems.
The following, however, are the most common causes of infertility in humans:
- Genetic alteration that you do not want to pass on to your offspring
- Poor egg and/or sperm quality
- Advanced maternal age
- Low ovarian reserve
- Repeated IVF failures with own gametes
- Recurrent miscarriages
Infertility is not the unique reason why many patients use donor eggs and sperm, and/or donated embryos: new family types resulting from today’s society are also possible thanks to ART in combination with gamete donation and/or surrogacy.
In this sense, single females or lesbian couples are now able to have a child thanks to donor insemination or donor-sperm in vitro fertilization (IVF). Also, single men and male homosexual couples need not only an egg donor to become parents, but also a gestational carrier that bears the pregnancy and delivers the baby.
When infertility shows up due to poor gamete quality or even when the woman is unable to produce eggs, either due to natural or acquired reasons, egg and/or sperm donation are generally the best reproductive solutions to achieve pregnancy.
According to what is causing infertility, any of the following combinations will be indicated:
- Donor eggs with own sperm
- Own eggs with donor sperm
- Both egg and sperm being from third parties
- Embryo donation and adoption
In the first three cases, it should be clear that it consists of a gamete donation for the purpose of later creating the embryos. Conversely, in the case of embryo donation, the recipients use the excess embryos from another couple's previous IVF cycle to become parents. Embryo donation is the process by which another couple decides to donate the unused embryos from their own IVF cycle.
Egg donation is a process by which a woman donates her eggs so that they can be used by another woman or couple in an in vitro fertilization (IVF) cycle. IVF with egg donation has the advantage of offering high success rates, since the donors are usually young, healthy women. However, the patient must reject her contribution of genetic material, which is often difficult to assimilate on many occasions.
On the other hand, the recipient, that is, the woman who seeks pregnancy by ovodonation only has to undergo a hormonal treatment of endometrial preparation. Thanks to this treatment, the endometrium (uterine layer) are given the appearance and thickness required to favor the implantation of the embryos transferred to her uterus.
If you wish to continue reading more in-depth information about this reproductive technique, you can visit this article: What is ovodonation, and what is the price of the treatment?
When egg donation is used, the reproductive technique applied is necessarily IVF. However, donor sperm can be used in both artificial insemination (AI) and IVF, depending on the needs of each patient.
Sperm donation is a much simpler process than egg donation. Simply, the donor must deposit the ejaculate in a sterile jar. The sample is obtained by masturbation after a period of abstinence of about 3 to 5 days.
No hormonal treatment or surgery is required, although it is essential to have excellent seminal quality and that the sperm is able to survive freezing since all semen samples are frozen for a minimum of 6 months.
Sperm donation has allowed the emergence of new family models. Thanks to assisted reproduction with donor sperm, many women have been able to fulfill their desire to become single mothers. Also, lesbian couples can have children through this process.
If you want to know more details about sperm donation, I recommend you to read this article: sperm donation.
About 30% of all infertility cases are caused by female infertility, and another 30% by malefactors. The remaining percentage corresponds to couples where both members have developed a fertility issue. Cases of unexplained infertility are also included in the latter group.
When the gamete production system is damaged both in the male and the female, using both donor eggs and donor sperm (double-donor IVF), or receiving donated embryos, is usually the solution.
These treatments are indicated in those cases where neither the eggs nor the sperm from the members of the couple is viable to produce healthy embryos. However, the difference between these two methods should be clear:
- Embryo donation
- In this case, there are two couples involved, being the former couple who donate their leftover embryos after an IVF cycle to the latter couple.
- Double-donor IVF
- The embryos are produced from anonymous egg and sperm donors in order to be transferred later to the woman’s womb so that she can get pregnant.
Surrogacy, also known as surrogate motherhood, is a fertility treatment in which a woman other than the intended mother carries the pregnancy to term and delivers the baby for the intended parents. This technique is the one involving a greater degree of complexity from the ethical and technical points of view.
There are two types of surrogacy:
- Partial, straight, or traditional surrogacy
- The surrogate contributes the eggs, and therefore is the genetic mother of the resulting child. It is done via intrauterine insemination (IUI), using the sperm of the intended father or from a donor.
- Full, host, or gestational surrogacy
- The surrogate, in this case named gestational carrier, just carries the pregnancy, which means her oocytes are not used, and therefore she is not the biological mother of the child. The eggs are contributed by the intended mother or an egg donor.
It should be noted that traditional surrogacy arrangements are falling into disuse nowadays, given the level of involvement required to the surrogate. Gestational surrogacy arrangements are more common today, preferably using the intended mother's eggs or, if not possible, donated eggs.
Fertility treatment options
Depending on the fertility problem, some infertility treatments may be more adequate than others. Carrying a pregnancy to term and subsequently delivering a healthy baby is the sole purpose of everyone getting involved in third-party reproduction agreements.
Every time we talk about egg donation, the technique used is in vitro fertilization (IVF), since it is necessary for fertilization to occur in the laboratory. Once fertilized, the embryos will be transferred to the uterus of the intended mother.
Different alternatives can be found if donor sperm is used, though. In this case, we can choose between artificial insemination or IVF according to the woman’s age and depending on whether she is infertile too or not.
Nonetheless, with embryo donation, the embryo has to be transferred to the uterus, which means that the embryos have been previously obtained through IVF and then stored by means of embryo cryopreservation.
When a woman or couple decides to start a fertility treatment using donated embryos, a frozen embryo transfer (FET) is necessary. In such cases, it is unnecessary for recipients to undergo ovarian stimulation. Instead, the only thing left to do is prepare the endometrial lining, so that the embryos are able to implant.
Cost of third-party reproduction
The cost of turning to third-party reproduction to create a family depends on the treatment of choice as well as on the country and even the clinic where it is performed. However, to get a general overview, we have created a list of treatments in the order of most expensive to least expensive:
- Surrogacy: Given the complexity of the procedure, its overall cost ranges from $35,000 to 150,000. The most expensive country is the USA, although it varies widely depending on the particular needs of the intended parents.
- Egg donation: On average, the price of IVF using donor eggs can be as high as $7,500 in countries such as Spain, or as low as $4,500 in other destinations such as Cyprus, the Czech Republic, or Ukraine. On the other hand, the USA is again the most expensive country: $20,000-40,000 approximately.
- Sperm donation: It depends on the treatment used. While IVF with donor sperm can cost $3,400-4,500, a cycle of donor insemination can be twice as cheap. Should donor eggs be necessary as well (i.e. double-donor IVF), the price will amount to $5,000-8,000.
- Embryo adoption: It is the most cost affordable of all third-party reproduction arrangements, with a cost that usually ranges from $1,500 to $3,500.
If you need to undergo IVF to become a mother, we recommend that you generate your Fertility Report now. In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.
Regulations governing egg and sperm donation as well as embryo donation are not equal worldwide. For this reason, we can find great disparity in the following aspects of the donation process:
- Anonymity of sperm and egg donors
- Donor compensation
- Permitted fertility treatments
- Who can become a recipient of donor eggs and sperm
Due to the wide range of differences that can be found from country to country in this field, we have witnessed the birth of fertility tourism, also known as reproductive tourism. This concept is defined as the process of traveling abroad to undergo fertility treatment.
Singles and couples who opt for this option are usually forced to do so because of the restrictions they find in their own country, or because the process or part of it does not accommodate their needs.
You can learn more about this phenomenon by visiting the following post: IVF abroad.
FAQs from users
Is it better to use double-donor IVF or to adopt embryos?
“Double-donor” IVF involves creating embryos from an egg donor and a sperm donor. Pregnancy success rates are typically based on the age of the woman’s eggs. So, egg donation cycles can often result in a much greater 50% live birth rate provided all other fertility factors are optimal.
Embryo adoption cycles offer the transfer of fertilized eggs, usually from couples who have donated their embryos. In contrast to egg donation cycles, embryo adoption cycles may be less successful because the age of the eggs (and sperm) are not always ideal to maximize outcomes.
In some patients, egg donation is the only possibility to achieve pregnancy. Do you think there is currently a shortage of egg donors?
There has been much discussion in the media lately about the possible increase in gamete donations, both eggs and sperm, due to the economic crisis. However, the reality is that we still have waiting lists of patients to enter our egg donation program.
It should be noted that only 20% of the women who consult for egg donation actually end up donating.
Sperm donation is much simpler and there are sperm banks with more than enough samples to meet the demand. We must also bear in mind that the need for donor sperm has been reduced by 80% since the introduction of ICSI or sperm microinjection, which is a technique that allows an egg to be fertilized with a single sperm, so that even men with severe seminal alterations can be fertilized with their own sperm.
At present, the main indication of donor sperm is for the treatment of women without a male partner.
How much do they pay to donate sperm?
The economic compensation given to donors for semen donation is between 100$ and $150 for each sample deposited. It is usual for each donor to deposit between 15 and 20 samples, although it will depend on each case.
What are the consequences of egg donation on children, does it affect their emotional development?
Numerous studies indicate that the fact of having been born thanks to egg donation has no negative consequences on the intellectual or emotional development of the child. If the parents treat the treatment naturally and do not educate their child differently simply because he or she does not have the same genetic load as they do, the child does not have to grow or develop differently.
Should I explain to my child that I needed to donate?
It is a very personal choice, it depends on how you are going to feel. Experts in psychology recommend that the subject should be explained and treated as a matter of course. In society, we are increasingly aware that being a mother or father has nothing to do with providing an egg or a sperm.
How much does egg donation cost?
An IVF process with ovodonation has an approximate price between $15,500 and €40,000. The final cost of the treatment will depend on the clinic where it will be performed, the number of attempts, the dose of medication, complementary tests, etc.
What is the number of ovodonation attempts that must be made to achieve success?
There is no fixed number of attempts. It will depend on the situation of each person or couple. There are those who achieve pregnancy in the first IVF attempt with donor eggs, and want to need two, three or four treatments until they can obtain a positive pregnancy test result. There are also patients who, even with donor eggs, are unable to have children because their problem is uterine and not ovarian.
In any case, egg donation generally increases the pregnancy rate, since the eggs come from young, healthy women, i.e., they are good quality eggs.
What are the ICMR guidelines on third-party reproduction?
The Indian Council of Medical Research (ICMR), on Chapter 3 of their Code of Practice, entitled Ethical Considerations and Legal Issues, establishes the following basic guidelines in relation to third-party reproduction arrangements:
A third party donor of sperm or oocytes must be informed that the offspring will not know his/her identity [...]
A third-party donor and a surrogate mother must relinquish in writing all parental rights concerning the offspring and vice versa [...]
What tests are performed on gamete donors?
To be an egg or sperm donor it is necessary to have a very good oocyte or sperm quality. Karyotype tests, most frequent genetic diseases and sexually transmitted diseases are also performed to guarantee the quality of the gametes.
Finally, an in-depth psychological interview is included to rule out any psychological alteration. Once all these tests have been passed, the candidates will be accepted as egg or sperm donors.
One possible fertility treatment with the donation is IVF with double donation. If you are interested and want to continue reading about this topic, we recommend you to visit the following article: IVF with egg and sperm donation: treatment steps and price.
Also, if you would like to know more information about the price of reproductive treatments, do not forget to visit this link: What is the price of assisted reproduction treatments?
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FAQs from users: 'Is it better to use double-donor IVF or to adopt embryos?', 'What does the HFEA say about third party agreements?', 'In some patients, egg donation is the only possibility to achieve pregnancy. Do you think there is currently a shortage of egg donors?', 'Telling a child about donor conception, in favor or against?', 'How much do they pay to donate sperm?', 'What are the consequences of egg donation on children, does it affect their emotional development?', 'Should I explain to my child that I needed to donate?', 'How many parents can a child conceived via third-party reproduction have?', 'How much does egg donation cost?', 'Is donor conception wrong?', 'What is the number of ovodonation attempts that must be made to achieve success?', 'What are the ICMR guidelines on third-party reproduction?' and 'What tests are performed on gamete donors?'.
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