There are several reasons why couples consider egg donation. Some women are unable to produce eggs. This may be because their ovaries have never developed or due to premature menopause which may be a result of surgery or certain types of drug therapy. Other women have a genetic abnormality which could be passed on to a child if their own eggs are used.
Who is Suitable to Donate Eggs?
An egg donor needs to be a fit, healthy woman of 35 years of age or under, who has had at least one healthy child of her own. There should be no family history of hereditary disease. All donors are screened to check that they are medically fit. They also have blood screening to check for sexually transmitted diseases, Hepatitis B and C and HIV. They also have an appointment to see our counsellors to discuss the ethical,emotional, social and legal implications of their decision.
Approaches to egg donation
1). The donor is anonymous so that neither of you know each other.
2). You have a relative or friend who donates to the programme on your behalf.
3). You have a relative or friend who donates directly to you.
Egg donation is done on a purely voluntary basis. There can beno financial remuneration.
Will I need special medication when I receive the embryos?
You will be given hormone replacement therapy (HRT) in the form of oestrogen patches and progesterone injections. Some recipients will need ovarian suppression with Buserelin before the womb is prepared with the HRT. Some recipients may require an assessment cycle to assess the response of the lining of the womb to medication. This will involve ultrasound scans to check the womb and blood tests to check hormone levels. At the end of this cycle an endometrial biopsy is taken. This is a small sample of the lining of the womb. It will help us to assess your response to the HRT and plan your future treatment.
What further investigations will we require?
Following a medical consultation, you and your partner will berequired to undertake blood screening for Hepatitis B and C, HIV and other sexually transmitted diseases, and your blood group. In addition, the female partner would need a vaginal ultrasound scan of the pelvis at the time of the consultation. The male partner would be required to have an appointment for sperm analysis. In the treatment cycle, the male partner will need to take antibiotics from the time the donor starts her treatment until the day of egg collection. This is to ensure that a suitable spermpreparation is obtained on the day of egg collection.
What happens in the actual treatment cycle?
Over a period of approximately two weeks, the donor undergoes an IVF treatment cycle. She takes daily hormoneinjections to stimulate her ovaries to produce several eggs andattends the IVF unit for regular blood tests and scans to monitor progress. When the eggs are mature, she will come to the unit to undergo a minor operation to collect the eggs. Your partner also needs to attend the unit to produce a fresh sample of sperm, which is then prepared and used to fertilise the eggs collected from the donor.
If you are ready for the embryo transfer, this usually takes place two or three days later.
Sometimes, however, it may be necessary to freeze the embryos for your use at a later date. The embryo transfer is a simple, painless procedure that is similar to having a smear test. It involves an internal examination to insert a fine, soft catheter (along which the embryos will be passed) through the neck of the womb. Usually two embryos are transferred. Since a range of factors need to be taken into account, the final decision about how many embryos to transfer is made with you at the time of transfer.
After embryo transfer, any remaining embryos of good quality can be frozen, (although we first need to obtain consent from the donor for this). Freezing embryos gives an opportunity for a further attempt at treatment, however it must be remembered that some frozen embryos will not survive the procedure offreezing and thawing. An embryologist will discuss this with you further.
Can I be sure my baby will be healthy?
No pregnant woman can be guaranteed a healthy, live baby. Studies that have compared babies born following In Vitro Fertilisation (IVF) show that there is no increase in abnormalities compared to the normal population. However, IVF does not protect you against the risks of having problems during pregnancy or a baby with abnormalities.
Will the baby look like me?
The baby’s genetic makeup will be inherited half from the male and half from the female. Donors and recipients are matched as far as possible, but due to the shortage of donors, we cannot guarantee a close match.
What is the Success Rate?
Pregnancy rates with donated eggs are better than in IVF. This is because in general donors are under the age of 35, healthy and fertile. (See Pregnancy Rates)
Can the treatment cycle be cancelled?
Just as with any IVF cycle, a donor may respond by producing too many eggs or produce too few to continue with treatment. In either of these cases the cycle will have to be cancelled.Whether a further cycle can be attempted depends on the donor. Occasionally the donor cycle may not progress as required and the cycle has to be abandoned. This can be very disappointing for you and very stressful for the donor who may feel that she has let you down.
Human Fertilisation and Embryology
Authority (HFEA)
The Human Fertilisation and Embryology Authority (HFEA) is the organisation that regulates the work carried out in IVF clinics. It maintains a Register of highly confidential information. Each clinic is legally required to collect certain information about donors – including their name, physical characteristics and ethnic origin. Knowledge of the identity of the donor is restricted to the staff at the treatment centre and the HFEA who maintain the Register. Donors are encouraged to provide additional non-identifying information about themselves and recipients can request to see this information. The IVF unit is not allowed to reveal identifying information about a donor who has asked to be anonymous (unless there are exceptionalcircumstances - see Disclosures below). Any child born as a result of egg donation will be genetically related to the donor’s own child(ren). In genetic terms they will be half brothers and sisters. From 2008 people aged 16 (if contemplating marriage) will be able to ask if they were conceived as a result of sperm, egg or embryo donation and, if so, whether they are related to the person they want to marry. From 2010 the right to this information will apply to 18 year olds. However, the law does not allow them to know the names or other identifying details about the donor.
Will anonymous donors remain anonymous?
The government is currently considering what general information people will be given if they apply to the Register and whether the law should be changed to make it possible for future donors to be identified. No decision has yet been made but the government has confirmed that all past donors will remain anonymous.
Disclosure of Donor Identity
Donors have to disclose their own and their family medical history in detail to the IVF unit. If a donor withheld information from the unit about an inheritable condition and a child were to be born with this abnormality, that child may be able to seek compensation for damages under the Congenital Disabilities (Civil Liabilities) Act 1973. In these circumstances information potentially identifying the donor could be disclosed.
Who are the legal parents?
Any woman who gives birth to a baby is the legal mother. Her partner or husband is the legal father if he has provided the sperm. The child’s birth certificate would state that the recipients were the legal parents. However, being a legal parent does not necessarily give the man full parental responsibility unless he is married to the child’s mother. Couples who are not married and have a child by egg donation, may wish to seek legal advice about obtaining parental responsibility for the child. The donor has no legal responsibilities or rights in relation to any child that is born.
What should I tell my child?
There are no regulations set down about telling children about the use of donated eggs for their conception. You are encouraged to think carefully about this decision. There are important issues to consider whether you decide to tell them or not. You may wish to discuss this in more detail during your session with the counsellor. We ask all donors to complete a detailed personal questionnaire that provides information about themselves and their family without identifying them. This information is collected so that you can use it in the future if you want to talk to your child about his/her origins.
Counselling
There are many issues to consider before making a final decision about using egg donation in your treatment. It is essential that you are fully informed and have had sufficient opportunity to explore the implications for you and your partner if you are to plan a family in this way. For this reason, we arrange for you to see one of our counsellors who will talk through the ethical, emotional, legal and practical details of egg donation. You may find that egg donation is not the right decision for you. Should you wish to discuss other alternatives, such as adoption, this can be done with your counsellor.
What next ?
We have set out this basic information for you about egg donation and we hope it will help you to decide whether youwant to proceed.
If you have any questions please call Sister Turner on 020 8383 8168.
