Egg donation

Egg donation is the process by which a woman provides several eggs (ova, oocytes) for another person or couple who want to have a child. Egg donation involves the process of in vitro fertilization as the eggs are fertilized in the laboratory. After the eggs have been obtained, the role of the egg donor is complete. Egg donation is part of the process of third party reproduction.

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Indication

The need for egg donation may arise for a number of reasons. Infertile couples may resort to acquiring eggs through egg donation when the female partner cannot have biological children because she may not have eggs that can be successfully fertilized. This situation is often based on advanced reproductive age. Another indication would be a genetic disorder on part of the woman that can be circumvented by using eggs from another person. The couple can personally get acquainted with the egg donor, her children and family members. At the couple’s will the couple’s passport data will remain confidential from the egg donor. Egg donation is also required for gay couples using surrogacy (see LGBT parenting).

• Congenital absence of eggs
  • Turner syndrome ^[1]
  • Gonadal dysgenesis/agenesis ^[1]

• Acquired reduced egg quantity / quality
  • Oophorectomy^[1]
  • Premature menopause^[1]
  • Chemotherapy ^[1]
  • Radiation therapy^[1]
  • Autoimmunity^[1]
  • Advanced maternal age ^[1]
  • Compromised ovarian reserve ^[1]

• Other
  • Diseases of X-Sex linkage^[1]
  • Repetitive fertilization or pregnancy failure ^[1]
  • Ovaries inaccessible for egg retrieval ^[1]

Procedure

Egg donors are recruited, screened, and give consent prior to participation in the IVF process. Some patients bring their own, designated donors, while other patients rely on the services of often anonymous donors typically recruited by egg donor agencies or, sometimes, IVF programs. Once the egg donor is recruited, she undergoes the IVF stimulation therapy, followed by the egg retrieval procedure. After retrieval, the ova are handed over to the recipient couple, fertilized by the sperm of the male partner in the laboratory, and after several days, the resulting embryo(s) is placed in the uterus of the recipient. For the embryo transfer the lining of the recipient has been appropriately prepared in a synchronous fashion. The recipient is usually the person who requested the service and then will carry and deliver the pregnancy and keep the baby.

Results

Results in treatments with the use of egg from donors often have a better than 50% chance of success. With egg donation, women who are past their reproductive years or menopause can become pregnant. The oldest woman thus to give birth is Adriana Iliescu, age 66. Babies born after egg donation are not genetically related to the recipient.

Donor motivation

An egg donor may be motivated by a number of reasons to provide eggs. Some egg donors may be altruistic and feel that participation in the reproductive process provides a benefit for another person, sometimes a person they know or are related to. Others may be attracted to the monetary compensation.

Risks

Egg donor

Egg donation carries risks for both donor and recipient. The egg donor may suffer complications from IVF, such as bleeding from the oocyte recovery procedure (ovarian hyperstimulation syndrome) and, rarely, liver failure^{[citation needed]}. The long-term impact of egg donation on donors has not been well studied

Recipient

The recipient has the risk of contracting a transmittable disease. While the donor may test negative for HIV, such testing does not exclude the possibility that the donor has contracted HIV very recently, so the recipient faces a residual risk of exposure.

The recipient also trusts that the genetic and medical history of the donor is accurate. This factor of trust should not be underestimated in importance. Donors are paid thousands of dollars; monetary compensation may attract unscrupulous individuals inclined to conceal their true motivations. Moreover, recipients will have a de facto relationship to the biological parent of their offspring for life. Half of the child's genetic makeup, and related traits, capabilities, tendencies, etc. will come from the donor.

Multiple birth is a common complication if the physician transfers too many embryos. Incidence of twin births is very high.

Custody

Generally legal documents are signed to hand oocytes over to the recipient and renounce rights of ownership and custody on part of the donor, so that there will be no claims on part of the donor concerning the offspring.

Legality

Egg donation is regulated and /or prohibited in many countries. In the United States, having an attorney draft your contract is often necessary to establish and confirm your parental rights over any child.

Donor registries

Main article: Donor sibling registry

A donor sibling registry is a registry to facilitate donor conceived people, sperm donors and egg donors to establish contact with genetic kindreds. They are mostly used by donor conceived people to find genetic half-siblings from the same egg- or sperm donor.

Some donors are non-anonymous, but most are anonymous, i.e. the donor conceived person doesn't know the true identity of the donor. Still, he/she may get the donor number from the fertility clinic. If that donor had donated before, then other donor conceived people with the same donor number are thus genetic half-siblings. In short, donor sibling registries matches people who type in the same donor number.

Alternatively, if the donor number isn't available, then known donor characteristics, e.g. hair, eye and skin color may be used in matching siblings.

Donors may also register, and therefore, donor sibling registries may also match donors with their genetic children.

References

ASRM Practice Committee Reports, Fertility Sterility 82, Suppl. 1, Sept. 2004.

See also

• Sperm donation
• Donor conceived people