In vitro fertilisation (IVF) using donor eggs (ie, oocytes) from a known or unknown altruistic donor is becoming more accepted by couples and less of an ethical issue for society and the media. The desire that most couples have to have a child seems to be the springboard for overcoming the barriers, if any, of embarking on assisted conception treatment using donor eggs. Realistically, it is often the only option for infertile couples whose female partner has been diagnosed with poor or absent ovarian function as result of premature ovarian failure (also known as early menopuase), chronological age, surgery, chemotherapy, radiotherapy or smoking. Egg donation is also the avenue recommended to couples who have had repeated IVF failures with suboptimal ovarian response (less than 4 egg collected), low fertilisation rate and poor quality embryos in the context of normal sperm parameters and sperm DNA fragmentation test.
What is egg donation?
Egg donation entails the fertilisation in-vitro in the laboratory of eggs donated from a healthy third party with sperm from the male partner or a donor. The first egg donation cycle as a result of which a healthy child was born was carried out in Australia in 1983. Since then, egg donation programmes have become available in some fertility centres and in some countries. According to national statistics, approximately 9,500 in vitro fertilisation cycles using donor eggs were registered in the US in 2009, accounting for 9 per cent of all the cycles performed. According to data from the CDC (Centers for Disease Control and Prevention), over 47,000 children were born in the United States thanks to egg donation. In 2006 a total of 11,892 in vitro fertilisation cycles using donor eggs were performed in 17 Member States of the European Union, as a result of which 4,862 children were born. Although the number of donors increases year on year, however in the UK it is not yet close enough to the number needed to satisfy the demand.
Donor eggs become available through egg sharing (eggs provided by young women who undergo IVF because of tubal damage or male factor infertility, who agree to donate half of their harvested eggs in return for subsidised treatment) or true egg donation (eggs provided by young women, known or unknown to the recipient, who decide voluntarily and altruistically to undergo ovarian stimulation with hormones to donate all their harvested eggs to help somebody else have a family).
What does the egg donation process entail?
Following meticulous screening, dedicated implications counselling and accurate matching of the donor with the recipient, egg donation treatment follows the same standard process as in most cycles of in vitro fertilisation when the ovaries are stimulated with hormones to induce the growth and maturation of follicles within which the eggs are contained. When the follicles have reached an appropriate stage of development, the eggs are collected under ultrasound guidance in the safe environment of an operating procedure room. The eggs are then used for fertilisation in-vitro using either conventional IVF or intracytoplasmic sperm injection (ICSI). Mature eggs can also be frozen for future use.
At the Reproductive Health Group we offer a wide range of egg donation options to meet the demand and wishes of our patients. Although we have well established links with egg donation clinics overseas – Spain and Cyprus – we are amongst the very few UK-based licensed clinics to have donor eggs from altruistic anonymous donors with virtually no waiting times. The entire process is carried out under the supervision of our experienced fertility specialist team and coordinated by a dedicated nursing team.
In order to guarantee the maximum safety for the mother and protect the short- and long-term health of the child, each potential egg donor undergoes various examinations and tests. Only completely healthy women who meet the criteria below are eligible to donate their eggs:
- no genetic disorders
- no underlying medical problems
- no mental illnesses
- no transmissible diseases
- 35 years of age or younger
- satisfactory ovarian reserve (as confirmed by both AMH and antral follicle count)
By Luciano Nardo (Consultant Gynaecologist & Reproductive Surgeon at Reproductive Health Group)