Ovum donation

What is egg donation?

Egg donation involves one woman donating her eggs to another couple or individual in the hope of helping them achieve a pregnancy that otherwise wouldn’t be possible. Egg donation is one aspect of what the American Society for Reproductive Medicine (ASRM) refers to as third-party reproduction, in which a third-party (a woman) donates her eggs to use in assisted reproductive technologies.

The process begins by recipients identifying a suitable egg donor who goes through a rigorous screening process. Through IVF procedures, the eggs are retrieved from the donor and fertilized using the male partner’s (or donor’s) sperm. The resulting embryo is then transferred to the womb of the recipient mother for possible pregnancy.

The first pregnancy through egg donation occurred in 1984, and the practice has expanded significantly since then as fertility specialists have improved IVF and the egg freezing and storage process, called cryopreservation. The practice of egg donation has also gained in social acceptance and has increasingly become an option for overcoming several female infertility factors.

According to ASRM, average pregnancy success rates using donated eggs are 55-60 percent in the United States. Many factors determine success, but the age of the recipient does not appear to be one of them, although using donor eggs from a young woman (less than 31 years of age) is critical to the success of the procedure.

Candidates for using egg donation

Good candidates for egg donation are women experiencing infertility most often due to diminished ovarian reserve, which means that the eggs are of poor quality. Couples may also have medical or genetic issues that make a healthy pregnancy with their own eggs unlikely. LGBT individuals and couples who need healthy eggs to build a family are also good candidates to receive donated eggs.

Fertility specialists carefully evaluate women and couples receiving donor eggs, as they would anyone considering IVF. This evaluation may include:

• Complete medical history of both partners.
• Physical exam of the woman.
• Assessment of the woman’s ovarian reserve.
• Blood tests to screen for medical conditions and infectious disease.
• Evaluation of the uterine cavity via:

Sonohysterogram, an ultrasound using a saline solution.
Hysterosalpingogram, an X-ray imaging of the uterus and fallopian tubes.
Hysteroscopy, video imaging of the uterus done through the vagina.

 Male semen analysis.
Women older than 45 years of age should also be evaluated for additional medical issues, often including mammography and cardiac stress test.

Fertility clinics often have established guidelines for the maximum age of a woman seeking fertility treatment using her own eggs, and will often recommend a woman use donor eggs after a certain age to maximize the chances of a healthy pregnancy. Clinics often also have established guidelines on a maximum age to undergo fertility treatment, even with donor eggs.

Egg donation process

Egg donation requires the donor and the recipient to undergo certain aspects of the IVF process. Egg donation can be done as a fresh IVF cycle. This involves careful timing to coordinate egg retrieval from the donor, lab fertilization to create an embryo, and transfer of the donated egg to the recipient’s womb, making sure that the endometrium is in the proper time of the cycle to be receptive to the embryo.

Using frozen donor eggs in what is known as a frozen IVF cycle allows for fewer timing restrictions on the part of the donor and the recipient. A study published in the Journal of the American Medical Association shows that the pregnancy success rate using fresh eggs is slightly higher than in egg donations involving frozen eggs. However, other donor or patient factors may make frozen egg donation in a subsequent IVF cycle more likely to succeed.

The steps for both fresh and frozen egg donation IVF cycles are similar.

• Ovulation induction using medications stimulates the egg donor to produce more than the normal one egg per menstruation.
• Egg development is monitored using ultrasound and hormone level evaluation.
• A fertility specialist collects the eggs at the proper time by means of transvaginal ultrasound aspiration, which involves a needle placed through the vaginal wall into the ovary to retrieve each egg.
• The eggs are fertilized in the lab using the male sperm to create embryos.
• The recipient mother takes progesterone to prepare her uterine lining to receive the embryo(s), which are implanted in the recipient’s uterus about three to five days after initial egg fertilization.