Egg donation-guidelines
Recipient Information & FAQ
Women who are unable to produce eggs of their own, carry a genetic disorder or have poor egg quality are encouraged to explore the option of the egg (oocyte) donation program. To be considered as a recipient for donor eggs, you must have a normal uterus and be a suitable candidate in respect to the law regarding assisted reproduction practices.
Patients of advanced reproductive age are the most common recipients of donor eggs and are able to overcome the age barrier with the use of a donated eggs. Patients undergoing in vitro fertilization with a donated egg often have high success rates because the egg being used is from a young, healthy donor.
There are two categories of egg donors - anonymous and known. Anonymous donors are not permitted to meet the recipient, and do not learn whether or not a pregnancy occurred from the IVF cycle. Known donors are often related to the recipient, most often a sister, or are a compassionate friend of the couple.
In known donor situations, it is suggested that all parties involved sign a legal contract outlining details of the egg donation.
Screening for Recipients
During your initial consultation all aspects of the egg donation program will be discussed with you and your husband to determine whether or not you are a candidate for donor eggs.
The decision to conceive a child through the use of a donated egg can be very difficult for a couple. Therefore, the doctor may refer you to a psychologist for counselling and emotional support.
It is important to discuss issues related to non-biologic parenting, past fertility problems, parenting at an older age and positive and negative aspects of disclosure to potential offspring.
Both you and your husband must have blood tests done to screen for diseases and conditions that can affect your pregnancy such as Human Immunodeficiency Virus, hepatitis C, blood type RH and rubella immunity.
Your husband must also provide a semen sample prior to the transfer cycle.
The Greek law states
(Legistlation 3089,Article 1460):
The identity of the third party who has offered their gametes (oocytes or sperm) or pre-embryo shall not be known to the party who wish to become parents. Medical information ascertaining to the donor is classified without proof of his/her identity. Access to these files are only allowed to the child for reasons of his /her health.
The third party donor of gametes or pre-embryo will not know the identity of the child and the parents.
The Procedure
On the day of the donor's egg retrieval, your husband will provide a semen sample that will be prepared in the laboratory.
The sperm will then be placed in a dish with the donated eggs and incubated. The following day you will receive information regarding the success of the procedure. If fertilization has occurred, an embryo transfer will be scheduled one or two days later and the fertilized eggs will be transferred into your uterus.
Approximately two weeks later you will return to the IVF unit for a pregnancy test. Upon a positive pregnancy test result, we will adjust medications for the best chance of sustaining the early pregnancy.
Questions arising from oocyte donation
Oocyte donation is however an increasing part of assisted reproduction, particularly with couples who choose to start a family later in life or for couples that did not have the opportunity to achieve a pregnancy earlier.
Firstly there are differences in oocyte and sperm donation- oocyte donation is a complicated matter and is not so similar to sperm donor.
It is, of course, easier for a man to donate sperm; the female donor must undergo a full procedure of ovarian stimulation and egg collection that needs significant time and effect.
The opinion of egg donation is also different: in a recent survey in USA couples needing donor eggs were more willing to agree to the sister of the recipient to donate her eggs (86% women and 66% of their partners), than with a similar population of couples who needed a sperm donor who were willing to use the brother's sperm (9% women and 14% men). This was argued this was due to the different perceptions of feminine and masculine sterility.
Also the inability to store frozen eggs with great success means that the eggs cannot be quarantine for screening of infectious diseases as is standard practice in sperm donation.
It also complicates anonymous egg donor programs since female donor and recipients must follow the treatment in parallel and timing of the egg collection must be precise.
The need for donors gives rise to ethical questions and psychological pressure on relatives to resolve the problem (reduce the shortage).
Ethics
With ethics there are no rights and wrongs, no black and white, only opinions.
These opinions may vary form country-to-country and culture-to-culture.
Advanced maternal age and pregnancy is controversial
Is it wrong for a more mature woman to have a baby if the child will be "orphaned " at a very young age?
However a women over 40 may have more time to spend with her child, more secure job and economically more stable than a younger women.
Who is to deny anyone the wish of having a baby?
Source of donor eggs
KNOWN DONOR: is it better from a known person such as a female relative to donate eggs?
She is more likely to donate, and more likely to have physical similarities to the recipient.
However she may be put under undesirable pressure to donate and may see the child on a regular basis that could create psychological distress.
UNKNOWN DONOR gives their egg altruistically (or for payment) but are very scarce.
But have no connection with the couple and child and therefore lesser of a psychological problem.
In all, there are 4 types of donors (EXISTING ACCORDING TO POLICY OF CENTER AND LAW THAT GOVERNS IVF)
Occasional donors who are willing to donate for altruistic reasons, patients undergoing IVF treatment and agreeing to share oocytes, related oocyte donors, professional donors.
Egg sharing
Has become quite popular in the UK where a change in policy of the HFEA allows one party to pay or partly pay for the treatment of a couple in exchange for eggs.
The change in policy in 1999 was due to the limited number of oocyte donors, limited public funded IVF units and to avoid potential heath risks to non-patient donors.
(It has been argued that a women already willing to undergo IVF for her own treatment of fertility is not exposed to any additional hormones and additional risks that a purely egg donor may face).
A woman considering egg sharing must think very hard of the implications-and weigh up the advantage of a subsidized IVF treatment with the possibility of not becoming pregnant but the recipient receiving the donated eggs becoming pregnant!
