Egg donation is a process in which a fertile woman donates an egg, or oocyte, to another woman to help her conceive. It is a part of assisted reproductive technology, or ART. The procedure typically involves a doctor removing an egg or eggs from the donor, fertilizing them in a laboratory, and then transferring the resulting embryos into the recipient’s uterus. Doctors do this using an implantation procedure, such as in vitro fertilization (IVF). Sometimes, specialists at the facility may freeze some or all of the embryos for later use or implantation in different women. Egg donation frequently benefits women who cannot use their own eggs for various reasons, including ovarian failure, avoiding congenital anomalies in the fetus, or advanced age. One 2014 entry in the journal Fertility and Sterility suggested that 93 percent of all fertility centers in the United States offer egg donation. The same study indicates that the procedure results in a successful birth 49.4–50 percent of the time. In this article, we look at the criteria for selecting donors, the procedure itself, and legal ramifications following an egg donation. What to expect Specialists at the fertility facility will conduct an intensive selection process to find a suitable donor and will carefully run through the legal procedures. Before starting the procedure, most donors will need to take medication that stops their normal menstrual cycle. Side effects of this medication might include: hot flashes headache fatigue body aches The donor will then take a series of fertility drugs that stimulate the ovaries to produce several eggs at once. This is known as hyperstimulation. Donors will need to self-administer this medication by injecting it under their skin or into a muscle. Some women may experience mild side effects, such as bruising at the injection site, mood swings, and tender breasts. In rare cases, a woman may develop severe ovarian hyperstimulation syndrome (OHSS). This occurs when too many eggs develop in the ovaries. Women who develop OHSS may require hospitalization. Donors do have a risk of pregnancy before the eggs are retrieved, so it is a good idea to avoid intercourse or use a barrier contraceptive, such as a condom. Throughout the donation cycle, a donor will undergo frequent blood tests and ultrasound examinations to monitor their reactions to the medications. During extraction Shortly before the retrieval of the eggs, the donor will receive a final injection in preparation for the procedure. The doctor will perform a transvaginal ovarian aspiration to remove the eggs from the donor’s ovaries. They will insert an ultrasound probe into the vagina and use a needle to remove the egg from each follicle. During the procedure, which lasts around 30 minutes, the doctor might give the donor painkillers, sedatives, or an anesthetic. As this is a minor procedure, a donor will not need to stay at the clinic or hospital overnight. After donation Some women find they need several days of rest to recover from the transvaginal ovarian aspiration. Others return to normal activities the next day. Some programs provide aftercare to donors, but others do not. As the egg donation process can have a psychological impact, some women may find it useful to work with a counselor or psychotherapist after the procedure. Risks and side effects The risks of egg donation are relatively low. The procedures and medications for egg donors are the same as they are for women using their own eggs in the IVF process and carry the same level of risk. The use of anesthetic carries a small risk during the egg retrieval process, but serious problems are uncommon. Some women may experience bleeding when the doctor inserts the needle into their ovary. In rare cases, damage to the bowel, bladder, or nearby blood vessels might occur. However, serious damage or severe bleeding is unlikely. Infection might also occur following the removal of the eggs. The doctor might prescribe antibiotics to prevent this. Sometimes, the drugs a doctor prescribes to promote ovulation in an egg donor can cause OHSS, which can be mild, moderate, or severe. In all cases, consult a doctor. Severe cases may require hospitalization, with symptoms that include: difficulty breathing rapid weight gain stomach pain vomiting Criteria for donors Several factors may affect a woman’s ability to donate eggs. These factors increase the likelihood of a successful pregnancy and reduce the risk of congenital anomalies. Generally, donors are between 21 and 35 years of age. Women in this age group tend to respond better to fertility drugs and often have a higher quality and quantity of eggs. Donors should be free of infections, such as HIV and hepatitis C. Also, they should not have a high risk of genetic diseases, such as those who carry the cystic fibrosis gene. Women may not be eligible to donate if they face a high risk of exposure to HIV or other infections. Equally, an individual may not be able to donate eggs if they cannot provide a detailed family medical history. Some programs favor women who have already successfully donated eggs or given birth. Egg donor screening Reputable programs offer a rigorous screening process to minimize the risk of congenital anomalies and other complications. The U.S. Food and Drug Administration (FDA) issue guidelines to help fertility clinics confirm the eligibility of an egg donor. A program’s screening process may include several or all of the following steps: application interview, by telephone or in person physical examination blood tests drug tests ultrasound, to examine the reproductive organs medical and psychological history — to discover donor and family health history infectious disease screening screening for inherited disease Psychological screening Donating an egg can be an emotional experience for the donor and the recipient. Reputable egg donor programs include a thorough psychological screening of all individuals involved. Evaluating the donor’s mental health is vital to ensure the health of any resulting children, and to be sure the donor is making an informed decision before beginning the donation process. Legal implications for egg donors The legal status of egg donation varies by country. In the U.S., it is legal for a woman to donate eggs either anonymously or not. It is also legal to receive financial compensation for donating eggs. Egg donation clinics will require all donors to sign a contract that ensures they have no legal rights or responsibilities to any resulting children or embryos. Although the woman who receives the egg will not be a genetic relation of the child, legal documents will record her as the birth mother. Donor identity In the U.S., donors may be anonymous. They might also know or get to know the recipient. Many egg donation programs keep the donor’s identity confidential. In other cases, the recipients of the eggs will receive specific information about the donor but will not meet each other or know one another’s names. Some programs may allow donors and recipients to meet each other if both parties are willing. In some situations, recipients may permit the donor to make contact with the child once they reach a certain age. In other cases, the donor may already have a relationship with the recipients. This occurs if a woman asks a friend or family member to donate an egg. In these situations, clinics recommended making contact directly to arrange the screening, treatment, and transfer processes. Costs and donor payment Parents Via Egg Donation, a global non-profit organization, estimate the cost of fresh egg donation in the U.S. at $35,000–$50,000 for an exclusive fresh cycle. This means that the recipients do not share eggs with other women on the program. The cost of a shared donor egg cycle begins at around $18,000. A woman may choose to use frozen eggs from a donor bank. This typically costs $16,000–$20,000 in the U.S., with much lower rates available in Europe. Egg donors usually receive compensation for their time and effort. Payment does not depend on the outcome. Compensation varies widely depending on the donation program. The Ethics Committee of the American Society for Reproductive Medicine have concluded that paying women for donating eggs is ethical. They have also found that the amounts of money a donor can receive are wide-ranging and depend on a range of factors, including the region. Summary Egg donation is a brief procedure with a good success rate. It involves a doctor extracting an egg from carefully screened donors. The cost of a fresh egg donation ranges from $35,000–$50,000. An egg donor will take medication to stop their menstrual cycle and stimulate the ovaries. The procedure takes place under sedation, anesthesia, or with the use of painkillers. A donor might need a few days for recovery. Donating and implanting eggs can have physical and psychological side effects, but it is a generally safe and well-tolerated procedure. The recipient may know or not know the donor, and different facilities have different levels of donor confidentiality. Many donors receive financial compensation for their time and eggs. The screening process is thorough in minimizing the risk of congenital anomalies and genetic diseases. The facility will also clarify the legal implication to the donor and recipient of the eggs. Q: I tried using a donor egg to conceive, but it was unsuccessful in my case. What alternatives do I have? A: The options could include repeating the process. Some cycles involve using fresh donor eggs while some use frozen donated eggs. People can repeat the cycles up to three times. However, success rates decline the more cycles required. Some people also consider surrogacy. Surrogates carry a fetus to term[PF1] on another woman’s behalf. The process may involve using the woman’s own egg or eggs and her partner’s semen, donated fresh or frozen embryos, or any other combination. Costs for surrogacy depend on location. They can range from $90,000 to $130,000. Valinda Riggins Nwadike Source
