Egg DonationIn egg donation, eggs are borrowed from a young woman (less than 33 yrs of age) called the donor, with her consent. These eggs are then fertilized with the sperms of the husband of the recipient woman and the resultant embryo (the earliest form of the baby), is inserted into the womb of the recipient. The success rate of this procedure is in the region of 30 to 40%. In fact, many women till the age of 50-55 have become pregnant by this technique.
Reason for Egg Donation
- For Career Oriented Women who are getting married late. By the time they start planning to have children; they are nearing the fourth decade of their life (40 years).. Fortunately, at this age, many women can conceive naturally. However nearly 10 to 15% women fail to conceive within a year's time.Women after the age of 40 tend to have fewer eggs in their ovaries or the quality of the eggs they produce may be poor. Thus, even new technologies like IVF and ICSI may not ensure a successful pregnancy. Furthermore, after the age of 40 to 42, many women stop producing eggs as they enter the stage of Perimenopause (decreased periods) or menopause (stoppage of periods). And here we suggest for Egg Donation.
- According to rules of Government younger couples are preferred for adoption so for the couple above 40-45 can opt for egg donation. Egg donation can also be perfomed on women who have had multiple cycles of test-tube baby (IVF or ICSI) and have still failed to conceive and become pregnant.
- Egg donation can be done in younger women whose ovaries have prematurely failed.
- Egg donation is also used in patients who are carrying major chromosomal defects so that they do not pass the genetic defect to their children.
- Patients suffering from severe Tuberculosis and severe Endometriosis may also produce poor quality eggs and hence can be treated by egg donation.
- For young women who have undergone radiation or chemotherapy for cancer. Radiation or chemotherapy destroys the eggs and hence these women have a failure of their ovaries.
General Recipient Background:
In general, any woman with a medical or genetic indication for using an egg donor can be a recipient, if there are no medical contraindications to pregnancy. Our current age limit is 55 years. The decision to utilize donor eggs is made in association with staff and consultants. If a male factor exists, donor egg with ICSI is also available.
And also psychiatrist and a physician would assess a recipient. This is done to gauge the mental and physical fitness of the patient. This analysis is very important to withstand the pressures of childbirth.
The process of egg sharing is an excellent example of symbiotic relationship between women, one with a physical need and one with a monetary need, with the ultimate common goal of bearing a child. It is a safe, effective, successful, legal, ethical and socially acceptable method of advanced reproductive technology.
Who can be a Donor?
A. As easy as the method may sound, the biggest problem faced by both doctors and patients is the availability and source of egg donors. Ideally, the best donor would be her own sister or near relative from her side (not from husband's blood relative). We have done such cases successfully in Lilavati Hospital. However, in this day and age of small nuclear families many times it is difficult to get such donors.
Further more, it is very important that if there is a sister donating eggs, there should be a very good mental understanding between the sisters. The donor is not anonymous in this case, and thus many a time there are possibilities of inter–personal conflicts arising when the child becomes older.
We also accept recipients who have identified their own non–anonymous donors.
B. The other and the most acceptable donor would be a voluntary unrelated donor. There are a lot of women who may just out of altruistic (philosophical) reasons donate eggs to women who are suffering from the trauma of infertility. It is important to popularize such egg donation. However, even in an advanced society like Britain's, there is a great dearth of voluntary egg donors, in spite of extensive advertisement in the press.
By voluntary egg donation, we mean donation of the eggs by the donor without expecting any monetary or other reward in return.
C. The third area, which can be a source of donors can be a paid donor. You may be surprised that this is legal in USA and young college girls are paid as much as US$6,000 for donating their eggs. But in a protestant society like Britain's, this form of donation is considered illegal and unethical. Even in the Indian society, where there is no law on egg donation at present, such kind of paid donation may not be socially and culturally acceptable. Clinics in India do not practice paid donation.
Recently the Govt of India has appointed Indian Council of Medical Research to legalize infertility practice in this country including that of egg donation, embryo donation, semen donation & surrogacy. The ICMR has legalised paid egg donation and surrogacy. Our unit at Bloom IVF Mumbai has just started doing some degree of paid egg donation based on the ICMR draft.
In all the groups of related, voluntary or paid donors, there is a certain degree of risk the donor is exposed to. The donor is given multiple injections to produce eggs, as well as a shot anaesthetic. She is also exposed to the risk of surgical egg removal.
D. Hence, there evolved a new concept of shared egg donation which started in Britain but is now popular in the USA and also in India. There are many young women who are infertile due to other reasons and who also need the procedure of IVF or ICSI.
However, they cannot afford to spend money for these procedures. Many of these women produce 8 to 10 eggs during their treatment. These patients are asked to share some of their extra eggs with the recipient. This is done by taking the informed consent of the young woman. In return, a part of the expense of medical treatment of the young woman is borne by the recipient. Thus, both the donor as well as the recipient who need IVF, are benefited, without any extra amount of risk to the donor. The anonymity of both–the donor and the recipient–is maintained so that they don't know each other. With the help of this technique, many young women who cannot afford IVF can mother a child. The same goes for elderly women who can afford IVF and can have a child.
Embryo Donation is similar to egg donation the difference over here is that both the egg and sperm are derived from donors. Which are further fertilized, embryos is formed which can be donated.
Patients those who are eligible for egg donation can also opt for embryo donation. Rather if we compare embryo donation is preferable choice if couples has no objection in using donor sperm because it is cost effective than egg donation and also yields the highest pregnancy rate-as high as 30-40%.
Source of Embryo Donation:
There are many young patients who need IVF / ICSI procedure, but who cannot afford it. These patients produce lot of eggs and hence many embryos. Even there are young women who produce many eggs and hence we produce embryos from them, the best quality embryos are been choose and transferred in patient, rest we freeze them and when patient gets pregnant and do not wish to have more children's can donate their embryos to infertile couple who wish to start their family.
The pregnancy rate in our clinic is 30-40% per cycle. The reason for the high pregnancy rate is two fold. Firstly, these are often excellent quality embryos. Also, since we prepare the Endometrium using hormones, the uterine receptivity to these embryos is usually very good.
in our clinic, embryo donation is totally anonymous, unless it done by a friend or relative of the recipient. There is no contact between the donating couple and the recipients, who never see each other. There are no records maintained about the origin and the ultimate resting place of the embryos.
Similar to egg donation, patient who are menstruating have to take hormonal drug for the hormonal control of the cycle which is taken over by starting GnRh analogue injection such as Suprefact, Lupride or Nasaral spray starting from 21st day of previous cycle. Once the patient gets her period, EstradiolValeratetablets(Progynova 2 mg) is started from the 2nd day of period. On the 10th day an ultrasound is done to assess the receptivity of the Endometrium by measuring its thickness.
For pregnancy endometrial thickness should be around 9mm. Once this is achieved embryo can be placed. Transferreing of embryo is non surgerical procedure and involve no risk. In case of menopausal woman, who have stopped having periods, cyclical hormones are given for 3-6 months till the time the patient starts having her periods. After that the procedure is the same, starting with Progynova tablets from the second day of period. In these women, there is no need to give GnRh analogues such as Suprefact, as the hormonal control has been naturally shut of.
Different from surrogacy:
In surrogacy, another woman accepts the embryos of a couple and carries the pregnancy for the benefit of the infertile couple. In contrast in embryo donation, the infertile couple carries the embryos of another couple and ultimately delivers the child that they will parent.