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If you are struggling with fertility problems, you may want to consider egg donation. Visit our website to find out more and book a specialist online today.
A couple may need to consider treatment using donated eggs because of the following reasons:
Egg donors give details of their characteristics (hair, skin and eye colour; blood group, etc) which is provided to the recipient couple. Any further voluntary information the donor wishes to provide (e.g. occupation, hobbies, religion, hand-drawn profile) may also be given to the recipient couple. Since April 2005, all new donors are required to provide the previously mentioned information, plus their names, addresses at the time of birth and at the time of the donation. They will also be required to keep the HFEA (Human fertilisation and Embryology Authority) updated as to changes of address. Their names and addresses will not be available for the recipient couple, but will be held on record by the HFEA and may be released to any child born as a result of their donation if they request it when they reach the age of 18. This does not entitle the child to have any legal claim on the donor’s estate, nor does it allow the donor to have any legal, material or emotional claim on the couple or the child.
Certain information relating to treatment using donor gametes (eggs and sperm) is required by law (The Human Fertilisation and Embryology Act 1990 and 2008) to be filed and kept with the Licensing Authority (the Human Fertilisation and Embryology Authority, HFEA):
The stated aims of the legislation are:
Egg donors (and indeed any gametes donor) are allowed by law to request and be provided with information about children born as a result of their donations, including number of children, their gender and year of birth.
Similarly, people seeking treatment with eggs donated by an anonymous donor are allowed to be given non-identifying information about donor, including:
Children born following egg donation treatment are allowed access of the above non-identifying information of the donor from the age of 16. They also have the right to access the following information:
If your child is conceived using egg from an anonymous donor, telling them about their origins can be a sensitive topic to discuss. However, if done honestly and if discussed at the right time, the issue need not be a difficult one to broach.
Evidence from the experience of adoption, as well as studies of donor-conceived people, suggest that it is best for donor-conceived people to be told about their origins in childhood. Finding out suddenly, later in life, may be emotionally damaging to donor-conceived people and their family. This, coupled with the donor-conceived people’s legal right to find out about their genetic origins, means that it is advisable for parents to be open with their children from an early age.
Family secrets can undermine trust and lead to conflict and stress. They can also suggest to donor-conceived children that their parents are ashamed of how they were conceived. If parents are open about how the child was conceived, there is no reason they should feel any different to any other child. If donation has been part of the family story for as long as the child can remember, their genetic origins need not be an issue. Some donor-conceived children are likely to want to know more about their donor, while others will not be particularly interested.
It is therefore recommended that parents should let their children know about their origins at an early age. The “Donor Conception Network” has produced a series of booklets called “Telling & Talking”, which prepare and support parents of donor-conceived people to tell their children about their origins.
The potential recipient couple are required to attend for consultation with a consultant and a counsellor. For a couple who are bringing their known donor, the donor and her partner are also required to attend the consultation, initially separately from the recipient couple, and then together. The donor couple are also required to undergo independent counselling, which enable them to explore their own feelings of the donation process and to fully appreciate the treatment process and the implications of egg donation.
At the initial consultation, medical and family histories of the recipient couple are taken. A clinical examination and a pelvic ultrasound assessment of the woman are carried out. The male partner is asked to produce a semen sample for analysis. The clinical details of the donation programme are fully discussed during the consultation.
The physical characteristics of the recipient couple are recorded on a “Characteristics Matching Form”. Arrangements are made to ascertain the woman’s rubella (German measles) immunity status and cytomegalovirus (CMV) status, and the blood and rhesus groups of both partners. These can be carried out at the Fertility Centre or via the couple’s general practitioner(s). All couples in the egg donation programme are required to have HIV, hepatitis B & C screening.
Regardless of whether the egg donor is known or anonymous, there are strict criteria they must fulfil:
All donors have to undergo health screening, which includes obtaining a personal and family medical history. All reasonable steps are taken to prevent passing-on of serious genetic disorders. In most situations, this is served by taking a thorough family history. In this respect, blood tests are also carried out for chromosome patterns, and for carrier status for cystic fibrosis.
All donors also have blood tests to check for infections such as hepatitis B and C, and another for HIV, the virus that can lead to acquired immune deficiency syndrome (AIDS). The blood and rhesus group, and cytomegalovirus status of the donor are also checked, mainly for matching purposes.
Many couples ask if there is any chance of suffering from any other sexually transmitted infection following donor egg treatment. Although no guarantee can be given, the chance of this happening is very small. Similarly, despite all reasonable efforts made to exclude the possibility of heritable conditions, egg donation treatment does not protect the baby from having some form of congenital defects. The risk of this developing is no greater than if donated eggs were not used. It should also be borne in mind that every pregnancy carries some risks, regardless of whether donor egg is used or not.
All egg donors are informed of the possibility that, if a child is born disabled as a result of a donor’s failure to disclose defects, about which she knew or ought to have known, she may be liable to damages in the court of law.
Although ideally the general characteristics (skin, eye and hair colour, build, height, CMV status, and blood group) of the donor should match those of the recipient woman, the matching is seldom perfect due to the rarity of donors.
The number of families that can be helped by each donor is restricted by law to no more than 10. Once this number is reached, the donor is no longer allowed to donate her eggs. This is largely to reduce the likelihood of marriage between two people conceived from eggs of the same donor.
There are no payments for egg donors. They are, however, reimbursed for reasonable expenses and material costs (e.g. loss of earnings) up to a maximum of £750.00 over the whole course of donation.
Egg donors retain the right to withdraw consent to the use of the eggs or resultant embryos, or alter the terms at any time up to the point of transfer of the embryos (created using their eggs) into the recipient’s uterus (womb), although in practice this is highly unlikely.
In order to be able to donate eggs, the donor undergoes a treatment cycle of In Vitro Fertilisation (IVF); full details of which are available in our IVF Information Leaflet. IVF treatment essentially entails a series of different daily injections for the donor, in order to stimulate the production of eggs within the ovaries. When the eggs are mature, the donor undergoes the procedure of ‘egg collection’, which is a minor operation involving aspiration of eggs from the ovaries via a sharp needle inserted into the ovaries through the vagina. On average, 8 to 10 eggs are collected during each procedure, but the number of eggs varies hugely, and is dependent on the response of the donor’s ovaries. Donated eggs are then subjected to an insemination process in the laboratory, using the recipient husband’s/partner’s sperm.
Once the egg collection procedure is completed, this spells the end of the treatment for the donor. A review consultation is arranged for the donor a few weeks after the procedure.
The treatment for the recipient couple depends on whether they would use the fertilised eggs (embryos) fresh (i.e. within a few days that they are produced) or if they prefer to freeze (cryopreserve) all the embryos for used at a later date. Most couple prefer to plan for a ‘fresh’ cycle of treatment, whereby any embryos created in the treatment cycle are available for fresh transfer and freezing. The main advantage of this approach is that the success rate associated with fresh embryos is significantly higher than that with frozen embryos. The main disadvantage is that the embryos have not been quarantined to exclude a very small possibility of transmitting HIV infection.
Occasionally, all the embryos have to be frozen because it has not proved possible to synchronise the cycle of the donor with the recipient, or alternatively to prepare the recipient to receive the eggs. Some couples prefer to have any resulting embryos frozen for a short period of time, so that their treatment can be planned for a more convenient time.
For treatment involving an anonymous donor, every step will be taken to maintain anonymity of the donor.
In order for the recipient woman to be able to have a fresh embryo transfer, it is important to synchronise the recipient menstrual cycle with that of the donor’s IVF stimulation cycle. This is achieved by temporarily “switching off” the recipient’s ovaries using medication. After this generally speaking the process detailed below is followed:
There is no requirement of synchronisation between the egg donor and the recipient woman, in this situation.
The donor will undergo a standard IVF treatment cycle. The only requirement from the recipient is for the male partner to produce a semen sample on the day of the donor’s egg collection procedure. All fertilised eggs will then be cryopreserved and kept in storage in the laboratory.
If a couple elect to cryopreserve all the embryos, it is advisable to keep them in storage for no less than 6 months. This is the quarantine period; at the end of which the donor will be tested again for her HIV status, thus ensuring negligible risk of transmitting HIV infection.
When the time comes when the couple decide to have the “frozen-thawed embryo transfer” (or FET) treatment, the medication schedule is implemented.
There are a few essential points that must be appreciated regarding frozen embryos:
It is important to look after yourself (both woman and man) before and during treatment. Smoking has a negative effect on fertility, general health and the health of the baby. Similarly, excessive alcohol drinking is detrimental to fertility and pregnancy. These should therefore be best avoided. It is also advised that all women undergoing fertility treatment should take folic acid supplements before and during early part of pregnancy. This minimises the risk of having a baby with spina bifida (spinal defect).
Before committing to an egg donation programme, all couples are required to receive counselling, which is provided free of charge. Counselling provides an opportunity to discuss with an impartial person any concerns you may have about your treatment. It is part of your initial consultation and decision-making process. Further counselling is available to you at any stage of your treatment.
The HFEA Code of Practice sets out the types of counselling that should be available through all licensed clinics. This includes:
Apart from counselling offered by the clinic, it may also be helpful for you to contact one of the national support groups who may be able to put you in touch with others who have had egg donation treatment.
According to the current legislation (HFE Act 1990 & 2008), any couple undergoing oocyte donation treatment can have no more than 2 embryos transferred into the womb. However, it is strongly advisable (and indeed one of the regulations of the Human Fertilisation & Embryology Authority) that no more than one embryo is used at any one transfer. This regulation reduces the chance of multiple pregnancy occurring.
As previously mentioned, all donors are screened carefully for common and serious infections. It is however impossible to exclude all forms of infection which may be transmitted via the embryos. The chance of this happening is very small.
If you become pregnant it is important to keep the fertility unit fully informed - it is a legal requirement. It is necessary to keep a check on the effectiveness of each donor, and to ensure that the legal limit on the number of children from each donor has not been exceeded.
Once you have conceived through egg donation treatment, your pregnancy should follow a normal course. Having egg donation treatment will not affect your chance of having a normal pregnancy, a normal delivery, and a normal baby. However every pregnancy carries some risks, including congenital abnormality of the baby, bleeding and blood pressure problems in the mother. It is generally recommended that the pregnancy should be monitored more closely.