Many couples who want to have children find it difficult or impossible to conceive. Presently using special modern techniques, some couples can conceive using their own eggs and sperm. Others are forced to use donated sperm and/or donated eggs. Thanks to modern medicine egg donation has allowed some women, whose ovaries do not produce enough healthy eggs, to become pregnant using donated eggs.
It is very serious decision to use donated eggs and it is important to know everything about egg donors and egg donation.
EGG DONATION – who can become a donor
Not all women can donate eggs. Certain rules are set for legal reasons. All potential Egg Donors must meet the following basic criteria:
- Between the ages of 21 and 30 years old;
- In good health and mature;
- Well educated;
- Weight and height proportionate;
- Mature and prepared to help a couple have a child.
The age lower limit ensures that a woman can legally enter into a contract. The upper limit reflects the fact that older women respond less well to fertility drugs. There is also a chance that an older woman’s eggs will be abnormal, making pregnancy less likely or increasing the risk of a birth defect.
Some programs prefer to use donors who have already given birth or successfully donated eggs. It is believed that they are more likely to be fertile and it is easier to anticipate their feelings about having genetic offspring born to someone else.
EGG DONATION – donor selection
First selection process for egg donors includes the interview. During interview the set of standard questions are asked and selected egg donor should agree with following statements:
EGG DONOR STATEMENTS:
Statement 1 – I am at least 21 years of age
Statement 2 – I am interested in donating my eggs
Statement 3 – I am aware of the medical and psychological risks associated with egg donation
Statement 4 – I understand that I will follow all agreements mentioned in my egg donation contract.
Second part is general medical screening. Potential egg donor should have physical examination, including pelvic exam. Blood will be drawn to check level of hormones. Ultrasound test will check reproductive organs and some other pelvic organs. All tests should confirm healthy status of potential egg donor.
Third part detailed medical and psychological history egg donor and close blood relatives. It will include questions about used cigarettes, alcohol, and both prescribed and illegal drugs. Some clinics will require objective tests.
Fourth part will insure screening of infectious disease. When blood or tissue is transferred from one person to another, it can carry viruses or bacteria. To minimize the risk that a donor egg could cause illness in the recipient, donors are tested for a variety of infections including sexually transmitted diseases (STDs).
Fifth part includes screening for inherited disease. All possible risks for inherited genetic diseases should be excluded. Tests will include medical questions about egg donor’s biological parents, grandparents, brothers and sisters. Genetic tests usually involve a simple blood test.
Sixth set of questions will insure psychological screening. Some ethical, emotional and social issues should be discussed. Egg donor should be psychologically ready to donate healthy egg without any future psychological problems. No matter how motivated, most donors do not find the process easy. If needed the psychological counseling and support should be provided.
The American Society for Reproductive Medicine suggests that a woman should not donate eggs if she:
- Has a serious psychological disorder.
- Abuses drugs or alcohol or has several relatives who do.
- Currently uses psychoactive medications.
- Has significant stress in her life.
- Is in an unstable marriage or relationship.
- Has been physically or sexually abused and not received professional treatment.
- Is not mentally capable of understanding or participating in the process.
EGG DONATION – recipient selection
Egg donation should be used for infertile women who do not produce enough normal eggs but are otherwise able to be pregnant. Some of these women have problems in ovaries (hormonal or genetic dysfunctions) or diagnosed with premature ovarian failure or entered menopause at an early age. Some infertile women could be candidates for egg donation because they are at an age when they produce eggs less readily, even with fertility drugs.
Less commonly, women decide to use donor eggs because they are aware of an increased risk for inherited disease in their biological offspring. For example, the woman herself may be healthy, but she and her partner may both carry a gene for the same disease. This creates a risk in the child if it inherits the altered gene from both parents. Using an egg donor who does not carry the gene eliminates this risk.
In most cases donated eggs are used by women in their late 30s or 40s who are attempting to become pregnant. Very few women under the age of 36 use donor eggs. Programs have various upper age limits for recipients. Some programs will allow women over age 50 to be recipients.
EGG DONATION – how egg donors should match recipients
Most egg donation clinics/programmes use “anonymous” donors and medical professionals are responsible for matching the recipient – they match a recipient with the donor who most closely resembles her, including ethnicity, height, body build, skin type, eye color, and hair color and texture. Once a possible match has been found, the recipient is given information about the donor and decides whether to proceed or wait for another donor.
EGG DONATION – process
There are several standard steps which were developed by experienced professionals:
Your menstrual cycle rhythm could be changes if needed and some medications will be prescribed. A doctor or nurse will give you an injection or instruct you about how to inject the medication daily at home.
Possible temporary side effects: hot flashes, vaginal dryness, fatigue, sleep problems, body aches, mood swings, breast tenderness, headache, and/ or vision problems.
Stimulating egg production – the goal is to obtain several mature healthy eggs. Donor will be prescribed medication to stimulate ovaries to mature more eggs than normal (called “controlled hyperstimulation”). Stimulation treatment will start on a specific day of the menstrual cycle and will continue for about ten days.
Possible temporary side effects: soreness, redness or mild bruising around the injection site; mood swings, tender breasts, enlarged ovaries and mild fluid retention. Sometimes controlled hyperstimulation can cause more hyperstimulation than intended (known as “ovarian hyperstimulation syndrome,” or OHSS). This will cause fluid retention and swelling of the ovaries. In mild OHSS, you may have abdominal pain, pressure and swelling. This should go away after your next period.
Monitoring is important during stimulated cycle. Monitoring could include frequent blood tests and ultrasound examinations to track the developing eggs and to see how you are responding to the hormones. When the time is right, you will receive one final injection to prepare the eggs for retrieval (in most cases in the middle of cycle).
Possible temporary side effects: blood drawing can cause mild discomfort and there is a chance you will develop a bruise in the area where the needle was inserted.
Trans-vaginal ovarian aspiration – for removing all mature eggs from ovaries. This procedure usually done under ultrasound control. The thin needle attached to the probe will be inserted into each follicle. Using suction, the egg and liquid inside each follicle will be removed. You could be given painkillers, sedatives or anesthesia during the retrieval, which lasts about 30 minutes. When all the eggs have been retrieved, you will recover for a few hours before going home.
Possible temporary side effects: ovarian small bleeding during egg suction.
You can become pregnant during the stimulated menstrual cycle, if you have unprotected intercourse. Pregnancy is possible if some of the eggs are released before retrieval, or if the doctor was not able to retrieve all of the mature eggs. There is a chance that you could become pregnant with twins, triplets or quadruplets. You must abstain from intercourse or use effective barrier contraception.
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