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Thank you for expressing an interest in our egg donation programme. If you wish to take a step closer to becoming an egg donor, we would be pleased to arrange a visit to the Unit and for you (and your partner) to meet a counsellor and doctor.
Egg donation and the law
Eggs may be donated ‘directly’ to a known couple or ‘indirectly’ to a couple not known to the donor, but who are registered with this Unit and who wish to receive treatment with donated gametes.
In 2005, the law relating to gamete donation changed. Egg and sperm donors can no longer donate anonymously. At age 18 donor-conceived children will be able to find out identifying information about their gamete donors. This information is available only to the child, and not to the recipient(s). At age 18 donor-conceived children may be able to be put in touch with any donor-conceived half siblings, if both siblings agree to contact. At age 16, donor-conceived children will be able to find out if they are donor conceived and will be entitled to find out non-identifying information about their donors and any donor-conceived half siblings they may have.
Donors will have the right to find out limited non-identifying information about their genetic offspring, including the number of children born from their gametes, and the year and gender of each child. A donor will not be the legal parent of any resulting children and will not have legal rights, claims or responsibilities towards the child. If you wish to donate indirectly, you are not entitled to know any information about the recipient(s).
Who do we use as donors?
In line with the Human Fertilisation and Embryology Authority (HFEA) guidelines, potential donors should be healthy women, ideally between the ages of 18 and 35. Donors must be women with no history of hereditary diseases, congenital abnormalities or significant medical disorders requiring intensive and/or regular medication.
Potential donors over 35 years of age may be considered at the doctors’ discretion. The use of eggs from older women will only be considered in known donation if the donor has an acceptable AMH level (hormone level depicting satisfactory ovarian reserve).
Who do we treat?
Donated eggs are required to treat women who have undergone premature menopause, for couples who have had failed IVF cycles of their own due to poor egg quality, or to avoid passing on a serious genetic disorder. Unfortunately, the number of couples who require treatment with donated eggs far exceeds the supply.
How do I start the egg donation process?
Potential donors (and where applicable, their partners) are required to discuss the moral, ethical and legal aspects of becoming an egg donor with a counsellor and doctor. Written information will be sent to you before the counselling session.
As well as meeting with the counsellor, you will be asked to attend for baseline blood tests and an ultrasound scan. You will then be seen for a medical consultation. If the decision has been made that you are a suitable candidate for egg donation, the risks associated and the process of ovarian stimulation and egg recovery will be discussed in detail. Should you wish to proceed with the egg donation process, additional screening tests will be required, following which, all the necessary consents will be completed.
What screening tests will be done?
In order to make sure there isn’t a risk of passing on any infections or disorders to the recipient and/or offspring, a number of screening tests are carried out. Although several tests are necessary, this is usually accomplished with a single blood sample. The following tests are undertaken: blood group and Rhesus status, full blood count, hepatitis B and C, syphilis, HIV and HTLV, cytomegalovirus, cystic fibrosis and a chromosome analysis. You will also be asked to provide a urine sample to test for chlamydia and gonorrhoea. A repeat HIV screen will be taken 6 months after the initial test.
It is essential that the donor’s weight for height is within the normal range. An ideal body mass index (BMI) is between 20-30. This is because treatment is more successful when women are within the ideal weight range for their height. In certain circumstances, we may consider accepting donors with a BMI up to 35.
It would also be preferable for egg donors to be non-smokers. This is not only due to the negative impact on your own health but also because smoking can be directly responsible for poorer egg quality. We would therefore encourage you to see your GP to receive help with smoking cessation.
Outline of a typical donor treatment cycle:
The donor telephones the Unit on the first day of a period to arrange to attend for a blood hormone test and scan within the first 5 days of the menstrual cycle. If these tests are satisfactory, an appointment will be made to see a member of our nursing staff, approximately three weeks later, to start the treatment cycle. During this interval it is necessary to use an effective barrier method of contraception.
- At this appointment, Buserelin injections are commenced. These are given under the skin and are easily self-administered (or may be given by a partner/friend/relative). Our nurses will give the necessary instruction. This drug ‘down-regulates’ or switches off the natural hormonal responses so that the donor can then be stimulated to produce more than the usual one egg in any given month.
- After 14 days of Buserelin, the donor will be asked to attend for another blood hormone test and will have had another menstrual period in this time. She will then be informed when to start the gonadotrophin, or stimulation, injections. Buserelin injections will also continue.
- The donor will be required to attend the Unit on days 3 and 6 of the stimulation injections for blood tests.
- Provided that the ovaries are responding normally, she will next attend on day 8 for an ultrasound scan so the developing follicles can be measured.
- Ultrasound scans are usually repeated on day 10, and then on alternate days as required by the Doctor.
- An injection of hCG (Pregnyl or Ovitrelle) is given when 3 leading follicles are about 18mm in diameter.
- The donor will be admitted as a day case for egg collection 36 hours after the hCG injection.
- The eggs are collected by trans-vaginal ultrasound under sedation. The donor will be required to stay on the ward for the morning, and will need someone to drive her home and stay with her for 24 hours following sedation.
What happens after the egg collection?
All the eggs are inseminated with the recipient’s partner’s sperm. If you are donating indirectly, and sufficient eggs are recovered, it is sometimes possible to split the eggs between two couples. If fertilisation is achieved, all the embryos are frozen and stored for six months. The embryos are only replaced if the donor’s follow up HIV test is negative. Occasionally we can carry out fresh embryo replacements for known donors/recipients. This can be discussed at your consultation.
Possible side effects and risks, these will be discussed at length at your medical consultation:
Ovarian Hyperstimulation Syndrome (OHSS)
This occurs in approximately 8% of women in whom ovarian function has been suppressed with Buserelin and the ovaries subsequently stimulated. It is characterised by ovarian swelling; this causes discomfort and pain and an accumulation of fluid in the abdomen and sometimes around the lungs. Most women feel nauseated and some may vomit. 1% of women will have severe symptoms (nausea, vomiting, pain, abdominal swelling and shortness of breath) that require admission to hospital. The condition will subside as the ovaries return to their normal size, approximately two weeks after the egg recovery. OHSS can be potentially life threatening and if the patient is thought to be at very high risk, the treatment may be cancelled.
Ovarian Cancer and Ovarian Stimulation
Concern has been expressed about repeated cycles of ovarian stimulation causing ovarian cancer. The relationship between these two factors is not proven. Women who never conceive have a higher risk of getting ovarian cancer. Women who conceive after ovarian stimulation are at the same risk as those who conceive naturally. Women whose close female relatives (mothers, sisters, maternal aunts and maternal grandmothers) have had the disease are at a higher risk, and they need specialist genetic counselling and in some cases genetic testing. Ovarian cancer usually occurs in post-menopausal women. It will obviously therefore be some time before we know the true risks however, most data collected so far seems relatively reassuring.
Risks of surgery and anaesthesia at the time of egg recovery:
The risks are actually very small. St. Mary’s Hospital carries out approximately 920 egg recoveries each year and on average have only one significant complication from this surgical procedure, usually infection.
Reimbursement for expenses and lost income (up to £750)
From April 2012, the HFEA made it possible to reimburse egg donors up to £750 for expenses and lost income incurred as a result of the egg donation process. We will be happy to reimburse you the full amount but would ask that you provide us with receipts or signed declarations from you stating that you incurred those expenses and lost income. Please discuss this further with us if you have any queries.
If you are still interested in becoming an egg donor, please get in touch to book a confidential consultation.