What is egg donation and how does it work?

Egg donation is defined as the procedure in which a woman donates an egg or an oocyte to help another woman to conceive. It is part of assisted reproductive technology (commonly known as ART) which involves removing an egg or eggs from the donor, fertilizing this egg in the laboratory, and then implanting the resulting embryos into the recipient’s uterus through the technique called in-vitro fertilization.

Women who donate eggs can benefit other women who cannot use their own because of reasons like an ovarian failure, avoiding congenital anomalies in the fetus, or at an advanced stage.

A study featured in the journal Fertility and Sterility suggested that around 93 percent of all fertility centers in the United States offer egg donation. This study also indicates that the success rate is around 49 to 50 percent.

What to expect?

The fertility center will conduct a selection process to find a suitable donor by following proper legal procedures. Before starting the procedure the donor will take certain medications which will inhibit their normal menstrual cycle.
Various side effects that might occur due to the use of these medications are as follows:

• Hot flashes
• Headache
• Fatigue
• Body aches

In order to stimulate the ovaries to produce several eggs at once the donor may need to take a series of fertility drugs. This is called hyperstimulation. The donor will be administered these medications by injecting them under their skin or directly into a muscle.

Some women may experience various mild to moderate side effects such as mood swings, bruising at the injection site, and tender breasts. There is very little chance that a woman might also develop severe ovarian hyperstimulation syndrome (OHSS). A woman may need hospitalization if she suffers from OHSS as too many eggs develop in the ovaries.

It is always advisable to avoid sexual intercourse or use a barrier contraceptive such as condoms because the donors do have a risk of pregnancy before the eggs are retrieved. The donor will undergo frequent blood tests and ultrasound examinations throughout their donation cycles to monitor their reactions to the medications.

During extraction:

Before performing a transvaginal ovarian aspiration to remove the eggs from the ovaries, the donor will receive a final injection in preparation for the procedure. A specialist will insert an ultrasound probe into the vagina and may use a needle to remove the eggs from each follicle of the ovary. Patients are generally administered sedatives, painkillers, or an anesthetic during the procedure. This is a minor procedure that generally lasts for 30 minutes and the donor does not have to stay at the hospital.

After donation:

Women can continue their normal activities the next day while some women may take several days to recover from the transvaginal ovarian aspiration. An egg donation process can have a psychological impact on women so it is always better to provide aftercare to the donors.

Risk and side effects:

The risk factors for egg donation are relatively very low and the occurrences of serious problems are uncommon. Some women may experience bleeding during the needle insertion into the ovary. Sometimes infection might also occur which can be easily managed by antibiotics.

Occurrence of these symptoms in severe cases may require hospitalization:

• Vomiting
• Stomach pain
• Difficulty in breathing
• Rapid weight gain

Criteria for donors:

Women tend to respond better to fertility drugs between the ages of 21 to 35 years and provide high quality and quantity of eggs. The selected donor should not have any sexually transmitted diseases like HIV or Hepatitis C and should not have a risk of genetic disorders. If an individual is unable to provide their family medical history then they might not be able to donate the eggs.

Egg donor screening:

An individual might go through regular screening to minimize the risk of congenital anomalies and other complications. Various tests which may be performed are as follows:

• Physical examination
• Blood tests
• Drug tests
• Ultrasound to examine reproductive organ
• Infectious disease screening
• Screening for inherited disorders

Psychological screening:

Egg donation can be an emotional experience for the donor and the recipient. Thus it is important to evaluate the donor’s mental health to ensure the health of any resulting children.

Legal implications for egg donors:

The legal status for donating the eggs may vary from country to county. A donor needs to sign some legal contract papers which ensure that they don’t have any legal rights or responsibilities to any resulting children or embryos.

Donor identity:

Many egg donation clinics and programs keep the identity of the donor confidential while in some cases the recipient might get some information related to the donor but they will not meet each other or know one another’s name.

Sometimes the donor and recipient can meet each other if both parties are willing to meet. In other cases where the donor is a friend or a family member then the clinic recommends making contact directly to arrange the screening, treatment, and transfer process.

Cost and donor payments:

It is estimated that the cost of fresh egg donation in the U.S. is 35000-50000 dollars for a fresh cycle as reported by Parents via Egg Donation, a global non-profit organization.
It costs around 18000 dollars for a shared donor egg cycle while it costs approximately 16000-20000 dollars for a woman who chooses to use frozen eggs from a donor bank.

Donors are paid for their time and efforts irrespective of the outcomes.

Conclusion:

Donating and implanting eggs are generally safe procedures but they can have physical and psychological side effects on the individual. Egg donation is thus considered a brief procedure with a good success rate. The success rate will depend on various factors like the age of the donor, the retrieval process, and the recipient’s overall health.

Dr. Gauri Agarwal is one of the best-known Infertility and IVF Specialists in India with over 15 years of experience in the field of gynecology and infertility. She is also the Founder-Director of Seeds of Innocence, a reputed and recognized chain of IVF Centers, and Gene strings Diagnostic Centre.