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). Till now, such women could only have a baby through the route of adoption. However, in the last ten years, a new technique of egg donation has come as a blessing to many such women. It makes the miracle of life possible for women when there is no other hope.
The egg donation process enables a woman who cannot get pregnant with her own oocytes due to poor quantity/ quality or who are menopausal , to use an egg which is donated by another woman to achieve a pregnancy. In many cases where the egg quality is not good, leading to failure of repeated cycles of treatment, donor eggs treatment is the viable option.
It starts with synchronizing the menstrual cycles of the donor and recipient. The donor undergoes a cycle of ovarian stimulation with the aim of producing as many eggs as possible. The recipient is given estrogen and progesterone to prepare the lining of her uterus (like in case of a frozen cycle). The eggs are collected and fertilized with sperm from the recipient’s partner. Resulting embryos are observed and the best chosen for transfer. Any other viable embryos are frozen for later attempts. This option of egg donation offers a chance to women of advanced age to still carry a child in their own womb with a chance of success being as high as 50% per single attempt.
Formation of an embryo involves the fertilization of a healthy oocyte or egg by a healthy sperm. Accordingly, if either the egg has an anomaly, is poor in quality &/or quantity, successful fertilization will not occur. Egg quality is one of the major factors for a successful IVF. If the egg quality is not at par due to reasons such as the age of the woman, health factors etc. then the success rates of IVF goes down. This is where IVF process using Donor Eggs can prove fruitful and can increase a couple’s chances of successful pregnancy.
What is the process of egg donation?
Egg Donation/ Donor Egg IVF is the process of extracting eggs from the uterus of a healthy and tested female, fertilizing it in a lab environment and implanting it in the uterus of the patient. It requires the eggs to be donated anonymously by an egg donor. The process is same as the IVF apart from the donation part.
Who can benefit from Donor Egg IVF?
Women who cannot produce eggs in sufficient number or of required quality and have been unable to conceive with the help of other IVF techniques should look at egg donation as an option. 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, usually till 50 years of age.
Donor egg IVF is effective in the following cases;
- Women are of advanced age.
- Ovarian failure resulting from menopause, premature ovarian failure or ovarian surgery or rare genetic syndromes like Turner’s syndrome.
- Past treatment with chemotherapy or radiotherapy. Radiation or chemotherapy destroys the eggs and hence these women have a failure of their ovaries.
- Poor quality eggs and failure to establish pregnancy through conventional IVF.
- Women whose ovaries are inaccessible for obtaining oocytes.
- Recurrent miscarriages.
- Mothers with abnormal genetic defects which might be passed down to their future children.
- Chromosomal abnormalities in the woman or her embryos
- Repeated failure with IVF is when women do not respond to ovarian stimulation, or when they fail to achieve fertilization on several occasions with ICSI, or when they experience repeated embryo implantation failure.
What steps are involved in Donor Egg IVF procedure?
-Recruitment and selection of egg donor
Usually it is done by the agency. Donors are thoroughly screened and then are enrolled for the programme.
The ideal candidate for the egg donation process should be between 23 and 33 years of age and has proven fertility with delivery normal babies in past with at least one pregnancy preferably , have a healthy Reproductive system, and are tested negative for hereditary diseases are utilized for egg collection. She is first interviewed to make sure she understands the legal, ethical, physical & social aspects of the donation process and is able to understand the procedure and knowingly give her consent. Subsequently, a complete medical checkup is performed to make sure there are no medical illnesses. Their family history is taken, to rule out any genetic problems. Donors undergo a thorough workup to rule out cysts, myomas, polyps and other abnormalities in the reproductive organs. The donor is also tested to confirm she is free from transmissible diseases such as HIV, hepatitis and syphilis. Her blood group and Rh factor are also checked and genetic disorders like thalassemia are ruled out.
-Cycle synchronization & Endometrial Development for the Recipient
We coordinate the cycles of the donor and recipient to accomplish a fresh embryo transfer whenever possible. Synchronization of cycles includes using a series of medications to facilitate a hospitable uterine environment for the transfer of embryos wherein intended mother( recipient) is treated with hormonal therapy to ensure the uterus is ready to accept the embryo.
-Ovarian stimulation and IVF
It involves harvesting and fertilizing the eggs or preserving them. Ovulation induction is used to stimulate the release a healthy egg which is then harvested under ultrasound by ovum pick up procedure.The donor eggs are fertilized with the partner’s sperm in lab either by IVF or ICSI and kept in the incubator for two-three days and the fertilized embryo is then transferred to the uterus. However, if the fertilization and implantation process is not performed immediately, the eggs can be frozen in liquid nitrogen and preserved till it’s needed, whereby they can be thawed and used.
Normally, embryos are transferred on day 3 after egg retrieval. Sometimes, it can also be day 5. The checkup is done to make sure that the donor is recovering properly from ovarian stimulation and egg retrieval.
Recipients will have a pregnancy test done 2 weeks after the embryo transfer via a blood test to measure the levels of HCG in her blood.
What are success rates?
Donor egg IVF success rates are similar to that of the normal IVF procedure and at times even higher (60%) if the couple tried unsuccessfully in the past to achieve pregnancy through conventional IVF. It provides her the same gestational experience as natural conception which help to form the bond between mother & child.
Pricing in egg donation
Other than normal IVF procedure costs, there is an additional cost related to the egg donor as well. This additional cost caters to the expenses of the donor who has to undergo rigorous testing and possibly, certain rounds of medication and drugs.
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 legalized paid egg donation and surrogacy. According to ICMR guidelines, the donor is anonymous. 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 anesthetic. She is also exposed to the risk of surgical egg removal. 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 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. Wherein the donated egg will be fertilized externally using the sperm of the male partner and the resulting embryo then placed in the uterus of the female partner to carry forth the pregnancy. The baby born will be genetically related to the male partner only. However the birth certificate will mention the name of the intended parents only and the donor will not be mentioned anywhere.
IVF using donor eggs’ with Anmol Fertility & IVF Centre
Our donors are screenedwith rigorous screening criterias so that good-quality and number of eggs are obtained from healthy donors. Our facilities offer some of the most comprehensive and successful storage, vitrification programs. We follow low-dose drug protocols so that the risks for both the intended parents and the donor are minimized. Such protocols also improve quality of the eggs and facilitates a safe and successful implantation.