|Clinical IVF/ICSI pregnancy rates for patients using donor eggs (n=111)*|
This treatment is done when a woman seeking fertility treatment doesn’t have her own eggs but has an intact and healthy uterus. She receives in her womb, an embryo resulting from donor egg. Commonly, the sperm from the partner of the woman undergoing treatment is used to make the embryo.
Typically ovum donation is needed by women who have poor quality eggs, premature menopause etc
This is totally different from surrogacy wherein the couple has to use the womb of another woman to grow their baby in. By law the woman who gives birth to the baby is the legal mother and so ovum donation treatment does not need the legal procedures that surrogacy does.
When do we need ovum donation?
Unlike in man, in woman the number of gametes(eggs/oocytes) is limited and is decided even before the birth. All throughout life, the number of eggs decreases month after month and year after year such that even the onset of adulthood (beginning of menstrual cycles) the number of eggs in a woman’s ovary is fewer than when she was born. At menopause the total supply of eggs effectively finishes. However it is well known that around ten years before menopause the transition towards menopause gather space and during this time the supply of eggs is far less than optimal. In the light of this information you may appreciate when we need ovum donation.
1. Increased age of the woman, mid forties. The average age when woman choose to have children is increasing in the western society. The age of woman seeking help for fertility will increase in as well. The age of menopause and .. egg supply hasn’t changed. Typically a woman of higher age may try cycle or two to see if her own eggs work. The success rate for such successful pregnancy is not very high and ovum donation may be a solution.
2. Premature ovarian failure can happen in a good proportion of woman for no obvious reasons. This may be association with autoimmune conditions like diabetes or other allergies. But the bottom line is there are no eggs to make a baby.
3. Turner’s syndrome and other such conditions wherein the ovaries do not have eggs right from birth. Variations of turners syndrome is that will mean that the supply of eggs is very less and such women attends menopause as early as 20 or 25 years.
4. Removal of ovary because of cyst or tumours
5. Destruction of ovary because of endometriosis or surgery etc.
Type of ovum donation – fresh vs frozen
In effect an ovum donation cycle is like a single normal IVF cycle split
between two women. The ovum donor will receive all the injections to create the eggs which are retrieved by the usual egg collection process. After oocyte retrieval, the donor’s cycle is over; there is no embryo transfer (unless it’s an egg sharing cycle discussed later). The recipient will have her endometrium “in synch” with the donors cycle such that when the embryos were formed and ready to make friends transferred to the womb, the recipients endometrium is well prepared and at the right state of physiology. She effectively doesn’t have egg collection but only the second half of the cycle i.e. embryo transfer onwards.
When these two phases are matched in real time, the ovum donation is referred to as “fresh cycle OD”. This has some obvious challenges in terms of ensuring anonymity between egg donor and recipient if both are treated in the same centre.
Frozen embryo transfer is when the eggs are retrieved from the donor, embryos are made and instead of being replaced immediately, a frozen to be replaced at a later date. Click here to read about our blog wherein recent report saying frozen embryos are as good as the fresh ones.
The usual rule about anonymity of donor applies and the right for the child to know about his/her genetic parent at the age of 18 applies for ovum donation as well as it does for sperm donation.
Commercial ovum donation is not legal in UK. For that reason ovum donation was not an easy treatment to offer and the waiting list for recipients has been quite long. More recent legal changes means that up to £750 can be paid to ovum donors (towards expenses) and this has largely increased the recruitment for ovum donation. We have to remember that ovum donation is a far more involved process with all the injections to take and operation to undergo, as compared to sperm donations. This mostly explains the challenges in recruiting ovum donors are compared to sperm donors.
Typically an ovum recipient will pay for not only her own cycle, but also the expenses incurred in administering most of an IVF cycle to donors. This increases the cost of a typical cycle by around 60-70%.
In the middle nineties egg sharing was offered as a solution to problems of egg donation by the
Cromwell Centre in London. The concept is simple in which in woman who need IVF but couldn’t afford would act as egg sharers and donate half their eggs to women who needed them. Effectively the woman who donated her eggs got a free cycle whereas the recipient would pay for the expenses for both of them. “Egg sharing” is now very much the accepted norm in the world of fertility treatment but when it was first introduced, it had raised a media storm.
Egg sharing is available at our centre.