December 5, 2019 by AltiusHospital
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Egg donation is one of the techniques of reproductive medicine.Its basic principle consists of retrieving from a woman (called a donor) her reproductive cells or eggs, called oocytes or ova, which are situated in the ovary, in order to donate them to another woman (the patient, called the recipient) to be used in the latter’s parenting project, through in vitro fertilization (IVF) (Fig.1). This donation, regarded by some for as a donation of an organ or blood, is a donation of life, result of the fruit of great feminine solidarity, enabling certain women to allow others to become mothers. This exceptional donation without any doubt gives rise to questions at various levels: practical, genetic and ethical.
WHO IS A CANDIDATE FOR DONOR EGGS?
The Donor Egg Program is designed for patients who cannot conceive from their own eggs. Most commonly, such patients include.
DOES THE EGG RECIPIENT KNOW THE EGG DONOR?
Most commonly not. Most of the patients choose an anonymous donor, someone who is unknown to them. Patients find a suitable egg donor, either from donor pool or from an agency that provides such donors. The identity of the egg donor will never be disclosed to the recipient. Anonymous donors get compensated financially for their time and efforts by the recipient. Some patients may have relatives or friends who are ready to donate eggs for them.
HOW ARE DONORS SCREENED?
Anonymous donors have to be 21-32 years old, physically and psychologically healthy and non-smokers. Candidates fill out a questionnaire, which includes detailed medical history, genetic history, family history, as well as social behavior and general interests. Psychological, emotional, ethical and legal aspects of the donation are discussed. It is of extreme importance to us to make sure that the donor is fully informed and comfortable with the process, and that the donation process will not affect her adversely. Once the donor gives her full, voluntary consent to participate in the process, the following tests then take place:
DO RECIPIENTS GET SCREENED AS WELL?
Yes. Patients will have an initial consultation . At that time all aspects of the egg donation will be discussed. Special issues that will be addressed include the anonymity of the donor, the screening of the donor, and the potential psychological impact that having a child through egg donation might have on the recipient. Since we realize that the decision to conceive through egg donation may be very difficult for the couple, they will be referred for a psychological intake and emotional support to discuss issues such as third-party reproduction, issues of disclosure to the future offspring and parenting at a later age, where appropriate. Patients 45 years or older will need medical clearance from their internist, in addition to pre-conception counseling with a high-risk obstetrician. Both the recipient and her male partner will be screened for infectious diseases. The partner will provide a sperm sample for evaluation and freezing. Arrangements can be made for donor sperm in applicable cases.
HOW DOES THE ACTUAL DONOR CYCLE WORK
Recipient and donor cycles are synchronized with the help of medications. The donor receives fertility injections for 7-13 days to stimulate her ovaries to produce eggs. During that time period, she gets monitored frequently by blood tests and ultrasounds. In the meantime, the recipient’s uterine lining is prepared with estrogen. Once the donor’s eggs seem ready, she receives an HCG injection. One-and-a-half days later, she undergoes an egg retrieval procedure. This procedure is done with the guidance of a vaginal ultrasound machine and under anesthesia (IV sedation). The donor is discharged following observation in the recovery room.
DONOR IS ADVISED TO PRACTICE CONTRACEPTION FOR ANOTHER 3 WK AS THERE MIGHT BE A CHANCE FOR DONOR TO CONCEIVE.
All eggs are isolated, counted and placed safely in the incubator. The recipient starts progesterone treatment. Her husband provides a sperm specimen. The donor’s eggs are then fertilized with the recipient husband’s sperm, and returned to the incubator. Embryo development is recorded in the lab over several days. Finally, on the third or fifth day post retrieval, several embryos are transferred into the recipient’s uterus. The remaining embryos are frozen for future use by the recipient couple.
Planning the Cycle:
An Egg Donor IVF cycle consist of the following protocol:
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