Egg Donation - Information for Donors
At present there is a shortage of donated eggs in this country so women who need them often face a long wait for treatment.Why is egg donation needed?
Egg donation offers new hope for some women whose ovaries do not produce eggs. This may occur because of premature ovarian failure, or because the ovaries have not developed properly (chromosomal problems such as Turner’s syndrome), or due to previous surgery, chemotherapy or radiotherapy. Premature menopause affects 1% of women under the age of 40 and well over 100,000 women are affected in the United Kingdom alone. Also, many older women undergoing fertility treatment may have a better chance of achieving a pregnancy if they receive donated eggs.
Egg donation is also of benefit to women who are carriers of genetic disorders (e.g. Haemophilia and Muscular dystrophy) and have a high risk of passing such disorders to their children.
Selection of Egg donors
Potential donors should be aged 18 years or more and not over 36 (unless there are exceptional circumstances) and preferably of proven fertility. You can donate eggs for your relative or friend or to an anonymous recipient. Please note that since 1st April 2005 so that children born from donor egg treatment (or donor sperm treatment) are now entitled to know the identity of the donor when the child reaches the age of 18 years.
All donors will have blood tests to check their chromosomes, and also for HIV antibodies (AIDS), Hepatitis B&C, CMV and Cystic fibrosis.
Will I receive payment for donating my eggs?
No. Donors will have all transport expenses and other reasonable expenses reimbursed, but there is no financial remuneration for the actual donation.Will donors remain anonymous?
The law has changed since 1st April 2005 so that offspring of donor egg treatment (and donor sperm treatment) are now entitled, if they wish, to know the identity of the donor when the child reaches the age of 18 years.
Clinics have a legal obligation to record a donor’s name and all relevant details about her. The Human Fertilisation and Embryology Act 1990 requires that the names and details of all donors must be registered with the HFEA. It also makes the unauthorised disclosure of these names a criminal offence. In general, the only people allowed to know a donor’s name are the members and employees of the HFEA, and staff covered by an HFEA licence at a clinic. In the same way, the names of the woman treated and any resulting child are confidential and cannot be passed to the donor. Note that the HFEA has a legal duty under the HFEA Act to tell adults who ask whether they were born as a result of treatment using donated eggs or sperm. People aged 16 or over, who ask, can be told whether they could be related to someone they wish to marry.
What information will the recipient be given about me?
All information will be non-identifying, and will include information you provided on your registration form. We try and match donor and recipient physical characteristics as closely as possible, however, we advise the recipient that the results of this cannot be guaranteed.Will I have a continuing responsibility to any child born following the donation?
No. Donors have no relationship in law with any child resulting from treatment using eggs that have been donated and no obligations to or rights over the child. At the time of donation you relinquish all legal rights and claims over any offspring which may result from the donated eggs, and all duties towards it.Will I be held responsible if a child born from my donation is disabled in any way?
It is your responsibility to inform us of any genetic or inheritable diseases which have occurred in your family. Failure to do so is an offence. A child born with a disability because a donor did not disclose information about an inherited disease in her family which she knew about, or ought reasonably to have known about, may be able to sue the donor for damages. However, provided a donor is open and honest about her medical and family history, this is extremely unlikely.Will I receive counselling?
The HFEA guidelines state that skilled and independent counselling by someone other than the medical practitioner involved in the procedure must be available to the donor. We encourage you take up the offer of counselling, however, it is not compulsory. You should ensure that all your questions are answered and that you understand all the issues involved and that you have sufficient information to make an informed decision.What will happen if I change my mind?
Donors must give “informed consent” to the use and storage of embryos produced from the donated eggs. Consent is given by completing and signing a form supplied by the HFEA to the hospital, before any treatment begins. This consent may be withdrawn or varied at any time except in respect of an embryo which has already been used.Donors will be asked to give consent to the egg collection procedure. Donors are free to withdraw consent to the egg collection at any time before the operation.
What are the steps involved in Egg Donation?
Initial Hospital visit:
This involves a consultation with a doctor who will record your full family and medical history as well as explaining in full, the potential medical and surgical complications of the procedure. He or she will also discuss the social, ethical and legal aspects of egg donation. Your permission will be obtained so that we can write to your General Practitioner for confirmation of your medical history. The different steps in egg donation will be explained. Consent forms will be discussed. The implications of the screening tests especially HIV testing will be discussed and it is then left to you to decide if you wish to proceed.Drug treatment to control your cycle and stimulate your ovaries:
In general, donors will receive three forms of medications.- Nafarelin or Buserelin: is given as a nasal spray two or three times a day. The function is to suppress your own reproductive hormones and enable greater control over when the eggs are produced.
- Gonadotrophin: This is a course of daily subcutaneous injections to stimulate your ovaries. Your will be taught to self-inject using a special easy to use auto-injector.
- HCG (Profasi): Approximately 34-38 hours before egg collection you will be required to have this injection subcutaneously, same way as you have been having the gonadotrophin injections. This injection is timed so that the egg maturity is complete and egg collection can be performed prior to ovulation.
Egg Collection:
Eggs are collected through the vagina using a needle guided by ultrasound. This is done under intravenous sedation, rather than general anaesthetic.What are the possible side effects of the medications?
Nafarelin or Buserelin spray or injection work by suppressing the production of hormones from the pituitary gland in the brain which stimulate the ovaries to produce follicles. After approximately 10-14 days administration of Synarel, the normal function of the ovaries will be “switched off”. This allows for more control over the development of follicles in response to the administration of fertility injections. It also prevents spontaneous ovulation. Once the ovaries are switched off and the oestrogen level in the blood is low, some women may experience symptoms which could include hot flushes, feeling of depression, irritability and headaches – it is perfectly safe to take paracetamol if needed. Whilst taking the nasal spray your period may be different from usual (sometimes lighter, but it may also be heavier). These symptoms usually disappear once fertility injections are commenced.Possible treatment risks to the Donor
These risks are small. There may be mild side-effects noted with the drugs, such as hot flushes and irritability. Sometimes a sensation of bloating in the lower abdomen is noted. Following egg collection there may be lower abdominal pains but these usually subside.
On day 9 of injections an ultrasound scan is performed to see how many follicles have developed. At this stage it may be clear that the egg donor has responded excessively to the injections and has produced too many follicles. To avoid the development of more serious side-effects known as Ovarian Hyperstimulation Syndrome (OHSS), the final injection and egg collection may have to be cancelled.
Despite careful monitoring, a small number of women may develop a mild to moderate form of OHSS. Cysts may appear on the ovaries and fluid may collect in the abdominal cavity, causing abdominal discomfort. It is usually treated by bed rest, drinking plenty of fluids and taking simple pain-killers. The cycle may have to be abandoned. Very rarely (in about 1% of cases) the response to the injection is excessive and a large number of eggs develop causing the ovaries to swell. Side-effects such as nausea and vomiting, abdominal pain and swelling, and shortness of breath occur. A patient may also feel weak and notice a reduction in urine output. These serious complications require urgent hospital treatment to restore the fluid balance and monitor progress. Women undergoing ultrasound-directed egg recovery may notice a small amount of blood in their urine or from their vagina for a day afterwards. This is quite common and should not cause concern.