Egg Donation: Requirements, Tests and Process

By (embryologist), (gynecologist) and (babygest staff).
Last Update: 12/02/2019

In a surrogacy process, egg donation must sometimes be used so that IVF can take place and the embryos be formed. Single men, gay couples as well as women with problems producing quality eggs should turn to an egg donor.

In some countries, like in Spain for example, the gametes donation is an altruistic and anonymous act, in no way can the identity of the donor be known, the choice is made by the clinic staff and it is only verified that they share blood type and general physical characteristics with the future mother. Once the candidate has passed the initial fase, the process begins, which basically consists of the fases: ovarian stimulation and follicular punction.

When the donor eggs are extracted, they either can be fertilized fresh or vitrified for the future recipient.

What does egg donation mean?

Egg donation is the voluntary, altruistic and anonymous transfer of eggs from one woman to another so that she can achieve her wish: to become pregnant.

Naturally, women are born with about 400,000 immature eggs in their ovaries and only about 400 will mature and be able to be fertilized. Therefore, the donation of eggs does not condition the fertility of the donor, since the donated oocytes would never be used.

The process of egg donation is not simple and it is necessary to pass tests and requirements established by law. All aspects must be well known before making a decision.

Requirements to donate

Surrogacy egg donors meet the same requirements as any other donor, and these women are young enough (21-30 years) to obtain many good quality eggs and to respond well to the medication received for the stimulation process.

They also undergo psychological testing, infectious disease testing, and genetic evaluations to ensure that the future baby has the healthiest genetic material. They will follow the same procedure that is used in any donor. The success rate they have in gestational surrogacy with donor eggs is around 70%.

Here we list some of the requirements which must be met in order to take part in egg donation programs:

  • Being of legal age and not older than 35 years.
  • Perfect health conditions (mentally and physical).
  • Not being adopted
  • Having a normal function of the reproductive system.
  • Not having any malformations, infections and hereditary genetic diseases.
  • Having a healthy BMI between 18 and 25.
  • Not having more than 6 live births which includes own children of the future donor.

A positive but not essential aspect is that the egg donor has already been a mother or has donated eggs on other occasions, which guarantees her chances of success.

It should be added that at this point the woman has not yet become an egg donor, as she must first pass all the tests discussed in the following section.

Choosing a donor

Legislation is different in each country, so conditions for oocyte donation should be taken into account. For example:

  • Most countries do not allow the surrogate to donate her eggs, so there is no genetic link with the baby.
  • There are countries where the donor can be selected, is not anonymous and can even arrange an interview with her.
  • In the U.S., parents are allowed to contribute to the donor, so she may be a family member, friend...

The donor should always be tested to verify that she is a healthy woman and does not have any inherited diseases. Donors should be young women, as the quality of eggs decreases with age. Among the tests, an interview is also necessary to check that you are aware of what an egg donation means and wish to participate in the process on a voluntary basis.

Each country has its peculiarities, and it is also important to keep in mind that the cost of this technique will be added to the price of surrogacy. The price will vary depending on the destination but is a costly process, for example in the United States, it can mean an increase of 10,000 dollars.

Medical Screening

This type of testing is intended to confirm that the egg donor does not have any sexually transmitted or infectious diseases that may be transmitted to the offspring. Thus, the following procedures will be carried out:

Gynecological examination
a vaginal ultrasound, Pap smear, or culture is done to check the functionality of the reproductive tract.
Blood analysis
includes a complete hemogram and a hormonal analysis.
Serology
to ensure that the donor has no viral or sexually transmitted diseases. Therefore, the herpes virus, hepatitis B and C, syphilis and HIV are studied.
Genetic study
a karyotype is performed to see all the chromosomes of the donor.

Psychological Screening

The psychological interview conducted with egg donors aims to ensure that the woman has full capacity to act voluntarily and that the donation process would not be psychologically damaging in the future.

The future donors will have to fill in some questionnaires that are given to them in the center. In addition, they will undergo an interview with the psychologist that will take into account the following aspects:

  • current emotional state.
  • Psychiatric background.
  • Family history.
  • motivation for donation.

When all the necessary tests are performed, the psychologist is responsible for making the decision as to whether or not to accept the candidate as an egg donor. Therefore, if the results are satisfactory, treatment is initiated to obtain the oocytes from the donor.

Types of donor

According to each country, the donor may chose to be anonymous or public. In some countries, however, the donor is exclusively anonymous, so the future parents and their newborn won't have the opportunity to get to know the women, who voluntarily chose to provide her own eggs to help the couple get pregnant.

In this section, we are going to explain the differences between anonymous and public egg donation.

Anonymous Donor

Most egg donation programs work with anonymous donors, but there are also some programs that offer a catalog of available donors, each with a profile, family medical history, ethnicity, weight, height, build, skin type, eye color, and hair color and texture. One of the most important characteristics is the age of the donor, as young donors (20 -30 years) respond much better to fertility treatments and provide a greater number of healthy eggs.

Thus, oocyte donors may be patients who have surplus oocytes after ovarian stimulation and who voluntarily give their consent for their remaining oocytes to be donated to women who need them, healthy women up to the age of 35 with normal reproductive function who are willing to undergo the donation process in exchange for financial compensation.

Usually, the choice of the donor is made by a medical team based on the physical characteristics of the recipient, ensuring the maximum possible phenotypic similarity with the recipient woman to promote the integration of the future child in the family nucleus.

Known Donor

In other cases, donors may be known, usually friends or relatives of the prospective parents, provided that the country's legislation permits this. For some parents the genetic inheritance is very important for that reason there are several couples who use the eggs of a sister to carry out this treatment.

How does the egg donation process work?

The process that the egg donor goes through consists of two parts: ovarian stimulation and follicular puncture. The egg donor must administer a hormonal medication to produce multiple ovarian follicles and then extract the eggs generated.

These two processes are described in the following sections.

Ovarian Stimulation

This stage for egg donation consists of administering hormonal medication to the donor to promote the development of multiple ovarian follicles. This means that the ovaries will be able to produce a large number of eggs.

The hormonal medication will be provided by the clinic and will be administered according to the indications marked by the gynecologist. There is no single stimulation protocol, but it is different according to the characteristics of each woman. This medication contains the hormones FSH, LH and also some GnRH analogues to prevent spontaneous ovulation.

Generally, ovarian stimulation lasts 8-10 days and during this time, the donor will visit the clinic every two days to check the growth of the follicles until reaching a size of 16-18 mm .

In this way, the doctor will indicate the most appropriate time for ovarian puncture. In addition, the donor should administer the injection with the hormone hCG to induce ovulation 32-36 hours before the intervention.

Follicular Punction

Ovarian puncture or follicular puncture is a simple intervention to extract eggs and is performed under sedation. The process usually lasts approximately 15-20 minutes , during which the gynecologist will aspirate each of the ovarian follicles that have grown using a suction needle.

Ovarian follicles are small fluid-filled sacs that contain eggs and are located in the ovaries.

Success rates

The gestation rates obtained through oocyte donation are the highest in the field of assisted reproduction, reaching 60% gestation by embryo transfer.

FAQs from users

When is egg donation required?

By Dr. Joel G. Brasch (gynecologist).

Egg donation is required for decreased ovarian reserve with advanced maternal age or with premature ovarian insufficiency. Donor oocytes treatment does not have an age limitation.

In case I need donor eggs for surrogacy, can I get to know my egg donor as well?

By Dr. Joel G. Brasch (gynecologist).

There are two types of egg donation – anonymous donation and know donation. You will not be given your donor’s contact information if it’s anonymous donation, but you will see their pictures and detailed background information. You can contact and get to know your donor if it’s known donation, but the cost may be a bit higher. Both options are available, but anonymous donation is more common.

What are the risks for egg donors?

By Marta Barranquero Gómez (embryologist).

The main risks of egg donation for women derive from ovarian stimulation and follicular puncture.

Although rare, egg donors may experience ovarian hyperstimulation if their body responds intensely to the medication given. In addition, follicular puncture is performed under anesthesia, so it is not completely risk-free.

Does the egg donor receive any financial compensation?

By Marta Barranquero Gómez (embryologist).

This depends on the country the egg donation is going to take place.

While in the U.S an egg donor can make up to 14,000 dollars per cycle, in other countries like Spain the process is completely altruistic which means she only gets her expenses covered which derive from the egg donation process. Thus, the compensation she'll receive will be between 800 and 1000 euros.

Can I have sexual intercourse during egg donation process?

By Marta Barranquero Gómez (embryologist).

It is not advisable to have sexual intercourse during an egg donation process. The donor is subjected to a hormonal treatment for ovarian stimulation, which multiplies the risk of pregnancy during those days.

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References

Authors and contributors

 Cristina  Mestre
Cristina Mestre
Embryologist
Bachelor's Degree in Biological Sciences, Genetics & Human Reproduction from the University of Valencia (UV). Master's Degree in Biotechnology of Human Assisted Reproduction from the UV and the Valencian Infertility Institute (IVI). Embryologist at IVI Barcelona. More information about Cristina Mestre
Dr. Joel G. Brasch
Dr. Joel G. Brasch
Gynecologist
Dr. Joel Brasch is the Medical Director of Chicago IVF, founded in 2005. He is board certified by the American Board of Obstetrics and Gynecology, and has over 25 years of direct experience in fertility treatment and reproductive care. He is also the Director of Mount Sinai Medical Center’s Division of Reproductive Endocrinology and Infertility. More information about Dr. Joel G. Brasch
Adapted into english by:
 Marie Tusseau
Marie Tusseau
Babygest Staff
Editorial Director of Babygest magazine in French and English. More information about Marie Tusseau

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