Questions With Dr. Blotner About Egg Donation
The first child born from egg donation was reported in Australia in 1983 at the Monash IVF clinic. Over the past thirty years, thousands of infertile women, single men and gay male couples have been able to use human oocyte donation to build their families.
For those women who do not have viable eggs, using an egg donor is a great option to consider. Dr. Blotner answers the most frequently asked questions regarding egg donation.
Q: What type of fertility issues would cause a woman to consider egg donation?
A: The primary reason for a woman to seek an egg donor would be very low egg reserve, which also implies a decreased egg quality. This will be reflected in an elevated FSH (follicle stimulating hormone) or a low AMH (anti-mullerian hormone). Also in the cases where in vitro fertilization has failed multiple times, eggs from a donor may be appropriate.
Q: What is a snapshot of the “typical” egg donor?
A: The typical egg donor is a woman over 21 years of age, commonly in graduate school or pursuing a career. While financial compensation is a central motivation, there is often an altruistic desire to help other women conceive.
Q: Does health insurance cover any of the costs of retrieving eggs from the donor?
A: Unfortunately, health insurance can only be used for tests and procedures that involve the recipient (not the donor). The costs include those for mandatory laboratory screening; intake appointment and physical exam; medications involved in stimulation of the donor; monitoring hormone levels and ultrasound development of the follicles; the actual egg retrieval with anesthesia and donor compensation.
Q: How extensive is the screening of egg donors? Are donors checked for genetic abnormalities that could cause miscarriage or life threatening illnesses in the baby?
A: The donors are screened for sexually transmitted diseases (HIV, Hepatitis B and C, etc.) as well as genetic testing for chromosome analysis, cystic fibrosis, and hemoglobin abnormalities. Other genetic tests may be obtained when applicable (i.e.: Tay-Sachs screening for Ashkenazi Jewish descent).
Q: How are donor eggs retrieved?
A: The egg donor is stimulated with injectable hormones (FSH and LH) on a daily basis from the early phase of the menstrual cycle, and she is monitored every few days by serum estrogen levels and ultrasound evaluation of the ovaries. At the same time the recipient’s uterus is being prepared with hormone supplements to ultimately receive the embryos. When the eggs are deemed mature, the donor undergoes general anesthesia for 15-20 minutes while the eggs are retrieved by transvaginal ultrasound and a needle aspiration of the eggs from each ovary.
Q: What happens to the donors’ eggs after they are retrieved?
A: The donor eggs are isolated in the laboratory and injected with the sperm of the recipient’s male partner (or sperm donor, as indicated). The resultant embryos are monitored and allowed to develop to an appropriate stage for transfer into the recipient’s uterus. Often extra embryos may be present to be cryopreserved (frozen) as a backup for additional attempts or future pregnancies.
Q: Can the egg donor donate multiple times? Does the couple receiving the eggs know about the other babies that have been born using the same donor?
A: Egg donors are allowed to cycle several times. Information regarding prior successes is available, but the specific information regarding other patients and their offspring is protected under HIPAA (privacy law).
Q: How does a person choose an egg donor?
A: Egg donors are recruited by agencies, and are generally selected by the recipients based on shared physical characteristics, desired educational or ethnic backgrounds. Extensive family history screens are also presented for review.
Q: What are the challenges in using a donor’s egg? (monetary, physical, emotional)
A: Donors may be local, which makes monitoring easier or they may need to commute or even fly from their place of origin. This requires coordination with a fertility center in their locale. This also requires lodging and accommodations for the donor during the time of the egg retrieval. This adds to the cost of the entire process. The recipient and her partner must also be emotionally ready to abandon the idea of conceiving with her own eggs.
Q: What are the benefits of the egg donation process?
A: While adoption is an option for many couples, the use of an egg donor provides the opportunity for the male partner to contribute to the genetics of the offspring. The recipient is also able to experience pregnancy and childbirth and bond with her child. The chance of conceiving through donor eggs is approximately 50-60% per transfer, as opposed to less than 5% using her own eggs.