Before in vitro fertilization (IVF) was developed, there were no options available for women who had diminished ovarian reserve, ovarian failure, or potential for genetically transmittable diseases. Luckily, today woman who have fertility problems can use an egg donor, which is a woman that donates her eggs to another woman or couple.
Who should use an egg donor?
The main indication for egg donation is premature ovarian failure (POF), which is defined as menopause that occurs before the age of 40 years. POF affects 1% of the female population in the U.S. This condition indicates diminished number of eggs and cessation of ovarian function. Other candidates for egg donation include women who have failed before on IVF, women who could pass genetic conditions on to their offspring, and women who have suspected poor egg quality.
What do women over 40 have problems with conception?
The predominant indication for egg donation at most fertility clinics is advancing age 40 years or older. Women over 40 have a poorer chance for success using IVF. The age-related decline in fertility is the result of aging eggs. The indication of diminished ovarian reserve is reflected by an elevated follicle-stimulating hormone (FSH) and estradiol levels early in the menstrual cycle.
How is the recipient female tested?
A woman considering using donated eggs will undergo a comprehensive medical evaluation. This includes a physical examination, medical history, and diagnostic tests. This testing is done to seek and correct any abnormalities that could compromise the success of IVF using donor eggs. Cervical cultures are obtained to assess for bacteria, a hysterosalpingogram is used to check for uterine abnormalities, and the male partner’s semen is analyzed for a coexisting male factor.
How is the recipient female prepared for receiving the donated eggs?
The donor egg recipient will undergo a preparatory cycle of hormone replacement before the actual IVF treatment cycle. This is done to ensure the medications will actually achieve the desired blood levels and uterus effects. To evaluate the regimen, ultrasound is used to measure uterine lining thickness, or the doctor performs an office endometrial biopsy. In addition, the woman will undergo pretreatment counseling to discuss the procedural aspects, risks of the procedure, and success rates.
Is the egg donor tested?
Each potential egg donor undergoes a thorough evaluation, whether she is known or anonymous. The egg donor must be 34 years of age or younger, have no indication of impaired fertility, and have laboratory evidence of a normal ovarian reserve. In addition, the donor is tested for communicable and transmitted diseases, such as HIV, syphilis, and hepatitis. Genetic screening is done using a questionnaire as well as certain blood tests. Finally, a formal psychological evaluation and history is done.
What medications are used?
To prepare the recipient’s uterine lining (endometrium) to receive the fertilized donor eggs that develop into embryos, certain medications are used. For women with premature menopause, the uterus is prepared using estrogen and progesterone, which aligns their cycles with that of the egg donors. The recipient who has ovarian function must take Lupron to suppress release of eggs. Estrogen (estradiol) can be taken by injection, skin patch, or pill for 2 weeks. Progesterone is administered by vaginal suppository, vaginal gel, or injection. After the embryos are transferred, the recipient continues taking hormones until the pregnancy test is positive.
How are donor eggs developed into embryos?
Once the donor eggs are retrieved or thawed, they must be fertilized in the laboratory using the male partner’s sperm. The recipient will undergo a transfer 3-5 days after egg retrieval from the donor. The sperm and eggs are combined in the laboratory where they culture and grow. The fertility specialist will place 1-2 embryos into the recipient female.