Egg and Embryo Donation

All processes are as per ICMR guidelines only. Counseling by an independent counselor is mandatory.

Egg and embryo donation should be considered after a definitive diagnosis and informed consent of both partners as per the ICMR guidelines. The donor and her husband are again counseled and both the couples should sign the consent as prescribed by the ICMR. Egg donation is when a woman (donor) gives her eggs to another woman (recipient) to allow the recipient to have a baby. To donate eggs, the donor must be given medications that will cause her to develop multiple eggs over a single cycle. The eggs are then removed from the donor by placing a needle that is attached to an ultrasound probe through the vaginal tissues. The eggs are then gently aspirated (suctioned) from the ovaries. Once the eggs are removed, they are evaluated by an embryologist. Then sperm from the male partner or a sperm bank is placed around or injected into each egg. This process is called in vitro fertilization (IVF).

Recipient Preparation

The recipient’s uterus (womb) must be synchronized with the donor’s stimulation so that they are ready at the same time. There are several ways to achieve this. Once the donor starts the medication to stimulate her ovaries, the recipient begins taking estrogen to develop her uterine lining. Around the time of egg retrieval, the recipient will begin taking progesterone to enable implantation of the embryo (fertilized egg). The embryo(s) will be transferred to the recipient’s uterus three to five days after fertilization. Hormones continue to be given until the pregnancy test and then, if the test is positive, during the early part of the first trimester of the resulting pregnancy.

Need for donor eggs

Egg donation is used for a woman who wishes to have a child but cannot get pregnant with her own eggs. This may be because she was born without ovaries, is in menopause, did not respond adequately to hormonal stimulation of her ovaries in the past, or has had poor egg or embryo quality with previous IVF attempts. Women may also choose to use a donor if they have a genetic disease that they do not want to pass on to their children.

Recipient Preparation

The recipient’s uterus (womb) must be synchronized with the donor’s stimulation so that they are ready at the same time. There are several ways to achieve this. Once the donor starts the medication to stimulate her ovaries, the recipient begins taking estrogen to develop her uterine lining. Around the time of egg retrieval, the recipient will begin taking progesterone to enable implantation of the embryo (fertilized egg). The embryo(s) will be transferred to the recipient’s uterus three to five days after fertilization. Hormones continue to be given until the pregnancy test and then, if the test is positive, during the early part of the first trimester of the resulting pregnancy.

Need for donor eggs

Egg donation is used for a woman who wishes to have a child but cannot get pregnant with her own eggs. This may be because she was born without ovaries, is in menopause, did not respond adequately to hormonal stimulation of her ovaries in the past, or has had poor egg or embryo quality with previous IVF attempts. Women may also choose to use a donor if they have a genetic disease that they do not want to pass on to their children.

Egg donor profile

Egg donors are women, usually between the ages of 21 and 30, who are willing to provide their eggs to a recipient. They may be anonymous (unknown) or known to the intended parents. Anonymous donors are recruited through egg donation programs or agencies and are not known to the recipient. However, some couples find donors through advertisements. Recipients should be cautious about recruiting donors without the use of an intermediary to screen the donors and should strongly consider seeking legal counsel. Known (also called directed) donors are generally a close friend or relative of the recipient.

Tests for the donor

The donor is tested for infections such as HIV, Hepatitis B and C, gonorrhea, and syphilis. All donors should be tested. Other genetic testing should be performed based on the donor’s history and ethnic background. Psychometric testing is often done as part of the mental health screening.

Tests for the recipient

Evaluation of the recipient is similar to that of couples undergoing routine IVF. This should include a comprehensive medical history from both partners, including blood type and Rh factor, and testing for sexually transmitted diseases including HIV, hepatitis, gonorrhea, chlamydia, and syphilis. The couple should be counseled by a mental health professional about the complexity of the decision to use donor eggs. The recipient should have a pelvic exam and an assessment of her uterus (womb). If she is over 45 years old, a more thorough evaluation should be done, including an assessment of heart function and the risk of pregnancy-related diseases. She may also be advised to see a doctor who specializes in high-risk pregnancy. The male partner’s sperm should be analyzed and appropriate genetic screening should be obtained based on his history and ethnic background.

The chance that a donor egg cycle will result in pregnancy

The success of egg donation depends on many factors but is not considered to be related to the age of the recipient. Success rates are an average birth rate per embryo transfer of 55% for all egg donor programs.

Embryo donation

When the egg and the sperm are absent or have severe defects, embryo donation program is one of the options counseled.