What is Egg Donation?
In egg donation, eggs are borrowed from a young woman (less than 33 yrs of age) called the donor, with her consent. These eggs are then fertilized with the sperms of the husband of the recipient woman and the resultant embryo (the earliest form of the baby), is inserted into the womb of the recipient. The success rate of this procedure is in the region of 30 to 40%. In fact, many women till the age of 50-55 have become pregnant by this technique. You will be surprised that the oldest woman pregnant by this procedure is 69 year old, residing in Italy. At Babies And Us, the oldest women who has conceived with this technique is 62 years of age. This is probably the oldest woman to have become pregnant, in India.
Who can qualify for Egg Donation?
In this day and age more and more career oriented women are getting married late in life. By the time they start planning to have children, they are nearing the fourth decade of their life (40 years). Fortunately, at this age, many women can conceive naturally. However nearly 10 to 15% women fail to conceive within a year's time. These women who are more than 37-40 years of age then resort to treatment of infertility by their gynecologist. If they still do not become pregnant they take help of newer technologies like IVF - In Vitro Fertilization (test-tube baby) or ICSI - Intra Cytoplasmic Sperm Injection. Women after the age of 40 tend to have fewer eggs in their ovaries or the quality of the eggs they produce may be poor. Thus, even new technologies like IVF and ICSI may not ensure a successful pregnancy. Furthermore, after the age of 40 to 42, many women stop producing eggs as they enter the stage of Perimenopause (decreased periods) or menopause (stoppage of periods). Till now, such women could only have a baby through the wonderful route of adoption. However, in the last ten years, a new technique of egg donation has come as a blessing to many such women.
In India, preference is given to younger couples to adopt children. Couples over the age of 45 can adopt, but find it difficult to do so, because of Governmental preference for younger parents. Such couples can tremendously benefit by egg donation.
Egg donation can also be perfomed on women who have had multiple cycles of test-tube baby (IVF or ICSI) and have still failed to conceive and become pregnant.
Besides elderly or menopausal women, egg donation can be done in younger women whose ovaries have prematurely failed or in young women who have undergone radiation or chemotherapy for cancer. Radiation or chemotherapy destroys the eggs and hence these women have a failure of their ovaries.
Egg donation is also used in patients who are carrying major chromosomal defects so that they do not pass the genetic defect to their children.
Patients suffering from severe Tuberculosis and severe Endometriosis may also produce poor quality eggs and hence can be treated by egg donation.
How are the Donors screened?
Generally, eggs are borrowed from healthy women less than 30-35 years of age and who are not suffering from any illness or genetic disorders. These young women, also called donors, are specially screened for AIDS and Hepatitis. Their family history is taken, to rule out any genetic problems. The donor can be married or unmarried. However, married donors with children would be preferable, primarily because they will have established their ability to bare children.
How is the procedure done?
The Babies And Us staff will coordinate the cycles of the donor and recipient to accomplish a fresh embryo transfer whenever possible. Synchronization of cycles includes using a series of medications to facilitate a hospitable uterine environment for the transfer of embryos. During egg donation, the donor is given injections to produce many eggs. When these eggs are ripe, she is given a short anesthesia and the eggs are removed from inside the vagina without giving a cut on the abdomen. The donor can return home three to four hours' after the procedure. The eggs are then fertilized with the recipient's husband's sperms in the laboratory, either by IVF or ICSI and kept in the incubator for two days.
Incase the recipient's husband's sperm is of poor quality; the eggs can be fertilized by the technique of Intra Cytoplasmic Sperm Injection (ICSI). Two days later, a four-celled embryo is formed. Three days later, a eight-celled embryo is formed or five days later a multi-celled Blastocyst is formed. This embryo (small baby) is then transferred back to the womb either at the four cell, eight cell or the Blastocyst stage.
30 to 40% of such women will become pregnant. Incase they fail to become pregnant they can have a repeat egg donation cycle. Many women undergo two to four cycles and achieve their goal of a child.
Who can be a Donor?
As easy as the method may sound, the biggest problem faced by both doctors and patients is the availability and source of egg donors. Ideally, the best donor would be her own sister or near relative from her side (not from husband's blood relative). We have done such cases successfully in Lilavati Hospital. However, in this day and age of small nuclear families many times it is difficult to get such donors.
Further more, it is very important that if there is a sister donating eggs, there should be a very good mental understanding between the sisters. The donor is not anonymous in this case, and thus many a time there are possibilities of inter-personal conflicts arising when the child becomes older.
We also accept recipients who have identified their own non-anonymous donors.
The other and the most acceptable donor would be a voluntary unrelated donor. There are a lot of women who may just out of altruistic (philosophical) reasons donate eggs to women who are suffering from the trauma of infertility. It is important to popularize such egg donation. However, even in an advanced society like Britain's, there is a great dearth of voluntary egg donors, in spite of extensive advertisement in the press.
By voluntary egg donation, we mean donation of the eggs by the donor without expecting any monetary or other reward in return.
The third area, which can be a source of donors can be a paid donor. You may be surprised that this is legal in USA and young college girls are paid as much as US$6,000 for donating their eggs. But in a protestant society like Britain's, this form of donation is considered illegal and unethical. Even in the Indian society, where there is no law on egg donation at present, such kind of paid donation may not be socially and culturally acceptable. Clinics in India do not practice paid donation.
Recently the Govt of India has appointed Indian Council of Medical Research to legalize infertility practice in this country including that of egg donation, embryo donation, semen donation & surrogacy. The ICMR has legalised paid egg donation and surrogacy. Our unit at BabiesAndUs fertility IVF ICSI centre has just started doing some degree of paid egg donation based on the ICMR draft.
In all the groups of related, voluntary or paid donors, there is a certain degree of risk the donor is exposed to. The donor is given multiple injections to produce eggs, as well as a shot anesthetic. She is also exposed to the risk of surgical egg removal.
Hence, there evolved a new concept of shared egg donation which started in Britain but is now popular in the USA and also in India. There are many young women who are infertile due to other reasons and who also need the procedure of IVF or ICSI.
However, they cannot afford to spend money for these procedures. Many of these women produce 8 to 10 eggs during their treatment. These patients are asked to share some of their extra eggs with the recipient. This is done by taking the informed consent of the young woman. In return, a part of the expense of medical treatment of the young woman is borne by the recipient. Thus, both the donor as well as the recipient who need IVF, are benefited, without any extra amount of risk to the donor. The anonymity of both-the donor and the recipient- is maintained so that they don't know each other. With the help of this technique, many young women who cannot afford IVF can mother a child. The same goes for elderly women who can afford IVF and can have a child.
The process of egg sharing is an excellent example of symbiotic relationship between women, one with a physical need and one with a monetary need, with the ultimate common goal of bearing a child. It is a safe, effective, successful, legal, ethical and socially acceptable method of advanced reproductive technology.
We at the Babies And Us Fertility, IVF & ICSI Centre generally indulge in family related donors or egg sharing.
We hope that more and more voluntary donors will come forth, to help needy infertile patients become pregnant.
What is the age limit of the recipient?
In general, any woman with a medical or genetic indication for using an egg donor can be a recipient, if there are no medical contraindications to pregnancy. Our current age limit is 55 years. The decision to utilize donor eggs is made in association with staff and consultants. If a male factor exists, donor egg with ICSI is also available. Generally a psychiatrist and a physician would assess a recipient. This is done to gauge the mental and physical fitness of the patient. This analysis is very important to withstand the pressures of childbirth.
What is the background of Recipients?
Centres are renowned for its egg donation techniques. The patients hail from all over the country. They are from different walks of life. Our unit facilities are also utilized by NRI patients (Non Resident Indians) from USA, UK, Africa, Middle East, Sri Lanka & Far East(Singapore). We are also getting some patients from other nationalities who hail from Asian countries..