Thousands of children are born every year using donated eggs, sperm, or embryos. Donation is an altruistic act which may represent the only hope for some infertile people to have children of their own.
The act of donating can have a significant impact on the people who receive the donation, the donor-conceived child, the donor, and their family.
It is not a decision to be taken lightly and should be carefully considered before being attempted.
There are many reasons to become a donor. It could be to help others, or a particular friend or family member, even if you have children of your own.
Counselling is usually necessary to give opportunity to discuss what is involved and future implications.
In a legal and social sense, recipients of donor eggs and sperm or embryos are considered parents of any child that is born.
Many couples require donor semen to create a pregnancy in cases of male factor infertility or to avoid transmitting a genetic disease. It may also be used by women who wish to become pregnant without involving a male partner.
When there is severe male factor infertility, couples are most commonly offered a choice between using donor semen and using in vitro fertilisation (IVF) with Intracytoplasmic Sperm Injection (ICSI).
A combination of IVF with ICSI is often considered. However, using donor semen is less invasive and less expensive, but the man will not be the genetic father of the baby.
Preferably, men in their 20s and 30s are eligible as older men are more likely to pass on problems like genetic disorders and even mental illnesses.
The sperm is often frozen and success rate is about 10 to 15 per cent per cycle, depending on age of the woman is who is using the sperm.
Typically, women in need of donors are often above the age of 40 and no longer have viable eggs.
They may have gone into early menopause, have a history of genetically transmittable diseases, or have had multiple unsuccessful IVF attempts using their own eggs. With technology it is now also possible to use frozen donor egg.
Most egg donors are young adult women who are recruited and screened by fertility programmes or through private arrangement by the infertile couple.
The donors undergo the required medical procedures (taking fertility drugs, monitoring, and egg retrieval) at the same programme as the recipient.
Screening of potential egg donors is essential and it is important for the couple to be comfortable with how the egg donor has been selected and screened, and how she will be treated by the programme.
Normally, known donors may be used if they fit eligibility standards. A friend or relative could serve as your egg donor.
Donor eggs may be used in IVF when a woman wants to avoid transmitting a genetic disease or no longer produces viable eggs, often because she is approaching or has entered menopause.
When donor eggs are used in the IVF process, the pregnancy rate corresponds to the donor’s age. With supplementary hormone treatment, many women in their 50s or older have given birth through this process.
Whether or not an embryo implants is determined by the age of the woman that produced the egg and not the age of the recipient.
This is an important aspect. Since younger eggs are higher quality and have significantly fewer chromosomal abnormalities, they have a much better chance of implanting.
It is also important to stress that when donor eggs are used, the recipient is the birth mother not the genetic mother of any resulting children.
The egg retrieval process is simple. Multiple eggs are retrieved from the donor’s ovaries through a minor surgical procedure and then mixed with sperm in the laboratory to enable fertilisation and form embryos.
Then, one or more of the best-quality embryos is transferred to the uterus of the recipient in the hope that it will attach to her uterine wall.
Medication often helps boost implantation and conception after a donor embryo is transferred into a woman’s uterus. Usually she should have received medication to prepare her uterus to receive the embryo.
Donor embryos are used when there is both male and female infertility, by couples who wish to avoid transmitting a genetic disease, or as a possibly less costly alternative to a complete IVF cycle.
Donor embryos may come from couples who created and froze extra embryos during their own treatment but no longer wish to use them. The donors are screened just as thoroughly as semen or egg donors.
The use of known donors can sometimes be an ethical slippery slope and that has made some clinics to place restriction on the relationships they allow.
This is to ensure that a woman does not feel pressured to donate because of her emotional or financial ties to the recipient e. g some clinics do not permit an employee or young adult daughter of a woman to become her egg donor.
Written by Dr. Abayomi Ajayi