When All That Science Has To Offer Is Not Enough
Even sophisticated, 21st-century medical technology has its limitations. When the best science has to offer is not enough for other medical problems, we may be forced to rely upon the replacement of faulty organs with donor organs. When science cannot help in reproduction we can turn to donation of sperm and eggs to achieve a healthy pregnancy. Donation of semen has been practiced for more than a century. The history of egg donation spans almost four decades. Initially it was applied only to women with ovarian failure who were unable to produce any eggs. Its use has further expanded with the realization that egg quality and number are critical to IVF outcome. Egg donation will yield much higher success in:
- poor responders to stimulation or women who produce poor-quality eggs or embryos, or both
- those who have a markedly reduced prognosis due to an elevated Day 3 FSH
- women who are of advanced age
When Is Egg Donation Appropriate?
Prime candidates for utilizing donor eggs are patients when the female partner:
- has laboratory evidence of premature ovarian failure, usually manifested in elevated gonadotropin levels (FSH and LH)
- has demonstrated poor follicle development with stimulation due to reduced ovarian tissue because of previous surgery, damage to the ovaries by chemotherapy or radiation during successful therapy for a malignancy, or for unknown reasons
- carries a genetic disease or chromosomal defect likely to be passed on to her offspring, resulting in miscarriage or an abnormal baby and does not want to do PGD or PGS
Or in which the couple:
- may have had multiple failed IVF procedures, particularly with poor egg quality being found
- may be over 40 and may choose egg donation because of a dramatically higher rate of success
Making the Decision
The decision to utilize donor eggs can be made in two ways.
- It seems to be an easier decision to make if the patient has a relative or friend who wishes to donate eggs for her. However relatives or friends may not make the best donors as they are being selected because of their relationship, not characteristics which would make them most likely to succeed.
- Therefore we usually recommend obtaining eggs from an anonymous donor who is selected because of physical characteristics similar to the intended parent, her young age and her excellent ovarian reserve. The characteristics used to match a donor to a recipient are usually primarily ethnicity, hair and eye color, and, in some cases, education. The recipient couple can ask for any set of criteria, but the stricter their criteria, the less chance that they will find a suitable donor. The anonymous donor is fully vetted for her background, health history, habits, psychological and genetic profile and screened according to FDA rules for infectious diseases.
How Do We Find A Donor?
Until recently all egg donation was done in a fresh IVF cycle which required both the donor and recipient to have their cycles suppressed over a lengthy period of time so that they will be in synch. Fresh donors are available at some IVF centers or egg donation agencies, which recruit and initially screen the donors and charge a fee for their services.
Now, thanks to technology that allows eggs to be frozen, frozen eggs are available which can be used in a much quicker and easier process for the recipient couple. Reproductive Partners is fortunate to have partnered with Donor Egg Bank USA, which has frozen eggs from prescreened donors available immediately. The lack of a need to suppress the recipient’s cycle and coordinate with the donor’s cycle and schedule makes the process much quicker, often completing the embryo transfer within three weeks of the recipient’s last menstrual period. The efficiency of being able to use one donor’s frozen eggs for several potential recipients makes the process much less expensive.