Egg donation is a medical process where a fertile woman provides her ova, or eggs, to an individual or couple who cannot conceive using their own eggs. This procedure is a well-established form of Assisted Reproductive Technology (ART) that allows intended parents to pursue pregnancy. The donated egg is fertilized in a laboratory setting through In Vitro Fertilization (IVF) before the resulting embryo is transferred to the recipient’s uterus. This method is classified as third-party reproduction because it involves a third person contributing genetic material.
Who Needs Donor Eggs
The decision to use donor eggs is made after a patient receives a diagnosis that suggests a low probability of success with their own eggs. Advanced maternal age is a primary factor, as the quality and quantity of a woman’s eggs decline significantly after the mid-30s, increasing the risk of chromosomal abnormalities. Another common indication is Premature Ovarian Failure (POF), also known as primary ovarian insufficiency, which causes the ovaries to stop functioning before the age of 40.
Diminished Ovarian Reserve (DOR) is a diagnosis where a woman has a reduced number of eggs, which can be due to age, genetics, or previous ovarian surgery. Additionally, donor eggs are utilized when intended parents wish to avoid passing on a known genetic disorder to their child. Patients who have experienced multiple failed IVF cycles due to poor egg or embryo quality may also be advised to use donor eggs to improve their chances of a successful pregnancy.
Becoming an Egg Donor
The process of becoming an egg donor is selective and begins with a rigorous screening process to ensure the donor’s health and the quality of her eggs. Most programs require donors to be between the ages of 21 and 30, a range associated with optimal egg quality and the highest success rates for recipients.
Donor Screening
Prospective donors undergo extensive medical and genetic evaluations, including infectious disease testing for conditions like HIV and Hepatitis B and C. This medical screening also assesses the donor’s ovarian reserve, often through an Anti-Müllerian Hormone (AMH) blood test and an ultrasound. A mandatory component is a psychological evaluation conducted by a qualified mental health professional. This assessment determines the donor’s motivation, emotional stability, and understanding of the long-term implications of the donation.
Stimulation and Retrieval
Once accepted, the donor begins the physical process, which involves a two-week course of self-administered hormonal injections to stimulate the ovaries to mature multiple eggs. The donor’s response is monitored closely through frequent blood tests and transvaginal ultrasounds.
The final step is the egg retrieval procedure, a minor surgery performed under light sedation. Using ultrasound guidance, a thin needle is passed through the vaginal wall to gently aspirate the fluid-filled follicles and collect the mature eggs. This procedure typically takes 20 to 30 minutes, after which the donor is monitored briefly before being discharged. The retrieved eggs are then immediately passed to the laboratory for fertilization.
The Recipient Procedure
The recipient’s body must be prepared to receive the embryo, a process separate from the donor’s egg retrieval.
Uterine Preparation and Synchronization
If a fresh egg donation cycle is performed, the recipient’s uterine cycle must be precisely synchronized with the donor’s cycle using hormone medications. Synchronization ensures the recipient’s uterus is at the optimal stage for implantation. This synchronization step is eliminated when frozen donor eggs are used, offering a logistical advantage and a faster timeline.
The recipient’s uterine lining (endometrium) is prepared with a regimen of estrogen, which promotes lining growth. This is followed by progesterone, which changes the lining’s structure to make it receptive to an implanting embryo.
Fertilization and Transfer
The donated eggs, whether fresh or thawed from a frozen egg bank, are fertilized in the laboratory with sperm from the intended father or a sperm donor. Fertilization is often achieved through Intracytoplasmic Sperm Injection (ICSI), especially with frozen eggs, where a single sperm is injected directly into the egg.
The resulting embryos develop in the laboratory for three to five days. The embryo transfer, a non-surgical procedure, involves placing one or two of the best-developing embryos into the recipient’s uterus using a thin catheter. Advances in cryopreservation, using a rapid-freezing technique called vitrification, have made frozen donor eggs nearly as successful as fresh eggs. The use of frozen eggs offers greater flexibility and eliminates the need for the recipient to coordinate their schedule with the donor.
Legal and Emotional Considerations
The use of donor eggs requires careful legal and emotional preparation for the intended parents.
Legal Protections
A comprehensive legal contract is drafted and signed by all parties before the donation takes place to protect the parental rights of the recipients. This legal agreement explicitly states that the egg donor waives all parental rights and responsibilities to any children resulting from the donation. Consequently, the intended parents are established as the legal parents, which is the foundational legal protection for the family.
Disclosure and Identity
Intended parents must choose between an anonymous and a known or open donation, a decision with long-term emotional consequences. Anonymous donation offers privacy and clear boundaries, as the donor and recipients do not know each other’s identifying information. Many modern arrangements are “open-identity,” allowing the donor-conceived child to access the donor’s identifying information once they reach the age of majority.
The emotional journey often includes grief for the loss of a genetic connection, which is a normal part of accepting the need for a donor. Research indicates that the bond between parents and donor-conceived children is strong, and family functioning is primarily dependent on the quality of parenting. Most experts advocate for open and age-appropriate disclosure to the child about their conception, which supports the child’s identity development and fosters a trusting relationship.