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Egg donation is also technically referred to as allogeneic oocyte transplantation. This means that the eggs come from a different woman. The donor is then the genetic mother of the child, but the legal maternity is transferred to the recipient of the donated eggs.
For some women, egg donation is the only way to have a healthy child or to get pregnant at all – for example, if they
The recipients of an egg donation can bring along their own donor who is willing to donate. Otherwise, the egg donation comes from a woman who is unknown to the recipient, which means the fertility clinic selects a suitable donor. In order to be eligible as a donor, young women must meet country-specific criteria in the countries where egg donation is permitted.
For example, in Denmark donors must be between 18 and 35 years old and may only donate 6 times corresponding to a maximum of 12 children. Recipients can use known, anonymous or open donors. Of course, the donors must also be free from relevant hereditary illnesses and infectious diseases (hepatitis, HIV, etc.). All specifics of each type of donation will be discussed during an interview at the clinic.
The selection of the donor also takes into account other characteristics such as:
First, the donor of the eggs is given hormone treatment. This causes more eggs to mature than in the natural cycle. The doctor then removes these from the ovaries with a hollow needle (follicular aspiration). This procedure is usually performed under local anaesthesia. A few days after the surgery, the donor’s menstrual bleeding occurs as usual, and her normal, natural cycle starts again.
The removed donor eggs are then usually fertilised with the recipient’s partner’s sperm in the laboratory by in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) and then transferred to the recipient’s uterus a few days later (embryo transfer). Both unfertilised and fertilised eggs can also be frozen to be transferred later (cryopreservation).
The recipient of the eggs is usually given hormones – oestrogen and progesterone – prior to the embryo transfer. As a result, the lining of the uterus builds up and is optimally prepared for the implantation of the eggs.
Risks for the donor
Hormone stimulation can sometimes have side effects – such as hyperstimulation syndrome. This can cause severe abdominal pain, nausea or shortness of breath, for example. Hyperstimulation syndrome may result in hospitalisation.
In the course of the follicular aspiration, it is also possible that bleeding, postoperative bleeding, swelling, impaired wound healing or infections may occur, or that neighbouring organs are accidentally injured during the procedure. And anaesthesia is never entirely risk-free. All of these complications are rare, but must be thoroughly discussed with the donor women before a donation is made. Selecting stimulation protocols that are as gentle as possible is also a way to try to avoid complications in the donors as far as possible.
Risks for the recipient
If more than one fertilised egg is transferred during the embryo transfer, a multiple pregnancy may occur. This may be dangerous for both the mother-to-be and the children. It is also important to bear in mind that if the recipient is already somewhat older (e.g. over 40), any pregnancy entails a higher risk than in younger years. These risks are addressed in detail and the situation discussed thoroughly with the couple during medical consultations before starting the treatment.
However, it should also be noted that the risk of numerical chromosomal abnormalities, something which correlates with the age of the eggs used, can be significantly reduced by egg donation. A 40-year-old woman has around a 1:100 risk of trisomy 21 (Down syndrome) using her own eggs, whilst with donor eggs from a 25-year-old the risk of trisomy 21 is reduced to the same level as that of a 25-year-old (1:1350).