Egg donation is a fertility treatment in which a woman donates her eggs to a patient who would not be able to produce good quality eggs due to medical or genetic problems or to help a single male or same-sex couple.
One of the principle reasons intended parents use egg donors is their inability to produce viable eggs, such as a prospective mother being older or having premature ovarian failure (POF). Egg donation can help increase pregnancy rates for these women because egg donors are strictly selected during screening to produce the best quality oocytes.
Couples also may need egg donation because of ovarian reserve issues, previous in vitro fertilization failures, or genetic conditions. Egg donation can help these patients achieve better pregnancy rates.
Fertility doctors want an egg donor to produce as many high-quality eggs as possible so the egg donor recipients will have the highest chance of a successful pregnancy and the opportunity for more than one embryo transfer, if necessary. They prescribe injectable hormonal medications so the egg donor produces many follicles containing eggs they will collect during the egg retrieval.
In a natural cycle, most of a woman’s eggs start growing but then deteriorate before they mature. However, in a stimulated cycle, all the eggs grow and develop. The medications achieve an increase in egg production.
Under medical guidance, the egg donor undergoes a controlled and safe ovarian stimulation leading to the egg retrieval. Retrieved eggs are combined with the intended father’s sperm and then transferred to the recipient mother’s or surrogate’s uterus. Egg donation can be anonymous or known.
One of the myths of donating eggs is that donating could affect the donor’s fertility. A woman is born with all the eggs she will ever produce; the majority is inactive, but at least one grows to maturity and is ovulated each month. Donation does not affect fertility because hormonal stimulation awakens the eggs that otherwise would not be ovulated.
Fertility doctors monitor the development and quantity of mature eggs in each donating cycle. A poor response to stimulation is when four or fewer eggs mature. Typically, we expect 10-15 eggs to mature with little probability of Ovarian Hyperstimulation Syndrome (OHSS) problems. If the donor produces a substantially higher number of eggs and she experiences symptoms of OHSS, the doctor will decrease the medication dosage to stabilize the patient and avoid side effects. A higher medication dosage and more eggs produced are not always proportional to their quality. The hormonal imbalance created by OHSS could affect egg quality, and the retrieved eggs could be immature due to their rapid development and the hormonal imbalance.
The quantity of eggs the egg donor creates is important for the success of IVF treatments. If the donor produces a large number of eggs, this increases the probability of a successful pregnancy and live birth, but there might be a limitation to the quality of the eggs. That is why it is essential to keep track of the medication given to donors. A donor with OHS could produce a higher number of eggs, but it must be taken into account that an OHS can affect the health of the donor negatively, increase her discomfort and cause more severe side effects. Also, OHS is related to the production of immature eggs that are not good for fertilization.
The number of eggs needed for each patient can vary individually according to their diagnosis and medical history so it is important to talk with the medical specialist who will start the donation process.