oocyte donation, ovum donation, gamete donation
Egg donation is the process by which a woman donates eggs for purposes of assisted reproduction or biomedical research. For assisted reproduction purposes, egg donation typically involves IVF technology, with the eggs being fertilized in the laboratory; more rarely, unfertilized eggs may be frozen and stored for later use. Egg donation is a third party reproduction as part of ART.
Egg donor may have several reasons for donate her eggs:
First step is choosing the egg donor by a recipient from the profiles on or clinic databases (or, in countries where donors are required to remain anonymous, they are chosen by the recipient's doctor based on recipient woman’s desired trait). This is due to the fact that all of the mentioned examinations are expensive and the agencies/clinics must first confirm that a match is possible or guaranteed before investing in the process.
Each egg donor is first referred to a psychologist who will evaluate if she is mentally prepared to undertake and complete the donation process. These evaluations are necessary to ensure that the donor is fully prepared and capable of completing the donation cycle in safe and success manner. The donor is then required to undergo a thorough medical examination, including a pelvic exam, blood tests to check hormone levels and to test for infectious diseases, Rh factor, blood type, and drugs and an ultrasound to examine her ovaries, uterus and other pelvic organs. A family history of approximately the past three generations is also required, meaning that adoptees are usually not accepted because of the lack of past health knowledge. Genetic testing is also usually done on donors to ensure that they do not carry mutations (e.g., cystic fibrosis) that could harm the resulting children; however, not all clinics automatically perform such testing and thus recipients must clarify with their clinics whether such testing will be done. During the process, which usually takes several months, the donor must abstain from alcohol, sexual intercourse, cigarettes, and drugs, both prescription and non-prescription.
Once the screening is complete and a legal contract signed, the donor will begin the donation cycle, which typically takes between three and six weeks. An egg retrieval procedure comprises both the egg donor's cycle and the recipient's cycle. Birth control pills are administered during the first few weeks of the egg donation process to synchronize the donor's cycle with her recipient's, followed by a series of injections which halt the normal functioning of the donor's ovaries. These injections may be self-administered on a daily basis for a period of one to three weeks. Next, FSH is given to the donor to stimulate egg production and increases the number of mature eggs produced by the ovaries. Throughout the cycle the donor is monitored often by a physician using blood tests and ultrasound exams to determine the donor's reaction to the hormones and the progress of follicle growth.
Once the doctor decides the follicles are mature, the doctor will establish the date and time for the egg retrieval procedure. Approximately 36 hours before retrieval, the donor must administer one last injection of hCG to ensure that her eggs are ready to be harvested. The egg retrieval itself is a minimally invasive surgical procedure lasting 20-30 minutes, performed under sedation (but sometimes without any). A small ultrasound-guided needle is inserted through the vagina to aspirate the follicles in both ovaries, which extracts the eggs. After resting in a recovery room for an hour or two, the donor is released. Most donors resume regular activities by the next day.
Laws by state
The legal status and compensation of egg donation has several models across states with examples:
Egg donation could have a number of reasons. Infertile couples may resort to egg donation when the female partner cannot have genetic children because her own eggs cannot generate a viable pregnancy, or because they could generate a viable pregnancy but the chances are so low that it is not advisable or not financially feasible to do IVF with her own eggs. This situation is often, but not always based on advanced reproductive age. It can also be due to early onset of menopause, which can occur as early as their 20s. In addition, some women are born without ovaries, while some women's reproductive organs have been damaged or surgically removed due to disease or other circumstances. Another indication would be a genetic disorder on part of the woman that either renders her infertile or would be dangerous for any offspring, problems that can be circumvented by using eggs from another woman. Many women have none of these issues, but continue to be unsuccessful using their own eggs in a case when they have undiagnosed infertility - and thus turn to donor eggs or donor embryos. Egg donation is also helpful for gay male couples using surrogacy which allows them to have their “own” children.
Egg donation is recommended in these cases:
Congenital absence of eggs
Acquired reduced egg quantity / quality
Maternofetal immune tolerance is essential to maintain pregnancy. It has been reported that maternal morbidity during egg donation pregnancies is higher as compared with spontaneous or IVF pregnancies. If the recipient is less genetically similar to the fetus than a biological mother, pregnancies are associated with a higher incidence of pregnancy-induced hypertension and placental pathology. The local and systemic immunologic changes are also more pronounced than in normal pregnancies, so it has been suggested that the higher frequency of some conditions in egg donation may be caused by reduced immune tolerance from the mother.
Egg donors place themselves at risk for developing a number of complications: from the relatively minor side-effects of fertility drugs (i.e., bloating, weight gain, and irritability), to potentially serious conditions, including ovarian hyperstimulation syndrome, future infertility, blood clots, and liver or kidney failure. This list does not mention the risks of the surgical egg extraction itself, which requires a needle to be inserted into the vagina, and which carries a risk of infection, bleeding, adverse reaction to anesthesia, and the accidental puncture of an organ.
The long-term impact of egg donation on donors has not been well studied, but because the same medications and procedures are used, it should be essentially the same as the long-term impact (if any) of IVF on patients using their own eggs. The evidence of increased cancer risk is equivocal; some studies have pointed to a slightly increased risk while other studies have found no such risk or even a slightly reduced risk in most patients (women with a family history of breast cancer, however, may have a higher risk). 1 in 5 women report psychological effects—which may be positive or negative—from donating their eggs, and two-thirds of egg donors were happy with the decision to donate their eggs. In accordance with the American Society for Reproductive Medicine guidelines, female donors are given a limit of 6 cycles that they may donate in order to minimize the possible health risks.
However, it appears that repetitive oocyte donation cycles does not cause accelerated ovarian aging, evidenced by absence of decreased AMH hormone in such women.
There appears to be a slightly higher risk of pregnancy-induced hypertension and first trimester bleeding in pregnancies of egg donation. Pregnancies after oocyte donation represent a unique group of pregnancies because they are achieved with an immunologically foreign embryo. This may underlie the observed increased obstetrical and perinatal risk associated with these pregnancies. However, obstetrical risk factors such as advanced maternal age, primiparity and multiple pregnancies tend to be more common in this population. Moreover, there is a higher incidence of potential obstetrical risk factors that necessitate oocyte donation treatment, such as previous pelvic radiation, immunologic disorders or severe endometriosis.
The success rate of egg donor cycles is over 60% in US. When a "fresh cycle" is followed by a "frozen cycle", the success rate with donor eggs is approximately 80%. Pregnancies with egg donation are associated with a slightly increased risk of placental pathology. The local and systemic immunologic changes are also more pronounced than in natural pregnancies, so it has been suggested that the association is caused by reduced maternal immune tolerance towards the fetus, as the genetic similarity between the carrier and fetus from an egg donation is less than in a natural pregnancy. In contrast, the incidence of other perinatal complications, such as intrauterine growth restriction, preterm birth and congenital malformations, is comparable to conventional IVF without egg donation.
A semen pH value outside of the normal range which is harmful to sperm and can cause infertility.
Female disorder in reproductive system at which a woman miss the uterus and thus she is not able to get pregnant and carry a child.
A type of cancerous tumor that develops in the gland cells.
A tumor-forming variant of adenomyosis (endometriosis in the myometrium of the uterus).
Medical condition characterized by the presence of ectopic endometrial tissue within the myometrium.
Failure of the adrenal glands to produce sufficient amounts of hormones.
The absence of a menstrual period in women of reproductive age.
A neurodevelopmental disorder with intellectual and developmental disability, sleep disturbance, seizures, jerky movements and frequent laughter.
A disorder of sex development in which individuals have both testes absent at birth.
An eating disorder characterized by the maintenance of a body weight below average, fear of gaining weight, and a distorted body image.
Failure of the ovaries to release an oocyte over a period of time generally exceeding 3 months.
A condition when immune system mistakenly attacks some of the standard proteins in blood.
An inflammation of the appendix that may be associated with female infertility.
A medical condition, where the walls of the uterus stick to one another due to bands of scar tissue.
Male diagnosis connected with male infertility characterised by the complete absence of semen.
The thickening, hardening and loss of elasticity of the walls of arteries.
A condition arising from an abnormal immune response to a normal body part.
A disease in which antibodies against the thyroid gland and its hormone products are produced and destroy the thyroid’s cells and the entire gland.
Complete absence of sperm in the ejaculate of a man.
A noncancerous increase in size of the prostate.
Inborn morphological deviation of the uterus - one of the Müllerian duct anomalies where the uterine cavity is divided in the upper part.
A blockage of both fallopian tubes.
A cancer that develops from breast tissue.
Narrowing of cervix - the opening to the uterus.
A common sexually transmitted disease (STD) caused by the Chlamydia trachomatis bacteria that can lead to serious reproductive morbidity.
A condition in which the vasa deferentia reproductive organs, fail to form properly prior to birth.
Fallopian tube(s) blocked from birth unabling to let the ovum and the sperm converge, thus making fertilization impossible.
Male infertility diagnosis characterized by extremely low concentration of sperm in semen.
A man's inability for or persistent difficulty in achieving orgasm, despite typical sexual desire and sexual stimulation.
A class of sexual disorders defined as the subjective lack of normal ejaculation.
Cancer that arises from the endometrium, the lining of the uterus.
Thickening of the lining of the uterus.
The finger like overgrowths attached to the inner wall of the uterus that extend into the uterine cavity which are made of endometrial tissue
Benign ovarian cysts containing thick, old blood that appears as a brown fluid.
A state in which pieces of the tissue alike to the lining of the uterus (endometrium) grow in other parts of the body.
An inflammation of the inner uterine lining that could interfere with conception and pregnancy outcomes.
An inflammation of epididymis.
The inability (that lasts more than 6 months) to develop or maintain an erection of the penis during sexual activity.
An obstruction prevents the egg or sperm from traveling down the tube, thus making fertilization impossible.
An abnormal growth of fallopian tube tissue.
Persistent, recurrent problems with sexual response, desire, orgasm or pain which may cause fertility problems.
Genetic condition that is the most common inherited cause of intellectual disability, as well as the most frequent cause of autism spectrum disorder.
A sexually transmitted infection which is the most common cause of diseases accompanied by genital ulceration.
Fleshy growths or lumps found around the genitals and anus transmitted through sexual intercourse or during labor.
A group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception.
A rare abnormality of sperm morphology, with the majority of sperm cells being round-headed, which leads to male infertility.
Any congenital developmental disorder of the reproductive system characterized by a progressive loss of germ cells on the developing gonads.
A sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae.
The tumor that arises from the granulosa cells (normally surrounding the oocytes and line the developing follicle) and could impair menstrual periods.
Occlusion of some part of the female genital tract, especially occlusion of the vagina by a thick membrane.
Various types of conditions that can affect the function of the heart or blood vessels, which may have the negative effect also to the infertility
A collection or retention of blood in the uterus, affecting the patient´s fertility.
Hematosalpinx is a medical condition involving bleeding into the fallopian tube.
An infection caused by the hepatitis B virus which inflames the liver and which could also impair sperm motility.
An infection caused by the hepatitis C virus (HCV) that affects the liver and could be transmitted through sexual intercourse by blood or from infecte
A viral infection that progressively destroys certain white blood cells and can cause acquired immunodeficiency syndrome (AIDS).
A common virus that affects both males and females that could result in genital warts or cancer.
An accumulation of clear fluid in the tunica vaginalis, the most internal of membranes containing a testicle.
A hydrosalpinx is an abnormal pouch containing liquid in a fallopian tube.
A medical condition characterized by excessive levels of androgens in the body.
An excessive amount of estrogenic activity in the body.
Decreased functional activity of the gonads, with retardation sexual development, associated with high levels of hormones that stimulate the gonads.
The condition of elevated concentrations of gonadotropins within the blood.
Excess levels of insulin circulating in the blood relative to the level of glucose and impairing the hormonal levels, even those involved in reproduct
Abnormally elevated levels of any or all lipids in the blood.
The presence of abnormally high levels of prolactin in the blood.
Condition that occurs due to excessive production of thyroid hormone by the thyroid gland.
A medical condition characterized by not enough androgenic activity in the body.
A lower than normal level of estrogen which is the primary sex hormone in women.
A medical term which describes a diminished functional activity of the gonads – the testes and ovaries.
Partial or complete loss of production of one or more of the pituitary gland hormones.
A deficiency in the serum levels of the prolactin hormone.
An anomaly of the penis, with the opening of the urethra located on the underside of the penis, which may lead to infertility.
A condition in which a man has an unusually low ejaculate (or semen) volume.
Group of diseases, which have impact on function of hypothalamus.
A surgery performed to remove a woman's uterus.
A condition in which fertility impairment occurs spontaneously or due to an unknown cause.
A genetic condition where the primary symptom is a failure to start puberty or a failure to fully complete puberty.
The set of symptoms that result from two or more X chromosome in males.
Laurence-Moon syndrome (LMS) is a genetically predisposed disorder affecting both genders.
A presence of more than one million of white blood cells in 1 millimeter (mL) of ejaculate.
Mutation causing impaired Leydig cell differentiation and testosterone production.
Patients with a low number of retrieved oocytes despite adequate ovarian stimulation during fertility treatment.
Collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks normal, healthy tissues.
The luteinisation of ovulatory follicle without a release of an oocyte.
The time in most women's lives when menstrual periods stop permanently, and the woman is no longer able to have children.
An abnormal condition in a woman's menstrual cycle.
The condition of only one testicle present in the scrotum.
Mumps was a common childhood viral disease caused by the mumps virus. Mumps frequently causes orchitis and impairs male fertility.
Necrospermia is a condition in which spermatozoa in semen are either immobile or dead
Type of cancer arising from the lymphoid tissue.
Complete absence of sperm in the ejaculate due to testicular failure.
A frequent autosomal dominant developmental disorder primarily characterized by short stature, typical facial features and heart defects.
A manifest variant of nutcracker phenomenon, renal vein entrapment syndrome, or mesoaortic compression of the left renal vein.
A disease of excess body fat that can have a negative effect on health, leading to reduced life expectancy and other health problems.
Absence of sperm in the ejaculate despite normal spermatogenesis, caused by an obstruction of the genital tract.
Repetitive nocturnal complete collapses (apneas) or partial collapses (hypopneas) of the upper airway during sleep.
Male fertility diagnosis defined as a combination of low sperm concentration, reduced motility and abnormal sperm morphology in the ejaculate.
Light or infrequent menstrual ﬂow at intervals of 39 days to 6 months or 5–7 cycles in a year.
Semen with a low concentration of sperm and is a common finding in male infertility.
Defect during oocyte maturation.
An inflammation of the testes, involving swelling and heavy pains.
A type of cancer in which abnormal cells begin to grow in one or both of a woman's ovaries.
Abnormal sacs filled with liquid or semi-solid matter found in the ovary, which can have negative impact on female fertility.
A clinical symptom complex that can occur in some women undergoing assisted reproductive technologies and that could result in pregnancy complications
Surgical removal of one or both ovaries.
A physical syndrome described by pain or burning sensation of the urethra or perineum during or following ejaculation.
The rare chronic disease typically features a number of small, interlinked abscesses within the pelvis.
A form of abdominal adhesions in the pelvis.
Infection of the upper part of the female reproductive system and a common complication of some sexually transmitted diseases.
An infectious disease caused by the bacterium Mycobacterium tuberculosis and one of cause female infertility.
A pituitary malfunction is a disorder affecting the pituitary gland, either by overproduction or underproduction any of pituitary gland hormones.
An abnormal growth that develops in the pituitary gland that could impair the hormonal balance needed for fertility function.
A condition in which a woman has an imbalance of female sex hormones. This may lead to changes in the menstrual cycle, cysts in the ovaries, trouble g
A condition of abnormally high concentration (more than 250 million / ml ) of sperm in the semen.
A condition of low fertility characterized by low numbers of remaining oocytes in the ovaries or possibly impaired oocyte development or recruitment.
A genetic disorder due to loss of function of specific genes on chromosome 15.
A man experiences orgasm and expels semen soon after sexual activity and with minimal penile stimulation.
The loss of function of the ovaries before age 40.
An inflammation of the prostate gland.
A distally blocked Fallopian tube filled with pus.
Three or more consecutive pregnancy losses prior to 20 weeks gestational age from the last menstrual period.
Three or more consecutive pregnancy losses before 20-24 weeks of gestation or below a fetal weight of 500 g.
A kidney cancer that originates in a part of the very small tubes in the kidney that transport waste molecules from the blood to the urine.
The absence of implantation after three or more transfers of high quality embryos or after placement of 10 or more embryos in multiple transfers.
The semen, which would normally be ejaculated via the urethra, is redirected to the urinary bladder.
A long-term autoimmune disorder that primarily affects joints.
Surgical removal of one (unilateral) or both (bilateral) fallopian tube(s).
An acute inflammation of the fallopian tubes.
The absence of any developmental stage of sperm cell in the testes.
An infection of the paranasal sinuses and/or the lungs, associated with several conditions of impaired fertility.
Antibodies that bind to sperm, inhibiting their movement, stopping recognition and entry into the egg.
High level of DNA damage in sperm cells that may lead to male infertility.
A rare disorder characterized by a phenotypic female with an XY karyotype.
A sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum.
Teratospermia is a condition characterized by the presence of sperm with abnormal morphology that affects fertility in males.
A medical condition in which the testes diminish in size and may be accompanied by loss of function (production of sperm and testosterone).
Cancer that develops in the testicles.
The inability of the testicles to produce sperm or testosterone.
Emergency medical condition occurring when the spermatic cord twists and cuts off the testicle's blood supply.
Cancers that develop within the thyroid gland.
A medical condition impairing the function of the thyroid.
Medical emergency that afflicts the human penis.
A permanent form of female sterilization, in which the fallopian tubes are severed and sealed or "pinched shut", in order to prevent fertilization.
Turner syndrome is a genetic disorder in which a female is partly or completely missing one X chromosome that results in ovarian dysgenesis.
In the case of cryptorchidism one or both testes are absent from the scrotum. It is is the most common etiologic factor of azoospermy in the adult.
Congenital uterine anomaly (one of the Müllerian duct anomalies) usually associated with communicating or non-communicating rudimentary horn.
A condition of blocked passage through one of the Fallopian tubes.
The most common benign smooth muscle tumors of the uterus encountered in women of reproductive age.
Rare uterine malignant tumour that arises from the smooth muscular part of the uterine wall.
A type of female genital malformation resulting from an abnormal development of the Müllerian duct(s) during embryogenesis.
Congenital uterine malformation where both Müllerian ducts develop but fail to fuse, thus the woman has a "double uterus".
A form of a congenital malformation where the uterine cavity is partitioned by a longitudinal septum. It is one of Müllerian duct anomalies.
A form of a congenital malformation where the uterus is partially divided by a longitudinal septum. It is one of Müllerian duct anomalies.
A disease of the vagina caused by excessive growth of bacteria, with possible detrimental effect on female fertility.
An abnormal enlargement of the pampiniform venous plexus in the scrotum.
The male sex chromosomal disorder characterized by a spectrum of clinical presentations, ranging from ambiguous to normal male genitalia.
A rare condition causing chronic lung disease, rhinosinusitis and azoospermia.
The removal of the ovaries.