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Egg Donation

To assist Intended Parents with family completion, Omega Family Global can source egg donors though our partner agencies.  Remove your worries and let OFG arrange for egg donation.  If you have any questions about egg donation, please contact Omega Family Global.

If you are interested in being an egg donor, please read this section and contact us at info@omegafamilyglobal.com.

Egg Donation, Rationale, Types and Success Rates

Egg donation is the process in which a woman provides one or more eggs (also called ova, singular, or oocytes, plural) for purposes of assisted reproduction or biomedical research. These eggs are harvested from the woman through simple surgical means. Typically the woman is given hormones so she will release more than one egg. Eggs obtained in this manner may be cryopreserved or used fresh for subsequent fertilization and re-implantation into the same woman, or a surrogate (more common).

In assisted reproduction, egg donation typically involves the process of in vitro fertilization (IVF: fertilization outside the body, in Latin, meaning in glass) as the eggs are fertilized in the laboratory; more rarely, unfertilized eggs are frozen and stored for later use by the Intended Parents or for biological research.

Egg donation is part of the process of ART (Assisted Reproductive Technology). The ASRM (American Society of Reproductive Medicine) has issued guidelines for these procedures, and the Food and Drug Administration (FDA: www.fda.gov) has a number of guidelines as well. In other nations, boards of physicians and scientists have developed guidelines regarding proper protocols for egg removal and donation.

Egg DonationEgg donors are typically women between the ages of 20 and 31 with desirable medical and personal histories. All fertility clinics and agencies that collect donated eggs have minimum requirements to be an egg donor, such as a high school degree, and parameters for body size and weight.

 

 

 

 

 Rationale for Donated Egg Use

The need for donated eggs can arise from a number of reasons. In the case of Intended Parents that are gay, the use of egg donation is often required.

Intended Parents, in the case of heterosexual couples, may resort to egg donation when the female partner cannot have genetic children because her own eggs have failed to generate a viable pregnancy.   In this case, sperm viability has been ruled out, possibly uterine factors, and the failure to attain pregnancy is attributed to poor egg quality.

Alternatively, the Intended Parents may have some chance of a viable pregnancy but the chances are so low that it is not advisable nor financially feasible to do IVF with her own eggs. This situation is most often attributed to 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.

Below are some reasons Intended Parents many choose to use an egg donor. are not physically accessible, this can be due to the following:

    • The woman has some chromosomal abnormality such as Turner syndrome
    • She may have improperly developed ovaries and/or may suffer from Gonadal dysgenesis
    • The woman has reduced egg quantity / quality
    • One or both ovaries have been removed. termed Oophorectomy
    • The woman has premature menopause
    • She has been through Chemotherapy. .which potentially causes damage to the ovum (eggs)
    • She has been through radiation therapy, which may have damaged the genetic material in the ovum (eggs)
    • She has an autoimmunity, which her body tries to reject her eggs
    • Advanced maternal age
    • She has a compromised ovarian reserve, whereby harvesting eggs may be detrimental to her feminine health
  • Other possible reasons for not having a member of the intended couple donate eggs include:
    • Diseases of X-Sex linkage
    • Repetitive fertilization or pregnancy failure
    • Ovaries inaccessible for egg retrieval possibly due to scarring from prior surgeries.

Improved Success Rates

One of the main benefits of using donated eggs and IVF is the high success rate. Success rates with donated egg use and IVF can be 10 times higher than with IVF and the intended parents egg.   The factor attributed to higher success rates is simply the age of the egg.   Data presented in the table below is derived from fertility clinics reporting to The Society of Assisted Reproductive Technology (SART: http://www.sart.org/). The table below reports the United States average IVF success rates per age group using non-donor eggs (2011). Success rates are clearly higher when eggs are fertilized from younger women. Similar trends would be assumed with the use of donated eggs.

 

Nominal Success Rates for IVF Based on Age of Woman (Non-donated eggs)*
Age of women <35 35-37 38-40 41-42 >42
Number of cycles 39721 19930 20130 10277 6033
Percentage resulting in pregnancies 46.2 38.5 29.3 19.5 9.1
Percentage resulting in live births 40.1 31.9 21.6 12.2 4.2
* This is only an indication that younger eggs impact success rates, other factors impact these statistics when donor eggs are used

Sources and Selection of Egg Donors

Across the United States there are numerous agencies that specialize in providing egg donors as a stand-alone service. Also many fertility clinics offer this as an additional service. Both obtain egg donors by advertising or appearing in public places and looking for donors that appear to fit desirable profiles. Perspective egg donors are first asked to fill out an application to that enables the agency or clinic to screen for qualified candidates.

The application is compromised of a detailed questionnaire about the potential donors´ background, medical, family, and personal history. They also ask for photographs, which later might be used to better match donors to Intended Parents´ physical trait desires.

Those candidates that meet the criteria then undergo psychological and genetic counseling. If this is successful, donors are then physically screened and medically examined.

The physical examination includes a pelvic exam and cervical cultures. A blood sample is taken to screen for infectious diseases and specific genetic diseases, and to test reproductive hormone levels. A reproductive endocrinologist will also explain to the potential egg donor the medical procedures involved and discuss any medical risks to them.

Once donors are accepted their pictures and profile information become accessible to Intended Parents, in an anonymous fashion, in an egg donor database. Egg donor database information can be observed on the web sites of agencies that specialize in egg donation.

Once a recipient is chosen as an egg donor, they attend classes on how to prepare and administer their hormone treatments. Often they can elect to inject themselves or attend a medical clinic for these treatments.

Hormonal Preparation and Egg Collection

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.  Some egg donors are hormonally prepared, have their eggs harvested and stored (cryobanked) for future Intended Parents. Other egg donors have their menstrual cycles synchronized with the gestational surrogate so that eggs are harvested, fertilized, and implanted in the surrogate at the proper day of the surrogate’s menstrual cycle.

In most cases of egg donation the egg donor and the gestational surrogate have their menstrual cycles synchronized.

The egg donation process consists of two phases. The first phase consists of ovarian hyperstimulation where donors receive a series of hormonal drugs, which cause the ovaries to produce multiple mature eggs during one menstrual cycle.

Ovarian hyperstimulation utilizes a class of drugs termed gonadotropin-releasing hormone agonist analogues.  These drugs suppress the release of luteinizing hormone (LH) by the pituitary gland, which normally triggers eggs to mature in the ovary. This creates an “artificial menopause” in donors. With the creation of the artificial menopause, the timing of egg maturation and ovulation can be controlled and timed as desired (such as synchronizatin of menstrual cycles with the surrogate).

The hormones (drugs) are generally administered daily, subcutaneously, through the span of the stimulation cycle.

In the United States a number of commercial preparations of Gonadotropin-Releasing Hormone Agonist Analogues are available. These are sold under a number of trade names, including, but not limited to, Lupron, Nafarelin, and Triptorelin.

Following suppression of hormone levels in phase one, donors typically begin daily injections of either follicle stimulating hormone (FSH) or human menopausal gonadotropin (hMG). These drugs (hormone preparations) have stimulate development of multiple follicles (each follicle has an egg) in the ovaries.   The intent is that multiple eggs can be recovered in a single procedure.

While donors are taking these medications, physicians monitor maturation of eggs through pelvic ultrasounds and blood tests. Doses of FSH or hMG may be adjusted, based on blood test results, to minimize side effects and optimize the number of eggs available for harvest.  In the United States commercial preparations of FSH or hMG are sold under an number of trade names including, Humegon, Menagon, and Pergonol.

Once tests indicate that eggs have matured, ovulation is triggered through a single injection of human chorionic gonadotropin (hCG). Egg retrieval occurs 34-36 hours after this injection.  In the United States commercial forms of hCG are sold under a number of trade names, including, but not limited to APL, Oxidrel, and Pregnyl.

At the end of phase two mature eggs are removed from the donor through a surgical procedure called transvaginal ultrasound aspiration.  The process is a minimally invasive surgical procedure lasting 20–30 minutes. In this procedure, donors are sedated and a small ultrasound-guided needle is inserted through the vagina remove the follicles in both ovaries, which extracts the eggs.

Following egg removal, eggs are combined with sperm in the laboratory (in vitro fertilization). Following an incubation period of typically 48 to 72 hours, fertilized eggs are placed in the surrogate (or donor) within 48 hours. Depending on the choice of the Intended Parents, in consultation with the fertility physicians, one to four fertilized eggs will be transferred. In some cases, extra eggs (fertilized or unfertilized) might be stored (cryopreserved) for later use.

Safety and Regulation of Donated Eggs

The United States Food and Drug Administration (FDA) regulates human reproductive tissue, which includes donated eggs (oocytes) and sperm (semen). Donated reproductive tissue (eggs or sperm) are regulated as human cells, tissues, and cellular and tissue-based products (HCT/Ps).  Any establishment that performs one or more manufacturing steps for HCT/Ps (recovery, processing, storage, labeling, packaging or distribution of products) must register with FDA and list their HCT/Ps in accordance with Title 21 Code of Federal Regulations (CFR) Part 1271.

Information on any of these FDA registered facilites can be publically accessed here:

https://www.accessdata.fda.gov/scripts/cber/CFAppsPub/tiss/index.cfm

Donor screening consists of reviewing the donor’s relevant medical records for risk factors for, and clinical evidence of, relevant communicable disease agents and diseases.  These records include a current donor medical history interview to determine medical history and relevant social behavior, a current physical examination, and treatments related to medical conditions that may suggest the donor is at increased risk for a relevant communicable disease.

Specimens from reproductive tissue donors must be tested for the below listed infectious diseases (referred to as “relevant communicable disease agents and diseases” in the regulations):

  1. Human Immunodeficiency Virus (HIV), types 1 and 2
  2. Hepatitis B Virus (HBV)
  3. Hepatitis C Virus (HCV)
  4. Treponema pallidum (i.e. syphilis)
  5. Chlamydia trachomatis
  6. Neisseria gonorrhea

In addition to those listed above, sperm donors must also be tested for:

  1. Human T-lymphotropic virus (HTLV), types I and II
  2. Cytomegalovirus (CMV)

In addition, the FDA conducts inspections of facilities that are registered for collection and handling of human biological material such as donated eggs and sperm. Various factors can determine the frequency of inspection, including any objectionable conditions found on a prior inspection and/or if FDA received Information regarding an establishment indicating there is a potential violation of FDA regulations.

Omega Family Global only recommends and works with registered facilities and those in good standing. We also monitor the published success rates released by the CDC on the respective agencies and clinics we work with. We also follow the FDA inspections of clinics, and if any adverse findings are published, we cease working with those respective clinics.

More information about FDA regulations, procedures, and classifications, regarding human biological material can be accessed here:

http://www.fda.gov/BiologicsBloodVaccines/TissueTissueProducts/default.htm

Social and Legal Factors Surrounding Known or Anonymous Egg Donation

Per the law in the United States, if desired (and if the egg donor agrees), Intended Parents can meet and get acquainted with the egg donor, her children and family members. More often, egg donations are totally anonymous or semi-anonymous (i.e. the egg donor may provide personal and medical information, photographs of herself and/or family members, and an email or third party willing to convey communications between the donor and recipients).  This is not true in all countries and in some countries; the law requires non-anonymity (e.g., the United Kingdom). In other countries, the law requires anonymity (e.g., France, Spain, the Czech Republic, South Africa). In the US the donor and recipient make the choice between anonymity, semi-anonymity and non-anonymity. The decision also is impacted by the donor agencies (IVF clinics) that maintain their own databases of egg donors strongly encourage or require anonymity.

The trend in the United States is to remain have egg donors remain anonymous.   At Omega Family Global, we respect the decision of the parties, and do not have a policy on the matter. Intended Parents can choose the option best for them based upon their level of comfort. We recommend they completely understand the legal implication of the decision and take into account what each option will mean for their future child. Omega Family Global is here to counsel intended parents on the legal implications of each option.

Implications of Anonymous and Known Egg Donation

With known egg donation, Intended Parents and egg donor learn their respective names and can have the opportunity to come to know one another. The main advantage of this type of egg donation is primarily that of the future child.   Some people feel that children want a broader sense of identity and want to know “where they came from.”   A second potential advantage of this option is it allows Intended Parents and their children to keep updated on the egg donor’s medical history as it changes over time.

For some Intended Parents, anonymous egg donation is the more comfortable option. In this form, there is no open contact between the egg donor and the Intended Parents.

In practice, semi anonymous egg donation is commonplace. In this form the agency, or IVF clinic that recruited the egg donor keeps the information about the donor and shares some details to Intended Parents in an anonymous form. This information could include update health information on the egg donor as it changes over the years.

Omega Family Global does not share any information about egg donors or Intended Parents, unless legal authorized to do so.   We respect the wishes of the respective parties and adhere to their legal agreements.

Egg Donor Compensation

The American Society for Reproductive Medicine’s (ASRM. www.asrm.org) Ethics Committee reports that compensating donors more than $10,000 is unreasonable and constitutes risked coercion. The ASRM recommends women be compensated no more than $5,000. However, to Omega Family Global´s knowledge, typical compensation is in the range of $7000 (USD).

Omega Family Global will make all the legal agreements (described here) between intended egg donor and Intended Parents. We will manage any funds for intended parents and insure egg donors are compensated in a timely and appropriate manor. We also mange money for intended parents and pay involved fertility physicians.

Other References

The Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Assisted Reproductive Technology Bottom has published recommendations for evaluation of potential sperm, oocyte, and embryo donors. The publication incorporates information about optimal screening and testing for sexually transmitted infections, genetic diseases, and psychological assessments. It also contains information from the U.S. Centers for Disease Control and Prevention, the US Food and Drug Administration, and the American Association of Tissue Banks. It can be access through the following link.

http://www.fertstert.org/article/S0015-0282%2812%2902256-X/abstract

 

Egg Donation