In Vitro Fertilisation (IVF)
Egg Donation IVF
Egg donation IVF is the type of fertility treatment offered to most women who have suffered a premature menopause.
In women who still have their uterus (womb) it is possible to achieve pregnancy using eggs donated by an egg donor and fertilised in a test tube (in vitro fertilisation or IVF) with their partner’s sperm.
Children born as a result of this treatment are not biologically the mother's children but she is their legal mother and her name will appear on the birth certificates.
From April 2005, children born as a result of this treatment will have the right to identifiable information about their donor at the age of 18.
This hopefully produces embryos, and a maximum of two can be placed in the womb. Any spare embryos of good quality can be frozen. The success of Egg Donation / IVF treatment is variable. For up to date information on the clinics’ success rates contact The Human Fertilisation and Embryology Authority (HFEA) .
In some areas of the country this treatment is available on the NHS. From April 2005, all NHS regions should offer a single cycle of IVF. Private treatment is widely available and in 2005 typically cost £3,500-£4,000 per treatment cycle.
Finding a donor is difficult, and there is no national register of donors. If you cannot find a donor you will be put on your clinic’s waiting list – these vary in length from a few months to over two years in some of the larger centres. You can get information about this treatment and finding a clinic from The Human Fertilisation and Embryology Authority (HFEA) .
Questions To Consider
Before embarking on egg donation IVF there are a number of questions you might like to consider:
- If it’s successful, what will you tell the child and at what age?
- Who else would you tell about undergoing this type of treatment and at what stage?
- Do you have a support network if it’s unsuccessful?
- How many cycles would you be prepared to undergo?
- If successful, who would you tell about how the child was conceived?
- Also, in light of recent cases you should discuss the implications of your relationship breaking down and your partner’s right to withdraw consent for the use of any frozen embryos.
These are just a few questions to think about. However, these and many more questions should be aired when you see a counsellor before undergoing treatment.
Choosing A Clinic
If you decide to try egg donation IVF treatment you will need to decide which clinic to go to. Some clinics have waiting lists of 2-3 years, others of 6-9 months. Many couples decide to become patients at several clinics in order to increase their chances of getting a donor and being treated. You should also expect to pay to go on a waiting list if you are using a private clinic, in some cases this is refundable against treatment. Remember that you are paying for your treatment - you are the customer - and have the right to make an informed decision based on full information.
The Daisy Network does not recommend any clinics, however below are some questions that you may wish to ask when deciding where to have your treatment:
- How long will I have to wait for treatment?
- Do the clinic specialists have any expertise or research interests in any particular area?
- What are the live birth rates for people with my condition and my age? (Ask for the latest year and the one before for a good comparison.)
- How many egg donation treatment cycles did the clinic carry out last year?
- How many embryos do they implant?
- What is the cancellation rate for treatment cycles?
- Are freezing facilities available for unused embryos?
- Is there a dedicated counsellor available at all times and will I have to pay for this?
- How much do treatments cost?
- What is the cost to go on the waiting list? Is this refundable against treatment?
- What other costs are likely to be involved? (e.g. drugs)
- Will the clinic accept results from investigations carried out elsewhere? (Your GP may agree to organise blood tests and semen analysis on the NHS)
- Will I have to buy drugs from the clinic? (You may be able to get them cheaper from your GP - it’s always worth asking, or from private drug companies.)
- How will I be expected to pay and does the clinic have any payment plans to help spread the cost?
- Will I be able to see the same Doctor every time?
- Does the clinic actively recruit donors and how do they do this?
- Does the clinic offer egg share treatment?
- Do the clinic offer known donor treatments?
Egg Share
Owing to the lack of egg donors some clinics now offer the opportunity to share eggs. This is when a woman undergoing a 'normal' IVF cycle offers to share her eggs in order to reduce the cost of her treatment. How this is managed varies from clinic to clinic.
Known Donor
This is when a friend or relative agrees to donate eggs on your behalf. If blood type and CMV match then this means you will be the recipient of your known donors eggs. Although at first the idea of a known donor seems very attractive there may be more implications down the line than if an unknown donor is used. It is something which requires very careful consideration. If a match does not occur, what normally happens is that your known donor’s eggs are offered to another couple and you will automatically go to the top of the waiting list and be offered the next suitable donor. Not all clinics offer known donor treatment and will offer the latter option.
Be aware that donors do sometimes withdraw from treatment for many reasons and this can put good friendships or relationships under a considerable strain.
Altruistic Donor
A woman that has decided to donate her eggs out of the goodness of her heart.
What Does The HFEA Say About Donors?
The HFEA guidelines say that a donor should be an altruistic and preferably anonymous volunteer, between the ages of 18 and 35, who has completed her family. She should not receive any financial compensation for her donation save for the fixed sum stated in the HFEA regulations, but may be reimbursed her travel expenses. Recruiting a donor is stressful. Do not expect your female friends and relatives to donate - many people are deeply sympathetic to you but will stop short of offering to donate, for practical, moral or health reasons. The media may be interested in your story and this can increase your chances of finding a donor - be aware that they may also want photographs. Think carefully about how much exposure you want.
What Does Egg Donation IVF Treatment Involve?
For Your Partner
Your partner will have his sperm analysed before a treatment cycle takes place to make sure that his sperm are OK. His role in the treatment cycle is to produce a semen sample on the day of egg collection. The sperm are then treated in the laboratory so that only the best ones are used. A quantity of sperm is put with each of the eggs collected from the donor, and you will usually know the next day how many have fertilised.
For the Recipient
If you have no natural cycle, you will be scanned at the start of the treatment cycle to make sure that the lining of the uterus is minimal. If you still have a cycle, you may be given a single injection or a drug inhale which you use continuously, to suppress it. Then you will take oestrogen tablets to build up your uterine lining. The development of your lining will be monitored by trans-vaginal ultrasound scans over the next 2 weeks. The lining should ideally be between 9 and 12 millimetres thick when transfer takes place. On the day of egg collection you will be given progesterone pessaries to take each day. If there are embryos to transfer, this will usually occur 2 days after egg collection.
Transfer itself is not an uncomfortable procedure and takes no more than 10 minutes. The embryos are sucked into a narrow, tube-like catheter which is then inserted through the vagina into the entrance of the uterus. The embryos are them released and the instrument withdrawn. You may be asked to come with a full bladder as this makes it easier to insert the instrument. Some clinics like you to remain lying down for a while after the transfer. You will continue to take progesterone pessaries and oestrogen tablets until the result of your transfer is known, usually 12 days later. If you are pregnant, you will continue to take both oestrogen and progesterone for the first 3 months of pregnancy. If you are not pregnant, you should be advised by the clinic about your medication.
For The Donor
The donor will have been screened for hepatitis B and HIV and a full medical history will have been taken. There are a number of ways of treating the donor in order to stimulate the development of a number of eggs. There are two elements to the treatment; the first is to suppress the donor's own cycle, and can be done by single injection or using a 'sniffer' drug throughout the cycle. The second element, usually injections and/or tablets, gives hormones so that the ovaries are stimulated to produce many eggs, rather than the usual one.
Vaginal ultrasound scans show how the follicles in the ovaries are developing, and a final injection is given to complete the maturing process for the eggs. The timing of this last injection is crucial - it should be given 34-38 hours before collection so that the eggs are mature but have not yet been released from the follicles.
Egg collection is usually carried out using a needle guided by ultrasound, either through the urethra or vagina. This method can be carried out under light sedation. Egg collection can also be carried out using laparoscopy, for which an anaesthetic is required. In this technique a small hole is made below the navel for a laparoscope to be inserted and a fine hollow needle is inserted separately to remove the eggs.