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Egg Donation

Egg donation and IVF

 The desire to reproduce and have one’s own children ,is for many women and men primarily instinctive. However we recognize that these desires are not universal and may also be influenced by culture, religion and personal opinions( amongst other things)

There are many causes for infertility.  I will briefly discuss the “egg factor”.

 Women are born with a finite number of eggs. (On the other hand, men continue to manufacture new sperm. Sperm therefore are not subjected to the same aging process that eggs are.)

The ovaries in women are therefore like “egg banks” The average gril is born with about 2 – 4 million eggs. From the moment after birth, eggs are dying every day. So that by the time a girl gets to puberty, the ovaries only contain about 200-300,000 eggs. By the age of 37 years, this egg reserve has dropped to about 50,000.

So although women only ovulate ( release an egg) once a month – literally thousands of eggs are dying monthly.

 As the ovaries age, and as the egg population declines, so does the pool of “perfect eggs” It is important to remember that not every egg has the same potential. No woman ovulates a perfect egg every month. For instance is most likely that the average healthy 30 year old woman who ovulates monthly, releases about 7 – 10 “normal” eggs per year. During the months an imperfect egg is released – she will either not conceive, or if she does, she will likely miscarry.

 As a woman she gets older – and the egg pool declines,  so does the number of perfect eggs. So that by the age of 40, the “average” woman is likely only releasing a few normal eggs per year. ( understanding that there is wide range of fertility in women)

 Women with low egg reserve and poor quality eggs, will have more difficulty conceiving, and if they do, will also experience higher rates of miscarriage.

For women with egg factor related infertility, egg donor IVF is a treatment option.

Egg donation falls into the category of “third party parenting”. This includes sperm donation, embryo donation and surrogacy as well.

The decision to use an egg donor to enhance the chance of having a successful pregnancy becomes a classic battle between the head and heart.  The suggestion to consider egg donation as a treatment option to help have a successful pregnancy may come as a surprise to many women and men. Often time is needed to explore this further, and we certainly encourage counseling to assist the exploration of one’s views and opinions. It is paradigm that is new to many, and only by having time, information and counseling guidance can one intellectually move forward.

 The miracle that allows a woman’s immune system to accept an implanting embryo does not require that the mother be genetically related to the embryo, and this has paved the way for egg and embryo donation. Egg Donation and  In Vitro Fertilization allows a woman to be the “biological mother” in that she carries and delivers the baby, although she has not provided the genetic material to that child. Compared with adoption, egg donation is for many a wonderful alternative which gives a woman the opportunity of participating prenatally, experiencing pregnancy and birth, also allowing the option for a male partner to contribute genetically, perhaps have the experience of carrying a child of a man she may love,  and enjoy breast feeing and the further bonding that goes with this between a Mum and her baby.

Our experience at VFC is that by the time the recipients of donor eggs/embryos deliver, most of the concerns over bonding and relatedness dissipate as they become new Mums and Dads.

 I am not suggesting that egg donation is the best choice for any particular person or couple. I am just explaining it as an option, embraced and enjoyed by many of our patients.

 Frequently asked questions about egg donor IVF

What is involved with donor egg IVF ?

The egg donor would go through a cycle of ovulation induction. This will mean her taking fertility injections for about 2 weeks, then having the eggs retrieved and fertilized.

While the egg donor is doing this – the intended Mum would prepare her uterus by taking combinations of estrogen and progesterone hormones.

The fertilized eggs become embryos, which are cultured for 3 – 5 days, and then preferably one is transferred to the uterus of the intended Mum and extra embryos   ( if available) frozen for future use.

 

How do I find an egg donor ?

 There are two options here. The first is finding someone to be your egg donor. The second is using frozen eggs from an Egg Bank in the USA.

 Finding your own egg donor.

This is the most daunting of exercises for many of our patients. Most of our patients are overwhelmed at the thought of asking someone to do something so personal, intrusive and time consuming., always fearing rejection. There are sensitive ways to do this – but it does take courage. Remember also that it may be very flattering for someone to be asked.

Many of our patients look first to family, extended family and friends for an egg donor. The ideal egg donor would be under the age of 35 years, have good ovarian reserve or proven fertility, be mature, have a stable and happy social and personal life, and a healthy genetic background. For many women a relative may be favored for the obvious genetic and personal reasons.

Compared to “purchasing frozen eggs” which will soon be discussed, having your own egg donor will likely provide you with “more eggs” to work with, (understanding that not every egg has the potential to produce a baby.)

We do feel that disclosure is important for the child, though appreciate that this ultimately will be the parents decision. For many people having a known donor may make the issue of disclosure easier.

For some it may be difficult to find a suitable donor through their own social and family network. The internet and social media is a powerful tool, and many of our patients find wonderful donors using these means. Although our legislation prohibits paying donors for their eggs in Canada, it is of course completely legal to reimburse donors for their expenses. No donor should be out of pocket for the IVF cycle.  Advertising and posting blogs on community websites ( such as kidsinvictoria.com, Craigslist,Islandparent.com,IVF.ca among many others) is all perfectly legal – and indeed many of our patients have found wonderful egg donors using these vehicles.

There is further information on our website for egg donors – explaining the medical process.

 Using frozen donor eggs.

Although in Canada one cannot “buy” eggs, this is perfectly legal in the USA.  As a result of newer “freezing” technology   ( called Vitrification) eggs can now be successfully frozen, warmed and fertilized.

It is legal for our Canadian patients to purchase eggs from “Donor egg banks” in the USA, and have them transferred to VFC, where we will store and use them. The egg bank that VFC works with is called “Donor egg bank USA”                                                    ( www.donoreggbankusa.com)  The website is very informative and easy to negotiate.

The advantages of using an egg bank are the following: convenience and ease of process, choice of egg donors, anonymity ,avoiding the need for synchronizing cycles with a fresh egg donor, and the fact that many of these egg donors have a “proven history”

The disadvantages: are that there may be fewer eggs to work with, and that if the egg donor chooses to be anonymous, disclosure is not possible.

 What are the legal requirements surrounding egg donation ?

 In Canada the birth mother is recognized as the legal mother. For this reason a “legal Contract “ ( as is mandatory with surrogacy) is not required. However, it is an option to consult a lawyer for a legal contract if preferred.

What are some of the main factors that Intended parents should consider when selecting an egg donor ?

 They may consider the genetic and family history, physical characteristics, ethnicity, education and employment background, lifestyle and personality.

 What are the arguments in favour of disclosing the egg donation to the resulting child/children. ?

Proponents of disclosure assert that the child has a right to know about their genetic heritage. There is nothing shameful or degrading about egg donation. Holding a secret of this enormity,regardless of the content, can set up a harmful dynamic within a family. Open communication and sharing of information in a positive framework will affirm that it is not merely genetics that create family bonds. We at VFC respect parents opinions, however very much encourage openness and disclosure, believing this to be in the child’s best interests.

There are excellent resources and books available discussing these issues, which educate and guide parents through the journey.

A popular and informative website is www.donorsiblingregistry.com. The principal behind the website is Wendy Kramer whose recent book “ Finding our families” is worth reading.

 

What are the arguments in favour of not disclosing the egg donation to the resulting child or children ?

 Proponents of non disclosure assert that information will be confusing and burdensome to a child. That the child may reject the intended mother and feel frustrated that they may never be able to make contact with their genetic link.

 

What are the choices of the intended parents with regard to the disposition of remaining unused frozen embryos ?

Remaining extra embryos  may be frozen for the exclusive use of the intended parents, ethically destroyed, donated to science for research and training, or donated to other infertile patients. The parties ( the egg donor and IPs) should reach a mutual understanding regarding the disposition of frozen embryos.

What are the costs involved ?

 These can vary depending on whether you are choosing to purchase donated frozen eggs from Donor egg bank USA, or using a donor having a “fresh cycle” at VFC.

The costs for purchasing frozen eggs from DEBUSA are explained on their website.

For doing a fresh cycle the costs are as follows:
Consultation for egg donor  $300.(however  this would be covered by the medical services plan if the egg donor is from BC and has a referral from a family doctor)
Third party counseling: approx. $150.00
The VFC cost for the cycle : $6750.00 for standard IVF ( there is an extra cost for ICSI)
The drug costs for the egg donor and the recipient:  Approx: $4000.00
The cost of freezing extra embryos ( if available)   $700.00 + annual storage fee of $200.

How long does the process take ?

It normally takes a few weeks for the consultation, counseling and investigations to be done. Then the IP and ED will take the BCP for about a month to synchronize their cycles, and after that is done – the treatment cycle itself takes 3 weeks.                 ( includes the cycle of ovulation induction, egg retrieval and embryo transfer)


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