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Egg Sharing Treatments

Egg Sharing Treatments

We would like to first say “Thank you” for considering becoming an egg share donor.

We believe that all egg donors are wonderful women who provide a “Gift of life” to others.

Unfortunately, some women and couples face a difficult situation in which their only chance of conceiving is with donated eggs. In many cases this is because the woman’s biological clock – the woman’s store of eggs in her ovaries has run out. Typically, this occurs as women reach their mid 40s, ahead of the menopause but it can also occur in younger women who have premature ovarian failure.

Egg sharing is a unique programme designed to benefit two groups of women simultaneously: those having conventional IVF (the egg sharer or egg share donor) and those who are unable to produce their own eggs (the recipient). The egg sharing arrangement allows these two groups of women to help one another: egg share donors receive free IVF treatment and recipients receive the eggs they need for IVF. Hence, if you decide to take part in the egg-sharing program, as a donor or a recipient, you will be helping someone else to become a mum.

The increasing demand for donor eggs

Over the past two decades the age at which women have their first baby has been increasing. Currently, the average age of first pregnancy for women in European countries is close to 30. One of the many consequences of this dramatic social change is a greater occurrence of age-related infertility. Many have simply left it too late to conceive naturally.

Donor eggs are also needed for young women surviving cancer for whom cancer treatment has caused loss of ovarian function and for some women who are increased risk of passing along a genetic disorder. Hence, there is an ever increasing demand for egg donors.

Who can be an egg sharer?

Potential egg share donors must meet the following criteria:

  • Be aged between 18 and 35
  • Be a non-smoker
  • Be fit and healthy with a BMI between 20 and 30
  • Have a good ovarian reserve: determined by an AMH level within the normal range and good number of antral follicles in an ultrasound scan
  • Have a normal baseline FSH level (less than 10 IU/L)
  • Have both ovaries in place
  • Have no history of severe endometriosis
  • Must not have severe polycystic ovarian syndrome (PCOS)
  • Have no previous occurrence of poor ovarian response to stimulation (in IVF)
  • Have no history of infectious diseases
  • Have no personal or family history of inheritable diseases

Assessment

As with all of our patients, your doctor will perform a thorough assessment of your fertility before considering any form of treatment. This will include ultrasound scans and hormone blood tests for you, as well as a semen analysis and possible further testing for the man. Without accurate information, a doctor cannot suggest the best treatment, nor can they optimise that treatment for your unique situation. This is particularly important for a potential egg sharer because you will be donating half of the eggs collected and hence, the treatment choice must be in your best interest.

You will also see a nurse to complete some basic information about yourself. The nurse will provide you with a letter containing a medical history form that you must complete and have confirmed by your GP. Once we receive the completed medical history form (provided everything is clear), you will be offered a session of implications counselling, with an accredited fertility counsellor, to discuss the social and ethical issues pertaining to egg donation.

You will then be screened for the following:

  • Full blood count
  • Blood group and Rhesus type
  • HIV and HTLV
  • Hepatitis B and C
  • Syphilis (VDRL)
  • Cytomegalovirus (CMV) antibodies
  • Chromosomal analysis
  • Cystic fibrosis gene defect
  • Chlamydia and gonorrhoea (urine test)

Non-Caucasian donors will also be screened for the following as appropriate:

  • Sickle cell tests for Africans
  • Thalassaemia for Asians and Mediterraneans
  • Taysach’s disease for Jews

Though the list appears long, all of these can be done in a single blood test, except the urine sample.

It is important to inform us of any medical information that may come to light after donation that may have health implications for any woman who receives treatment with your eggs or for any child born as a result of such treatment. Furthermore, failure to disclose known problems or conditions can result in legal action being brought against you by the recipient or the clinic.

The screening process may reveal previously unknown conditions or infections, some of which may be treatable. Your chromosomes will be screened and therefore previously unsuspected genetic disorders may be brought to light. We will arrange referral to Genetics Counselling and provide support.

In some situations genetic disorders may affect other members of your direct family and we will discuss the relevant issues with you should these come to light.

A second set of infectious disease screening (HIV, Hepatitis B, Hepatitis C) will be performed immediately before you start your treatment cycle. This second panel is performed using a nucleic acid amplification (NAT) method and can detect any latent infections.

Matching of donor and recipient

Typically, donors and recipients are matched for ethnicity, and physical characteristics such as eye-colour, hair-colour, skin-colour, height and build.

In the UK, per the fertility regulator’s (HFEA) guidelines, a donor’s cytomegalovirus virus (CMV) status should be matched with that of the recipient. If the recipient is CMV (IgG) positive, she can use a CMV (IgG) positive or a CMV negative donor. If a recipient is CMV negative she can only be matched with a CMV negative donor. We attempt to match egg donors and recipients as rapidly as possible but this process can take some time – typically donors are matched within three months but can take longer in certain cases.

What does an egg sharing cycle involve?

Once you are matched with a recipient, you will both be given the contraceptive pill to synchronise your periods. Can you believe that we use the contraceptive pill to make a woman pregnant? Once your cycles are synchronised, the treatment follows the same procedure as a normal IVF cycle.

Briefly, you will undergo a course of hormonal injections for approximately 10 days to stimulate growth of follicles, containing eggs, in your ovaries. When the follicles have developed to a suitable size, you will be given a trigger injection to start the final maturation process of the eggs. The egg collection is a day case procedure, typically lasting less than 30 minutes and is performed under mild intra-venous sedation to minimise any pain or discomfort.

Egg sharers must ideally have 10 to 14 good sized (> 14 mm) follicles visible on ultrasound scan after ovarian stimulation. If fewer than 10 good sized follicles are seen on the ultrasound scan, you will be offered the following options:

  • Continue with the egg share treatment, donate the first five eggs that are collected to the recipient and keep any remaining eggs for yourself.
  • Donate all the eggs in this cycle to the recipient and have a subsequent free IVF cycle for yourself.
  • Opt out of the egg sharing treatment, continue the treatment and keep all the eggs collected. You will be charged for IVF treatment & medicines at current prices.
  • Abandon the cycle with no further cost or commitment.

If the ultrasound scan after ovarian stimulation shows 10 or more good sized follicles, and the level of oestrogen is satisfactory, you will proceed with the egg sharing arrangement:

  • If 10 or more eggs are collected, the eggs will be equally divided between you and the recipient. If there are an odd number of eggs, the extra egg will be given to you.
  • If less than 10 eggs are collected, you will receive the first five eggs and the recipient may or may not receive the remaining eggs (depending on the total number of eggs collected).

We strive to provide you and the recipient a minimum of five eggs, however, you and the recipient may mutually agree to receive less than five eggs each in certain scenarios.

Recent studies indicate that performing an embryo transfer during a cycle that does not involve ovarian stimulation can yield better pregnancy rates. Based on this evidence, we have begun freezing the embryos created during an IVF or egg sharing cycle and transferring those embryos in a subsequent cycle. For egg sharers there is no additional cost involved in this process.

If your first cycle of egg sharing is not successful, you will be invited for a free follow-up consultation to discuss further options. Depending on the results of the first attempt you may be allowed to attempt to egg share again.

Anonymity

All fertility treatment in the UK, including egg, embryo and sperm donation, is strictly regulated by the HFEA. The HFEA code of practice stipulates that all donors and recipients (excluding known donors) must remain anonymous to each other. We take a lot of care to ensure that strict confidentiality and anonymity is maintained.

However, all children born as a result of donation have the right, at the age of 18, to obtain identifying information about their donor from the HFEA, including their full name, last known address and date of birth. The HFEA is required to make a reasonable attempt to contact the donor and forewarn them before disclosing their details to the donor conceived child. A person born from donation treatment can also access identifying information about donor conceived genetic siblings, with mutual consent, from the age of 18.

Your information

The HFEA keeps a register of information about donors, including egg sharers, and any children born as a result of their donation. As a donor, you may request information from the clinic or the HFEA directly about whether a live birth resulted from your donation and, if so, the number of such births, the gender of the children born and the year of their birth. It is important that you inform the clinic of the outcome of your treatment, i.e. whether you gave birth to a child(ren) and the details of the delivery, in order for the HFEA to be able to monitor the number of families created by any one donor. When the number of children born from a single donor reaches 10, the donor will be advised not to create any additional families and only donate again to create siblings.

Counselling

All patients considering egg sharing will be required to see an experienced fertility counsellor for a session of implications counselling due. They will explore any anxieties you may have about egg sharing or the treatment process. They will also discuss the possible implications of sharing your egg within social, ethical, genetic and legal frameworks. We work with two counsellors who are available to couples at any stage: before, during or after treatment. The counsellors are independent to the clinic’s medical and nursing teams, and are therefore able to offer a confidential on-going support service to all patients.

Consent

Informed consent is a critical part of fertility treatment and in particular egg donation. You will be provided with written information, such as this booklet, and verbal information during your consultations and counselling session(s). It is important that you consider this information carefully prior to completing the required consent forms. You are free to withdraw or alter your consent at any time, up to the time the embryos created from your eggs are transferred (or used for research or training), including those which have been cryopreserved.

Further resources for egg sharers

Your decision to share your eggs is an important one with life-long implications. There are many issues to consider, and some of them are complicated. There are a number of organisations that can provide further information about the issues involved.
You may also wish to discuss those issues with the counsellor at the clinic, as they will have experience in helping you explore the implications of your decision, now and in the future.

Human Fertilisation and Embryology Authority (HFEA)
The HFEA is the regulator of fertility treatment in the UK.

British Infertility Counselling Associate (BICA)
BICA is the professional organisation for infertility counsellors in the UK.

National Gamete Donation Trust (NGDT)
NGDT is a registered charity and acts as a central reference point for issues pertaining to sperm, egg and embryo donation in the UK.

Donor Conception Network
The Donor Conception Network is a supportive network of over 2,000 people who have been involved in donor conception, as donors, recipients or children conceived from donation.

Legal parenthood

As an egg share donor, you have no legal claim to any child born as a result of your donation, nor do you have a right to any information about such children. The recipient couple are the legal parents of any children born as a result of your donation. This is stated again in our consent form for egg share donors.

Please speak to a member of our clinical staff if you would like a more detailed explanation.

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