The woman who donates eggs is the donor and the woman who receives the embryos (fertilized eggs) is the recipient.
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.
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.
Due to recent changes in the legislation by the Human Fertilisation and Embryology Authority (HFEA), the UK regulator of fertility and increasing awareness of the demand for donor eggs, our clinic has seen an increasing number of donors come forward. This has resulted in our waiting list for donor eggs being dramatically cut. We now expect to match most recipients with a suitable donor within 3 months even for patient of ethnic minority origins! Our donor egg bank was started due to the increased availability of egg donors: we often found ourselves unable to match an egg donor with a suitable recipient. Therefore, we freeze the eggs from such donors. This has only be made viable due to the new egg freezing techniques that provide over 90% survival rates for the freezing process.
Donors can be known or anonymous. A family member (sister or niece) or a close friend can act as an egg donor. The other option is to advertise and recruit anonymous donor.
The long-standing debate is whether it is morally correct to pay the donors. In the UK, from 2012 legislation from the Human Fertilisation and Embryology Authority (HFEA), the UK regulator of fertility treatments, allows clinics to compensate donors (up to £750) for their travel and expenses.
Another potentially controversial point is anonymity. Some donors would like to meet the recipient and to know what sort of person is going to receive her eggs. But this can lead to other social problems. Some donors do not wish to know or meet the recipient. They would like to know only the basic information about the recipient. Along the same lines, many recipients do not like to know or meet the donors. But, some would like to meet and know the donor before proceeding with the treatment.
Any healthy woman who is:
It is preferable for the donor to have had a healthy child (or children) of her own but not required.
Altruistic egg donors generously choose to donate their eggs for altruistic reasons. Altruistic egg donors are not paid but can be compensated for the expenses they incur in connection with the donation process, such as travel costs, accommodation, loss of earnings and childcare. Altruistic egg donors may receive compensation of up to £750 per cycle of donation. Should you choose to receive eggs from an altruistic donor in a fresh egg donation treatment cycle, we will allocate all of the eggs collected from that donor’s treatment cycle to you, i.e. you will not share the eggs with another recipient.
Egg sharing is a unique process whereby a woman who needs IVF shares half of the eggs collected during her treatment cycle with an anonymous recipient in return for heavily subsidised treatment costs. If you take part in an egg sharing arrangement, you will be helping yourself and someone else to become a mum.
Due to recent advances in egg freezing techniques, which provide freezing and thawing success rates are over 90%, it is now not necessary to use fresh eggs for egg donation cycles. Harley Street Fertility Clinic has established an egg bank of frozen eggs from UK donors. One of the benefits of using frozen donor eggs from our egg bank is the lack of worry of the number eggs you might receive for your treatment: we guarantee a minimum of 10 mature frozen eggs for each treatment cycle. Frozen eggs do require fertilisation by intracytoplasmic sperm injection (ICSI) and the extra charge for this is included in our treatment cost for a recipient using frozen donor eggs.
Egg donors initially have a consultation with a doctor who will take a detailed medical history and perform a physical examination. The doctor will explain the procedure involved in egg donation treatment. The donor will then see a nurse to fill out some basic information about herself. She will then be provided with a letter, containing a medical history form that she must complete and have confirmed by her GP.
Once we receive the completed medical history form (provided everything is clear), the donor will be offered a session implications counselling, with an accredited fertility counsellor, to discuss the social and ethical issues pertaining to egg donation.
The donor will also be asked to attend the clinic for a vaginal ultrasound scan and hormone blood tests between days 2 and 5 of her period. These tests are performed to assess the current fertility of the donor.
Donors must inform the clinic of any medical information that may come to light after donation that may have health implications for any woman who receives treatment with their eggs or for any child born as a result of such treatment.
The screening process may reveal previously unknown conditions or infections, some of which may be treatable. Donors’ chromosomes are 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 a donor’s direct family and we will discuss the relevant issues with the donor should these come to light.
Immediately prior to starting her stimulation the donor will be screened once more for infectious diseases (HIV, Hepatitis B and Hepatitis C, Chlamydia, Gonorrhoea) by a new method called the nucleic acid amplification technique (NAT). In addition to providing a repeat set of results, this technique allows early detection of viral infections that may have a incubation period during which they cannot be detected by traditional methods (e.g. HIV can be dormant for up to 180 days).
Typically, donors and recipients are matched for ethnicity, and physical characteristics such as eye-colour, hair-colour, skin-colour, height and build. You will be offered donors who our egg donation team believes are a close match to you and your partner. You will be provided with the following information for each donor:
Please note that all egg donors and recipients must be matched for their CMV status (please speak to a member of our egg donation team for further information)
The law regarding donor anonymity was amended in 2005. For the avoidance of doubt, we provide the HFEA’s guidance notes pertaining to this matter:
The HFEA keeps a confidential register of information about donors, patients and treatments. This register was set up on 1st August 1991 and therefore contains information concerning children conceived from licensed treatments from that date onwards.
People conceived as a result of licensed treatment aged 16+ (if contemplating marriage) or 18, who ask the HFEA, will be told whether or not they were born as a result of licensed assisted conception treatment and, if so, whether they are related to the person they want to marry.
As the law now stands, children born as a result of treatment in the UK using donor eggs will have the right to learn the identity of the donor on reaching the age of eighteen, if the treatment was carried out on or after 1st April 2005. No information about patients, their children and donors related to treatment before this date* will be given out by the Authority under any circumstances other than those outlined above. The names of the children are not collected.
*An exception would be if the child was born with a disability as a result of a donor’s failure to disclose inherited disease. If he or she were to sue a clinic for damages, a court might require the HFEA to disclose the donor’s identify under the Congenital Disabilities (Civil Liabilities) Act 1976.
In the UK, per the 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.
The risks of using donated eggs from a registered donor at an HFEA licenced clinic are minimal because all clinics must adhere to a strict code of practice. At Harley Street Fertility Clinic we take the following precautions:
No. The HFEA Act, 1990, states that a person donating eggs will not be the legal parent of any resulting offspring. At the time of donation you relinquish all legal rights and claims over offspring that may result from the donated eggs.
It is a donor’s responsibility to inform the clinic of any genetic or inheritable diseases present in their immediate family. Failure to do so is an offence and it is the right of any child disabled as a result of failure to pass on this information to sue the donor for damages. However, most abnormalities arise from spontaneous genetic mutation or complications during delivery, in which case the donor would not be held responsible.
A donor may withdraw or vary their consent to donate their eggs for the treatment of others up to the point where an egg, or an embryo created using those eggs, is:
a) transferred to a recipient
b) used in a research project (defined as being under the control of the researchers and being cultured for use in research)
c) used for training (if it has been donated for this purpose)
d)allowed to perish
The law states that there should be live births in no more than 10 families from any one donor. However, we recommend that donors only donate for a maximum of 5 cycles, so this limit will not be reached. Additionally, a donor may specify an upper limit of families that may be created from their donation.
Donors cannot be paid for donating their eggs but they may be compensated for their time, expenses and lost earnings. Donors may be compensated a maximum amount of £750 per donation cycle.
There is a huge shortage of egg donors in the UK. The waiting list in a lot of clinics can over 1 year for an egg donor. Luckily, in our clinic the waiting time is shorter (typically 3 months or less) but there is still a shortage of egg donors, particularly among ethnic minorities.
Egg donation is a relatively recent scientific development. Twenty five years ago, people who did not have eggs or ovaries could not have a child. Now, using donated eggs, such women are able give birth to a healthy baby. We believe this is something very positive!
Your decision to receive treatment using donate 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 issues with the counsellor at the clinic prior to your treatment, 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)
British Infertility Counselling Associate (BICA)
