Egg Donation Information for Donors

Why is egg donation needed?
Egg donation offers new hope for a large number of women who previously thought they could never have children. It is for women who have lost their ovaries or the function of their ovaries whilst young. This could be because the ovaries have never developed properly, or because of cancer, surgery, chemotherapy or radiotherapy or, for a surprisingly large number of women, early menopause. As premature menopause affects one per cent of women under the age of 40, well over a hundred thousand women are affected in the UK alone.

It is also of benefit to women who have a high risk of passing genetic disorders on to their offspring. Rather than risk giving birth to a child who may suffer greatly and die at an early age, a couple may request egg donation in order to have the chance of a healthy child.

The treatment of choice in these cases is IVF (In Vitro Fertilisation) - frequently also called the ‘test tube baby technique’. In IVF, donated eggs are fertilised outside the body by the sperm of the recipient’s partner and up to three embryos are transferred to the womb of the recipient. If all goes well, a normal pregnancy develops and the patient will have the chance of having a baby.

Who are potential donors?

1. Volunteer donors
   
2. Women undergoing sterilisation
   
3. Relatives or friends of recipients whose eggs are given to a woman unknown to the donor.
   Ideally, egg donors should be between the ages of 21 and 35 years. It is preferable that they are of proven fertility, but not essential

Will I have to pay for the treatment?
No. All medical expenses will be covered by the hospital. Donors will have all public transport or petrol expenses reimbursed on receipt but will receive no financial remuneration for this service.

Will the donation be anonymous?
Yes, except in very rare cases where your approval and that of the recipient couple must be obtained before any information is divulged. In normal circumstances your identify will not be disclosed to any person other than the staff of the centre at which the operation is performed.

The Human Fertilisation & Embryology Authority (HFEA) register 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.

As from the year 2008, people 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, no information about patients, their children and donors will be given out by the Authority, under any circumstances other than those outlined above. The names of children are not collected. The current law does not allow people who apply for information from the register to know the identity of current or past donors*, or of patients and their children. It is a criminal offence to disclose that information.

The kind of information the Authority now collects, relates to a donor’s appearance, interests and occupation. In the future, Parliament might decide that adults who contact the Authority and learn that they were born as a result of treatment using a donor might be given some details about that donor.

*If a child were to sue the clinic for damages if the child were born with a disability as a result of a donor’s failure to disclose inherited disease, a court might require the HFEA to disclose the donor’s identity under the Congenital Disabilities (Civil liabilities) Act of 1976.

What information will the recipient be given about me?
All information will be non-identifying. We try to match donor and recipient physical characteristics as closely as possible but clearly advise that the result of any matching cannot be guaranteed.

What information will I be given about the recipient?
None. All donations, except in the above-mentioned rare cases, are anonymous. You will not be told the outcome of your donation. However, you will be told how many eggs were collected and how many recipients you have helped.

Will I have a continuing responsibility to any child born following the donation?
No. By law (HFE Act 1990) the person donating the eggs will not be the legal parent of any resulting offspring. At the time of donation you relinquish all legal rights and claims over any offspring that may result from the donated eggs, and all duties towards the child or children.

Will I be held responsible if a child born from my donation is disabled in any way?
No. However, it is your responsibility to inform us of any genetic or inheritable diseases, which present themselves in your immediate family. Failure to do so is an offence and it is the right of any child resulting from this to sue the donor for damages.

Which tests will be done before I am accepted?
By law all donors must be tested for HIV antibody (AIDS), hepatitis B&C and syphilis. Other blood tests include antibodies for cyclomeglavirus, chlamydia, as well as, blood group, chromosomes, cystic fibrosis and hormone analysis. All these tests can be done on two samples of blood.

How does egg donation work?
In a menstrual cycle usually only one egg becomes fully mature. Although it is possible to donate this one mature egg, we prefer to give egg donors drugs so that more eggs are produced. Egg development is monitored by vaginal ultrasound scanning which enables a picture of ovaries containing the eggs to appear on a television screen.

When the eggs are mature we collect them using a needle guided by ultrasound. This is a very short procedure, which takes approximately 10 minutes to complete. A fine hollow needle is passed through the vagina and each egg is removed in turn. According to the donor’s preference it can be done under general anaesthetic or a mild sedative. Some women undergoing sterilisation decide to donate eggs. For them no additional operative procedure will be required.

What happens to my eggs after donation?
Your eggs will be divided in two groups (depending on how many eggs are obtained). Eggs from each group will be placed together with the recipient’s sperm in a dish in the incubator. The dish will be inspected the following day to see whether the sperm have fertilised the egg. If they have, the resulting embryos will be left to grow for up to a day longer and then two will usually be transferred to the recipient’s womb. Two weeks later we will perform a pregnancy test and if positive, two subsequent ultrasound scans.

How many visits will I have to make to hospital?
Under normal circumstances there will be five visits. The first involves a consultation with the doctor who will record your full family history and medical history as well as explaining in full the potential medical and surgical complications of the procedure. He or she will also discuss with you the social, ethical and legal aspects of egg donation, and obtain your written consent. The implications of HIV testing will be discussed with you before blood tests are carried out. Once your blood results are ready, (approximately six weeks later) a second appointment will be made to discuss these.

If you are prepared to go ahead, it is then left to your discretion as to when you wish to donate. The co-ordinator will take you through a detailed account of the drug regimen and complete donor matching and consent forms. The drugs will be prescribed so that you can take them with you. Other visits occur in the actual treatment cycle.

What medication will I be given?
In general, donors will be prescribed three forms of medication:
Synarel spray. This is a nasal spray, taken twice a day. Its function is to suppress your own reproductive hormones so that spontaneous ovulation will not occur in the donation cycle.

Gonal-F or Menogon. This is a course of nine daily injections which can be administered either at the unit, by the GP, or you can be taught how to do this yourself. These injections are a combination of two hormones which normally stimulate the ovary but are of a concentrated form in order to promote ovarian response.

Profasi/Pregnyl (HCG). 34 to 38 hours before egg collection (usually about 9pm) you will be required to have an injection of Profasi/Pregnyl. This injection is timed so that egg maturity will be completed, but collection will occur before ovulation. We can arrange for your local hospital to administer this injection.

What are the possible side effects of the medication?
Synarel works by suppressing the production of hormones from the pituitary gland in the brain which stimulate the ovaries to develop the follicles. It sometimes make you sneeze, avoid blowing your nose immediately after administration. Approximately 10 to 14 days after administration of Synarel the normal function of the ovaries will be ‘switched off’. This allows more control over the development in the follicles, in response to the administered fertility injections and prevents spontaneous ovulation. However, once the ovaries are ‘switched off’ and oestrogen levels in the blood fall some women may experience symptoms. These include hot flushes, feelings of depression, irritability and headache (it is fine to take paracetamol). The period may be different from usual (sometimes lighter but it may also be heavier). These symptoms usually disappear once fertility injections are commenced.

The fertility injections stimulate production of follicles and hormones in the ovaries. While receiving these injections some women may experience abdominal bloating, breast tenderness, increase in vaginal secretions and, if the ovaries are very swollen with a large number of follicles, some abdominal discomfort may be noted. The majority of women do not experienced side effects, but if they do, they are usually short-lived and cease when the treatment is completed.

A scan will arranged on the fifth day of your injections, and also on day ten, along with a blood test, to see how many eggs are developing in the ovaries, and to check your oestrogen levels. At this stage it may be clear that a woman has over responded to the drugs and too many eggs have been produced. To avoid the development of a more serious side effect known as Ovarian Hyperstimulation Syndrome (OHSS), the final hormone injection and egg collection may have to be cancelled. Despite careful monitoring, a small number of women may develop a mild or moderate form of the syndrome. Ovaries may become enlarged with multiple cysts and fluid may develop in the abdominal cavity, causing discomfort. This condition is treated by bed rest, drinking plenty of fluids and taking simple pain killers.

The most severe form of OHSS occurs extremely rarely (in much fewer than one percent of all patients). It is characterised by nausea, vomiting, ovarian enlargement, and fluid in the abdomen causing marked abdominal pain and distension and breathlessness. The patients may also feel weak and faint due to reduction in her circulating blood volume (hypovolemia). In the most extreme cases there is reduction of urine output. None of our donors has ever developed this condition.

Those patients who develop severe OHSS require hospital admission, usually for a few days, to relieve their symptoms and to monitor their progress.

Can I have sexual intercourse during the cycle?
Yes, but you MUST use some form of contraception (other than the contraceptive pill) during the month of the cycle.

How many times can I donate
This decision is entirely at your discretion. However, the law states that no more than 10 children should be born from any one donor.

Will I be given counselling?
The guidelines issued by the HFEA, state that skills and independent counselling by someone other than the medical practitioner involved in the procedure must be available to the donor. Counselling is not compulsory but you should ensure that you are given and have understood sufficient information to make an informed decision. If you are in any doubt about any part of the procedure or the ethical aspects involved, feel free to ask questions.

In cases where a known donor is used, it is required that the counsellor provides counselling for a minimum of three to four sessions as outlined below.

1. Recipient couple together.
2. Donor alone.
   
3. Donor with partner (if has one)
   
4. All parties concerned together
   

There may be a need for further contact with the counsellor, in which case, this will be negotiated with relevant parties.
The counsellor will provide a report which will then be presented to the ethics committee, in order that a decision may be made with regard to pursuing treatment with a known donor.

The aim is that the counsellor will attempt to work to a time scale of six to twelve months from receiving referral to presenting to the ethics committee if the minimal number of contact visits are required.

After decision from ethics committee persons should be made aware that independent counselling will be made available for them should they so wish.

If you are interested in egg donation, please call us on 0151 702 4212 and we will arrange an appointment to discuss egg donation further.

Egg Donation Information for Recipients

Who needs egg donation?
Egg donation offers new hope for a large number of women who previously thought they could never have children. It is for women who have lost the ovaries or the function of their ovaries whilst young. This could be because the ovaries have never developed properly, or because of cancer, surgery, chemotherapy or radiotherapy or, for a surprisingly large number of women, early menopause. As premature menopause affects 1 percent of women under the age 40, well over a hundred thousand women are affected in the UK alone. It is also of benefits to women to who have a high-risk of passing genetic disordesr onto their offspring. Rather than risk giving birth to a child who may suffer greatly and die at an early age, a couple may request donation in order to have the chance of a healthy child. The treatment of choice in these cases is IVF (in vitro fertilisation) - frequently also called the “test tube baby technique”. In IVF, donated eggs are fertilised outside the body by the sperm of the partner, and up to three embryos are transferred to the womb of the recipient. If all goes well, a normal pregnancy develops and the patient will have a chance of having a baby.

How successful is egg donation?
For various reasons egg donation is more successful than the standard test tube baby technique. There is approximately a one-in three chance of achieving pregnancy once the embryos have been transferred into the womb.

Who are potential donors?

1. Volunteer donors
2. Women undergoing sterilisation
3. Relatives or friends of recipients whose eggs are given to a woman unknown to the donor. Donors are women who for different reasons have decided to help someone else have a baby. They are of different ethnic, religious and social backgrounds. All of them are less than 36 years old. Most of the donors (but not all them) have completed their families. Some of them have had problems with sub fertility in the past, or know someone who has had problems with infertility. Some of the donors are relatives of patients.
4. If you are able to recruit a donor who will donate on your behalf to our egg donation bank anonymously, we will endeavour to provide an anonymous donor for your treatment which will potentially reduce your waiting time.

Which tests will be done before a donor is accepted into the programme?
All donors will be tested for HIV antibody (AIDS), hepatitis B&C, syphilis, chlamydia, cyclomeglavirus, blood group, chromosomes, cystic fibrosis and a hormone analysis.

Are donors paid?
No. All donations are made for purely altruistic reasons. No financial remuneration is offered to any donors but reasonable travelling expenses may be covered.

What information will I be given about the donor?
All information will be non-identifying. You’ll be told the donor’s ethnic origin, nationality, eye & hair colour, build and height, and, if the donor wants to disclose it, her occupation and leisure interests. The Human Fertilisation & Embryology Authority (HFEA) is a government body that regulates infertility treatment in the UK. It 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.

As from the year 2008, people 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, no information about patients, their children and donors will be given out by the Authority, under any circumstances other than those outlined above. The names of children are not collected. The current law does not allow people who apply for information from the register to know the identity of current or past donors*, or of patients and their children. It is a criminal offence to disclose that information.

The kind of information the Authority now collects, relates to a donor’s appearance, interests and occupation. In the future, Parliament might decide that adults who contact the Authority and learn that they were born as a result of treatment using a donor might be given some non-identifying details about that donor.

If you have any queries about the information held by the Unit or the HFEA, confidentiality or communication, please do not hesitate to discuss it with the Unit or with the HFEA (click here for ‘Useful addresses’)

*If a child were to sue the clinic for damages if the child were born with a disability as a result of a donor’s failure to disclose inherited disease. If this were to occur, a court might require the HFEA to disclose the donor’s identity under the Congenital Disabilities (Civil liabilities) Act 1976.

What information will the donor be given about me?
None. However, we will reassure the donor that her eggs are donated to couples who satisfy the established legal, medical and social ethics of our department. The donor will be told how many eggs were collected and how many recipients she has helped. The donor will have no way of tracing who she donated eggs to.

Who has a continuing responsibility to any child born following the donation?
You. By law (HFE Act 1990) the person donating the egg’s will not be the legal parent of any resulting offspring. At the time of donation, the donor relinquishes all legal rights and claims over any offspring that may result from the donated eggs, and all duties towards it. You are therefore, solely responsible for the child’s or children’s up bringing.

What happens if a child born as a result of donation is disabled in any way?
As a legal parent, you will bear the full responsibility for the child’s up bringing. However, the donor has a responsibility to inform us of any genetic or inheritable diseases which present themselves in her immediate family. Failure to do so is an offence and it is the right of any child resulting from this to sue the donor for damages.

How does egg donation work?
In the menstrual cycle only one egg usually becomes fully mature. Although it is possible to donate this one mature egg, we prefer to give donors drugs so that more eggs are produced. Egg development is monitored by ultrasound scanning which enables a picture of ovaries containing the eggs to appear on the TV screen. When the eggs are mature, we collect them using a needle guided by ultrasound. This is a very short procedure which takes approximately 10 minutes to complete. A fine hollow needle is passed through the vagina and each egg is removed in turn. Some women undergoing sterilisation decide to donate eggs. For them no additional operative procedure will be required. Eggs will be divided into two groups (depending on how many eggs are obtained). While the donor is undergoing stimulation and egg collection, we will give you hormonal tablets and pessaries to prepare the lining of the womb for the replacement of the embryos. On the day of egg collection, we will ask your partner to provide a semen sample. Donated eggs will be placed together with your partner’s sperm in a dish in the incubator. The dish will be inspected the following day to see whether the sperm have fertilised the egg. If they have, the resulting embryos will be left to grow for up to a day longer and then a maximum of three will be transferred to the recipient’s womb. Two weeks later we will perform a pregnancy test and, if positive, two subsequent ultrasound scans, and continue with medication.

What will I have to do?
Preparation: Under normal circumstances there will be five visits. The first involves a consultation with the doctor who will record your family and medical history as well as explaining the procedure in full. He or she will also discuss with you the social, ethical and legal aspects of egg donation, and obtain your written consent. The doctor will take details of you and your partner’s physical characteristics. The co-ordinator will take a blood sample from you and your partner, which includes your blood group, and for the female, a check for antibodies for rubella and cyclomeglavirus. Also a date for your partner to produce a semen sample, for testing, will be made. Once the results are ready, your details will be held until a suitable donor is available for treatment. This can sometimes take longer than six months.

Treatment: In order to make the lining of your womb more receptive, we will have to synchronise your cycle with the donor’s cycle. To do so, we will put you on a standard hormone replacement treatment (you may already be on this treatment). If you still have spontaneous cycles, an additional drug will be prescribed to suppress ovarian function which could interfere with the egg donation cycle.

What medication will I be given?
Hormone replacement treatment. Pre-menopausal ovaries produce 2 hormones. In the first part of the cycle a hormone called oestrogen is produced while in the second part of the ovaries produced progesterone in addition to oestrogen. Among other functions, the combination of oestrogen and progesterone changes the lining of the womb and in the middle of the cycle makes it receptive to pregnancy.

Progynova is a drug which closely mimics the normal hormone production of ovaries. It is taken daily for at least sixteen days prior to embryo transfer.

Cyclogest - Vaginal/rectal pessaries. This drug will start two days prior to embryo transfer to help implantation.
If you still have periods you’ll be given spray in addition to the above mentioned.

Synarel nasal spray - works by suppressing the production of hormones from the pituitary gland in the brain which stimulates the ovaries to develop follicles. Approximately 10 to 14 days after administration of the drug the normal function of the ovaries will be switched off. By switching off the ovaries, Synarel prevents spontaneous ovulation which would be detrimental to an egg donations cycle.

What are the possible side effects of the medications
Progynova: side effects of hormone replacement treatments are rare. However, some patients experience anxiety attacks, increased appetite and weight gain, bloating, and breast tenderness, dizziness and leg pains.
Cyclogest: Effects are similar to the above.
Synarel: Can occasionally cause light headaches for which it is fine to take paracetamol. Also some experience hot flushes and mood changes.

Will I be given counselling?
The guidelines issued by the HFEA, state that skills and independent counselling by someone other than the medical practitioner involved in the procedure must be available to the donor. Counselling is not compulsory but you should ensure that you are given and have understood sufficient information to make an informed decision. If you are in any doubt about any part of the procedure or the ethical aspects involved, feel free to ask questions.

In cases where a known donor is used, it is required that the counsellor provides counselling for a minimum of three to four sessions as outlined below.

1. Recipient couple together.
   
2. Donor alone.
   
3. Donor with partner (if has one)
   
4. All parties concerned together
   

There may be a need for further contact with the counsellor, in which case, this will be negotiated with relevant parties.

The counsellor will provide a report which will then be presented to the ethics committee, in order that a decision may be made with regard to pursuing treatment with a known donor.

The aim is that the counsellor will attempt to work to a time scale of six to twelve months from receiving referral to presenting to the ethics committee if the minimal number of contact visits are required.

After being informed of the decision from the ethics committee, independent counselling will be made available for the donor and / or the recipient, should they so wish.

Support
If you have any questions feel free to ring the Ovum Donation Co-ordinator tel: 0151-702-4212