Treatment: EGG DONATION
Treatment: EGG DONATION
For an ever-increasing number of infertile women, ovarian failure is an insurmountable obstacle to the production of viable eggs. Yet the desire to achieve and carry a healthy pregnancy remains strong. Ovum donation (OD) – commonly called egg donation – provides them with a realistic opportunity of going from infertility to parenthood.
Egg donation has many benefits over standard IVF cycles. Firstly, in many instances, more eggs are retrieved from a young donor than would ordinarily be needed to complete a single attempt at achieving an IVF pregnancy. As a result, there are often additional healthy embryos for cryopreservation and storage. Secondly, since eggs derived from a young woman are less likely than their older counterparts to produce aneuploid (chromosomally abnormal) embryos, the risk of miscarriage and birth defects such as Down’s syndrome is considerably reduced to that of the age of the donor, rather than that of the recipient.
- Indications
- Selecting an Egg Donor
- Matching the Egg Donor with the Recipient
- Egg Donor Recruitment
- Evaluating Prospective Egg Donor Candidates
- Preparation for the Egg Donor IVF Process
- The Cycle of Treatment
Factors Influencing the Outcome of Egg Donation
We have referred to the relationship between the embryo and the endometrium as a “seed-soil” relationship. An optimal seed-soil relationship is central to successful procreation regardless of whether it occurs naturally, following ovulation induction, with conventional IVF or via IVF with egg donation. Optimal egg/embryo quality is largely influenced by the age of the egg provider and the method of ovarian stimulation. Uterine receptivity is governed by appropriate endometrial development in response to hormonal therapy in the absence of uterine surface lesions, endometrial abnormalities and infection. These factors, coupled with embryo transfer technique, impact significantly on outcome of IVF with egg donation. The age of the recipient has minimal impact upon success as long as she is in general good health.
Emotional Aspects of Egg Donation
The long-term quest for pregnancy is stressful at any age. After age 40 it takes on the added stress of the relentlessly ticking biological clock. Women between 40 and 43, who still have the ability to respond adequately to fertility drugs, must choose between attempting IVF with their own eggs and using donor eggs. The choice of treatment is highly personal and should be considered in light of the financial and emotional costs involved. The further the woman’s age advances beyond 40 yrs and the closer she gets to menopause, the more likely it becomes that she will require multiple attempts at IVF to have even a reasonable chance of achieving a viable pregnancy with her own eggs. However, after the age of 43 the adverse effect of age on a woman’s egg quality so reduces the likelihood of successful IVF (with her own eggs) that egg donation represents the most rational choice. Aspiring parents should carefully consider this reality. The couple must assess whether they can withstand the many possible disappointments on the road to childbearing. How important is it now that the child is genetically theirs? Is it more important to them at this point to achieve a pregnancy with donor eggs and get on with their lives? Potential parents have to answer these questions according to their own personal value systems.
Moral/Ethical Considerations
The moral/ethical and religious implications of egg donation are diverse and have a profound effect on cultural acceptance of this process. The widely held view that everyone is entitled to their own opinion and that each person has the right to have their opinions respected, governs much of the attitude towards this process in the United States. The extreme views on each end of the spectrum hold the gentle central swing of the pendulum in place. This attitude results in a general acceptance in the United States of diverse views, provided that they don’t infringe on the rights of others and that they follow guidelines set forth by various diverse ethics panels.
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