Egg & Sperm Donor Program

All About Sperm & Egg Donation Program

What is Egg and sperm donor program?

Nowadays, if you decide to go for a donor program, you can face problems or difficulties in finding a trusted sperm bank and donor. Fertility Centres that conduct donor programs help people with the inability to become parents naturally. It is a part of fertility treatment which includes sperm donation and egg donation.

There are several reasons behind choosing the donor sperm or egg for use. Sometimes, people choose this process to avoid the transfer of the genetic disease to the child. Other than this, some couples who are a lesbian or single mothers, also opt for this. The men who cannot provide the sample of sperm for the process of in vitro fertilization (IVF) or intrauterine insemination (IUI), can take the advantage of sperm donation.

What is third-party reproduction?

Third-party reproduction involves any other person other than the couple or single parent who plans to raise the child. In this process, some people donate sperms or eggs or embryos and someone else carries the pregnancy. It also involves the process of surrogacy in which one woman is a carrier of pregnancy and another woman provides an egg to the carrier of the baby.

What is egg donation?

The report of the first pregnancy from Egg Donation came in 1984. It helped many people who were struggling to get pregnant. When the intended parents donate eggs and sperm together, they can have a link to the child genetically. The egg is necessary for the process of in vitro fertilization(IVF). In the case of Egg Donor, a woman donates eggs and after fertilizing them in the laboratory, doctors transfer them into the uterus of the intended mother.

Steps for the donation of egg, are:

  • First, you need to find an egg donor who can be known or an unknown person to the intended parents.
  • To stimulate the ovaries, the donor needs to take hormonal injections that help in the production of eggs.
  • They collect the sperm from the male partner of the recipient that is the intended father or unknown donor.
  • To establish a successful pregnancy, doctors transfer the chosen embryo to the womb of the carrier woman (Intended mother)
  • Depending on the circumstances, the intended mother or another woman ( in the case of surrogacy) can be the carrier of pregnancy.

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What is sperm donation?

In the procedure of sperm donation, the men donate their sperm. It can help his female partner if she is getting pregnant with in vitro fertilization or IUI ( intrauterine insemination) process. Other than this, the lesbian couple and a single woman who are interested to have a child can find this helpful to fulfill their dreams of becoming parents.

In the last 10 years, the use of donor sperm has decreased as ICSI is been used as a widespread treatment for male infertility. The process of ICSI or artificial donor insemination is done exclusively with frozen sperms. The current guidelines suggest that sperm should be quarantined for at least six months before using it.

When is there a need for egg and sperm donation?

Different people can take help from egg or sperm donation for different reasons.

The need for egg donation:

The conditions that indicate the need to use third-party oocytes include:

1.Women with non-functioning ovaries

  • Premature ovarian failure
  • Ovarian is absent
  • Both ovaries have been surgically removed
  • Sequelae of cancer chemotherapy
  • Menopause

2. Women with functioning ovaries

  • Risk of inheritable genetic disease in children
  • Poor quality eggs that lead to multiple failed IVF attempts in the past
  • Inaccessible ovaries

The success rates of egg or oocyte donation depend on various factors but are generally independent of the age of the recipient. The major risk for the donor egg program is multiple pregnancies.

The need for sperm donation:

The conditions that indicate the need to use third-party sperm include:

  • Obstructive and non-obstructive azoospermia or no sperm count which may be congenital or acquired.
  • Severe oligospermia that is low sperm count and poor mobility or shape of the sperms
  • Ejaculatory dysfunction
  • Risk of inheritable genetic disease in children
  • If the female is Rh-sensitized but the male is Rh-positive.
  • For a single woman or lady parent who desires a pregnancy but doesn’t have a male partner

The ICMR guidelines have stated that the age of the donors should be between 21 to 45 years along with his normal semen analysis report.

Evaluation of donors

The basis of selection and Screening of oocyte or egg donors according to the Indian Council of Medical Research (ICMR)depends on:

  • That a donor should be healthy, well-screened, and should be between 21 – 35 years.
  • It is necessary to record all the relevant information of the donor, such as his age, height, weight, blood group, educational qualifications, profession, the color of the skin and the eyes, etc
  • The doctor should know the detailed history of the donor to rule out any hereditary disease and in order to exclude donors who might be at high risk for HIV, or sexually transmitted infections, or other infections that can transfer via gamete donation.
  • The doctor should also do all basic investigations that must include genetic karyotyping and hemoglobin electrophoresis to rule out any conditions such as thalassemia, etc.
  • Psychological evaluation and counseling for the egg donor and her partner should be done. In cases that involve known donors, this counseling should be given to the donor and her partner, as well as to the recipient and her partner.
  • The donor must be made clear that the offspring will not know anything about her identity.

Preparation of egg retrieval

To stimulate the development of multiple eggs, doctors prescribe hormonal medications to the donor to retrieve multiple eggs from the ovaries of the donor. The recommended medicines are recombinant follicle-stimulating hormone (r-FSH), human menopausal gonadotropin (hMG), and FSH (nonrecombinant). Thus the process is controlled ovarian stimulation.

The measurement of hormone levels and ultrasound monitoring helps in monitoring the development of the eggs. To prevent the donor from spontaneous ovulation, they use gonadotropin-releasing hormone antagonists (GnRH-ant) or gonadotropin-releasing hormone agonists (GnRH-a). When egg development has been achieved, a trigger injection is given to allow the eggs to mature. After which the egg retrieval is done under anesthesia under ultrasound guidance. After this, the egg donor has no role to play.

Recipient uterine preparation:

Doctor check for a normal uterine cavity by means of a hysteroscopy or ultrasound hysterography. Also, all the recipients should undergo a preparatory cycle in order to measure the endometrial response to exogenous estradiol. The doctors try to synchronize the recipient’s cycle with the donor cycle by using standard oral contraceptive pills. On the second day of the menstrual cycle, estrogen supplementation is given for endometrial preparation and once it becomes ready, progesterone supplementation is given and the embryo transfer is planned accordingly.

Embryo Donation

Now, if there are extra embryos, either frozen or fresh, can be donated by the couples after successfully conceiving through IVF. The most common embryo donors are the couples that have successfully conceived and now wish to donate their embryos to help other infertile couples. This is also recommended to couples in which the male partner has some primary germ cell failure or inheritable genetic abnormality.

Surrogacy

Gestational surrogacy also known as full surrogacy or IVF surrogacy is a surrogacy option that can also involve embryo donation. In this surrogacy, an individual becomes a uterine carrier where the embryos created by the intended parents are transferred for pregnancy. The gestational surrogate mother has no genetic link to the baby she is carrying. Despite the requirement for in vitro fertilization (IVF) to create embryos, the utilization of a gestational surrogate, legally, is less risky as she is genetically not related. And after this procedure, if implantation happens successfully, then according to a contract agreement, the surrogate woman will carry the pregnancy till the term in the normal course of events.

When is surrogacy needed?

Surrogacy may be required in cases like:

  • Absent or congenitally abnormal uterus
  • Absence of a uterus due to surgery
  • Damaged uterus due to severe Asherman’s syndrome or intrauterine adhesions
  • Recurrent implantation failure
  • Recurrent miscarriage
  • Women with a medical contraindication to pregnancy such as severe diabetes or heart or kidney disease.

Gestational surrogates or a surrogate mother can be a relative or a friend of the intended parents who wish or volunteer to carry a pregnancy for them. Alternatively, gestational surrogates can be identified through agencies that (10) specialize in recruiting women to become surrogates.

Rates of pregnancy with egg and sperm donation

For egg donation, the pregnancy rate depends on several factors. According to the Society for Assisted Reproductive Technology (SART), the rate of success was 46.2% of the average live-birth rate per egg-donation cycle across all programs of egg donation. Multiple gestations are the major risk for egg donation. They limited the number of embryo transfers to lower the risk of multiple gestations. With the 21 to 35 aged donors, most programs limit embryo transfer to transferring a single high-quality embryo known as elective single-embryo transfer (eSET).

Conclusion

Many couples fulfill their dream regarding getting a child by third-party reproduction. They design the comprehensive nature of the screening and counseling to fulfill the need of all the parties. Because of using third-party reproduction, they continue to understand the moral, ethical, and legal issues. According to reproductive law, the MHPs, physicians, and attorneys help people to fulfill their dreams of getting a child.

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He is a highly experienced and successful Embryologist with more than 10 years of experience in IVF.

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