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Donor egg IVF is an option for couples whose eggs will no longer fertilize and produce healthy embryos. Egg quality generally declines with advancing female age but it can occur at any age. Ovarian reserve is a measure of "egg quality" and is evaluated during the infertility workup. Egg donors are either unknown or known and may be a friend or relative.
All egg donors undergo careful physical and psychological testing including a fertility history and screening for genetic diseases. Donors receive compensation for their time and inconvenience. In the donor egg process, follicle stimulating hormone is administered to the donor to induce her ovaries to produce numerous follicles, each of which contains an egg.
Egg donors come to the clinic during the stimulation for routine ultrasound and estradiol monitoring to assess follicular maturation. During this time, the recipient mother receives hormones to synchronize her cycle with the donor's. Once the embryo is ready for transfer, the recipient's endometrium must be "thickened, vascular (in phase)" in order to accept and support the developing embryo.
The eggs are retrieved from the donor using a small "needle" passed through the vagina into each ovarian follicle, using ultrasound guidance. This procedure is performed under light anesthesia. The eggs are passed to the embryologist who separates them from the follicular fluid and prepares them for exposure to the sperm The husband provides sperm by masturbation and it is combined with the donor's eggs in the in vitro fertilization process. The resultant embryos will possess the genetic makeup of the husband and the egg donor.
After culture and incubation (3-5 days), the embryos are transferred to the recipient's uterus where they implant. The in vitro success rates for women in their early forties using their own eggs are dismally low. When donor eggs are utilized, success rates are dramatically improved and match those of the age group to which the donor belongs. In other words, a forty year old receiving eggs from a twenty year old will usually have IVF success rates for the twenty year old age group. Other candidates for donor egg include women who may have been born with absent ovaries (rare) or those whose ovaries were damaged by cancer chemotherapy or radiation. Donor eggs may also be used in cases of unexplained infertility.
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