Egg Donation FAQ
For many people, the only way they can achieve a successful pregnancy and create their family is with the assistance of an egg donor. Below is some general information for egg donors a guide only as practices differ from clinic to clinic. Who requires donated eggs?
Women with premature menopause.
Women who carry a genetic disease they do not want to pass on.
Women who have no ovarian function due to medical treatment or surgery.
Women who continue to respond poorly in IVF cycles.
Women whose egg quality and quantity has declined due to age. Who can donate?
- Varies from clinic to clinic, but in general, women 35 and under can be anonymous donors, 38 and under can be known donors.
- Clinics generally prefer donors to have finished their families.
- Women whose families are free of certain genetic problems.
- Having a tubal ligation does not stop you from donating.
- If you are breastfeeding, you will have to wait for a few cycles for your hormone levels to return to normal.
- If you are married, your partner is required to attend the counselling session and sign a consent form. He will also be required to have his blood tested. What types of donation are there?
Regardless of which donation you choose to pursue, be aware that your decision will impact on your own family. A successful pregnancy and birth will provide your own children with genetic half-siblings, and it is wise for donors to think about how they feel about this and how they will manage this dynamic within their own family.
Known donation is where the donor is a friend or a family member, or a growing number of women who meet with and get to know recipients with a view to donating. This second group of 'known' donors are usually want any people concieved from their donation to have access to the other half of their genetic story if/when they need it.
Anonymous donation is where the woman donating does not know or have any contact with the recipient couple or any resulting children. Recipients are given non-identifying information such as build, height, eye and hair colour etc. Depending on which state you live in, actual identifying information is available upon request to any people conceived when they reach a certain age.
Depending on which state you live on, laws differ as to what kind of donation you can undertake.
Victoria: Victoria currently has laws that prevent completely anonymous donation. To advertise for a donor, recipients must have their ads approved by the Minister of Health and each ad must contain a blurb from the department. People conceived from donor egg, sperm and embryos in Victoria have the right to know the identity of their donor when they reach the age of 18. Each party to the donation has to lodge their details on a database.
NSW, ACT, TAS, QLD and NT: No legislation. Anonymous donation allowed, although some clinics will only do known donation.
SA: Non-identifying information available when donor conceived people reach the age of 16. While there is no right to access identifying information there is also nothing in the legislation which forbids access to identifying information if all parties consent.
WA: Legislation in WA means a donor conceived person's right to know their genetic background is protected and they can access the identity of their donor. Known donors have a six month waiting period while anonymous donors can donate immediately. A donor can donate up to a maximum of five families.Do recipients get to match their looks with their donors?
There are so few donors that matching looks is usually not possible, particularly with anonymous donation. The only time this is a consideration is where the donor is non-caucasian - their eggs would be offered to a non-caucasian couple or a couple who had already indicated they were not concerned about this issue. Will the child know who I am?
Again, check your state's legislation. In most states, unless the family chooses to tell the person of their conception (and thankfully growing numbers do), the donor conceived person will not know how they were conceived, let alone who provided half of their genetic material. By choosing to pursue a known donation, you can in some way try to ensure that the person you help concieve knows their genetic truth.How do I find a recipient couple/person?
Please read 'Seven Steps to Sensible Donation'. Once you are ready to donate, there are a variety of ways to find recipient couples. Start right here, read through the classified ads of Sydney/Melbourne/Brisbane/Adelaide/Canberra Child and sometimes even your local papers. You can also approach your local clinic and ask to be matched with one of their recipients.
The internet is an increasingly common place to find recipients, particularly for known donation. There is a list of boards and groups at the end of the FAQs. Do I have to do anything special during donation?
You are asked to avoid cigarettes and alcohol during your donation cycle, as well as taking extra contraceptive precautions during and after the cycle. Does it matter what contraception I am using?
While most donor cycles will commence with the birth control pill, women who are using other methods of long term contraception may have to wait a couple of months after stopping before they can donate, to ensure that hormones have returned to normal. The clinic will advise you what to do, and it is important to let your IPs know as they will have to factor in this delay into their own schedules if necessary. Will I get paid to donate?
Egg donation in Australia and New Zealand is altruistic and it is illegal to either offer or request payment. Generally, depending on the clinic and recipients, donors are reimbursed for travelling expenses, any medical costs incurred in their name, time taken off work for appointments, egg pick-up and a day's recovery as well as child care if necessary. Donors should not be out of pocket because of their donation. Who "owns" the embryos I help create?
A donor can withdraw consent for the use of her eggs right up until the time of fertilisation - until that time, the eggs are legally hers. Once the egg is fertilised, it is considered to be the legal property of the recipient couple. Donors have no rights whatsoever over any children conceived, or any legal obligation.Is there any counselling available?
The emotional issues of egg donation are perhaps more important than the medical aspects. All donors and their partners usually have a mandatory counselling session, and known donors will usually have another counselling session with the recipient couple. Most clinics have a counsellor available either at the clinic or over the phone if you need to discuss something.
Some of the things to think about before making the decision to donate...
You are donating genetic material to assist a couple to CREATE A LIFE that will be carried, birthed and brought up by another couple - this child will not be yours.
You are providing your own children with genetic half siblings - how and when will you tell them?
You are providing your parents with genetic grandchildren, your brothers and sisters with genetic nephews/nieces - how and when will you tell them?
Who else will you tell? Do you have someone in your support network who can support you through this?
Even in a known donation, with the child knowing how they were conceived and how they are genetically related to them, they may not want to contact or meet you or your children - how would that make you feel?
The recipient couple decides what happens to any embryos they do not use - let succomb, leave to research or donate on to another couple - how do you feel about this, given these embryos will have genetic links to you and your children?
If you wish to have more children in the future and are unable to, how will you feel about this donation?
If you have not yet started your family, how do you feel about your future children having genetic half siblings?
How will the recipients treat/love the child/ren I help them conceive?
Will I still be happy with this decision in 20 years' time?What happens if I don't have health insurance?
If you don't have health insurance, recipients will pay for all of the gap that is not covered by Medicare. If anonymous donor, your recipients will be made aware of this. Be aware that if you experience any complications after EPU, you will have to cover your hospital costs and associated care, unless this is something you have discussed with your recipients. What if my husband doesn't want me to donate?
Your partner is an important part of your decision making. In order for you to donate he will have to attend a counselling session, have to sign consent forms and have a blood test. As well as this, you might require his emotional support during your donation. How will I tell my own children?
Research into adoption and some recent research into donor conceived children, shows that telling children early on in their lives in child-friendly language and concepts at the appropriate time, actually enables children to accept the information much more naturally into their lives. Be prepared that they might "play out" this knowledge in the company of other children and adults, which may impact on who else you choose to tell. What tests will I have to have?
You will have blood taken to test for a variety of diseases, and your hormone levels (usually day 3 of your cycle). You will have an ultrasound using a wand inserted vaginally (transvaginal inducer) to assess the health of ovaries and access to them for egg pick-up and to provide a baseline scan to refer to during your treatment. How long does a cycle take? What sort of time would I need off work or away from my children?
You may be on the pill for a few weeks before starting the cycle and then the actual cycle takes about four weeks. Be aware that depending on how well your body responds to the drugs, the cycle may be shorter or longer by a few days.
For initial appointments with the donor co-ordinator and Doctor, you will probably need to go during work hours. Blood tests are done early in the day for same day results so could possibly done before work (clinics open quite early). Ultrasound times will depend on clinics. Counselling can often be done in the early evening or after initial appointments, via phone.
Be aware that if you respond poorly to medication and the follicles need more time to develop, you may require one or more extra blood tests and scans to see how they are developing. What does a donor cycle entail medically?
The clinic will devise a protocol for you and the recipient which is a regime of timing, drugs and dosages to follow during the cycle. Once you are given the go ahead, the idea is to synchronise your cycle and the recipients cycle so that when your eggs are ready for pick-up, her body is ready to accept them. Most donors will go through a cycle of 'down regulation', where your ovaries are suppressed from producing eggs before being over stimulated. Your cycle will start with the pill, then generally a period of "down-regulation" (approx two weeks) where your body is prevented from ovulating, followed by a period of "stimulation" (approx 10/12 days) where your ovaries are over-stimulated to produce more than their usual one egg. A day of rest follows the trigger injection to release the eggs after the stimulation stage, and then EPU is 36 hours or thereabouts after this injection.
For the down regulation part of the cycle, most donors have to sniff a nasal spray (Synarel) twice a day. This drug tells your brain to shut down activity in your ovary and prevents your body from ovulating. After about a week on Synarel, a blood test is taken to ensure that your body is not ovulating. Then you begin the stimulation phase, using a drug called Purgeon or Gonal F, where your ovaries are over stimulated to produce more than one egg. This drug is injected into your tummy and you are taught how to do this at the clinic...once you know how to do it, it becomes very easy to do and hardly even stings.
After 8-10 days of stimulation, an ultrasound of your ovaries tells how may follices are developing and their sizes. Depending on this information, a date for egg pick up is decided. If the follices are too small and need more stimulation, another ultrasound date will be set and EPU moved backward. Sometimes the follicles are ready to go, and EPU is moved forward. Some cycles may also be cancelled at this stage if there is not sufficient follicle development, or in some cases, over-stimulation which can lead to OHSS.
After a final date is made for EPU, you will give yourself a 'trigger' injection at a particular time, for eg, exactly 36 hours before EPU. This trigger injection of hCG (Human Chorionic Gonadotrophin)is a drug that mimics preparation of the uterus lining for embryo implantation, thus tells the brain to release any eggs formed. It is given either in the tummy (subctaneously) or in the thigh (intramuscularly)...it stings a little more than the FSH injections and can remain a little tender at the injection site.
Day surgery admission for egg pick up, with fasting both food and drink after 12am the night before. You will talk to the anethetist and the nurse before the procedure. You will be given a light anesthetic and be out for about an hour while the doctor picks up your eggs. This is done using a needle and needle guide through a vaginal transducer. The fluid in the follicles is drained, and the eggs are then taken for fertilisation.
When you wake up from surgery, you may feel quite groggy. You will need someone to take you home and expect to rest for the rest of the day and the next day after pick up. You may have some spotting and your ovaries may be quite tender. Clinics advise Panadol forte for pain relief, heat pack for your abdomen. Very important is to drink an extra two litres of water to help your body heal and to help with constipation after the GA. Metamucil or the like is also recommended. What are the side effects of the IVF drugs?
The job of the suppressant drugs, such as synarel, is to force your body into a temporary menopausal state where you will not ovulate. As such you may experience some menopausal symptoms such as spotting, hot flushes, headaches, breast tenderness, discomfort in lower back and abdomen due to increased ovarian activity. A full list of symptoms and what to be aware of is available from the clinic.
Stimulation drugs, such as Puregon and Gonal F, ask your ovaries to produce many more eggs than their usual one. The worst side effect of these drugs is Ovarian Hyper Stimulation Syndrome (OHSS) where the ovaries are so over stimulated that fluid leaks from the ovaries... in very rare cases some patients require hospitalisation. However, most women get some minor signs of OHSS during their treatment - swelling, tenderness - which is all treatable at home. Clinics are very careful to monitor anyone who may be prone to over stimulation, usually women who produce 15-20 eggs plus. Although rare, OHSS is a very real risk and must be taken seriously - please make sure you consult your clinic for a list of symptoms to watch out for.
General Anesthetic - although a light anesthetic is used, the usual side effects of a general anesthetic apply and some people may experience drowsiness, nausea etc. How many eggs will I produce?
There are so many factors that impact on the number of eggs produced and as yet no one clear method to foretell how many eggs will be picked up... age, health, BMI, smoker or non-smoker are some of the things that might make a difference. Most donors are given the minimum dosage of drugs necessary and then it is up to how their bodies respond to these drugs. A woman doing an IVF cycle may produce anywhere from 0 to 30 plus eggs, with the average being between 5-15. It is the quality of the eggs that is important as well, the ability of an egg to become fertilised and divide into two cells, and then four so on. Any left over eggs will be frozen for future attempts of FET or Frozen Embryo Transfers. What is the chance of a pregnancy?
Pregnancy rates are anything from 15-40% depending on clinic, age of recipient, existence of other fertililty problems eg. male factor etc. The clinic can provide you with a list of their pregnancy rates. Research has shown that donor egg embryos have the same success rates as "normal" embryos. What happens after EPU? What will I be told about any pregnancies?
Depending on what relationship you have with your recipients, your journey may end here. You can contact the clinic to find out how many eggs were successful, and by law the clinic must tell you if there is a successful birth, the sex of the child and if there are any disabilities. However, clinics in general do not appear to be very apt at taking care of their donors, so you may have to remain in contact with them. Down the track, if you or family members contract any hereditary diseases, it would be prudent to contact the clininc so they can alert the family. Likewise keep them informed of any address changes in case the family or children conceived would like to contact you when the time comes if you have agreed to this.
For known donors, your recipient will probably keep you informed of the outcomes up to pregnancy and hopefully beyond. Where can I find further information?
AussieEggDonors Private Forumshttp://www.aussieeggdonors.com/index.html
Australia - Donor Conception Support Group http://members.optushome.com.au/dcsg/
UK - Donor Conception Network http://freespace.virgin.net/dcnet.website/...nors-origin.htm
Egg Donation FAQs http://www.fortunecity.com/meltingpot/gree...79/question.htm
ACCESS - Australia's National Infertility Network http://www.access.org.au/
INCIID - International Council on Infertility Informatin Dissemination http://www.inciid.org/ Books
"Experiences of Donor Conception" by Caroline Lorbach. Excellent reading for anyone contemplating donation or donor conception. Leans very heavily towards the need for disclosure and openness in donation. Articles
Choosing identity-release sperm donors http://humrep.oupjournals.org/cgi/content/...y=aiUnHNwjDmQHc
Telling the story: parent's scripts for donor offspring http://humrep.oupjournals.org/cgi/content/full/14/5/1392
Should offspring from donated gametes continue to be denied knowledge of their origins and antecedants? http://humrep.oupjournals.org/cgi/content/full/16/5/807 Stories from donor-concieved adultshttp://members.optushome.com.au/dcsg/resou..._offspring.html http://members.optushome.com.au/dcsg/resou...ine_hewitt.htmlWith thanks to CindyK, who posted this information origianlly. Updated 19/09/08