A couple who wants to undergo egg donation must undergo several medical examinations and psychological assessments before they can be approved. The wait for the egg can sometimes, in the worst case, extend to several years depending on the supply of egg donors.
To be approved as a recipient of a donated egg, a doctor must first make a medical assessment. In consultation with a behavioral scientist, the doctor also makes an assessment of the couple’s psychological and social fitness as parents.
Both the man and the woman should be tested negative for HIV, hepatitis B, hepatitis C and syphilis, among others. However, assisted fertilization may occur if it is judged that there is no risk that any of the infectious agents or diseases can be transmitted to the woman or child. This means, for example, hepatitis B disease is not an insurmountable obstacle to obtaining egg donation.
The limit for the woman to receive eggs should be in accordance with the law. Some fertility centers usually favour women within the menopause age as against those that have passed the menstrual phase. Some countries have a general limit at 38 to 40 years for women. This is because the risks associated with a pregnancy increases for the woman the older she gets. A woman who is older than 55 and becomes pregnant is more easily affected by diabetes, pregnancy poisoning (high blood pressure, egg white in the urine, blood clots and poor growth in the baby) or other complications, studies have shown.
There are also rules for men. The man should not be older than he can take part in parenting throughout the child’s upbringing. But the boundaries are fluid and the state of health is also important for the assessment
But in many countries, women who have passed through menopause can also donate eggs. In Italy and the USA, for example, women who have passed the menopause receive donated eggs. Statistics have shown that a lot of women in these countries between the ages of 60-65 have given birth through egg donation.
The donor and recipient are matched, so they match eye, hair and skin color as well as physique. The identity of the donor is usually kept away from the couple. The parents might choose to disclose to the child about how he/she was conceived.
The spouse or cohabitant whose sperm is used during fertilization must sign on a paper approving the treatment. The woman who received the donated egg is counted as the child’s legal mother both during pregnancy and after childbirth. No special paper is signed after delivery, as all the legal aspects must have been concluded before the commencement of treatment.
The receiving couple has no obligation to tell about the method of conception when they go to, for example, the maternal health care center. However, if the woman is to undergo a NUPP test with ultrasound, it may be appropriate to tell, since the risk of the child having Down’s syndrome is calculated, among other things, on the woman’s (and therefore the egg’s) actual age.
Hormone treatment for the egg to attach
The woman is prepared with hormones so that the uterus can retain the fertilized egg. The hormone treatment, which consists of estrogen and progesterone tablets, causes the mucous membrane to grow in the uterus and help the eggs to attach.
Estrogen treatment lasts for about two weeks and the progesterone is given for a few days before the egg is inserted. Therapy is then continued for about ten weeks to allow the uterus to maintain pregnancy. After eight weeks, the placenta begins to produce the estrogen and progesterone needed for pregnancy.
Risk for the recipient
The hormone treatment produces few side effects. The risk of over-stimulation on the receiver is small because the amount of hormone given corresponds to the hormones a woman produces during a normal menstrual cycle and a normal pregnancy. Many people feel good about getting estrogen, which is also called a “positive hormone” and provides well-being. Possible side effects may be similar to menopausal treatment / birth control pills.
After the eggs are removed from the donor’s ovaries and fertilized with sperm from the man, they are allowed to grow for a few days in a test tube bowl. The embryo that is considered to be of the best quality is selected and inserted into the woman via a plastic tube while the doctor uses ultrasound. If more embryos have survived and are of sufficiently good quality, they are frozen.
Transfer of the eggs
The number of embryos transferred is determined by the number of healthy embryos that survived. If a doctor assesses that the quality of the eggs is poorer, two embryos are often inserted since the risk of twin pregnancy is considered small. Younger women usually have fewer fertilized egg inserted because they have a greater chance of becoming pregnant per inserted egg and have more years to try than older women have.
Inserting more than one egg increases the possibility of pregnancy, but also of multiple births, something the doctors want to avoid. The risk of complications during pregnancy increases if the woman becomes pregnant with twins. Twins are also often born prematurely and often require long-term intensive care. Studies have also shown that women who receive multiple eggs are more likely to suffer from high blood pressure than others.
Sometimes the couple’s wish can conflict with the doctors about how many eggs to transfer. Because of the huge financial cost involved in IVF and egg donation, a lot of women prefer to transfer more eggs per trial to increase the chance of a pregnancy.
The chance of becoming pregnant per embryo insertion, or per fertilized egg, is just about 25%. Women under the age of 35 have more success rate as compared with older women.