Egg Donation Mechanism, Pros, Cons And Expert Opinions

Ovodonation (or donation of oocytes) is a process in which a female individual donates her own ovum so that they can be used with heterologous fertilization by a couple with fertility problems.

This procedure is more complicated than the donation of male seminal fluid (semedonation), as it requires a small surgical procedure (called follicular puncture) to extract the oocytes. The female gametes thus extracted are then fertilized in the laboratory with the seed of the partner or a donor alien to the couple, through the most appropriate medical-assisted procreation techniques.

The donor who decides to donate oocytes to other women at an assisted reproduction clinic must be subjected to specific examinations such as, for example, health history and analyzes for infectious and genetic diseases.

A brief premise: requirements for heterologous fertilization

Ovodonation (or donation of oocytes)

Heterologic Fertilization is a medication-assisted procreation technique (PMA) that helps couple couples who want a child but cannot spontaneously engage in a pregnancy. In heterologous fertilization, one of the two gametes used for procreative purposes (female oocytes or male sperm) does not belong to one of the parents who undergo treatment, but comes from a subject other than the requesting couple (donor).

The use of this technique is legitimate in a course of treatment where the infertility or infertility of at least one of the two parents is established and there are no other effective therapeutic methods to solve this condition. However, heterologous fertilization is only allowed for sexually-identical couples, married or cohabiting steadily. The donation therefore cannot be used by either single persons or couples of the same sex.

Ovodonation: what is it?

Ovodonation is a process that involves the inoculation of the ovule coming from a specifically stimulated donor, and the transfer of the embryo thus obtained in the recipient’s uterus.

In proven infertility conditions, women may resort to seizures if they have:

  • Older age.
  • Insufficiency or poor premature or congenital ovarian reserve.
  • Pathologies that have compromised reproductive capacity.
  • Chromosomal or genetic abnormalities.
  • Multiple abortions.
  • Repeated failures of other medically assisted procreation techniques.

In any case, however, strict controls are required to ensure that donors do not have infectious diseases or chromosomal abnormalities. Suppliers’ foreign banks must also guarantee the traceability of biological samples and the safe transport conditions.

Donor requirements

To access heterologous fertilization, it is possible to use frozen oocytes in the centers themselves, or donated by women in turn to subjected to assisted fecundation.

Oocyte donation can be made in the presence of the following requirements:

  • The woman who gives her oocytes must be between the ages of 21 and 34.
  • The donor must be in perfect state of health, physical and mental.
  • The donor’s ovulatory function must be normal.
  • Each donor has a maximum of ten births with her own gametes.

Those who donate oocytes must not have malformations, genetic or congenital or hereditary diseases (not even the closest family members may have it, so the donor may not have been adopted because it is essential to know the medical history). In addition to the previous requirements, potential donors of ovules will have to pass two indispensable tests: on the one hand blood tests and, on the other hand, a gynecological examination to evaluate fertility.

Ovarian donors are healthy women, young (21-33 years) and with proven fertility. These criteria are needed to ensure optimum recovery of oocytes in terms of number and quality. The donation of oocytes must take place in an anonymous and voluntary form. In the selection process, the donor’s family and personal clinical history, gynecological health status, psychological, aptitude and professional conditions, as well as specific tests to exclude infectious or hereditary diseases are evaluated.

For matching, guidelines for heterologous fertilization recommend that the donor’s immunologic (physiological) and phenotypic characteristics – such as skin color – be compatible with those of future parents, so the clinic must ensure some criteria, Such as respect for the eternity and the blood group. This promotes the natural process of family integration.

How does it happen?

Prior to oocyte withdrawal, it is crucial that donor respects absolute fasting during the 6 hours prior to surgery. This precaution is necessary for the pick-up to take place normally and does not imply any side effects or unforeseen complications. The patient is admitted to the clinic on the same day of induced ovulation, one hour before the surgery.

How does it happenStimulation of the donor’s ovarian activity. Once the most suitable donor is selected, it is subjected to controlled ovarian stimulation by administering hormones. The purpose is to induce the maturation of several follicles to extract, if possible, more oocytes, before natural ovulation occurs (in order to collect egg cells it is necessary to locate them first).

The donor is then subjected to periodic ultrasound and hormone doses to control the evolution of the process and determine the time to collect the ovules by follicular puncture (surgical intervention to extract the ovum of the woman from within mature anthrax follicles).

Recovery of oocytes. When the follicles reach a diameter of approximately 16-18 mm, oocyte withdrawal (follicular puncture or pick-up) is programmed, then the hCG hormone is administered to induce ovulation within the next 36 to 48 hours.

Recovery of the oocytes is carried out by transubstantial transjaginal puncture (hence from the donor’s vagina). This procedure is performed after administration of a mild anesthesia, generally local, and sedation. The surgery is performed by a gynecologist, embryologist and anesthesiologist, and lasts about 20 minutes.

The gynecologist opens the cervical canal with the help of the speculum and introduces the ultrasound along with the suction needle. With the support of transvaginal ultrasonography, the physician then locates the follicles, and the sting of these is accomplished one by one, collecting the fluid they contain, inside which the oocyte is present.

Always maintaining a temperature of 98.6°F, the transferred material is transferred to the lab, where embryologist specialists recuperate and select the mature eggs, and prepare them for use.

Endometrial preparation of the receiver. The oocytes thus obtained will be inseminated fresh or cryopreserved and used in the appropriate times. Before artificial insemination, the endometrium of the recipient woman must have an optimal receptivity for embryo implantation.

Risks and possible complications

Ovodonation is a painless process, carried out under sedation. The woman may leave the center shortly after the follicular puncture. It is however recommended that you wait about an hour to fully recover from local anesthesia and to go to the clinic.

After withdrawal, menstrual abdominal pain or mild vaginal bleeding may occur. To recover from the pipeline, it would be best to stay at least one day and not undergo great efforts.

The response to ovulation inducing drugs should be monitored (with ovaries and / or hormone doses) in order to suspend treatment in the event of ovarian hyperstimulation syndrome, i.e. the development of an excessive number of follicles. This condition may involve various symptoms such as increased ovarian volume, abdominal pain, weight gain, lack of breath and nausea. In the most severe cases, an abdominal distension and blood clots can be formed that may require hospitalization. Donating eggs does not compromise the donor’s future fertility. Usually, a period of 2 months is indicated between the intervention and donor’s pregnancy, if any such is planned.

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