Egg cell donation – a brochure for the recipient What is egg cell donation? Egg cell donation is the donation of unfertilized egg cells by a donor. These egg cells are given to a woman with a well-functioning uterus but who has problems with the generation of her own egg cells or who does not produce suitable egg cells. Medically speaking, egg cell donation is not as obvious a procedure as sperm donation. The egg cell donor is asked to undergo a hormonal stimulation and an ovarian puncture. The egg cells that are collected from this treatment are donated to a recipient and then fertilized with sperm cells from the recipient’s partner. The supply of egg cells is limited which means that the waiting list of recipients is long. Thanks to recent developments, it has become possible to freeze egg cells. The technique used to do this is called vitrification. This is a method in which the freezing process occurs very rapidly. This minimizes the damage to the egg cells that results from the freezing and later thawing processes. This technique offers new perspectives for the establishment of egg cell banks that are analogous to sperm banks. The introduction of the egg cell bank has made it possible to utilize safer and more patient-friendly stimulation schedules. Furthermore, the egg cell donor enjoys a greater degree of freedom in planning her treatment, since the timing of the preparation of the recipient does not have to be taken into account.
There are various types of donation There are two egg cell donation formulas: anonymous and known donation. 1. Known donation (with fresh material) It is possible that there is someone in your family who is willing to donate egg cells. By obtaining a donor themselves, the pressure on the recipient couple to proceed to known donation can be great. This means that throughout their treatment only the material from the donor they obtained will be used. For the donor, it can be out of an ‘exclusive’ motivation that she does this for the couple. Often the donor is the sister of the woman or the partner of her brother. And for the couple themselves, the argument of loyalty can play a role. They have asked someone whom they trust to be a donor, someone with whom they have a shared history, genetic or otherwise. There are also situations in which known donation is the only option. For example, if the donor obtained is older than 35 years of age and can therefore not be accepted into the regular donor network. Or if it is a question of skin colour. wKnown donation always occurs using fresh egg cells. 2. Anonymous donation (via egg cell bank) Egg cell recipients can receive anonymous egg cells from the egg cell bank in three ways: Voluntary anonymous donation With this, the recipient couple does not obtain its own donor, because, for example, they do not want to involve anyone from their personal circle in the treatment.
This couple will be advised to choose a voluntary donor who is undergoing fertility treatment for the sole purpose of anonymously donating her egg cells. Egg sharing With this method, the donor is a woman who is undergoing IVF treatment herself. It goes without saying that these women are capable of producing fertile egg cells themselves, a portion of which will be fertilized with sperm from their own partners as part of their own fertility treatments and another portion which will be given up for donation. When the egg cell pick-up of the donor results in at least x mature egg cells, she will donate X to the egg cell bank. This always occurs anonymously. The donor couple does not know who the recipient couple is. The recipient couple does not know the origins of the egg cells. Anonymous donation via an obtained donor In this case, the recipient couple obtain a donor who donates her egg cells to the egg cell bank. However, the recipient herself will not receive egg cells from this donor but will receive other egg cells from the egg cell bank. This way anonymity can be guaranteed. The great advantage of this formula is that as a result of obtaining a donor herself, the recipient can more quickly be provided with a donation.
Who are egg cell recipients?
Women who do not have ovaries Women who produce too few egg cells in an IVF stimulation Women who are carriers of a genetically transmittable disorder Women with poor-quality egg cells Lesbian couples in which one woman donates egg cells to her partner
What are the practical steps of the procedure? Before starting the procedure, you come to the Fertility Centre for a consultation with the gynaecologist and the psychologist. The gynaecologist determines the indication for egg cell donation, provides medical information about the treatment and is responsible for the processing of the data and the coordination of the treatment. The psychologist discusses the psychological aspects of being egg cell recipients with you and your partner. The aspect of anonymity is also addressed at this time. The attendance of your partner during these consultations is mandatory.
What exactly is involved in the medical treatment? Until recently, egg cell donation was only possible with fresh egg cells, which meant that the treatment of the donor and that of the recipient had to be perfectly timed to one another; they had to be synchronized. Known donation still occurs in this manner. The donor undergoes the entire IVF treatment up to the pick-up: preliminary examinations, hormonal stimulation of the ovaries, ultrasounds, hCG injection and ovarian puncture (for the exact procedure, we refer you to the general information brochure). As a recipient, in fact, you undergo the ‘second’ part of an IVF treatment, starting from the embryo transfer. While the donor egg cells are fertilized in the laboratory with the sperm from your partner and develop into embryos, your uterus is prepared for the transfer by replacing the normal cycle with an artificial cycle (for the exact procedure, we refer you to the general information brochure).
Preparation of the uterine lining on the basis of an artificial cycle After pick-up from the donor or after thawing in the case of vitrified egg cells, the egg cells must be immediately fertilized in the laboratory using the sperm of the recipientâ€™s partner. Ideally one or two of the resulting embryos will be placed in the uterus of the recipient on day 3 or day 5 after fertilization. Thanks to the artificial cycle, it is easy to carefully prepare the uterus. The uterus is prepared for the arrival of the embryo using oestrogens. These oestrogens must be taken orally in the form of pills. You begin to take the pills at least two weeks before the embryo transfer. The thickness of the uterine lining will be monitored via ultrasonography. If you still have a natural but irregular cycle, the natural cycle is blocked with GnRH analogues. After three weeks, you must combine the use of the GnRH analogues with the administration of oestrogen. The embryo transfer can be performed at the earliest two weeks later.
In cases of egg cell donation, the insemination of the egg cell with the partnerâ€™s sperm is always performed using the ICSI technique. This technique involves the injection of one sperm cell per egg cell. In comparison to traditional IVF, ICSI provides the higher chance of fertilization per egg cell.
How many pregnancies can be achieved from the same donor?
The number of pregnancies that can be engendered within one region by the same donor is not unlimited. This prevents the risk that half-brothers and half-sisters would enter into relationships with one another in the future. In Belgium, the legally established maximum number of recipients per donor is 6.
What is the cost of treatment? Please refer to the attached price list.
How can you contact us?
With this artificial cycle, you must start introducing progesterone into the vagina several days before the embryo transfer so that the uterine lining is ready for implantation.
It is best to make an appointment with the doctor and the psychologist at +32 9 224 60 92 or + 32 9 222 99 22.
Fertilization: always ICSI
On the (scheduled) day of the fertilization, the recipientâ€™s partner is expected to provide a fresh sperm sample with which to inseminate the donated egg cells.
Dr. Tom Coetsier
Dr. Nele Van Renterghem
Dr. Isabelle Meire
If it is not possible for the man to provide a sample on the required day, frozen sperm, which can be thawed several hours before insemination, can be used if necessary.
Team of psychologists Psypunt
Dr. Tom Coetsier
Fertility Centre AZ Sint-Lucas Groenebriel 1 – 9000 Gent tel. +329/224.60.92 – fax. +329/22406602 e-mail : Fertiliteit@azstlucas.be
Fertility Centre AZ Sint-Lucas