Egg donation: Procedure, donor criteria, and legal implications

1. 🩺 What is oocyte donation?
2. 🤰 Donation preparation - recommendations
3. ⭐ Procedure steps
4. 💊 What should be an egg donor?
5. ✔ What about the risks and complications?

What is oocyte donation?

The procedure, when one healthy woman donates her eggs to another to facilitate the conception of a baby, is called donation. The process is part of ART. Oocyte recipients can be both intended parents and a surrogate mother carrying a child for spouses.

The essence of the process is to extract eggs from a donor, fertilize them during IVF, and transfer the resulting embryo into the uterus of the intended or surrogate mother. Excess eggs, like embryos, can be frozen for subsequent procedures or for transferring genetic material to other couples.

Donation benefits women who are unable to use their own oocytes for a variety of reasons, including ovarian failure, genetic abnormalities, or old age. According to studies, in almost half of the cases, the use of donation leads to successful pregnancies and childbirth.

Usually, the process takes 2-6 months, depending on the IVF protocol. An average of 5-25 eggs are retrieved per cycle. At the same time, the woman receives a financial reward for the donated genetic material. The amount of the fee depends on the country, clinic and other factors.

Procedure steps

In order to synchronize the menstrual cycles of the donor and recipient, as well as stimulate the production of more oocytes, the woman will take various injections. Once the oocytes are mature, the doctor will remove them through transvaginal puncture under ultrasound guidance. The extracted germ cells are sent to the embryological laboratory.

Now let's look at the steps of the process in more detail:

1. Application for participation. To donate oocytes, a candidate must meet the stated criteria, including age 21-35 years, physical and mental health, and having their own healthy children. A successful egg donation experience will be a plus.
2. Examination. Serious donation programs such as at Feskov Human Reproductive Group, suggest strict screening of candidates in order to exclude hereditary anomalies and prevent other complications. Usually, these are examinations by a gynecologist and related specialists, tests, family history of diseases, psychological assessment.
3. Coordination. If all indicators are normal, the donor is included in the database and the process of searching for the intended recipients begins.
4. Medications being taken. After the analysis for hormones, hormonal drugs in the form of injections, which are administered during the first two weeks of the cycle (or longer, depending on the IVF protocol) are individually selected for the donor. They stimulate the ovaries to produce more than 1 or 2 eggs.
5. Removal of germ cells. After maturation, the doctor gives a trigger shot of hCG. And within a day, the eggs are removed from the follicles using an aspiration needle that sucks in the oocytes. The manipulation is carried out under local anesthesia for about 30 minutes. A woman can only feel a little discomfort.
6. The recovery period. Immediately after the removal of the genetic material, the woman is able to go home, no hospital stay is required. However, it is advisable, the next day, to be at home and relax.

As a result, the oocytes can be frozen or fertilized with the sperm of the intended father to create embryos which, after 3-5 days of cultivation, are implanted into the uterus of a future or surrogate mother.

What should be an egg donor?

For a reputable clinic to approve a donor for guaranteed programs involving a surrogate mother, as at Feskov Human Reproductive Group, a woman must meet certain criteria:

• age range from 21 to 35 years old;
• physical health;
• psychological stability;
• absence of infections such as STDs, HIV, hepatitis and others;
• have no family history of genetic diseases, such as cystic fibrosis, etc.;
• it is desirable to have own healthy children.

At this age, the quality of the eggs is higher and more of them are produced. In addition, young women respond better to hormonal drugs and tolerate all procedures more easily.

The screening process may include:

• application;
• interview;
• physical examinations;
• blood tests;
• ultrasound of the reproductive organs;
• drug and precursor tests;
• medical and psychological history;
• screening for infections;
• screening for genetic diseases, etc.

This is necessary to ensure the physical and mental health of all children received, as well as to make sure that the donor makes an adequate, balanced and informed decision about donating her genetic material.

What about the risks and complications?

Donation is a fairly safe and low-risk procedure, with close supervision of medical personnel. And there are no long-term health effects.

However, there is still a certain percentage of short-term risks that should be taken into account:

• unplanned pregnancy. If you have unprotected sex during your cycle (without a condom), there is a chance of getting pregnant. Since the medications taken improve the fertility of the donor and increase the chances of conception;
• increase in body weight. While taking hormones to stimulate superovulation, temporary small amounts of weight gain (3-5 pounds) may occur. Most often, this is due to fluid retention in the body and disappears after drug withdrawal;
• side effects from taking medication: headaches, mood swings, bloating, fatigue;
• ovarian hyperstimulation syndrome (OHSS). This is a very rare complication with a mild, moderate and severe stage that develops 3-9 days after the trigger injection. Symptoms: abdominal and ovarian pain, nausea, indigestion;
• ovarian torsion, which is even less common than OHSS. When the ovaries swell, they begin to curl which causes severe pain. Then surgery is required to treat this rare complication;
• infection after puncture. It occurs rarely, and is treated with preventive antibiotics.

Bleeding from a needle, damage to the bowel, bladder, or blood vessels are very rare. Severe OHSS is characterized by shortness of breath, rapid weight gain, abdominal pain, and vomiting. In these cases, you need to immediately call emergency help.

After retrieving the eggs, the woman may feel:

• bloating;
• slight soreness;
• cramping;
• slight bleeding.

The good news is that these symptoms go away on their own the next day. If the temperature rises or bleeding begins, this is a reason to see a doctor.

Donation preparation - recommendations

Preparing for donation is similar to preparing the body for artificial insemination. Leading a healthy lifestyle is the main recommendation for donor candidates, as well as for all women, regardless of age.

Reproductive health clinics such as Feskov Human Reproductive Group, advise to perform the following actions within 3 months so that the eggs mature in sufficient quantity and of the best quality:

• adhere to a balanced diet rich in fresh fruits, vegetables, protein, whole grains, etc. Drink plenty of fluids, except for caffeinated, sugary and carbonated drinks;
• regularly subject the body to moderate physical activity. This can be walking, swimming, or yoga. Also, you can ask experts to recommend specific exercises for a future oocyte retrieval procedure;
• do not drink alcohol, drugs, do not smoke.

Also, it will not be superfluous to create a circle of support. Oocyte donation can be challenging both physically and emotionally. Therefore, having close friends or family members nearby is very important. And this includes not only psychological, but also material assistance. For example, providing transportation to the clinic and back, helping around the house after a manipulation, or doing any other necessary thing.

But above all, don't be afraid to ask questions. According to the latest polls, it turned out that more than half of women know practically nothing about complications and risks. It is the responsibility of the clinic and doctors to provide comprehensive information, advice and recommend resources to better understand the process and reduce the risk of complications.

Legal background of donation

Egg donation is regulated by law (federally in the United States). The procedure can be either anonymous or open. It is possible to legally receive a reward for donated oocytes.

Reproductive clinics require the donor to sign a contract that guarantees the absence of legal rights and obligations in relation to the received embryos or those born children. Although the woman who received the egg will not have a genetic link to the baby, she will be listed in all documents as the biological mother.

There are different egg donation programs in which:

• the donor's identity is not disclosed;
• recipients receive all information about the donor without identification and the possibility of meeting;
• you can meet and communicate with the donor via video communication;
• recipients allow the child, upon reaching the age of majority, to come into contact with the donor (USA, Canada). This is not practiced in Ukraine;
• the donor may already have a relationship with the recipients if they are close friends or relatives.

Therefore, in the contract, in order to provide legal protection for all parties, the following points are indicated:

• lack of parental responsibilities of the donor;
• possibility of contact with future children;
• anonymity or openness;
• exchange of medical information between the donor and intended parents;
• conditions and date of egg retrieval;
• amount and date of receipt of the financial remuneration;
• reimbursement of associated donor expenses (insurance, complications, transfer, etc.).

Thus, after the conclusion of the contract, all parties will be legally protected and clearly understand their rights and obligations.

Feskov Human Reproductive Group has its own databases of verified donors. Therefore, a variety of donated reproductive programs are always effective and safe, and, most importantly, guaranteed, will give the happiness of parenthood!

Authors, contributors:

Vladyslav Feskov
Chief of the Surrogate motherhood Center of professor Feskov

published: 24 January 2022
updated   : 03 March 2023

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