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Infertility Treatments Continued: Egg and Sperm Donation

Jessica Evert, MD, edited by Benjamin McDonald, MD Updated: Jun 28th 2016

Egg Donation. Whenever possible, the eggs used for ART techniques are collected from the woman who is planning to become pregnant. There are conditions when this is not possible, however, and eggs must be sourced from a third party known as an egg donor. Women who cannot produce eggs, or whose eggs exist but are not viable for a variety of circumstances require donor eggs in order to have a child, as do same-sex male couples seeking to become parents.

couple talkingEgg donors are young women who wish to help out infertile couples by offering them some of their eggs. They typically take money in exchange for this act of service, but far less than an unrestricted market economy would provide for their act (e.g., between $3000 and $7000 USD). The idea is to compensate these women for their time, effort and good will, but not so much that there is an appearance that eggs are being sold.

After passing medical and psychological tests to prove their fitness for the task, egg donors undergo the same intensive egg stimulation protocol involved in traditional IVF. They inject themselves with hormones for several weeks so as to stimulate their egg production above normal levels. They attend multiple doctors' visits for monitoring tests, which typically involve blood work and transvaginal ultrasound to monitor egg follicle development. At the end of the procedure, their eggs are harvested directly from their ovaries via a doctor's needle inserted through their vaginal walls, guided by ultrasound.

Most egg donations are coordinated through agencies that shield donors' identities and enable them to remain anonymous. Recipient couples choose donors based on an anonymized history and profile, which may include photographs, family medical history and other data such as academic performance. Egg donors may become known to recipient couples, however, under certain circumstances. This is the case when donors are family members or friends, or when third party donors decline their right to anonymity and interact with the recipient couple. In all cases, egg donors sign a legal document, which relinquishes parental and other rights related to any children, which may result from their donation.

Current technology does not allow for freezing of unfertilized eggs with any precision or reasonable hope of recovery. Accordingly, all eggs produced by a donor must be fertilized immediately. This means that as the egg donor is cycled, so too must the recipient female be cycled as well. Where the egg donor's cycle is intended to stimulate her egg production, the recipient's cycle is intended to stimulate her uterine lining so as to prepare it to receive the embryo. The two cycles must be synchronized so that they end within hours of each other. If there are extra embryos at the end of an ART cycle, those embryos may be frozen.

Sperm Donation. Sperm donation operates on the same basic principles as egg donation. Some couples cannot produce viable sperm and must reach out to a third party donor for such material. Same-sex female couples are included in this category as are heterosexual couples that are infertile due to male causes that cannot otherwise be resolved.

Sperm are many orders of magnitude easier to collect than are eggs. A simple ejaculation such as most men might produce without any special preparation contains many millions of sperm. Further, sperm may be frozen and then thawed with good results. For these and other reasons, there is not nearly the difficulty or cost associated with lining up sperm donors as there is associated with egg donors. The ART clinic can simply acquire selected frozen donor sperm from a sperm bank and thaw it out as needed when the recipient eggs are ready to be fertilized.

 

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