Donor Options

Introduction

The single biggest problem with the use of donor gametes (sperm, eggs and embryos) is one of supply. There is both a local and worldwide shortage as these treatment options are being sought more frequently. I have specialised in this specific field of fertility and am able to offer a number of different solutions.

For any treatment occurring in NSW it has to conform to the NSW laws www.health.nsw.gov.au. Occasionally patients will need to seek help interstate and again we can assist them.

Finally some patients will need to find donors overseas. We have connections to a number of highly respected clinics internationally.

For donor oocytes please refer to www.donoreggsaustralia.com.au.

Donor Egg

The use of donor eggs is an effective fertility treatment for women who cannot achieve pregnancy with their own eggs. It allows a woman to use another woman’s eggs (donor) to experience the joy of conceiving a child.

Donor eggs are usually indicated for woman with premature ovarian failure, a condition in which menopause occurs before the age of 40 years. It can also be recommended for women who have a low number of poor quality eggs, had previously failed multiple in vitro fertilisation (IVF) attempts or has a risk of transmitting genetic diseases to her child.

The first step for donor egg treatment involves finding and choosing a donor. Once a donor is found, whether the donor is known to the recipient or is anonymous, a thorough screening is of utmost importance. All donor treatments undertaken in NSW is governed by specific NSW legislation. Note that the use of non-identifiable donors is not allowed in Australia i.e. children born of egg donation have the legal right to be given contact information about their egg donor when the child is 18, even if the egg donor is not known to the recipient.

Screening of the potential egg donor includes a thorough physical examination, review of medical history, and background and history check on genetic disease or birth defects. A social and psychological evaluation along with testing for sexually transmitted and certain genetic diseases is also performed. Once the donor and recipient, who also needs screening and fertility testing and counselling is ready and once an ideal donor is selected, the menstrual cycles of both the donor and recipient are synchronized with hormonal medications. Being on the same cycle provides the best chance for the recipient's uterine lining (endometrium) to be prepared to support the embryo.

The donor receives treatment to stimulate the ovaries to ideally produce more than one mature egg for donation. The eggs are retrieved from the donor. On the same day, the male partner’s or donor semen is collected as well. The egg and sperm are fertilised through IVF (in vitro fertilisation) in the laboratory. The fertilised eggs or embryos can be used immediately after two to five days of the initial retrieval or frozen for future use. The embryos are transferred into the recipient’s uterus for implantation. After 10 days of embryo transfer, the recipient is tested for pregnancy with a blood test. Fresh embryos have a higher chance of pregnancy than frozen embryos. The recipient will continue with hormonal medication for about 10 weeks into pregnancy, until the placenta becomes self-sufficient to provide the hormones on its own. If synchronisation of the donor and recipient are a problem then the recipient can also be prepared for embryo transfer with hormones and frozen embryo transfer can be utilised.

Egg donation treatment may involve certain risks and complications, which may include multiple pregnancies, side effects to medicines such as depression, headaches, hot flashes and sleeplessness. Ovarian hyper stimulation syndrome in the donor,is a rare complication that involves swelling and pain in the ovaries. Other symptoms that require immediate medical attention include shortness of breath, nausea, vomiting and pain in the abdomen.

Despite these drawbacks, egg donation has a success rate of up to 48% per embryo transfer. The success rate depends upon many factors, which include the age of the donor used, the partner's semen quality as well as the overall health of the woman.

Donor Sperm

The inability of a woman to conceive can be attributed to fertility problems in the woman or her male partner, or both. Donor sperm can be used when the male partner is infertile. It is usually indicated when a man produces little or no sperm, produces sperm that is not healthy enough to fertilise an egg or has genetic conditions that may be passed on to his offspring. Donor sperm are also being used for single women and same sex couples who desire a child.

Couples or individuals who have opted for this treatment can obtain sperm from a sperm bank or a known recipient. In either case, a thorough screening is of utmost importance. All sperm donors are rigorously screened by a thorough physical examination, review of medical history, history of genetic diseases and tested for exposure to infectious diseases including HIV, chlamydia, hepatitis, syphilis and gonorrhoea. The woman also undergoes a thorough physical examination, review of medical history and family history, and is screened for genetic diseases and infections. Hormonal tests are also performed to ensure that eggs are being produced.

The treatment process starts around the time of ovulation (release of egg from the ovary). Female patients may also be given medication to induce ovulation when indicated. Donated sperm are used in many fertility treatments, such as in vitro fertilisation (IVF) and intra uterine insemination (IUI). If you are using donor sperm for an IUI procedure, the sperm is placed directly into the uterus or at the entrance of the cervix (neck of the uterus) on the day of ovulation. For IVF procedures, mature eggs are retrieved from the ovary and combined with the donor sperm for fertilisation in the laboratory. The resulting embryo (fertilised egg) is introduced back into the uterus for implantation.

Various factors affect a woman's chances of becoming pregnant with donor sperm; these include the method used for insemination, number of inseminations per cycle, age and past history of pregnancy. The best chances of becoming pregnant with donor sperm provided the female is normal is based on her age.