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Donor Egg:
Women who have experienced ovarian failure, women
above age 45 years or women with certain genetic
disorders can elect to have children utilizing donor
eggs. patients are encouraged to get their own donors
failing which the center may arrange for an egg
donor .For this ,menstrual cycle of the recipient and
donor is matched .Identity of donor to the recipient
and vise versa is not revealed.
The donor Eggs of two types:
Sole donor:
All ooctyes received from a single donor are given to
one recipient woman.
Split Donor:
The oocytes received from a single donor are divided
between the recipient and the donor's cycle.
Consultation & Screening:
Before proceeding with an egg donation cycle, you will
need to consider the ethical and legal issues involved
very carefully. These will be discussed in detail both
during consultation with a member of the unit clinical
staff and at a counselling session with the
independent counsellor. You will be given information
concerning the drug therapy and treatment required;
its side effects and risks, before giving written
consent to donation.
Each potential donor is required to undergo certain
screening tests including a cervical smear, HIV,
Hepatitis B and C, and tests to exclude current or
past history of transmissible diseases. Chromosomal
analysis and screening for cystic fibrosis are also
carried out.
Counselling:
Prior to being accepted as an egg donor, you will be
required to see an independent counsellor. This is to
ensure you have been given sufficient information and
time to consider the implications before making an
informed decision.
Anonymity:
In the majority of cases the egg donor and recipient
remain anonymous to each other. You will receive no
information concerning the recipient, nor whether
donation has been successful in achieving a pregnancy.
On rare occasions a close relative or friend will
offer to act as the donor, but such requests must be
considered very carefully.
Legalities:
Treatment involving the use of donated gametes (eggs)
falls under the remit of the Human Fertilisation &
Embryology Authority (HFEA). This regulatory body was
set up in 1991 as a requirement of the Human
Fertilisation & Embryology Act (1990). Every clinic
that offers egg donation must be
licensed by the HFEA and is inspected annually to
ensure standards are maintained. Under UK law any
woman who gives birth to a child is regarded as the
legal mother, regardless of the genetic origins of the
child. Her husband/partner is regarded as the legal
father. The donor of any gametes has no parental
rights or legal obligations.
Donor Medication:
Suppression of the natural cycle is usually achieved
using a drug called Buserelin. This has the effect of
stopping the pituitary gland’s production of FSH and
LH. Complete suppression usually takes about two weeks
to achieve. Once pituitary suppression has been
achieved, the ovaries are stimulated to develop a
number of follicles, each containing an egg.
This is done using Urinary or recombinant FSH.
Depending on the preparation used, these may be
administered either subcutaneously or into the muscle.
The daily dose varies between individuals and (2-
ampoules of 7514) and
may be increased or decreased as necessary to optimise
the ovarian response. Buserelin administration also
continues during this stage. When sufficient follicles
have developed to an appropriate size, an injection of
human Chorionic Gonadotrophin (hCG) is given late in
the evening. This initiates the final stages of oocyte
maturation leading up to ovulation 36-40 hours later.
The egg collection is timed to occur 36 hours after
the hCG injection.
The Egg Collection:
The egg collection is carefully timed from the hCG
injection. The egg collection is done under local or
general anaesthesia. The procedure, which takes about 30 minutes, is
performed using vaginal ultrasound in the same way as
routine scanning. A needle is guided along the probe
through the vaginal wall and into the ovary. Each
follicle in turn is punctured and drained of the fluid
it contains. The embryologist examines this to
determine whether an egg is present. On average eggs
are retrieved from about 80% of mature follicles. The
eggs recovered will be inseminated using sperm
provided by the recipient’s partner. Those that fertilise will be cultured in the embryology
laboratory to establish further developments
occurring. Two or three days after the egg collection
the recipient will attend the unit for an embryo
transfer. Up to three of the resulting embryos will be
transferred to the recipient’s uterus. Spare embryos
may be cryopreserved (frozen) for future use by the
recipient couple, provided you have given consent for
this.
Possible Complications of Egg Donation:
The drugs are relatively free of both short and long
term side effects. Hot flushes, headaches, mood
changes and vaginal bleeding may be experienced during
the first stage of treatment. Sometimes sickness,
headaches and general irritability can occur before
the egg collection. After the egg collection, you will
feel drowsy for the rest of the day. We generally
allow you to go home after 2-3 hours.
It is important to have somebody to accompany you
home, as it is not safe to drive yourself. It is
common to feel some lower abdominal discomfort, for
which you may take painkillers such as paracetamol. If
you feel sick, avoid eating substantial meals and
stick to drinking fluids for the rest of the day. A
small amount of vaginal bleeding is normal. It is best
to use sanitary towels rather than internal
protection.
As your ovaries have produced a number of eggs, not
all of which may have been retrieved, you are at risk
of a spontaneous multiple pregnancy yourself. You are
therefore advised to use a barrier method of
contraception or abstain from intercourse until you
have had a full period. In very rare cases Ovarian
Hyperstimulation Syndrome (OHSS) may occur if the
ovaries over stimulate and produce large numbers of
eggs or high levels of oestrogen. If we think you are
at risk of developing this, we will provide you with
more detailed advice on what symptoms to watch out
for.
OHSS is characterised by lower abdominal discomfort,
swelling and nausea. Sometimes vomiting and difficulty
breathing may occur. It is important to drink plenty
of fluids to avoid becoming dehydrated. Passing small
amounts of dark urine is a sign of dehydration. If you
are worried that these symptoms are developing, please
contact the unit immediately. Occasionally admission
into hospital for intravenous fluids and observation
is necessary.
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