Oocyte Donation

Oocyte donation has made child-bearing possible in women previously thought to be untreatable. Women who request egg donation are those with premature menopause (occurring spontaneously, resulting from surgical castration, or induced by chemotherapy or radiotherapy) and women with resistant ovary syndrome. An additional group consists of women who repeatedly show poor ovarian response to stimulation or absence of fertilization with husband or donor semen, or who carry a genetic disease that can be transmitted to the offspring.

Oocyte donation involves egg retrieval from the donor, insemination with semen of the recipient's husband, and in vitro culture and transfer of cleaved embryos into the recipient's uterus. According to the 2001 ASRM/SART Registry, donor oocytes were used in approximately 10.5% of all ART cycles in the India

Steroid substitution therapy is mandatory in agonadal women to simulate the endocrine environment of the natural cycle. In women with ovarian function, replacement of embryos can take place in a natural cycle after mild ovarian stimulation in cases of dysovulation, or, alternatively, these women can be downregulated with GnRH agonists and then given exogenous steroids, as in the case of agonadal women

Oocyte donors undergo a detailed medical and social history and screening for karyotype abnormalities, cystic fibrosis, fragile X syndrome, and previous viral (hepatitis B and C, HIV, CMV) and treponemal infection. Donors usually are matched to recipients on the basis of skin color and ethnic origin only.

The age of the oocyte donor is a significant predictor of pregnancy success. Pregnancies resulting from oocyte donation are associated with increased risk compared with IVF pregnancies, although most oocyte recipients experience a favorable pregnancy outcome

Egg donation may impose risks on the donor's health. These include the development of OHSS, the occurrence of complications during oocyte retrieval, and the potential association of repeated ovarian stimulation with development of ovarian cancer.

An alternative source of oocytes for donation is egg sharing, in which women undergoing IVF donate a portion of their oocytes to an anonymously matched recipient in exchange for subsidized treatment. Donors in an egg-sharing program are not exposed to risks other than those pertaining to hormonal treatment and oocyte retrieval, which represent their only way of becoming parents by using their own genetic material. Egg sharing is an efficient method that reportedly results in three deliveries for every five oocyte retrievals.