Altruistic and Known Egg Donation
Altruistic egg donation can give up to two couples the chance of achieving a much wanted pregnancy. The donor will not be able to know the identity of these couples but if the treatment results in a live birth the 'donor conceived person' will be able to request further information on the egg donor including their identity.
A 'known donor' will be donating eggs to a close friend or a relation and will obviously be aware of their identity and the donor conceived person will have the same access to their identity as if they were an altruistic donor.
An egg recipient may have problems producing their own eggs for various reasons. This may occur because the ovaries were never developed properly, or due to premature ovarian failure (menopause) or the result of surgery or chemotherapy or due to the recipient age. For these couples, in vitro fertilisation (IVF) using donor eggs offer the only chance of achieving a pregnancy.
If you are considering either of these options you will need to fulfil all the criteria listed below. Both yourself and your husband/partner will need to attend implications and information appointments. You will both need to see our counsellor. In the case of know donation both couples will have a joint appointment with the counsellor. These appointments are mandatory and are for you to be given all the relevant information to enable you to explore the issues relating to egg donation. Following these appointments we would encourage you to take time to consider whether you wish to proceed.
The next step is to complete all the required screening. This may take up to eight weeks and the results may potentially mean that you cannot donate. Once all screening is complete the clinic will then need to identify suitable recipients (for an altruistic donor). This process may mean it can take three or four months from your first appointment to actually proceeding with egg donation.
When considering whether a donor should be accepted we must take into account the best interests of both donor and the recipient. Therefore acceptance is at the discretion of the consultant. It is probable that you will only be able to donate for a maximum of two cycles of IVF.
Criteria for Acceptance onto the Scheme
- Women should be between the age of 18 and 35
- Be fit and healthy with a BMI between 20 and 30
- Have an FSH level on day 2 – 4 of the cycle less than 10iu/L
- Have a normal or above normal AMH level for their age
- Have no previous history of severe endometriosis or of having had one ovary removed
- Have no history of a transmittable disease
- Have no family history of inheritable disorders
- Be a non-smoker
- An altruistic or know donor should have had a live birth and the child should be at least one year old. We will however consider individual situations.
Treatment involving the use of donated eggs is licensed and registered by the Human Fertilisation and Embryology Authority (HFEA).
If you donate through an HFEA-licensed clinic, which must conform to strict medical, legal and ethical standards:
- you will not be the legal parent of any child born as a result of your donation
- you will have no legal obligation to any child born from your donation
- you will not be named on the birth certificate
- you will not have any rights over how the child will be brought up
- you will not be asked to support the child financially
The HFEA keeps a confidential register of information about donors, patients and treatments. This register was set up on 1st August 1991 and therefore contains information concerning patients, their treatment and children conceived from licensed treatments from that date onwards. The information also includes details of everyone whose donated sperm, eggs or embryos are used at licensed UK fertility clinics.
A donor-conceived person born with an abnormality could sue their donor for damages if it is proven that the donor had not told the clinic relevant facts about their or their families medical history when they donated. This is why it is important to tell the clinic of any inherited disabilities, or physical or mental illnesses that affect you or anyone in your family.
An egg donor must be registered with the HFEA and give consent for her eggs to be used for the treatment of others.
The egg donor can withdraw or change her consent at any time about the use of her donated eggs. In IVF this would apply up to the point of embryo transfer. This also applies to any surplus embryos resulting from the egg donation that the recipients have had frozen for their future use.
In the UK, donated eggs, with the donors consent, may be used to create up to ten families excluding their own. You will be able to specify the number of families (and in the case of known donation a specific recipient) that your eggs can be used to treat. Egg recipients that have created and stored embryos from your donation will be able to use those embryos to try for a sibling pregnancy.
Access to and disclosure of information
From 1 April 2005 the HFEA has collected this information from all egg donors
- Their physical description (height, weight, eye and hair colour) if provided by the donor
- The year and country of their birth
- Their ethnicity
- Whether they had any children, how many and their gender
- Their marital status
- Their medical history
- A goodwill message to any potential children (if provided)
- Identifying information (the donor's name, date of birth and last known address)
Prior to treatment the recipient can have access to:
- Relevant non-identifying information about donors whose gametes are available to them, including the goodwill message and the pen-portrait (if available)
- Relevant information about genetic inheritance and, in particular, the likelihood of inheriting physical characteristics from the donor
If your donation results in a live birth:
The recipient may contact the HFEA for any further non identifying information they hold. Only information which could not, on its own or in conjunction with any other information, be used to trace or identify the donor will be given.
They can also find out the number, if any; of donor-conceived siblings who were conceived by the same donor (this does not include the donor's legal/natural children).
Donor-conceived people conceived after 1 April 2005, when they reach 16 years old, may apply to the HFEA to receive the non-identifying information that their donor provided (all information given by the donor except for their name and last-known address).
Donor-conceived people conceived after 1 April 2005, when they reach 18 years old are able to apply to the HFEA to find the information their donor provided, including identifying information.
From the age of 16 donor-conceived people who intend to enter into an intimate physical relationship can submit a joint application to establish whether they are genetically related. Also, anyone who intends to marry or enter into a civil partnership may submit a joint application to establish whether they are genetically related.
Donor-conceived genetic siblings are those born from sperm, eggs or embryos donated by the same donor.
Donor-conceived people 16 years or older are entitled to anonymous information about any donor-conceived genetically related siblings they may have including the number, sex and year of birth.
On reaching the age of 18, if both sides consent, donor conceived people will be able to find out identifying information about any donor-conceived genetic siblings.
Women whose donation took place after 1 August 1991 are entitled to request information from the HFEA about the number, sex and year of birth of any people born as a result of their donation.
You and your partner will be required to see our counsellor. This is in addition to seeing a consultant and a nurse. All counselling sessions are free. More than one counselling session may be needed.
The decision to donate eggs should obviously be well considered. You may find the following websites helpful:
All donors and recipients are cared for by the Egg Donation Team of nurses. We will give you details of this at your implications counselling appointment.
Investigation/Screening Required Prior to Starting Treatment
Before starting treatment you will need to be tested for the following:
- HIV I and II
- Hepatitis B surface antigen
- Hepatitis B core antibodies
- Hepatitis C
Blood test for the above should be taken within 6 months prior to egg collection and then repeated at least 3 months later, within 1 month prior to egg collection.
- CMV IgM
- Cervical smear (within 3 years)
- Rubella (within 3 years)
- Cystic fibrosis
- Chromosome karyotype
- Tay sachs
- Sickle cell
All of the above tests should be completed within 12 months of the date of egg collection unless specified.
CMV is a very common virus - of all adults 50-80% are infected. The infection may be passed via body fluids or by tissue donation. The symptoms are usually quite mild - sore throat or tiredness. CMV only becomes serious if your immune system doesn't work properly. If caught during pregnancy CMV can be passed to the baby through the placenta. If you catch CMV for the first time during pregnancy there is about a 40% chance you will pass it to your baby. About 300 babies a year develop serious problems due to CMV infection. It is not clear whether or not the CMV virus can be transferred during egg donation but small studies have concluded that it is unlikely. If you have a current (IgM) infection we would not be able to accept you as an egg donor and would advise avoiding pregnancy until the infection has passed.
In addition to the consent forms required for the process of egg stimulation and collection egg donors need to give consent for the use and storage of any donated eggs. Before this consent is given the donor and her partner must have received adequate information about these processes, and have undertaken counselling to fully understand the implications of egg donation.
Egg donors are also required to be registered with the HFEA as an egg donor. This involves providing a description of your characteristics and medical history. An egg donor can also provide additional information such as education, achievements, values and lifeexperiences; and also a goodwill message to the person conceived as the result of their donation.
We will also need to inform your GP of your intention to donate and seek their views regarding any issues that they feel we should be aware of (HFEA Welfare of the child requirement).
The Treatment Programme
The treatment cycle process is the same as a patient who is not an egg donor, as described in the IVF Patient Information leaflet, although we may use medication to manipulate the timings in order to synchronise the cycle with the recipients' cycle. Please ask if you have not been given this information.
Please be aware that we can never be absolutely sure how you will respond to the drugs to stimulate your ovaries and that, as with standard IVF, we may need to cancel the cycle due to a poor response or an over response. These can be difficult decisions; when the response is poor, we have to balance the potential number of eggs that may be collected with the risk of a general anaesthetic; when there is an over response then the health and potential risks to the donor have to become priority.
It is also particularly important that you are aware of the chance that you may conceive yourself during the treatment cycle. We advise that you should use barrier contraception from the beginning of the cycle prior to treatment until your period after the eggs have been collected.
After the Egg Collection
After egg collection you may experience increased discharge from the vagina and some low abdominal pain. If you notice excessive vaginal bleeding please contact the unit. To help the ovaries to recover you will need to recommence the down-regulation medication from the evening of the egg collection. You may expect your period to come within the next two to three weeks following which your cycles should return to their normal pattern. It is advisable that you only have protected intercourse until this period comes. It has been known for egg donors to become pregnant even after the eggs have been collected! Please do feel free to contact us if you have any worries or problems as a result of your donation. We are very happy to help if indicated.
The fertility unit is staffed Monday to Friday from 07.30 to 17.30 hr. outside these hours an answer phone is used. Please leave your name, date and time of your call. If there is an emergency a member of the team is always on call and can be contacted via the unit mobile (077404 22717), or via the main hospital switchboard (01483 227800).
The Financial Arrangements
Payments As from April 1st 2012, altruistic egg donors can be compensated up to £750.00 to cover financial losses incurred in connection with their donation. Assisted Conception Services Pt information leaflet – Altruistic and known donor Version 6.
This compensation may also be received by known donors. This compensation must be paid by the clinic and the clinic must be satisfied that no monies or benefits have been promised or received outside of this arrangement.
Any costs incurred by a known donor are the responsibility of the know recipient. The ovum donation co-ordinator will explain this to the relevant recipients. The couple will be responsible for all costs relating to the donor including all screening, consultations, counselling and the full cost of an ovum donation cycle, including the HFEA fee. The know recipient will also be invoiced for any compensation received by their donor.