Some women who need to have IVF treatment may wish to be considered for the eggsharing scheme. A patient who is willing to share her eggs (donor) will agree to donate 50% of the eggs retrieved at her egg collection to another woman (recipient). A 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 recipient age. For these couples, in vitro fertilisation (IVF) using donor eggs offers the only chance of achieving a pregnancy.
A woman considering treatment under the egg sharing scheme must fulfil all the criteria listed below. In addition you will need to attend implications and information appointments as a couple. You will also need to see a consultant. These appointments are for you to be given all the relevant information and to explore the issues relating to egg-sharing. We would encourage you to take time to consider whether you wish to proceed.
The next step will then be to complete all the required screening. This may take up to eight weeks and depending on the results may exclude a woman from the egg-sharing scheme. The clinic will then need to identify a suitable recipient. This process may mean that you will have to wait three to four months before being able to start your treatment cycle.
When considering a patient for the egg sharing scheme we must take into account the best interests of both the donor and recipient couple and therefore acceptance on to the scheme 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.
An Egg-share donor must have a diagnosis which requires them to need IVF in their own right. We cannot allow a patient to have IVF treatment unnecessarily in order that they can be an egg-share donor.
Criteria for Acceptance onto the Scheme
Egg donors should:
- Be between the ages 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 transmissible disease
- Have no family history of inheritable disorders
- Be a non-smoker for a minimum of 3 months
- Have had no more than 2 previous unsuccessful cycles
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.
The ovum recipient and donor in an egg share treatment may wish to enquire of the clinic the outcome of their treatment cycles.
- A Donor may be informed whether or not the recipient of their eggs achieved a pregnancy and subsequent live birth.
- A Recipient may only be informed of the outcome of the donors' treatment if the recipient achieves a pregnancy; and has reached at least 12 weeks of pregnancy.
This is to provide information to both parties with consideration to the prospect that halfsiblings may exist on both sides of the arrangement. Non-identifying information only can be given. Couples may feel this is an important factor when decisions are made regarding information they wish to give to their offspring.
Undertaking treatment can be emotionally stressful for you as a couple and it can help to talk things over with someone else.
At the Victoria Wing our counsellor and nursing staff will give support, before, during and after treatment, providing information and implications counselling, and guidance to explore relevant issues.
Implications counselling with the nurse and the counsellor is mandatory, prior to having treatment as an egg sharer.
It is important that your consent to treatment is informed and that you have fully considered the implications of your treatment.
This should include the implications for each other, any existing children and any children born as a result of your treatment. You also need to consider, if the treatment is successful, how you will tell your child about their origins. There is considerable information and support available to help you plan this.
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 Priot 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 IVF or ICSI egg sharers 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 life experiences; 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 Cycle
The treatment cycle process is the same as a patient who is not an egg donor, although we may use medication to manipulate the timings in order to synchronise the cycle with the recipients' cycle. This is never done in a way that would compromise risks or response.
On the day of Egg Collection the eggs collected are shared as below:
- The minimum number of eggs required to share is eight.
- Any eggs collected will be shared equally between the donor and recipient (i.e. a minimum of four eggs each).
- If an odd number of eggs are collected the donor will have one more egg than the recipient.
- If four to seven eggs are collected the donor has the option of keeping all of the eggs for their own treatment or donating all of the eggs to the recipient. We will discuss this in more detail at your implications counselling appointment.
- If three or less eggs are collected they may be offered to the recipient if the donor wishes but if they are not accepted must be used for the donors' treatment cycle.
The Financial Arrangements
The donor will be charged for:
- The initial consultation
- Semen analysis
- Any screening required for your partner
- Freezing and storage of any sperm or embryos
- The HFEA fee
- Any additional laboratory procedures – i.e. ICSI, assisted hatching
- Any screening or procedures not required for egg sharing purposes – e.g. immunology screening, trial embryo transfer
The donor will not be charged for:
- The IVF cycle
- Any screening required as an egg sharer
- Drugs required as part of the treatment cycle and as an egg sharer
- If the Consultant, for any reason, including a poor response to the drugs, cancels your treatment cycle prior to Egg Collection, you will not incur a financial penalty. The HFEA Act 1990 (as amended) states that you may withdraw or vary your consent up to the time your eggs, or the embryos created with your eggs are used for treatment of the recipient, including cryopreserved embryos.
You must be aware of the following:
If you withdraw your consent to donation and sufficient eggs are collected for sharing egg collection you will be charged the normal costs for all screening, treatment and drugs.
Payment must be made in full prior to the treatment cycle commencing.
Cheques should be made payable to the Nuffield Health, and all major credit cards are accepted.
We also offer you the facility for 'Banker's Automated Clearing Services' (BACS) which is a simple and cost effective way to make payments directly from your bank account to another bank account. For further information please discuss with our Accounts administrator.
The hospital will require details of a credit card before treatment starts, please discuss this with the ACS financial administrator if this is difficult for you.