Egg donation: what eggsactly you should know

Egg donation is a process which involves the extraction of eggs from a donor, which are then fertilised in a laboratory. A resulting embryo is then implanted into the uterus of the recipient. In this article, a consultant obstetrician explains the process of egg donation, for the donor and the recipient.

What is egg donation?

Egg donation is a procedure that patients may choose to undergo for various reasons, such as due to struggles with natural conception – like undergoing early menopause, prior history with chemotherapy, or structural or hormonal issues that prevent the proper maturation and release of eggs – or even donating them for research and training.

To be eligible to donate eggs, donors must be within a specific age range of 18 to 35 years old, be of a healthy weight and have good (both physical and mental) health, and without sexually or genetically transmitted diseases. This is to avoid as many complications as possible that could harm the recipient mother or the child.

The process involves participation from both the donor and the recipient.

What happens during egg donation?

For the donor, the process begins with a thorough review of their gynaecological condition, and personal and familial medical history. If there are no red flags, they will undergo a round of hormone-suppressant medication over the course of two weeks which will disrupt their natural menstrual cycle, but will also stimulate follicular production. This is so their doctor can control the timing of the egg maturation precisely, and so that many primed eggs are able to be extracted via a long needle which is inserted into each ovary, which will better the chances for successful fertilisation. The extraction takes around 30 minutes to complete, and ideally the doctor will be able to collect at least eight eggs. The eggs can be used fresh, or they can be cryogenically frozen for future use. To fertilise the eggs, sperm from the recipient’s partner, or from another donor, are infused with the eggs – this is called in vitro fertilisation (IVF).

Once an embryo is successful, it is ready to be implanted into the recipient. It is important that the recipient’s menstrual cycle (if they still have one) is synched with the donor’s so that the body is able to accept the embryo and it can be implanted into a nurturing environment. This may involve the recipient undergoing a course of medications, much like that which donor did. Typically, as the donor starts the ovary-stimulants, the recipient will take hormones, such as oestrogen, to strengthen and thicken the uterine lining. Whilst the eggs are being harvested from the donor, the recipient takes progesterone to facilitate the implantation of the embryo, which is normally done up to five days after fertilisation. However, this is only for cases where the implantation is immediate after extraction; for frozen embryo transfer, there is no need to synchronise the hormonal cycles of the donor and recipient.

What happens after egg donation?

Even after the implantation, the recipient continues with their medication in order to ensure that their body still remains suitable for fetal growth for most of the first trimester. Afterwards, the fetus should be stable and it will be safe to stop the hormone medication, though other medications and supplements are still required for the health and development of the baby.

After an egg donation, the donor may feel very tired and slightly sore in their abdomen, and can need some time to rest before returning to their normal routine. There is a risk of complication after extraction, like bleeding from the puncture, or infection, but it is very low. However, donors are encouraged to visit their gynaecologist after a week or so just to confirm that all is well.