Bangalore Assisted Conception center is one of the few infertility centers offering the option of donor gametes i.e. sperm and egg, to couples that are unable to achieve a pregnancy on their own.

Donors are available for eggs (oocytes) or sperms or embryos.
For Donor sperms see IUI

DONOR EGG PROGRAM

In this program a woman (recipient) is able to achieve a pregnancy by the fertilization of her husbands sperms with the oocytes of another healthy woman (donor) through assisted reproduction techniques. The fertilized egg is then placed inside the recipient by a process termed embryo transfer (see  IVF).

Indications for donor egg

• Premature ovarian failure – The ovaries have stopped their function of development of eggs, as well as the production of hormones. This state can be identified by hormonal tests in the blood and to some extent on ultrasound examination.
• Women more than 40yrs  - In these women although they are developing eggs the latter may be of poor quality and hence unable to fertilize or implant.
• Women with a genetic disorder in themselves or in the family for which they are carriers. E.g. Duchenne muscular dystrophy. Pregnancy by means of donor eggs is preferred in order to avoid passing the disorder to the offspring.
• Young women with poor quality embryos who failed to conceive on IVF

Donor Availability

Donor eggs are available from the following:

• Patient’s undergoing IVF treatment – Normally an excess number of eggs is produced by the woman on treatment for IVF and hence the excess eggs may be donated to another woman with consent.
• Women undergoing gynecological procedure such as laparoscopic sterilization – At the same sitting the eggs are retrieved from the ovary by the laparoscope.
• Known healthy women with proven fertility who offer to donate eggs to a known or an unknown recipient.

Criteria for donors 

• The age of the donor woman should be 21or more and less than 35yrs.
• Women over the age of 35yrs may become egg donors provided their recipients understand that their pregnancy chance is reduced and the abnormal pregnancy rate is increased.
• Proven fertility – The donor has a child of her own or her eggs have successfully produced a pregnancy.
• Stable marital relationship
• Physically and mentally healthy i.e. there are no medical, genetic or psychiatric disorders. The donor is put through an extensive evaluation (clinical and laboratory) as a screening measure.  Routine karyotype screening of donors is not carried out.

Criteria for recipients

• General health should be good with no contraindication to a pregnancy.
• The uterine cavity must be adequate for the conceptus to develop and grow. The uterine lining or endometrium should be receptive for implantation of the embryo. These facts are ascertained by a simple diagnostic procedure known as hysteroscopy.

Preliminaries

• It is mandatory that both donor and recipient are carefully selected, screened and counseled separately. Counseling is paramount in any donor program.
• A quarantine period like that of frozen semen is not applicable, as the technique of freezing oocytes is not sufficiently developed.
• An informed written consent is taken from the donor and recipient after explaining the procedure, outcome and risks involved, as well as ethical and legal issues.

The procedure

• The donor goes through treatment of ovarian stimulation. When the eggs are mature as assessed on ultrasound and hormonal assays they are removed from the ovary by a procedure termed oocyte retrieval (link). For women donating eggs on routine laparoscopic sterilization the procedure of ovarian stimulation may be omitted.

• The endometrium is made to develop by means of medications so that it is in the correct phase of the menstrual cycle for the embryo to implant. The stage of development is assessed by serial ultrasound examinations.

• The donor egg is then made to unite with the husband’s sperms in a dish and the resulting embryo (2-3) is transferred into the uterus of the recipient. Excess embryos may be frozen for use later in the event of an unsuccessful outcome. (See embryo transfer and after-care)

• Following embryo transfer the recipient is given medications to nourish the endometrium and thereby the embryo.

• The outcome is known by a pregnancy test (in the blood) 2 weeks later and then followed by ultrasound scans.

DONOR EMBRYOS

In this program a couple (recipient) achieves a pregnancy by fertilization of a donor egg and donor sperm. This is indicated in cases wherein the recipient eggs and sperms are either absent or of a poor quality. Selection, criteria and procedure are similar to donor egg and donor sperms.  

MEDICAL, ETHICAL AND LEGAL ISSUES

No problems or damage occur in the gametes or the embryos as a result of external environment and handling. The resulting pregnancy is expected to proceed as normally as a pregnancy achieved naturally. There is no increased incidence of abortions or congenital defects in the fetus as compared to a normal conception.The recipient is the legal parent of the resulting child. The donor does not have any legal or moral rights on the child. In fact the identity of the donor as well as the recipient remain unknown to both parties.  There is no breach of conduct or ethics on the part of the donor or the recipient entering such a program. It must be stressed that such a method of conception does not amount to adultery.