Martelize Brink from RSG interviewed Prof Igno Siebert, Aevitas Fertility Specialist on the topic of egg (ova) donation. Listen to the interview in Afrikaans (Titled: “Ovumskenking, Maandag 14 Oktober 2019“), alternatively a summary follows below.
When is it necessary to make use of donor eggs?
As women get older, there is a decrease in genetic quality and quantity of eggs. For example, a 43-year-old might struggle to fall pregnant, due to the deteriorating quality and/or quantity of her own eggs. However, she can make use of donor eggs. Egg donors are in general, between the age 20 – 30 years.
IVF success rates for a 20-year-old using her own eggs is 60 – 70%; IVF success rates for a 43-year-old using her own eggs is about 10%. However, if a 40-year-old undergoes IVF with donor eggs (from someone in her 20’s) chances of success would be like that of a 20-year-old undergoing IVF with her own eggs (60 – 70%).
These days more people are marrying at a later age, many women choose to pursue a career or meet their partners later in life. Although life expectancy keeps improving over the decades, currently being 60 – 80 years, the age at which female fertility reduces due to egg quality/quantity remains the same.
There are four main reasons why donor eggs are used during IVF:
- Woman’s age affecting their own egg quality and/or quantity.
- Woman who have undergone cancer treatment (e.g. chemotherapy), as this can affect the function of the ovary and egg quality.
- Woman who had ovaries surgically removed.
- Premature menopause (women entering menopause at an early age e.g. 20s or 30s, instead of between 45 – 55)
Is egg donation regulated by law?
Egg donation is regulated by the South African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG). Egg donor recruitment agencies in South Africa form part of a national database, which serves to monitor donors and pregnancies resulting from donor cycles.
What are the guidelines for egg donation?
Healthy women between the ages of 19 – 32 years can apply to become egg donors. It is preferred that the donor is at least 21 years of age. To ensure optimum health the donor undergoes a screening process consisting of:
- A medical examination. This includes STD- and viral screening and donors are evaluated to detect alcohol- or drug abuse.
- Ovarian reserve test (AMH). This indicates the capacity of the ovary to provide egg cells that are capable of fertilization.
- Psychiatric evaluation. This is to ensure that the donor is in good mental health and that the donor is comfortable and aware of the process and implications of donating her eggs.
What is the process of an egg donor cycle (IVF with donor eggs)?
One of two methods can be followed:
- Frozen Donor Egg Cycle
Donors are evaluated to ensure they are good candidates for the egg bank. They undergo screening and hormone stimulation. Eggs are then aspirated and frozen in liquid nitrogen. The egg bank therefore has a supply of eggs from various donors. The advantage of this is that a recipient can choose a donor and treatment for the recipient can start immediately. The frozen eggs are thawed and fertilised with the partner’s sperm through IVF. The embryo is then transferred into the recipient’s womb. The technology of egg freezing is fairly new, therefore the IVF lab process of freezing and thawing is critical to ensure good success rates.
- Fresh Donor Egg Cycle
With a fresh cycle, the donor and recipient cycle need to be synchronised. The recipient receives medication to suppress hormones, while the donor undergoes hormone stimulation leading up to egg retrieval. The recipient then receives oestrogen to ensure the womb is ready for implantation of the embryo. Approximately 5 days after IVF of the partner’s sperm and donor egg, the embryo is transferred into the recipient’s womb. A fresh cycle can take about 2 – 3 months from start to finish.
What advantages has the technology of egg freezing brought to the field of fertility?
- Freezing your own eggs
You can act as your own egg donor by freezing your own eggs. This is also known as social freezing. Woman that haven’t met their partners in their prime reproductive years, or women who choose to focus on their careers before starting a family, might choose to freeze their own eggs. If these women decide to start a family at the age of 40, but struggle due to decreased egg quality/quantity, they can make use of their frozen eggs. Research has shown few people end up using their frozen eggs, it is available if you need it.
- Prior to undergoing cancer treatment
A woman who is diagnosed with breast cancer, but still had plans to expand her family, has a big chance that the chemotherapy treatment will damage her ovaries. She can therefore opt to freeze her eggs, in order to preserve her fertility. In cases where there is not enough time to go through hormone stimulation and egg retrieval for the purposes of egg freezing, ovarian tissue can be removed, frozen and implanted at a later stage.
- Donor egg freezing
Enhancing the convenience of IVF with egg donation.
The technology of egg freezing has led to exciting advances in the field of fertility, from increasing convenience of IVF with donor eggs, to enabling women to act as their very own egg donors.