What is the aim of an ovum donation program?
In the Assisted Reproduction Centres, the aim is to achieve pregnancy in women whose ovaries do not function properly or after repeated failed attempts of In Vitro Fertilization.
Which features must an ovum donor have?
- Aged between 18 and 35
- To be of sound mind.
- Good physical and mental health.
- Normal ovulation function.
- Must not have family medical background related to malformations caused by chromosomopathies, genopathies or metabolopathies.
- Must not have given birth to more than six children.
- The donor and her family must not have any genetic illness that could indicate a risk of abnormalities in the baby.
- The donor must not have had a piercing or a tattoo done within the last six months before the donation.
Which tests have to be done in order to be a donor?
The tests are the following:
- A psychological evaluation.
- A gynaecological check up with scan.
- Blood test for blood group and RH, hemogram, biochemical, serologies (HIV, VHC, HbsAg, RPR, CMV), hormone test and a karyotype.
- The tests do not cost the future donor anything.
The retrieval of the ovum is a two part procedure:
1. A hormonal treatment.
2. A small surgical operation to obtain the eggs.
Requirements in order to be a donor:
1. A preliminary study to see if the donation can be done. This study works with the medical background in order to find out possible illnesses that could be transferred genetically. Moreover, a gynaecological check up with a scan and a blood test must be performed.
2. The donor must sign a consent form after the explanation of the process and the possible complications. The donor undertakes to follow the treatment and do the necessary tests.
The treatment is programmed to begin from the menstruation of the month prior to donation although the tests do not start until ovary stimulation starts.
The aim is to encourage the ovary to create more than one follicle in that month, and therefore more than one egg, through ovary stimulation treatment.
Gonadotropin-releasing hormones are used because in women they have an effect on the ovary. They are given by daily subcutaneous injections for 12 or 14 days. These medicines have been used in the process of in vitro fertilization for many years.
Recombine Genetic Test:
- Alpha thalassemia
- Beta thalassemia
- Cystic Fibrosis
- Spinal muscular atrophy
- Haemoglobinopathies (4: Hb, C, D, E & O)
- 24 X-linked diseases (including fragile X syndrome)
- There is the possibility of performing the recombine test on the recipient and doing genetic matching with the potential donor, in order to rule out the transmission of 300 recessive genetic diseases.
Possible undesired side effects of this medicine
It has no known negative effects on the ovary, it does not accelerate menopause or cause a weight increase. It has no effect on future fertility.
In some cases (1%) there can be complications which although very infrequent could be serious: ovary hyper-stimulation syndrome. It can take place at the end of the process in ovaries that have created many follicles and have produced high levels of a hormone called estradiol.
In serious cases, there is liquid retention, urine production diminishes, and it is necessary to be hospitalised in order to receive a specified treatment. The way to prevent these complications is through testing, that is why they are so important. If we observe an exaggerated response, we can interrupt the treatment and menstruation will occur thus avoiding the complication.
This operation takes place once the treatment is complete in order to obtain the eggs which are to be found within the ovarian follicles. For that reason we carry out a puncture of the ovary guided by a trans-vaginal ultrasound scan, so that it is possible to gently vacuum each follicle thus drawing out the desired oocytes.
This is usually performed under sedation, which is a light form of general anaesthetic, lasting the 15 minutes that it takes to complete the process. The recovery period only lasts between and hour and a half and two hours and it is not necessary to be hospitalised. It is not a complicated surgical technique although very rarely there may be risks of bleeding or infection. It is extremely rare that an accidental puncture of the intestine or ovarian torsion could occur.
Menstruation will take place a couple of weeks later and the last scan will be given in order to check the normal function of the ovaries, and to finally discharge the donor.
Discharge from the centre
Once the follicular puncture has been completed for egg donation, the donor is discharged from the clinic, normally after having had something to eat. She will be given precise instructions for the following days.
Some discomfort may be noted in both ovaries similar to that of ovulation or menstruation. Sometimes the discomfort can be a little stronger as the ovaries have been punctured. It is important to rest all day and if necessary you may resort to taking painkillers.
A check up with the doctor will be programmed for 7 to 10 days afterwards in order to ensure that recuperation is normal, that there are no complications and to advise on contraception.
Rules after the puncture
These are some of the most important standards to be met:
- When you are discharged from the clinic, you will have to have someone to collect you.
- It is forbidden to drive vehicles or manipulate dangerous machinery. It is also forbidden to travel for 24 hours following the puncture.
- We recommend avoiding bathing (beach, pools or bath, you can have a shower) and sexual relations the week after the puncture in order to prevent infection.
- During the 24-28 hours after the puncture you may feel abdominal pain and experience vaginal bleeding. It is normal and you do not need to worry. If the pain remains, you can take a pain killer. If it continues, consult your doctor.
- The day after the puncture you may work but you should not do any physical exertion.
- Avoid sexual relations from 4 days before the puncture to 10 days after it.
- It is indispensable to go to the control visit to make sure that the recuperation is progressing well.
Can the consent form be revoked?
The consent form for the ovum donation can be revoked at any time during the process until the moment when they are transferred to another person or another centre.
How is the donor compensated?
The donor can not be paid but the expenses incurred can be compensated for, such as travelling to the centre, possible absences from work or any other inconvenience. The Department of Health establishes the quantity to be compensated for.
What are the legal conditions regarding egg donation?
In Spain, ovum donation is legal.According to the current legislation, Law 14/2006:
- Ovum donation for authorised purposes by this law is a free, formal and confidential contract between the donor and the centre. The contract must be formally written. Before consent is given, the donor must be informed about the purposes and the consequences of the event.
- Donation will never be for lucrative or business purposes. The economic compensation will only compensate for physical, work and travelling expenses (this compensation is given to the donor the day of the egg extraction, after discharge from the centre).
- Donation will be anonymous and all the personal data will be kept confidentially.
- Children that are born have the right to have general information about the donor but never their identity. The recipients have the same right. The identity can only be revealed if the child's life is endangered.
- The donor must be between 18 to 35 years old, of good physical and mental health and be sound of mind.
- The choice of the donor will be the responsibility of the medical team who supply the assisted reproduction. As many phenotypic and immunological similarities as possible will be guaranteed as well as compatibility with the recipient woman.
- Authorised centres and the National Register will control that no donors have more than six children.
- Donation will be revoked when the donor, having become sterile, needs the eggs for herself, if the eggs are available the day of the revocation. In the case of revocation, the donor must return the amount of money received to the centre.