Egg / Sperm / Embryo Donation
The first pregnancy achieved with egg donation was reported in 1984. Since that time, there has been increasing use of egg donation to help infertile couples/individuals conceive. Egg donors are identified, and through the process of IVF, eggs are obtained from the donor’s ovaries and donated to the intended recipient. Sperm obtained from the recipient’s partner is used to fertilize these eggs, and embryos are transferred into the recipient’s uterus. If pregnancy occurs, the recipient will have a biological but not genetic relationship to the child; her partner (if he provided the sperm) will be both biologically and genetically related.
Egg donation initially was intended for women with ovarian failure. Typically, women were prematurely menopausal as a result of disease, chemotherapy, radiation therapy, or surgical removal of their ovaries. Egg donation is appropriate for women who were born without ovaries. Due to the success of the procedure, as well as the improvements in IVF technology, these indications have been expanded. Egg donation may be offered to women who are to be affected by or be the carrier of a significant genetic disease who would prefer not to pass this disease on to her offspring. This indication includes women who appear to have an egg factor as the cause of their infertility often is candidates for egg donation. In many instances, this includes women with multiple failures to conceive after IVF, women of advanced reproductive age, and women with inadequate response to ovulation induction.
Artificial insemination using donor sperm has been practiced for over a century, although the first published reports about the practice were in 1945.Over the past 10 years, the use of donor sperm has decreased as the use of intra cytoplasmic sperm injection ( ICSI) for treatment of male infertility has become widespread. Since the late 1980s with the emergence of acquired immunodeficiency syndrome (AIDS ) ,artificial donor insemination has been performed exclusively with frozen and quarantined sperm. Current ICMR guidelines recommend that sperm be quarantined for at least six months before being released for use.
Indications of Sperm Donation
Currently, therapeutic – donor insemination (DI or TDI) is appropriate when the male partner has severe abnormalities in the semen parameters and/or reproductive system. These abnormalities include both obstructive (caused by a blockage of the ejaculatory ducts) and non -obstructive (due to testicular failure) azoospermia ( absence of sperm ),which may be congenital or acquired. Examples of obstructive azoospermia include congenital absence of the vas deferens or previous vasectomy. Examples of non-obstructive azoospermia include primary testicular failure or secondary testicular failure due to previous radiation treatment or chemotherapy. Severe oligospermia (decreased sperm count ) or other significant sperm or seminal fluid abnormalities also are indications for DI.DI also indicated if the male has ejaculatory dysfunction or if he is a carrier or affected with a significant genetic defect and would prefer not to pass this gene on to his children. DI may be used if the female is Rh-sensitized and the male partner is Rh-positive .
Embryo donation is a procedure that enables embryos that were created by couples undergoing fertility treatment to be transferred to infertile patient in order to achieve a pregnancy. Indications for embryo donation include untreatable infertility that involves both partners, untreatable infertility in a single woman, recurrent pregnancy loss thought to be related to embryonic factors, and genetic disorders affecting one or both partners.
The process of embryo donation requires that the recipient undergo the appropriate medical and psychological screening recommended for all gamete donor cycles. In addition, the female partners undergo an evaluation of her uterine cavity and then her endometrium is prepared with estrogen and progesterone in anticipation of an embryo transfer.
Pregnancy following embryo donation depends on the quality of the embryos that were frozen, the age of the women who provided the eggs, and the number of embryos transferred.