Sperm donation and egg donation

Sometimes, as (a) prospective parent(s), you need the sperm or eggs of others in order to be able to fulfil your desire to have children. You will then be a candidate recipient.

Egg donation


I you are a woman who produces too few or no eggs, or if your eggs are unsuitable for genetic reasons, egg donation may offer you a chance of becoming pregnant.
The sperm with which these eggs will be fertilised, may come from your (male) partner, or from a sperm donor.
If this fertilisation in the lab produces a number of embryos, one (or two) will be transferred to your womb, where they can implant and grow to full term.
If there are supernumerary embryos, these are frozen and stored for a possible next attempt.

Egg donation is possible in two ways: named or anonymous. See infra under Types of donation.
In principle, anonymous donation is the preferred option. See Named versus anonymous: benefits and drawbacks.
But if the recipient(s) and the donor explicitly request it, named donation is also a possibility.


Egg donation is a less obvious than sperm donation. The treatment takes time and involves some physical discomfort. 
As a result, the number of voluntary anonymous donors – (young) women who have the treatment solely to donate their eggs to a recipient (couple) unknown to them – is rather limited.

 

For the conditions that a donor must meet, see Strict selection and genetic screening.

The general rule that egg donors must not be older than 35 can only be deviated from in case of named donation and with your explicit permisson as recipient (couple).
If egg donation and following ART treatment result in pregnancy, the recipient couple are advised to have a prenatal diagnosis, e.g. a NIPT.

What exactly is expected of an egg donor?

  • First of all, a donor must be prepared to have hormonal treatment to stimulate her ovaries to produce several ripe eggs.
  • She needs to be able to make time available for the various examinations and visits to the hospital, e.g. for the frequent blood samples and ultrasound scans.
    • The entire treatment – not counting the preliand you may experience a slightly distended abdomen dminary exams – takes about two weeks.
    • During the final days before egg retrieval the donor may experience a slightly distended abdomen. 
    • Cysts may also form in some cases, although this is harmless. They only need to be removed in a small medical procedure guided by ultrasound scan if they start producing hormones themselves (see Puncture of ovarian cysts).

    We care for our donors

    The CRG pays great attention to medical counselling of egg donors. As a result of the severe shortage of donor eggs, we apply our greatest professional skills because we expect a high degree of commitment and motivation from egg donors. Every measure is taken to reduce the risk of infection to the smallest possible degree.

  • However, any egg donation requires a surgical procedure to collect the eggs.
    This is only a minor procedure, almost always carried out under local anaesthetic, but it is an operation. Although all necessary medical precautions are taken, the chance of an infection cannot be entirely excluded. Any such infection carries a risk of infertility for the donor.
  • Finally, and strange as this may seem, the greatest 'risk' that an egg donor runs is of becoming pregnant herself during treatment. If she had no plans in this sense, this can be a serious problem. Egg donors are therefore expected to refrain from (unprotected) sexual intercourse for a significant period of time. 
    • Total abstention from all sexual activity at the end of the ovarian stimulation cycle is necessary. 
    • The donor must also avoid intercourse for several days after egg retrieval unless protected by a condom. This is to avoid fertilisation of any remaining ripe eggs.

Whose sperm?
Named donation
Treatment
Anonymous donation
Exchange donation
Treatment
The egg bank – efficient and patient-friendly


The CRG has two – actually three – formulas of egg donation: named, anonymous and exchange donation. We will discuss these later. 
But first we discuss the man's share in all this: how and with which sperm are the eggs fertilised?

Whose sperm? 

Fertilisation: always ICSI

Insemination of donated eggs with sperm is always done by ICSI, i.e. the injection of one sperm into each egg. This technique has a ninety percent success rate in terms of fertilisation, which is essential to have a reasonable chance of pregnancy.

As in every ART cycle the sperm to inseminate the eggs can come from two different sources.
  • Insemination with donor sperm is always with thawed sperm of the sperm bank. Donor sperm can be used in the following situations.
    • If the recipient is a single woman.
    • If the prospective parents are a lesbian couple.
    • If the sperm of the recipient man is not usable for whatever reason.
  • Sperm of a named donor is never used fresh either.
    • The donor first has the necessary tests.
    • If his sperm is considered suitable, his samples are frozen and stored. 
    • They are thawed on the day of the egg retrieval of the egg donor (in case of named egg donation) or on the day that the donor eggs are thawed.
  • Insemination with own sperm is preferably with fresh sperm, because the chances of fertilisation increase significantly.
    • On the day of the egg donor's egg retrieval, the recipient man is expected to supply a fresh sperm sample. After ‘preparation of the sperm’ in the lab, it is used to inseminate the donor eggs.
    • Frozen sperm may be used if the man is unable to supply fresh sperm, e.g. due to geographic reasons. The frozen sample is then thawed a few hours before insemination.

Named donation  

Pressure can be considerable to opt for named donation when a couple provides its own donor. This means you will be treated exclusively with eggs collected from the presented donor. Click here for the pros and cons of named donation.
  • For the donor it can often be her motivation that she is doing it for you. Very often, the donor is your sister or sister-in-law, or a very good friend.
  • Loyalty can also influence the recipient couple's decision: you asked someone you trust, to whom you may be related, who may even look like you and with whom you may share a (common) genetic history.
  • Sometimes named donation is the only possible alternative, for example when the presented donor is over 35. Etnicity may also limit the available options.
  • Whatever the case, named donation always involves a consultation with the psychologist, for both recipient(s) and donor.
    The psychologist's advice is binding.

Treatment 

Named donation is with fresh eggs.

  • The donor follows the entire IVF treatment up to egg retrieval:
    • preliminary examinations,
    • ovarian stimulation via hormone injections,
    • intermediate blood tests and ultrasound scans,
    • the hCG-injection to finalise the egg ripening process, and
    • the egg retrieval.
  • Following egg retrieval, we inseminate the donor eggs with your partner's or a donor's sperm in the lab
  • All embryos this produces are frozen and stored. 
  • In a next menstrual cycle, we prepare your body with specific medication for the transfer of one embryo (sometimes two) to your womb
  • The possible implantation is supported as with every ART cycle.

Anonymous donation 

There are not that many voluntary donors, i.e. young women who follow the treatment solely to donate eggs. This is known as voluntary anonymous donation.
  • The donated eggs are stored in the egg bank.
  • If you are a candidate-recipient who does not present her own donor – e.g. because you don't know anyone who is suitable or because you don't want to bother anyone with your treatment – you are put on waiting list of the egg bank.
  • The waiting period for voluntary anonymous donation varies from three months to two years.

Exchange donation 

Another situation is that a prospective parent(s) does present a donor but prefers anonymous donation – see named versus anonymous for the advantages. This is an exchange donation.
  • In exchange for the (named) eggs of ‘your’ donor, you receive anonymous eggs of the egg bank. 
  • The eggs of ‘your donor’ are frozen and stored and can – anonymously – be used for other prospective parents. 
  • Following the egg donation, your ART treatment can start. If you present your own donor you don't lose any time.

Treatment 

  • Fertilisation: always ICSI

    Insemination of donated eggs with sperm is always done by ICSI, i.e. the injection of one sperm into each egg. This technique has a ninety percent success rate in terms of fertilisation, which is essential to have a reasonable chance of pregnancy.

    The egg donor follows the entire IVF treatment up to egg retrieval, as described above.
  • The collected cells are frozen and stored. 
  • Available donor eggs are linked to recipients on the waiting list once a month. You will be notified when it is your turn and your treatment is planned.
    Your body can be prepared for the embryo transfer – with specific medication.
  • On the day the eggs are thawed, fertilisation is possible in three ways.
    • Either the recipient man is expected at the CRG to supply a fresh sperm sample.
    • The recipient man's sperm was frozen at an earlier time and it is thawed on the same day.
    • The same is done with donor sperm.
  • If the fertilisation results in the development of one or several qualitative embryos:
    • three to five days later one (or two) fresh embryos are transferred to your womb, and any supernumerary embryos are frozen and stored, or
    • we immediately freeze and store all embryos (freeze all) for transfer in later menstruation cycles.
    • The supernumerary embryos are stored for a next attempt or if you want another child later. See Transfer with thawed embryos.
  • The possible implantation is supported as with every ART cycle after the embryo transfer.

The egg bank – more efficient and patient-friendly  

The possibility to freeze and store eggs has existed since the development of the vitrification technique, i.e. ultra-fast vitrification without the formation of ice crystals.
Today most egg donations go through the egg bank because it is patient-friendly and more efficient.
  • It allows more patient-friendly stimulation schemes;
  • It offers freedom of planning because the donor and recipient cycles can be independent from each other;
  • the eggs are used more efficiently: one donor can help several recipients; and
  • It allows for better matching of external characteristics between donor and recipient.