Egg donation means that a woman donates her eggs for another woman to become pregnant.
In this procedure, the eggs collected from a donor (donor) are fertilized in the laboratory environment with the sperm taken from the male partner of the couple applying for donation purposes and the developing embryos are transferred to the female partner. In this application, the aim is to overcome the problem of infertility, which is dependent on the woman and cannot be overcome by conventional methods, by using eggs taken from healthy and young donors.
In egg donation, the first applications in the world were carried out in the early 1980s, 1 egg of a patient currently undergoing IVF treatment was used for another patient, and pregnancy was achieved. However, this pregnancy resulted in miscarriage and could not reach a live birth.
In the trial that followed, in 1984, the egg of a patient who underwent IVF treatment was used for a patient with premature ovarian insufficiency, that is, who entered early menopause, and in this application, the recipient’s endometrium was prepared with oral estradiol and vaginal progesterone. This trial resulted in pregnancy and live birth and went down in history as the first successful egg donation application.
After this success, egg donation has become widespread as the main treatment option for patients with premature ovarian insufficiency. This success has also shown that endometrium can be made suitable for pregnancy with the use of external estrogen and progesterone in patients with ovarian dysfunctions and has enabled egg donation to become widespread rapidly in the world.
The second important success in egg donation has been the introduction of egg freezing. In particular, with the development of the vitrification method for embryo freezing, the introduction of it for egg freezing in the early 2000s and the optimization of protocols, it is now possible to achieve more than 90% live return after freezing-thawing. This development has eliminated the necessity of synchronizing the cycles of the receiver and donor for donation and has made the planning of the process much easier for the applicant couples.
The presence of infertility problems is not necessary to resort to egg donation; couples can also apply to this application with their personal preferences. For a large part of the couples who apply to this application, donation is the only option to reach pregnancy.
Repeating standard IVF practices many times in order to reach pregnancy can sometimes be exhausting for couples. For these couples, egg donation can be considered as a choice.
The presence of hereditary genetic disease or carrier
Regardless of the reason for applying for donation, all your processes will be followed with the same sensitivity in our center. But especially for our couples who apply because they have no other choice, overcoming your infertility problem together, which you once thought was helpless, is the most enjoyable aspect of our work.
While all cells in the human body are damaged and constantly renewed by exposure to oxidative stress, this is not the case for reproductive cells in women. This situation causes the accumulation of damages in the eggs and the weakening of cell functions with advancing age. This is the most important reason for the increased risk of chromosomal anomalies in embryos depending on the advanced female age. Since donors with young and therefore healthy eggs are preferred in egg donation, this disadvantage is largely eliminated.
Another advantage of egg donation is that the effect of the age of the recipient on the chances of success is quite low. In clinical studies in this field, it has been shown that similar pregnancy and live birth rates are obtained in patients in this age group in the absence of uterine and/or endometrial factors that adversely affect implantation.
The most important factor determining the success of egg donation is the age of the donor. Clinical studies show that the highest success rates are achieved in applications where the donor age is 34 and under. In our country, the age range defined in the relevant legislation for donors is 18-35 years of age. In our center, donors are mainly used in the age range of 20-25. In addition, the donor’s body mass index should be in the range of 19-29 kg/m2.
Although a fertile relative preferred by the couple can be used as a donor (known donor) in egg donation, donors whose identity is unknown by the couple (anonymous donor) are preferred.
Procedures and screening tests defined in international guidelines (ASRM / ESHRE Guidelines) are applied to determine the suitability of the donor and recipient in egg donation.
First of all, taking into account the blood group of the donor and the preference of the couple, importance is attached to the compatibility of the physical characteristics of the donor (ethnicity, skin-eye-hair color, body structure, etc.) with the characteristics of the recipient. If fresh donor eggs are planned to be used, the donor and recipient begin to be prepared synchronously after the appropriate donor is determined. In the process of ovulation induction applied to the donor, it is aimed to obtain an average of 10 mature eggs. In this process, the use of the necessary drugs will be started to prepare the recipient’s uterus for transfer. If frozen donor eggs are planned to be used, the eggs will be thawed and used at the appropriate stage of the recipient’s cycle. In both cases, the obtained eggs are injected with the sperm of the male partner and the fertilization and embryo development process is followed.
Profile form, information and consent forms
Profile form, information and consent forms.
Examination, screening tests
Examination, screening tests
Introduction of ovarian stimulation drugs
Introduction of estradiol
Ultrasonographic examination for follicle monitoring, blood tests
Ultrasonographic examination, blood tests to assess the development of the endometrium
Introduction of progesterone
Egg collection (36 hours after injection), sperm injection
Embryo culture (up to day 3 or 5)
Embryo transfer/embryo freezing or
Embryo culture (up to day 3 or 5)
Embryo transfer/embryo freezing or
Embryo biopsy and embryo freezing
In our center, we achieve a live return rate of over 95% in frozen-thawed donor eggs and a blastocyst rate of over 65%, as well as very similar results in terms of pregnancy rates of fresh and frozen-thawed donor eggs.
Factors such as the age of donor eggs, their health status and the rate at which the embryo attaches to the uterus can affect the success rate. In general, the success rate of egg donation is high.
Since the eggs used in donation in our center are taken from donors who are young (20-30 years old), have health screenings and have predominantly known success rates, there are success rates of over 80% even in a single transfer. Normally, this rate may vary according to the sperm parameters of the male partner, but due to the sensitivity we show in our center about sperm selection, there is no significant change in our rates if there are no very severe sperm morphological defects.
When anonymous donors are used in egg donation practice, the identities of the donor and recipient are kept confidential. Applying couples can only access the information on the donor’s profile form, the photo, identity and contact information of the donor are kept confidential. In the same way, donors do not have access to the information of the couples whose eggs are used.
IVF and donation treatment processes in Cyprus are subject to the Law No. 57/2014 “Governing the Rules on Human Cell, Tissue and Organ Transplantation”. According to this law:
In donor cycles, the number of transfers is decided in accordance with the limitations in IVF cycles by including the ages of the donor and recipient, their prognosis and the quality parameters of the embryos to be transferred.
In order to perform embryo transfer in people over 45 years of age, Medical documentation by the Internal Medicine and Cardiology specialist that there is no obstacle to pregnancy.,
If the Ethics Approval Committee deems it necessary, additional examinations should be carried out.
The right to reproduction is one of the fundamental rights of individuals. The use of assisted reproductive treatment methods to support this right should also be evaluated ethically as long as they are maintained in accordance with the principles of beneficiality, non-harm, justice and autonomy in treatment processes.
In line with the principle of usefulness, detailed information should be provided about the scope of the treatment to be applied, and the benefits and possible risks should be clearly explained.
In line with the principle of non-harm, the health of both the couple undergoing treatment and the donor should be a top priority, it should be held above material interests. Again, it is necessary to observe the psychological health of the couple and the donor, and to avoid incomplete/misinformation and unrealistic hopes.
In line with the principle of justice, every patient who applies for treatment should be treated as equal individuals, regardless of their ethnicity, material/social status, beliefs and thoughts.
In line with the principle of autonomy, the personal beliefs and thoughts of the patients should be respected, and the process should be continued by obtaining their informed consent at every stage to ensure that there is no contradiction in the treatment to be applied. In addition, it should be ensured that both men and women are ready for the treatment process, and if they have any doubts/questions, they should be encouraged to share them openly and their needs in this direction should be fully met.
Since the child to be born in egg donation will be carrying the genes of a stranger by half, this situation can also cause social concerns in couples who apply for treatment. From the moment you become pregnant as a result of the treatment, the process will not be different from a normal pregnancy and the child to be born will legally be completely your child. Sharing how they achieved pregnancy is a completely subjective decision that couples will make together. Taking physical characteristics into account in the selection of the donor will reduce your concerns in this regard as it will increase the likelihood that the child to be born will be similar to the recipient couple. Since your identity information will be kept confidential and will never be shared with third parties, it is only up to the couple to know that they have made a donation application.
Since donation is a psychologically sensitive procedure for couples, it is recommended and supported to receive psychological counseling before treatment. For this purpose, the first consultation you will receive at our center is offered free of charge. In this counseling, couples will have the opportunity to receive psychological support about the long-term effects of donation application, treatment process and pregnancy occurs.
In egg donation, donors whose physical characteristics are similar to yours are used as much as possible. However, given the exact genetic makeup, an embryo that carries the genetic characteristics of the male partner and the donor will be transferred to you. Since a number of details such as physical characteristics and blood type are also taken into account in the selection of the donor, the baby will also resemble a couple in terms of physical characteristics to a great extent.
It is possible to determine the sex with genetic tests to be performed on the embryo formed after egg donation. These tests are: blastomere biopsy and FISH method, which can be performed on the 3rd day of embryo development, or trophoectoderm biopsy and NGS method, which can be performed on the 5th day.
Women whose ovarian reserve has been depleted or who have entered menopause can also become pregnant with egg donation, regardless of age. In order to transfer embryos only in women over 45 years of age: It is necessary to medically document that there is no obstacle to pregnancy by our Internal Medicine and Cardiology specialists. This reporting process can only be carried out in a few centers within Cyprus and our center is one of them.