Egg donation

Egg donation (also referred to as "oocyte donation") is the process by which a woman donates eggs to enable another woman to conceive as part of an assisted reproduction treatment or for biomedical research. For assisted reproduction purposes, egg donation typically involves in vitro fertilization technology, with the eggs being fertilized in the laboratory; more rarely, unfertilized eggs may be frozen and stored for later use. Egg donation is a third-party reproduction as part of assisted reproductive technology.

In the United States, the American Society for Reproductive Medicine has issued guidelines for these procedures, and the Food and Drug Administration has a number of guidelines as well. There are boards in countries outside of the US which have the same regulations. However, egg donation agencies in the U.S. can choose whether to abide by the society's regulations or not.

The first child born from egg donation was reported in Australia in 1983. In July 1983, a clinic in Southern California reported a pregnancy using egg donation, which led to the birth of the first American child born from egg donation on 3 February 1984. This procedure was performed at the Harbor UCLA Medical Center and the University of California at Los Angeles School of Medicine. In the procedure, which is no longer used today, a fertilized egg that was just beginning to develop was transferred from one woman in whom it had been conceived by artificial insemination to another woman who gave birth to the infant 38 weeks later. The sperm used in the artificial insemination came from the husband of the woman who bore the baby.

Before this development, thousands of infertile women, single men and same-sex male couples had adoption as the only path to parenthood. The donation of human oocytes and embryos has since become a common practice similar to other donations such as blood and major organ donations. The practice of egg donation has sparked media attention and public debate, and has had a substantial impact on the field of reproductive medicine.

This scientific breakthrough changed the possibilities for those who were unable to have children due to female infertility and for those at high risk for passing on hereditary disorders. As IVF developed, the procedures used in egg donation developed in parallel: the egg donor's eggs are now harvested from her ovaries in an outpatient surgical procedure and fertilized in the laboratory, the same procedure used on IVF patients. The resulting embryo or embryos are then transferred into the intended mother instead of into the woman who provided the egg. Donor oocytes thus give women a mechanism to become pregnant and give birth to a child that will be their biological child, but not their genetic child. In cases where the recipient's womb is absent or unable to carry a pregnancy, or in cases involving gay male couples, the embryos are implanted into a gestational surrogate, who carries the embryo to term, per an agreement with the future parents. The combination of egg donation and surrogacy has enabled gay men, including singer Elton John and his partner, to have biological children. Oocyte and embryo donation now account for approximately 18% of in vitro fertilization recorded births in the US.

This work established the technical foundation and legal-ethical framework surrounding the clinical use of human oocyte and embryo donation, a mainstream clinical practice, which has evolved over the past 25 years. Since the initial birth announcement in 1984, there have been well over 47,000 live births resulting from donor oocyte embryo transfer recorded by the Centers for Disease Control (CDC) in the United States to infertile women, who would not have been able to have children by any other existing method.

The legal status and cost/compensation models of egg donation vary significantly by country. It may be totally illegal (e.g., Italy, Germany, Austria); legal only if anonymous and gratuitous—that is, without any compensation for the egg donor (e.g., France); legal only if non-anonymous and gratuitous (e.g., Canada); legal only if anonymous, but egg donors may be compensated (the compensation is often described as being to offset her inconvenience and expenses) (e.g., Spain, Czech Republic, South Africa, Greece); legal only if non-anonymous, but egg donors may be compensated (e.g., the UK); or legal whether or not it is anonymous, and egg donors may be compensated (e.g., the US).

A need for egg donation may arise for a number of reasons. Infertile couples may resort to egg donation when the female partner cannot have genetic children because her own eggs cannot generate a viable pregnancy, or because they could generate a viable pregnancy but the chances are so low that it is not advisable or financially feasible to do IVF with her own eggs. This situation is often, but not always based on advanced reproductive age. It can also be due to early onset of menopause, which can occur as early as their 20s. In addition, some women are born without ovaries, while some women's reproductive organs have been damaged or surgically removed due to disease or other circumstances. Another indication would be a genetic disorder on part of the woman that either renders her infertile or would be dangerous for any offspring, problems that can be circumvented by using eggs from another woman. Many women have none of these issues, but continue to be unsuccessful using their own eggs—in other words, they have undiagnosed infertility—and thus turn to donor eggs or donor embryos. As stated above, egg donation is also helpful for gay male couples using surrogacy (see LGBT parenting).