Egg Donor & Recipient

Egg (Oocyte) Donation

Donor eggs may be offered as a treatment option in the following circumstances.

• When a woman's ovaries fail to produce eggs.
• When a woman's ovaries are absent.
• When the eggs which are produced fail to fertilise even when exposed to sperm of proven fertilising ability.
• When a woman has a known genetic disorder which may be passed on to her offspring.

The practice of donating eggs to another person is an involved process; therefore it is important that all parties undergo a series of investigations, consultations and counselling sessions.

Legal Aspects Of Egg Donation

The unit is not able to accept egg donations or provide treatment for recipients of donated eggs unless they fulfil the requirements of the legislation and comply with frm eligibility criteria.
It is the responsibility of the Director of the Unit or delegated officer to select suitable donors and provide security for confidential information.

According to present law, the child born as a result of egg donation is the child of the woman who gives birth and her partner (Family Relationship Act / Amendment 1984 s.10C & s.10D). The egg donor has no legal rights or duties with regard to the welfare of the child.

The Clinic keeps a record of the following information as a confidential record of each donor. Similar data is also recorded where possible about the donor's parents, grandparents and great grandparents.

Physical Characteristics

• Height
• Build/Weight
• Eye Colour
• Hair Colour
• Skin Colour
• Race

Social History

• Religion
• Nationality
• Country of Birth
• Education
• Occupation
• Marital Status
• Number of Children
• Interests (Hobbies/Sports etc)

Medical History of the donor, the donor's children and the donor's parents and grandparents are also recorded.
At Flinders Reproductive Medicine it is policy that all donor records are kept indefinitely, in keeping with the NHMRC Ethical Guidelines on the Use of Assisted Reproductive Technology in Clinical Practice and Research.

Donor Register

In keeping with current convention, there have been changes to the legislation in South Australia to enable a register of donors, donor conceived children and recipients to be established. This enables those who are conceived through donors to seek identifying information about their donors. For cases where the child is conceived after the 1st September (irrespective of the date the genetic material was donated), the changes will be retrospective. For cases where the child was conceived before the 1st September 2010, the changes will not be retrospective, however it is likely that a voluntary register of donors, recipients and children will also be established. Until the register is established the clinic is to act in the capacity of the Donor Conception Register by recording and keeping information.

Issues For Women Considering Egg Donation

Donor age

The age of the female donor shall be no greater than 34 years at the time of egg collection. Potential Donors over this age may be used with appropriate consultation with the recipients. We recommend that they have completed their own family before donation.

Exclusion criteria

Donors will be excluded if they have a personal or family history of a number of diseases including:

• Venereal disease
• Hepatitis B & C
• Acquired Immune Deficiency Syndrome (AIDS)
• Sickle cell trait
• Thalassaemia trait

Genetic screening

Egg donors are screened for known chromosomal abnormalities and for cystic fibrosis.

Health / Life Style

Donors must be in good health and will be required to sign a life-style declaration form. Donors and their partners (if applicable) will be screened for Hepatitis B, Hepatitis C, HIV (AIDS) and venereal disease prior to the donation.

Donor Consent

Donors may withdraw their consent at any time up until the time of fertilisation of the eggs.

Risk of Pregnancy for the Donor

If you or your partner, (if applicable) have not undergone a sterilisation procedure, there is a possibility that you might become pregnant. You will be required to take appropriate contraceptive precautions, such as not having sex at all during this particular cycle of treatment, or, less effectively, using barrier methods such as condoms or a diaphragm.

Social Implications

It is FRM policy to limit that the number of pregnancies per donor is currently restricted to 10 families so that the chances of related donor conceived children marrying are extremely low. The donor has the right to be informed about the number and sex of children born as a result of her egg donation.

Egg Donors

Medical Consultation

Potential egg donors will need to have medical consultations, which requires a referral from a General Practioner. At the first consultation the Specialist will take a medical history and order blood tests and a vaginal ultrasound. The potential donor is required to sign a Lifestyle Declaration.

At the second consultation these test results will be reviewed and a decision made on medical grounds if the potential donor is to continue. If any issues arise a medical consultation may be organised with the donor and the recipient.

The final medical consultation will discuss any issues that have been raised, answer any questions and consent forms for treatment will be signed.

Counselling (Donor)

You and your partner, (if you have one), will be asked to attend at least two counselling sessions with an approved counsellor recommended by the clinic. Counselling can be arranged by making an appointment with Julie Potts on 8204 4343.

At the initial visit the emotional aspects of egg donation will be discussed. It is important that you consider your reasons for wanting to donate, your views about the family and children who may result and the complex issue of talking with children about donor conception, including any children you may have. The implications of these issues and others you may raise are best addressed over at least two meetings.

(Known Donor Only)

An additional visit will involve discussion between yourself, your partner, the recipient/persons and the counsellor. Discussion will centre on the logistics of treatment and shared participation in the donor treatment cycle. Long term hypothetical issues will also be raised, for example health problems, which may occur with the child, family break-up and future relationships with the child. Ideas will be raised about how to provide and receive support for those involved, before, during and after treatment.

Counselling, (at no cost to you), is available at any time during or after your involvement in the egg donation program. It is not a sign of weakness or inability to cope in anyone seeking this help, but a way of increasing your own understanding and support network. You are free to seek assistance in whichever way you prefer, eg. with your minister of religion or General Practitioner.

We also hold a list of counsellors with an interest in infertility, who practise in the community. This is available to you on request.

Nurse Appointment

A member of the FRM nursing staff will discuss with the donor the logistics of the treatment, the proposed month of treatment and how procedures are performed.

Final blood screening tests are done 3 months after the first test.

Recipients Of Donated Eggs

Medical Consultations

During these consultations your doctor will discuss the treatment process and will obtain your consent.

Counselling (Recipient/s)

Following your medical interview you and your partner (if applicable) will be asked to attend at least two counselling sessions with an approved counsellor recommended by the Clinic. Counselling can be arranged by making an appointment with Julie Potts on 8204 4343.

The initial appointment provides an opportunity to talk about the emotional implications of fertility difficulty for you as well as the implications of considering treatment with the involvement of a donor. The subsequent appointment will address the implications of forming your family through donor conception.

The counsellor will assist you to identify the strengths in your relationships, to look at your abilities to deal with stress, time commitments, as well as possible disappointments which the programme may entail.

It is recommended that children be told about the nature of their conception. People conceived with the involvement of a donor have voiced very clearly their wish for open honest disclosure about the facts of their creation. Discussion with the counsellor may assist you in deciding how and when to tell your child about the method of conception. Information about the book "Sometimes It Takes Three To Make A Baby" by Kate Bourne is available through the clinic.

We know that children are very hurt if they find out information from someone other than their parents. Therefore it is important for donor recipients to decide who else they may tell about their treatment.

(Known Donor Only)

One appointment will involve discussion between yourself, your partner, the donor, the donor's partner (if appropriate) and the counsellor. Discussion will centre on the logistics of treatment and shared participation in the donor treatment cycle. Long term issues will also be raised, for example obstetric complications, health problems which may occur with the child, family break-up and relationships with the child. Ideas will be raised about how to provide and receive support for all the adults involved, before, during and after treatment.

Counselling (at no cost to you) is available at any time during or after your involvement in the egg donation programme. It is not a sign of weakness or inability to cope in anyone seeking this assistance, but a way of increasing your own understanding. You are free to seek assistance in whichever way you prefer, eg. with your minister of religion or general practitioner.

We also hold a list of counsellors with an interest in infertility who practise in the community. This is available to you on request.

Nurse Appointment

A member of the FRM nursing staff will discuss the logistics of the treatment and how the cycles of the donor and recipient are to be synchronised in order to enable a 'fresh' embryo transfer.

Treatment

If you decide to donate your eggs, you will need to have the same treatment as is given to women having IVF. (See IVF booklet regarding the procedure) Below: (figure 1) is a flow chart showing both the Donor and Recipient treatment cycles.