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Interview for Your Pregnancy February 2014

- Why do women need donor eggs? Woman need donor eggs when they have depleted their own ovarian reserve due to age, illness or unknown reasons. It may be that woman enter premature ovarian failure, meaning that the ovaries fail too early so woman of usual fertile ages cannot conceive. People also consider egg donation when they are predisposed to genetic concerns and do not want to reproduce with their own genes knowing that the chances of recreating this possible condition are high to guaranteed.

- For someone that knows nothing about this process, how would you explain it in simple terms?
Egg donation is an anomyous and safe process whereby woman aged between 18 and 34 come forward to make themselves available for confidential egg donation to help persons otherwise unable to conceive. It is a specialised type of fertility treatment undertaken in the major centres in South Africa.

Egg donation is an amazing deed. It is an opportunity for woman to give to one another and to make a living donation. It is about fertile ladies donating their eggs safely to another person, without adversely impacting on their own fertility or ovarian reserve. Every month woman loose a certain number of eggs and the process of donating eggs can be compared to fruit. An apple tree will drop the apples regardless (as will the eggs be released and leave the body). The treatment taken by an egg donor is like putting a basket under the tree. It is a means to recover some of the eggs that the body ordinarily looses.

These retrieved eggs are then donated to a needing recipient after the latter has selected and asked the donor to help – facilitated via the agency . With careful synchrinsation of the menstrual cycles, the reproductive cycles of the recipient and donor are aligned. V a In normal cases, the body produces the egg and prepares the uterus to hold the embryo. Now we need to align two bodies to behave as one.

The fertilised eggs (termed embryos after being put together with the sperm) are then implanted into the prepared uterus of the recipient.

The egg donor neither has further rights nor responsibilities after the donation process and the recipient is fully empowered to keep all details completely confidential. There is no means for recipient and donor to meet or engage in any way.

An egg donor contributes to a very special process and needs to be completely committed as there are often significant accessory costs for a recipient to partake in this treatment. These possibly extend to needing a surrogate (legal and medical costs around this process), flights and accommodation in addition to the medical costs.


- Has the need for donor eggs risen? Why?
The need for donor eggs has definitely increased because many recipients have waited until they are more emotionally and financially established to start a family. This may mean that they have compromised their fertility in the interim.
Second relationships in families also result in recipients considering egg donation to conceive as they have passed their natural fertile years.
Increased awareness of egg donation in general makes recipients more willing and open to consider the option of egg donation.
Increasing levels of infertility in naturally fertile years in modern era due to a variety of reasons - stress, hormones in food, pollution, etc.
Increasing acceptance of single men to conceive – requiring donor eggs (and surrogacy)
Male gay couples requiring donor eggs (and surrogacy)

- What are the associated costs? Fertility clinic costs, screening fees for an egg donor, agency fees and potential travel reimbursement costs for an egg donor.
- What are the risks/ success rates? These are roughly 50%. Success rates are influenced and impacted by uterine readiness and sperm quality. A good percerntage of all embryos are inherently abnormal in any event, so even in perfect circumstances (egg, sperm and uterus), a negative result may be the outcome. A significant aspect to understand about egg donation is that egg donation gives recipients a chance and hope to conceive and without these options there is no opportunity for such.
- What is the most common misconception about egg donation and using donor eggs? A judgemental view about persons going out of their way to conceive in this fashion, whilst children's homes are full. Another view is that this is not a normal process and if people are infertile, that is their fate and it should be accepted. Of course, egg donation is a very personal decision and persons embark on this route for unique reasons. Another notion is that egg donation is not widely accepted in certain cultures. The response on this view is that although egg donation is becoming an increasing solution to persons needing this type of treatment, egg donation remains a highly private and confidential process. It is most unlikely that recipients share the details of their conception - being through donor eggs – except occasionally with closest loved ones. In my experience it is really a handful of recipients that share the egg donation contribution with even their parents. South Africans have a culture of privacy and recipients have generally advised that the child will not be privy to these facts as well.

Proceeding with an egg donor means that the conception details can be kept confidential and private from all but the intimate parties involved. Further benefits include the contribution of sperm meaning that the child is genetically related to one of the parents. For the mother, the great benefit and experience of being pregnant and carrying this child cannot be stated strongly enough.

So whilst egg donation, being a recipient or a donor, may not be appropriate not right for everyone, it certainly does heal hearts and provide a spiritual lift. One of my donors was recently asked to donate her eggs. She was so excited as she was in a very low space in her life, having just lost a loved one and her being selected gave meaning and purpose to this stage of her life. For her to inconvenience herself gave her a reason to feel special and helped with the healing. So it is only in walking in the thickest of the forest, that you get to see the tiny beautiful flowers. From a distance, you see the picture, not the detail.

- How do you choose your donor? What information are you allowed to know about them? Is medical history important? The selection of an egg donor is a personal choice and every recipient identifies their preferred egg donor based on individual criteria. Aspects people often consider include physical traits, qualifications, religious affiliation, specific cultural interests, location and health aspects. Recipients are afforded access to a full detailed profile of all egg donors, these include detailed physical traits, behavioural traits, family background, medical history, philosophical views, education etc. The recipient's unique circumstances also sternly influence the required criteria. E.g a strong prevalence of blue eyes, a specific height, skin complexion or hair type may be imperative. If recipients have a strong exposure to a certain health concern on their own side or on the father's side, they may require an clean absence of any such concerns. So the selection and criteria really differ for all persons based on their circumstances. In many cases, it is a connection that the recipient makes when she reads the donor's profile, making an emotional or other association and therefore feels that such a donor is right for her. Other persons may take on a more analytical approach, studying finer details of perhaps the phsyical or educational aspects.

- Now on to the donor, do they have any rights over the child? No, egg donation is confidential and anonymous in South Africa. The birth mother has all legal rights and responsibilities. The egg donor's responsibilities ends on the day of egg donation.

- What happens to eggs that are not used? All eggs are fertilised. After a couple of days, usually three to five, usually two embryos are transferred into the recipient. Any remaining viable embryos may be frozen.

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