The Science Behind Egg Donation: What Happens in Your Body?

Egg donation is often considered a selfless act that affords intended recipients who struggle with infertility, the ability to experience parenthood. Recipients like those with low egg quality, ovarian failure or genetic concerns benefit from egg donation. The eggs can then be fertilized and implanted through In Vitro Fertilization (IVF).

Egg donor screening has to take place before the process can begin. The egg donor requirements include:

• Age: A donor has to be between the age of 18 and 35 as this is the age where the eggs are most viable.
• Health: They should have a healthy medical history with no genetic disorders.
• Lifestyle: They should be non-smokers with no history of drug abuse.
• Medical: The donor should not have infectious diseases like HIV or hepatitis and their ovaries should be healthy.
• Mental: The egg donor should be mentally and emotionally stable to cope with the emotional demands of egg donation.

The egg donation process requires commitment from the donors to follow through with the medical and emotional aspects of the procedure. It involves hormone stimulation, egg retrieval, and recovery thereafter. Lets have an in-depth look at the journey through the egg donation process and what to expect. 

The Role of Hormones in Egg Maturation

Once an egg donor has undergone the screening and is declared fit for egg donation, the first step is hormone stimulation. The egg donor will take hormone medications to stimulate the ovaries to produce multiple eggs instead of the usual one egg per cycle. The two key hormones that help with ovary stimulation are the Luteinizing Hormone (LH), which is a synthetic hormone that will briefly stop the ovary’s normal function and then the Follicle Stimulating Hormone (FSH), similar to the natural hormones produced by the body right before ovulation. The egg donor injects these hormones over a period of two weeks and they help with egg maturation and prevent premature ovulation. Throughout the hormone stimulation, the donor is monitored through blood tests and vaginal ultrasounds to assess the egg maturation process.

How Ovarian Stimulation Works

The work of the ovaries is to release eggs and to secrete estrogen and progesterone hormones that are responsible for the female characteristics. Every month during the menstrual cycle, tiny fluid-filled sacs called follicles which contain the egg, develop in the ovaries and release one egg. 

Ovarian stimulation happens in phases whereby in the first phase, an ultrasound in the initial 3 days of the cycle is performed to establish that the ovaries have no cysts and there are no enlarged follicles. 

In the second phase,the hormone injections begin on the 1st or 2nd day of the menstrual cycle to align the follicles to grow at the same time up to the correct size. This phase lasts between ten to twelve days.

In the final phase,32 to 36 hours before the follicles can be punctured for egg retrieval,  the Human Chorionic Gonadotropin (hcG) or GnRH hormones also known as the trigger shots are administered to finalize egg maturation in readiness for egg retrieval.

The physician will then retrieve as many eggs as possible from the mature follicles using a needle injected through the vaginal wall to the ovaries. The egg donor is usually under light sedation during this process. An embryologist then determines the number of eggs retrieved as well as their viability. 

What Happens to Your Eggs After Retrieval?

A number of processes usually take place after egg retrieval. Depending on the agreement, the donor may be kept abreast with these processes until fertility. First the number of both mature and immature eggs is determined and declared. The eggs are then placed in an incubator for maturity. The recipient may then decide whether to freeze the eggs or have them fertilized right away. 

The embryologist will fertilize all mature eggs with sperm and give updates on the fertilization process. A normally fertilized egg will have 2 nuclei. If fewer or more nuclei are achieved then the resulting embryos will have abnormalities. 

The embryos are then checked for morphology under a microscope and embryo grading is performed with 1 being the highest grade and 3 the lowest. To attain grade 1, the embryo should show normal cell division with a nucleus in every cell and the cells should be symmetrical and have almost the same size. This will enable further development.

After about 6 days, the embryo reaches the blastocyst stage, which is a hollow ball of cells from a fertilized egg. It contains two layers, the inner layer which is tightly packed to form a ball- the foetus, and the outer layer consisting of equally sized cells that form the placenta.

The blastocyst is then implanted into the recipient’s uterus or frozen depending on the agreement with the patient.

Short-Term & Long-Term Effects on the Body

An egg donor will usually experience the following short term effects after egg donation:

• Some donors reported having abdominal pains after egg retrieval and administered over the counter pain medication. 
• Some also experienced ovarian torsion which is a risk that arises when the ovary twists around the supporting ligaments thus cutting off blood flow. This is likely to happen when the egg donor is involved in strenuous activities during ovarian stimulation.
• Another risk is ovarian Hyperstimulation Syndrome (OHSS) where the ovaries swell and leak fluid into the abdomen as a result of hormone stimulation. 
• Infection resulting from the egg retrieval procedure is another likelihood.

According to a research by the National Library of Medicine on advocating for follow-up on the health of egg donors, the studies on the long term effects of egg donations are not conclusive. However, a few women have regretted donating their eggs citing psychological issues relating to the inability to be in contact with their genetic progeny or later infertility even though totally unrelated to their egg donation experience.

Understanding the egg donation process, from screening to egg retrieval and fertilization is very important for both the donor and the recipient because of the medical, ethical, financial and emotional aspects in play. Although the short term effects are quite manageable, the long term effects are still being studied. Egg donation does not deplete your reserves, it simply utilizes eggs that would otherwise be lost during menstruation. It also does not affect future fertility or your ability to conceive.

Our trusted fertility specialists at the Fertility Associates of Memphis (FAM) are well equipped to answer any questions you may have concerning egg donation, thereby helping you to make an informed decision whether as an egg donor or the recipient. Why wait! book your appointment today and make that life changing decision. 

FAQs

How does egg donation affect my hormones?

Egg donation temporarily affects the level of hormones due to the medications used to facilitate egg production even though it does not deplete future egg reserves.

Will donating eggs impact my future fertility?

No, egg donation does not affect future fertility as only the eggs that would naturally be lost during menstruation are retrieved. 

What medications are used during the process?

Egg donors take injectable hormones like the follicle stimulating hormone (FSH) and the luteinizing hormone (LH) to stimulate egg production. 

What is the difference between fresh and frozen egg donation?

In fresh donation, the donor and recipient’s cycles are synchronized for immediate fertilization while in frozen egg donation eggs are stored for later use.