Egg Donors

A technique of proven value is egg donation for older women, those with premature ovarian failure or women who are unresponsive to gonadotropin stimulation. The donor, who ideally should be under the age of 33 and has been both physically and psychologically screened, is down-regulated with a GnRH agonist, and then stimulated with gonadotropins as in IVF. Following retrieval, the donor's oocytes are fertilized with sperm from the recipient's partner. If the recipient is having periods, indicative of endogenous hormone production, she is down- regulated with a GnRH agonist before starting on at least 10 days of estrogen (a common dose is estradiol, 4-8 mg per day). When ultrasonography indicates adequate endometrial development, progesterone is added to synchronize the endometrium with the egg retrieval. If pregnancy occurs, the hormone supplementation continues for at least 10 weeks, until placental steroidogen- esis is firmly established. Success rates are lower in older recipients unless high doses of progesterone are provided for uterine support. A delivery rate in older women of approximately 40-50% per cycle can be achieved in a donor oocyte program. A cumulative birth rate can reach 90% with 4 or more cycles. (Source: Clinical Gynecologic Endocrinology and Infertility. Speroff, Glass, and Kase. Lippincott Williams & Wilkins. 1999)