Gamete Donation
For an increasing number of women, egg donation is the only way to achieve the long-awaited pregnancy.
Situations in which egg donation may be helpful include:
● Premature ovarian insufficiency and early menopause.
● Genetic abnormalities, such as Turner syndrome.
● History of bilateral oophorectomy (surgical removal of the ovaries).
● Ovarian insufficiency after chemotherapy or radiotherapy.
● Multiple failed IVF attempts.
● Women of advanced reproductive age (>40 years).
● Women with a reduced egg reserve (ovarian reserve).
● Women with low egg quality or poor-quality embryos in previous IVF attempts.
● Women with an inherited condition (use of donated eggs to avoid transmitting the condition to the embryo).
Egg donation is often considered a taboo. It is important to understand that it is an anonymous process (i.e., the donor does not know the recipient and vice versa), during which the donor provides her eggs to the recipient couple.
The eggs are fertilised with the sperm of the recipient’s husband/partner, and the embryos created from fertilisation are transferred to the recipient’s uterus. The donor follows an ovarian stimulation protocol (ovarian stimulation) to produce eggs, which are then collected through the egg retrieval procedure. Similarly, the recipient undergoes an endometrial preparation protocol, followed by embryo transfer.
How is the donor selected?
Before starting the egg donor selection process, it is important that certain requirements are met to ensure the donor’s health and suitability.
The most important criterion for selecting a donor is her age (<35 years). Studies have shown that the younger the donor, the higher the chances of fertilisation and pregnancy, with success rates approximately as follows:
● Donor aged 20–22 → 59.1%
● Donor aged 26–28 → 45.9%
● Donor aged 32–34 → 30.5%
A comprehensive medical, social, and family history is taken from the potential donor, and she undergoes thorough testing for her general health and, more specifically, for sexually transmitted infections (syphilis, AIDS/HIV, chlamydia, hepatitis B, hepatitis C, etc.). At our centre, a karyotype test (genetic material) is always performed for the potential donor, along with cystic fibrosis screening.
A potential donor will be rejected if:
a) she uses intravenous drugs for non-therapeutic purposes.
b) her history indicates sexual behaviour that places her at high risk of carrying sexually transmitted infections.
c) she has received known treatment for syphilis or gonorrhoea within the last 12 months.
d) she has undergone an organ transplant.
e) she has a history of spongiform encephalopathy.
Preparation of the couple
After a detailed history is taken by the fertility specialist, the recipient couple also completes a series of tests.
Assessment of the recipient begins with evaluation of the uterine cavity (where implantation will later occur) via gynaecological ultrasound, hysterosalpingography (HSG) if deemed necessary, or even hysteroscopy when indicated. The recipient is then screened for infections such as syphilis, AIDS/HIV, hepatitis B and C, etc., and a routine prenatal screening is also carried out.
The husband/partner—whose sperm will be used to fertilise the donor’s eggs—should have a full semen analysis and semen culture to identify microbes. He should also be screened for transmissible infections such as syphilis, AIDS/HIV, hepatitis B and C, etc.
The couple may choose to see a psychologist before starting treatment. The process begins with written consent from the donor and the recipient couple, as required by relevant legislation.
In cases where the couple’s infertility is due to very poor sperm quality or absence of sperm (azoospermia), the use of donor sperm from an anonymous donor may provide a solution. Donor sperm is widely used and considered safe worldwide.
Deciding to use donor sperm is often difficult for the couple and requires proper counselling and, potentially, psychological support. Once the decision is made, in most cases the journey ends with the couple holding their own baby in their arms!
Donor selection
The recipient couple can decide which sperm bank to use, as well as the donor criteria. Our centre—Biogenetic Centre—collaborates with several sperm banks in Greece and abroad.
Information about physical and ethnic characteristics, social history, educational level, professional development, and overall medical history should be available.
Ways donor sperm can be used
Donor sperm can be used in different fertility treatments. It may be used to fertilise an egg directly within the woman’s body, as in intrauterine insemination (IUI), or in the laboratory in the case of conventional in vitro fertilisation (IVF) or ICSI.
When is donor sperm indicated?
Donor sperm may be indicated when:
● The partner’s sperm shows severely abnormal parameters, such as an increased sperm DNA fragmentation index (DFI).
● The sperm produced is not able to fertilise normally (reduced motility, low count, abnormal morphology, etc.) and ICSI did not help in one or two attempts.
● There is a high risk of transmitting an inherited disease where preimplantation diagnosis cannot be effective.
● The partner has had a vasectomy (sterilisation).
● Multiple attempts attributed to poor sperm quality.
● Same-sex couples (two women).
What are the success rates when using donor sperm?
When the only infertility factor is the partner’s abnormal sperm, and the female partner is ≤37 years old with no issues identified in the evaluation, success rates for conception and pregnancy using donor sperm are very high.
If the woman also has a fertility issue (e.g., ovulation problems, endometriosis, etc.), success rates are lower, depending on the specific condition.
Overall success rates are in the range of 60–80% in younger women once the course of treatment is completed. A second stimulation cycle may be needed in some cases.
What risks exist when using donor sperm?
If donor sperm is obtained from a registered donor via a certified sperm bank, any risk is minimised, because:
● Donors in a certified bank must first answer a series of questions designed to ensure their suitability.
● Certified sperm banks are required to assess the health history of each donor and their family.
● All donors are strictly screened to confirm they do not have, or carry, conditions such as HIV/AIDS, hepatitis B & C, cytomegalovirus (CMV), syphilis, gonorrhoea, cystic fibrosis, etc.
● The sperm remains quarantined for 6 months while donor screening is completed, and is then made available.
● There are limits on the number of children that can be born from the same donor.
Joint written consent from the couple is required for the use of donor sperm.
The obstetrician and gynaecological surgeon Dr Dimitris Koleskas, MRCOG, fertility specialist, is by your side with sensitivity and scientific precision to guide you through every stage of the egg or sperm donation process. Learn about the requirements and any potential costs, discuss every question you may have, and receive personalised support to address infertility with hope and dignity. Get in contact and take the first step towards building the family you dream of.
