Egg donation, a gift of life
By Susan Newham
What would you do if you found out that your eggs were no longer viable and you couldn’t conceive a baby? Would you ‘adopt’ an egg from a donor? These days, it’s a very real way to have a baby.
Failed fertility treatment
“I remember when my doctor first told me how some women use other women’s eggs to fall pregnant. I thought, ‘Not me. I wouldn’t do that.’ But that was before my year of failed fertility treatments, which left me feeling depressed and hopeless,” says Amanda Cloete (names has been changed). Amanda always knew she would want children but, after getting married and divorced, she met her second husband when she was already 37. “Luckily, he was as keen to have children as I was so we started trying immediately,” says Amanda. After 10 months with no pregnancy, they decided to visit a fertility clinic. “I was told that although my husband’s sperm was fine, I wasn’t ovulating properly. I remember feeling numb.”
What followed was a year of unsuccessful fertility treatments, including one miscarriage. Amanda recalls, “It was after the miscarriage and finding out that my sister was pregnant with her second child and listening to my doctor kindly telling me that because I was nearing 40 the quality of my eggs wasn’t great, I began to look at the only other available option – egg donation.”
It wasn’t an easy decision. “My husband and I spent hours talking about it. Although adoption was a possibility, I really wanted the experience of being pregnant and giving birth. I also felt guilty about not being able to give my husband his own biological child, although he reassured me he would support whatever decision I made. We read everything we could find over the Net and also spoke to friends and family. Six months later, after much soul searching, we decided to give it a go.”
The first step was choosing an egg donor. “There really weren’t that many choices because very few women donate eggs. But there was one donor who was a good match for me physically. I liked the look of her baby picture and she seemed to have a good medical record. Once we finally decided on the donor, I finally started feeling excited again. We were going to have a baby!”
What followed was a series of medical procedures, which included the doctors at the clinic obtaining eggs from the donor. Although a number of eggs were extracted and fertilised with Amanda’s husband’s sperm, only two embryos were inserted into Amanda’s uterus. The rest were frozen for possible future use. Amanda remembers the day of the insertion: “My husband and I were like two schoolchildren, nervous and giggly. But the procedure was almost a non-event that happened very quickly on the gynae examination table. I felt like I was just going in for a pap smear.” A speculum was inserted vaginally and the embryos deposited into Amanda’s uterus. Amanda was told to wait two weeks before doing a pregnancy test.
“After so many failures, you build a protective resistance to thinking you’ll ever be pregnant,” says Amanda. “I almost didn’t want to take the pregnancy test but my husband urged me to… and I was pregnant! I couldn’t believe it had been that easy. “Egg donation has a 20 per cent chance of producing twins because of the number of embryos put back, and I had mixed feelings about that. But when I went back to the clinic I was pregnant with one baby.”
Amanda’s daughter is now 18 months old. “Before she was born, I worried that I wouldn’t feel like she was my child because she wasn’t biologically related to me. But now I can’t imagine loving or cherishing anyone more. I do think about the donor from time to time but mostly I feel that she must be an amazing woman for giving us this extraordinary gift of life.”
Success rate
Egg donation is an option that couples decide on after other treatments, like IVF, have been unsuccessful, usually because the woman’s eggs are not viable. Some women have a low supply of eggs or eggs of a poor quality that do not respond to IVF. Other women may have had their ovaries removed surgically or undergone chemotherapy, which leads to non-functioning of the ovaries. Like Amanda, many women are starting families
later in life when they are no longer so fertile.
Egg donation is relatively new in South Africa; the first baby conceived with a donated egg was born in the mid-80s. Since then, the numbers of people using this form of fertility treatment has increased but there are no statistics on the numbers of successful pregnancies. Dr Klaus Wiswedel, of the Cape Fertility Clinic in Cape Town, says, “We have about 120 pregnancies per year with this method.” These pregnancies are made up of South Africans and couple from the US and UK who come to South Africa for treatment because of high costs and long waiting lists for donors back home.
The success rate with egg donation is high. “There is a 60 to 70 per cent chance with each attempt – considerably higher than many other forms of fertility treatment – because the in-vitro fertilisation [fertilisation outside the body] depends on the age of the egg donor and not the recipient of the egg,” says Dr Wiswedel. Each attempt costs around R30 000, excluding agency costs and medical costs for the donor.
Finding an egg donor
There are a number of agencies in South Africa that have egg donors registered with them. EggdonationSouthAfrica, one of the largest, works with most of the fertility clinics in South Africa, Nairobi and the UK.
These agencies specialise in recruiting and screening donors. Founder member of EggdonationSouthAfrica Mbali Mkhize says, “I started the agency after I underwent my own fertility treatment. Although I was relatively fortunate in that I could produce my own eggs, I met wonderful women whose only option was to find a suitable egg donor. I found out that few donors are available and waiting lists are long. "Through this agency, I can give hope to these women. Egg donation is relatively new in South Africa but we have a considerable number of available donors of all population groups on our books.”
Mbali says that most of the donors are young university-educated women aged between 20 and 32. “Our donors are women who’ve heard about us from word-of-mouth or who’ve stumbled across our site. We take the screening of our donors very seriously. They undergo a detailed medical examination and blood test to screen for HIV and hepatitis, as well as having a psychological assessment.”
Donors are not paid for their eggs but are compensated for their time and inconvenience, usually around R5000 per cycle. All the eggs that are harvested with one cycle, usually between eight and 15, are used for one couple and they are given the option of freezing embryos for later use.
A donor can donate her eggs five times, which limits the number of babies borne to one donor. Available information on the egg donors includes their physical appearance, likes, dislikes and academic achievements, as well as a baby picture. No identifying information, such as name or adult picture, is given to ensure donor anonymity.
Implications for the child
There has been much research on the impact of being a donor-conceived child. The good news is that studies have shown that donor-conceived children do as well emotionally as naturally conceived children. However, a study released in July 2008 showed that donor-conceived children fair better if they are told when they are young that they were conceived this way. The study also showed that most children experience a desire to learn more about the donor and, in some cases, even meet the donor.
In South Africa, egg donors are all anonymous so meeting the donor is not a possibility. In the future, there might be the option of identity-release egg donors, where the donor makes herself known to the child at the child’s request once he or she turns 18. Presently, people wanting to go this route can explore the possibility of using egg donors from agencies in the United States. Of course, this is extremely costly, lengthy and complicated but some parents choose this option to give their child the choice of having some kind of contact in later life with their biological parent.
Being an egg donor
Gemma Page*, a 21-year-old university student and tutor, first heard about egg donation when visiting a website called Gumtree, a local Cape Town online advertising community. The ad asked for egg donors, which struck a chord with Gemma. A few months later, after reading an article in SL magazine on the topic, Gemma decided to look into it.
“I have never wanted my own children and have always felt guilty about this because I am healthy and fertile and there are so many couples out there who can’t have children. It seems unfair. Obviously the financial compensation was also attractive but I can’t say I felt desperate for money. Although I’m a student I am largely supported by my mother.” Gemma decided to Google “egg donation” and came across EggDonationSouthAfrica. After contacting the agency, she was put in touch with a fertility clinic in Cape Town. At the clinic, she underwent a physical examination and blood test. She says, “I also had to fill in loads of forms checking my medical history, as well as give details about my height, hair and eye colour. I also had to supply a baby photo.
“I visited a psychologist at the clinic who asked me questions to see whether or not I had any reservations. I guess they wanted to check that I wouldn’t pull out at the last minute and let down the couple going through the fertility treatment. The psychologist also asked whether or not I was depressed, and whether there was any history of mental illness in my family.” Gemma was given the all clear and told that there was a couple from the United States who might be interested in her as a donor. Gemma recalls, “It all happened very quickly after that initial visit. I was surprised at how simple and fast everything happened.”
Gemma had to give herself hormone injections everyday for 12 days. "I was shown how to do this using a pen-like injection, which stimulated my egg production. Although I was warned of negative side-effects, like feeling depressed, I felt fine. "I did feel quite nauseous towards the end and because the hormones made quite a few eggs ripen there was also a bit of abdominal discomfort." At ovulation time, Gemma returned to the clinic to have her eggs extracted. In her case, 14 healthy eggs were removed. The 10-minute procedure was performed under general anaesthetic.
"The nurse told me not to worry, that it was like picking grapes, which didn’t really reassure me. I didn’t feel great after the anaesthetic but a friend took me home and I spent the day in bed. I felt like I had mild period pains, but recovery was very quick. I asked the doctors if the treatment had been successful for the couple, but they weren’t allowed to tell me. I was a bit disappointed but otherwise there were no negative aspects to having done the procedure."
After a month’s rest, Gemma decided to do the procedure again when a German couple expressed interest in using her eggs. The second time around was just as straightforward, although the couple did delay the procedure a little after hearing about the xenophobic attacks in South Africa. "By the end of the second procedure, I was a bit tired of all the injections but I would definitely do it again in the future," she said.
Gemma feels positive about her decision to have donated eggs. "I don’t really think of the children. It’s more about donating tissue. If I donated a kidney after I died I wouldn’t think that it was me still walking around. When I was going through the procedure I only told my boyfriend and best friend, who was very supportive. My boyfriend surprised me by saying, ‘Oh, my sister did that last year.’ He knew more about the procedure than I did. I haven’t told my mother, although I might one day. I think she would worry about the fact that I was putting hormones into my body, and I don’t want her to get worried."
Gemma feels that having donated eggs has given her more sympathy for people who struggle to have children. "I believe that I won’t ever have children but if I do, I will remember this time and feel proud that I helped other couples. And I will always remember those women waiting so expectantly at the fertility clinic".
Copyright 2009 Fit Pregnancy, a division of Touchline Media Reproduction without permission is prohibited. All rights reserved.
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