Video > Medical facts & advice about egg donation

Medical facts & advice about egg donation

An Altrui egg donor talks to Dr Emma Sowerby about the medical facts and general advice about egg donation. Understanding the medical aspects of treatment is an important part of the decision-making process for any donor in whether or not to go forward with egg donation in the UK. The interview was held at the Assisted Conception Unit, Guy’s & St Thomas’ NHS Trust.

Transcription

>> Egg Donor: I am thinking of becoming an egg donor, but you hear lots of different things about it affecting your fertility. Is this the case?

>> Dr Sowerby: Broadly speaking, no. The majority of egg donors will go through cycles and have no problems with their future fertility at all. The thing I think people often worry about is that somehow they are going to use up their eggs quicker than normal. People often worry that they might reach the menopause earlier, for example.

>> Egg Donor: Does that happen then, reaching the menopause early?

>> Dr Sowerby: No, because what happens is, at the beginning of every natural menstrual cycle, you will get a whole group of eggs which will start to mature. Then, usually, most of them will die and just one, or occasionally two, will go on to ovulate.

Now, what we are trying to do when you donate eggs is capture all of those ones which start to grow at the beginning of a cycle, and get them all to come up to maturity. The eggs we are collecting would otherwise have been lost anyway, so you are not using up your eggs any quicker.

>> Egg Donor: Is it advisable to have had a family before you do it?

>> Dr Sowerby: Not necessarily, no. We can tell by doing things like scans and blood tests what your fertility levels are likely to be like. As I say, generally, you would not expect to have any fertility problems following donation.

>> Egg Donor: You know when you are actually going through stimulation drugs, does that make you more fertile then, if you are coming off – if you have the coil taken out, does that make you more fertile, being through the stimulation drugs? Because in effect, you are producing more and more.

>> Dr Sowerby: Yes, yes, it can do. What we ask is that once you stop your regular contraception, normally, you would go onto the Pill briefly. If you are not on the Pill, then we ask that you use barrier contraception through the treatment cycle, and up until the bleed that you have after the treatment cycle. Because you are at a slightly higher risk of becoming pregnant even after your eggs have been collected, because we never know whether there are one or two just left there inside.

>> Egg Donor: I am already on the contraceptive pill. Does it make a difference? Do I have to come off it for me to start the donation process?

>> Dr Sowerby: No. In fact, that is perfect, because very often we actually ask our donors to go onto the combined pill briefly, in order to start off a treatment cycle. Because what we are trying to do is to synchronise your cycle with the recipient cycle, and that is a perfect way to do it. No, we say to donors, “Definitely stay on the combined pill if you are on it”.

>> Egg Donor: What if I had a coil or something, would that make a difference?

>> Dr Sowerby: It depends a little bit what sort of coil it is. If you have just an ordinary copper coil, then that can stay in. It does not have any effect on the treatment cycle at all.
For people who have got one of the newer Mirena coils, or it is also called an ‘IUS,’ then we do ask that that is removed briefly during the donation cycles.

>> Egg Donor: What are the long term risks if I go through the cycle? Are there many major side effects to the medication that I am going to be put through?

>> Dr Sowerby: No, not really. The thing people often worry about, and understandably so, is that they might be at increased risk of cancer. There are been good studies looking at risks associated with things like breast cancer, ovarian cancer, endometrial cancer, and to date, there is no evidence to suggest that any of those are increased by going through ovarian stimulation egg collection.
In general, we have got a pretty good idea about who is at risk of hyperstimulation. The biggest risk factor is a group of people who have polycystic ovaries, where they have got lots and lots of eggs in the ovaries, lots of little follicles, and that is something we know from the word go.
It is also slightly more common in ladies who are very slim, and ladies who are under 30. For people where we know that they are at increased risk, what we would do is to start on a lower dose of drugs, and to monitor much more often during the injection phase with scans and blood tests. Then, we can adjust your dose, so that hopefully you do not run into any problems.

>> Egg Donor: The injections that we have to do, do they hurt? Where do they have to go?

>> Dr Sowerby: Generally not. They are just under the skin. Most people do them either into their thigh or into their tummy.

>> Egg Donor: I can get side effects from over stimulating. What does this mean, and what things can I do to stop that, or is there anything I can do to stop it?

>> Dr Sowerby: Okay. Ovarian hyperstimulation is probably the most serious risk for being a donor, but the good news is that it is rare. In general, we would say that up to 5% of people might have very mild symptoms of hyperstimulation. I will go on to tell you what those are. Probably less than 1% of people would actually have really severe hyperstimulation.
Obviously, when you take the drugs to stimulate your ovaries, they will become much bigger than normal. If you are someone who produces a lot of eggs, typically more than 20 eggs, then as well as having big ovaries, they can also release fluid into the pelvis.
The main things that people describe are feeling very bloated, feeling as if they have got quite a lot of discomfort in their tummy, and sometimes people feel sick. The most important thing you can do is just drink lots and lots. For most people, that is all you need to do.

>> Egg Donor: Are there any medical reasons why I would not be able to donate?

>> Dr Sowerby: When we first see you, we always ask you about family history. Sometimes things come up, genetic conditions which run in families, where we might advise that perhaps we would not want to accept you as a donor.
Sometimes, just in the course of screening, we find unexpected things. For example, occasionally we might find that donors might carry a gene for cystic fibrosis, which they did not know about previously.
When that is the case, we would obviously tell you, and give you advice about implications for having your own family in the future. Just because we perhaps might not accept you to be an egg donor, does not mean that you cannot have your own children.