If, for whatever reason, a man does not produce any sperm, or enough of good quality, or a woman does not produce any eggs, then assisted conception using donor gametes (eggs or sperm) offers the couple a chance of conceiving. Using donated eggs may also be advised for women in their forties who have a very small chance of success conceiving with IVF using their own eggs. (However, be aware that there is a national shortage of egg donors; all of the clinics offering this treatment across the country have couples on their waiting lists.)
Except where donation is intentionally between people known to each other, all donations in the UK are regulated by the Human Fertilisation and Embryology Authority (HFEA) and all donations are anonymous. If someone donates sperm or eggs to a couple for fertility treatment, neither the couple nor any resulting child will ever know who the donor is. The donor will be the ‘genetic’ parent of any child, but the couple themselves will be the ‘legal’ parents. Donors have no legal relationship with or any continuing responsibility to any children born from their donation.
Clinics record details of a donor’s physical appearance – such as hair, skin or eye colour, as well as height, build and blood group – and then usually try to match these physical characteristics with those of the male or female partner whose sperm or eggs are to be replaced.
If a couple decide to have DI, or IVF using donor eggs, there will be moral, philosophical and possibly religious aspects which they will need to consider, think through and accept. This is one reason why the HFEA insists that all couples contemplating the use of donor eggs or sperm are offered counselling. It is important, if either partner has doubts about what is involved, that couples take time to explore these issues before beginning treatment.
Insemination using donor semen (DI) is a tried-and-tested method of treatment; in the UK, there are approximately 1,500 such births each year. The way DI is carried out varies; some clinics recommend the use of drugs to ensure that the woman is ovulating, others prefer to rely on the natural cycle and the use of ovulation predictor kits. The number of inseminations carried out in each cycle can also vary, as can the method used – the sperm can be put into the vagina, the cervix or the uterus.
Egg donation is more complex. Women donating eggs need to go through the process of ovarian stimulation and egg collection. At the same time, the recipient’s body must itself be hormonally prepared for pregnancy. The process has to be timed and co-ordinated so that on the day when the eggs are collected from the donor, the man provides the semen so that the eggs can be mixed with the sperm and fertilisation can take place.
As with IVF, the embryos will then be placed in the recipient’s uterus using a fine catheter. She will need to take progesterone supplements until a pregnancy test can be done (about fourteen days later) and, if she is pregnant, these will continue for several more weeks.
Even if everything goes well physically and hormonally, a treatment cycle involving donated eggs or sperm involves complex emotions. For parents with children conceived by DI or through egg donation, a major issue is whether or not to tell the child about their origins, or other family members, or friends. This is something couples need to think through carefully before beginning treatment.