CRGW Ltd: 07029220
EGG SHARING – INFORMATION FOR PROVIDERS
What is Egg Sharing?
Egg sharing involves one woman (the egg provider) undergoing a cycle of IVF treatment and providing some of her eggs to another woman (the recipient). This increases the availability of eggs to potential recipients and enables the egg provider to receive her own IVF treatment at a reduced cost.
The Egg Provider
Who can be an egg provider?
To be eligible to be an egg provider you should;
- Be between 18-33 years old (egg collection will need to take place before 33rd birthday)
- Have no history of moderate or severe endometriosis
- Have antimullerian hormone levels within normal limits, the cost of this blood test is £80 (see the website price list for most upto date costs).
- Not have any transmittable diseases (infectious or inheritable)
- Have no family history of inheritable disorders/ congenital abnormalities
- Have both ovaries
- Have no history of poor ovarian response to stimulation.
- Be a non- smoker
- Have a body mass index between 19-35.
- Have no history of recurrent miscarriage ( 3 or more confirmed miscarriages)
- Have less than 3 previous failed IVF attempts
- Have no previous failed fertilisation
- Have less than 3 previous attempts at egg sharing
How do I join the egg share programme as a provider?
- You can contact us at CRGW on 01443 443 999. We will need to approach your GP regarding your suitability to be a donor.
- You will be invited for a consultation. At this visit we will take a medical, fertility and family history from you/partner. We will need to exclude the possibility of inheritable disorders.
- We will plan your investigations/screening tests and discuss how we assess your suitability as an egg provider.
Screening
This is to prevent transmission of infection or increased risk of abnormalities in any children born from treatment.
Please note, there is a non-refundable deposit of £500 required prior to these tests being undertaken. This deposit does not include the cost of the female AMH (£80) blood test or the male virology testing (£100).
Female:
Blood will be taken from you to test for;
- Blood group and rhesus antigen status
- HIV
- Hepatitis B core antibody & surface antigen and Hepatitis C
- Syphilis
- Rubella
- AMH (hormone)
- Genetic tests for chromosomal abnormalities including the test for the Cystic Fibrosis gene
- Specific tests related to ethnicity will also be carried out; Thalassaemia (Eastern Mediterranean), Sickle Cell (Afro-Caribbean ),Tay-Sacs (Jewish)
- HTLV 1 and 2
We will also do;
- A urine sample for Chlamydia and gonorrhoea
- Pelvic scan
Male
- Semen analysis
- HIV and Hepatitis B core antibody and surface antigen and Hepatitis C (blood tests)
Please note the male screening tests and semen analysis will not be covered by the recipient and therefore a charge will apply of £175.
N.B. HIV and Hepatitis B and C are carried out before being accepted onto the programme and are repeated at the start of any treatment cycle. This does not completely exclude the possibility of these viruses, as due to the nature of the test false positive and false negative results can occur.
Screening may reveal an unsuspected infectious or genetic condition which may have implications for your future health or the health of your family. We will, of course, do appropriate tests and provide counselling.
Welfare of the child
As with all fertility treatments the Human Fertilisation and Embryology Authority (HFEA) code of practice requires that we assess the suitability of you/your partner to be parents. This is done by you completing a questionnaire. If there are any issues raised from this we may need to contact your GP or other relevant professional. We will ask you to complete 'Consent to Disclosure' before we make these enquiries. It may also be necessary to discuss this at our social and ethical issues group.
Counselling
Prior to acceptance onto the programme we will ask you/partner to be seen by an independent counsellor who will explore ethical and legal issues with you. The counsellor may also discuss any welfare of the child issues that have arisen or, if appropriate, any feedback from our clinic meeting group.
Ethical Issues
These are some of the issues which you should consider;
- How will you feel about someone else having a child conceived from your eggs?
- How will you feel if the recipient is successful, but the treatment does not work for you?
- Consider what anonymous information you would like to receive about the recipient’s treatment, bearing in mind that donor anonymity has been removed and there is the potential that a child may make contact in the future.
- How will you feel if a child born from treatment contacts you when they are 18 years old? The law now allows access to identifying information when they are 18. We encourage parents of donor conceived children to tell the child from an early age how they were conceived as it is important for them to know about their origins. We encourage them to seek advice about how to do this from the Donor Conception website.
- You should consider the needs of any existing children or children born from treatment
- There is also a possibility that children born as a result of treatment could be unknowing siblings and may live in the same geographical area.
Legal Issues
Since 1991 the HFEA has kept a confidential register of information about all sperm, egg and embryo donations. This includes for all donors a physical description, ethnicity and (if provided) occupation and interests. The register includes all treatments and resulting children. The following information can now be accessed
Information donor – conceived individuals can receive
18 year olds will be able to obtain
- Identifying information about the donor including name, address, date of birth and physical appearance if the donation was made after April 2005.
- Identifying information on donations made prior to April 2005 if the donor has retrospectively removed anonymity
- Anonymous information if the donation was made before April 2005
- Those who intend to marry or enter into a civil partnership can submit a joint application to establish whether they are genetically related.
- Non-identifying information about their donor- conceived genetically related siblings including number, sex and year of birth.
- 18 year olds will be able to find out identifying information about donor- conceived genetically related siblings, if both sides consent, and will be able to find out about their donor, if applicable
16 year olds will be entitled to
- Non identifying information about their donor and their donor -conceived genetically related siblings.
- 16 year olds who intend to enter an intimate physical relationship can find out whether they are genetically related.
Information parents of donor-conceived individuals can receive
- They can be provided with non-identifying information about the donor by the clinic when they receive treatment
- Upon request the HFEA can provide them with the number, sex and year of birth of other offspring of the same donor
Information donors can receive
- They have the right to access the following anonymous information about their genetic offspring; number, sex and year of birth of people born as a result of their donation
- The HFEA is expected to contact and forewarn a donor of the fact that a donor conceived individual has requested identifying information about him or her
- Donors will be able to contact the clinic or the HFEA for this information
Further Legal Issues
- As the egg provider, you may withdraw your consent to the agreement at any time before any eggs or embryos created from the treatment are transferred into the recipient, used for research or allowed to perish
- The outcomes of the treatment cycles may be disclosed to the provider and recipient if both have consented (This is up to the individual and we respect your decision)
- We can give the recipient non-identifying information about the provider and we also encourage the provider to write a short biography which can be given to any child resulting from treatment
- Eggproviders have no legal claim to any children born from their donation
- It is illegal for payment to be made as part of an egg share arrangement
Medical Issues
- You may not produce enough follicles or eggs to continue the egg sharing arrangement. This cannot be anticipated as ovarian response to stimulation can vary in different treatment cycles and may happen even if you have previously had a good response.
- As with all IVF cycles there is a risk of over response which can have serious complications. Although we would like you to produce enough eggs to share we aim to avoid ovarian hyper-stimulation and would plan your treatment accordingly.
- Because you are sharing your eggs there may not be any/many embryos to freeze. You should also be aware that frozen embryo cycles are less successful than fresh embryo cycles.
- In an egg sharing arrangement both you and the recipient have fertility problems. You may have an undetected egg problem which will affect your treatment and that of the recipient.
- We would emphasise that neither you nor the egg recipient should feel under pressure to go ahead with the treatment.
- It is essential for the wellbeing of any children born as a result of the treatment that you disclose all of your personal and family medical history. If a child is born with a disability due to you withholding information regarding conditions about which you knew, or could be reasonably expected to know, then he/she may sue you personally for damages.
- In the future if you discover a previously unsuspected genetic condition, the clinic and the HFEA should be immediately informed. Consideration would be given to informing recipients who have had live births or where pregnancy is ongoing. In these circumstances appropriate tests would be arranged and counselling offered.
The Treatment Cycle
The treatment involves you undergoing a cycle of IVF at the same time the recipient takes medication to prepare her womb for embryo transfer.
Please note; if ICSI treatment is required, there will be a charge of £700.
To allow synchronisation of your cycles you may need to commence either the oral contraceptive pill (if not contraindicated) or a progesterone tablet. We will follow this with daily injections of a drug called Suprecur. This is designed to “switch off” your hormones to allow us to manipulate your cycle. After 2-3 weeks on these injections their effect is checked by a baseline scan. When your hormones are “switched off” you then start a second daily injection to stimulate the ovaries. You will continue both injections for approximately 2 weeks, with regular scans to monitor your progress. For a full description of an IVF cycle please see our information leaflet on IVF/ICSI treatment.
Following egg collection you will be asked to share 50% of your eggs with the recipient. Your eggs will be inseminated with your partners/donor sperm. The recipient’s share of the eggs will be inseminated with her partner’s sperm/donor sperm.
We will ask you to use pessaries/injections to encourage pregnancy to occur and to do a pregnancy test 16 days after embryo transfer. As with all fertility treatments there is a risk of ectopic and multiple pregnancies.
No more than 2 embryos can be transferred into your womb. To reduce the risks of a multiple pregnancy we now encourage a single embryo transfer.
Consents
There are number of consents and forms for you/partner to complete before the treatment can proceed.
- We will require a copy of your passport (which can be taken at the clinic).
- You will need to consent if we are to keep your GP informed of your progress or if we need to request information from them in the event of welfare of the child concerns.
- Welfare of the child questionnaire
- Consent to use and storage of eggs and embryos (female)
- Consent to treatment and embryo transfer (female)
- Consent to use of eggs in donation (female)
- Consent to use and storage of sperm and embryos (male)
- If using donor sperm there will be additional consents concerning legal parenthood (see information sheet regarding the use of donor sperm)
- The egg sharing agreement.(all concerned)
The Egg Sharing Agreement
N.B. There is a separate consent form for the agreement and the following outlines the contents.
- If you produce 8 or more eggs you will share 50% with the recipient.
- If you produce an odd number, the recipient will get the extra egg.
- If you get less than 10-14 follicles on scan we would not continue with the egg sharing,so you may keep all your eggs at the cost of the treatment cycle and cost of drugsor you can stop treatment.However we would discuss your response to decide if youwere able to take part in any further egg share programme.
- If you have less than 8eggs on the day of egg collection, then you keep all your eggs at no cost to yourself, but we would consider you to be unsuitable to undertake egg sharing in the future, if required.
- If you withdraw from an egg sharing agreement during your ovarian stimulation without a clinical reason you will be liable to pay for the cost of the medication and part of the IVF cycle.
- The cost of the treatment and the drugs is born by recipient
- If additional procedures are required the individual requiring them will meet the costs. Additional procedures include; ICSI, Donor Sperm, Embryo freezing (after the first year), Sperm freezing and Assisted Hatching.
Divulging Information
Neither you nor the egg recipient will have identifying information about the other and we will ensure that you attend clinic on different days or times, and are treated by different members of staff.
You can both consent if you wish to having/divulging information about the outcomes of each other’s cycles. You may not wish to do this and we respect your wishes.
N.B. Please note the information donors, donor-conceived individuals and parents of donor-conceived individuals can now obtain. (See under legal issues}
Document Name: PI 45 Egg Sharing – Info for Providers Version 6 (Feb 2014) Page 1 of 1
Approved By: Umesh Acharya
Author: Amanda O’Leary