Treatments and investigations


Egg donors are hard to come by and the demand far exceeds the supply. Egg sharing is a unique situation in which the egg provider is both an IVF patient and an egg donor. Not only does egg sharing increase the availability of donor eggs for a potential egg recipient, but also allows the egg provider to receive her own IVF treatment at a very much reduced cost or even no cost.

Who can be an egg sharer?

The basic criteria as to who can be an egg provider are the same as for egg donation (see egg donation information). But it is obviously in both the egg provider?s and egg recipient?s interests that sufficient eggs of good quality can be produced for sharing. The egg recipient will be understandably concerned that she does not receive poor quality eggs from a provider who has her own fertility problems. Centres therefore use very strict additional eligibility criteria when it comes to egg sharing. A potential egg sharer would be excluded from entering an egg share programme if:

  • at previous IVF attempts less than 10 eggs were collected on each occasion;
  • at a previous IVF attempt there was a failure of eggs to fertilise or a failure to reach the point of embryo transfer;
  • the FSH (follicle stimulating hormone) level taken during the early days of the menstrual cycle was raised indicating that it might be difficult to stimulate adequate eggs to grow;
  • she only had one ovary;
  • she had a history of polycystic ovary syndrome;
  • she had moderate / severe endometriosis;
  • there was a prolonged history of "unexplained" infertility.

This list will exclude the vast majority of potential egg providers in whom one could predict difficulty in recruiting an adequate number of good quality eggs for sharing. It means that the egg sharers will be seeking IVF for themselves because they have blocked fallopian tubes, a short history of ?unexplained? infertility, or there are significant male infertility factors. None of these should affect egg quality.

What are the screening tests for the egg provider?

The egg provider is screened as an egg donor (see Egg Donation Information) and her partner is screened in the same way as the partner of any patient undergoing IVF.

What are the egg provider?s expenses?

This will vary from centre to centre.

In some centres she will pay for her consultations, screening tests, and a proportion of the cost of an IVF cycle. There will be no additional charge for counselling, monitoring during treatment, egg retrieval, embryology or embryo transfer. If the provider?s own treatment required surgical retrieval of sperm, ICSI, blastocyst transfer, cryopreservation of embryos or frozen embryo transfer, she may be asked to pay these costs herself. It would be unreasonable to pass these charges across to the recipient couple. The centre will make it very clear to you what costs you will be expected to pay yourselves.

In other centres, the cost of the actual IVF cycle may be free of charge.

How do the egg share arrangements work?

A typical egg share programme guarantees that an egg recipient will receive at least four eggs. Eggs are shared equally between the provider and recipient so a minimum of eight eggs is required for sharing. You will be informed by the centre whether it is the provider or the recipient who will be allocated the extra egg when an odd number of eggs is retrieved.

While it is expected that the majority of egg providers will produce more than eleven eggs, this is not always the case. It is essential that you have a clear understanding of the arrangements if fewer eggs are collected than the minimum required for sharing. These will be discussed with you in depth.

How do I join the egg share programme as an egg provider?

You should be referred by your General Practitioner or Gynaecologist giving full details of your past medical history and infertility history. This should include the results of any investigations that have been performed and details of treatments you have already received. If you have previously been treated by IVF or ICSI, the centre where you are now proposing to become an egg sharer will need to have full details of the drug stimulation that was used, the number of eggs that were retrieved and the outcome with regard to the number and quality of the resulting embryos.

You will both have an initial consultation when a detailed medical, infertility and family history is taken. An examination is carried out too. If there are no obvious exclusions to you becoming an egg provider as listed above, the stages of how you will be assessed for suitability to join the egg share programme will be discussed.

The probable next step is to have a hormone screening test to ensure that there is no hormone imbalance which might indicate possible difficulty in producing an adequate number of eggs. This blood test is taken between day 2 and 4 of a natural menstrual cycle.
With your consent your GP will be asked if there is anything in your own or your family medical history that would make it inadvisable for you to become a donor. Because both of you are hoping to become parents by IVF, you will each be provided with a Welfare of Child questionnaire for yourselves to complete. This is to ensure that there are no medical or social reasons why either of you might be unsuitable to have treatment, as by law centres are required to consider anything that might adversely affect the welfare of any resulting child or existing child.

If the hormone profile is satisfactory, an appointment is arranged for you both to see a very experienced counsellor who will discuss your views about the implications of egg sharing as well as the legal and ethical aspects of donating eggs. For example, there are implications of remaining childless after your donation and perhaps eventually learning that the other couple with whom you shared your eggs did succeed. There are also implications of there possibly being half-siblings of a similar age resulting from treatment. The counsellor will also assess both your emotional and psychological suitability to become an egg provider. Whatever you discuss with the counsellor will remain confidential.

A different counsellor is used for the recipient of your eggs.

The next stage is to set up the remaining blood tests. These include all the routine screening tests for IVF, additional infection screen and a chromosome assessment (karyotype) and cystic fibrosis screening (see IVF and see Egg Donation Information). Arrangements are made for your partner to provide a sperm sample for the embryologist so that this can be assessed for IVF or ICSI.

When the results of all the preliminary tests are available, you will have a full planning session. During this consultation every aspect of your own IVF treatment and egg sharing and the ?timetable? of the procedure is discussed in depth. You will be asked to sign consent forms as an egg donor as well as consent forms for your own IVF treatment cycle. There may then be a lull until a suitable recipient is matched with you and the recipient?s tests etc are sorted out.

Legal aspects (see egg donation information)

Treatment cycle (see IVF information)

What happens if I change my mind?

Before you even begin the treatment cycle, you will have been very fully informed on all aspects of your planned egg donation. Your decision as to whether or not to proceed with egg sharing will therefore have been made on the basis of having the fullest possible information. You may very well decide that this form of treatment is not for you. In that case you will be thanked for the interest you have shown in the egg sharing programme and part amicably.

You can change your mind at any time without any fear of recrimination. If this should occur before the treatment cycle begins, you may have to bear the costs of your consultations and tests to that point. In what the centre would hope would be the very unlikely event of your changing your mind during the actual treatment cycle, there would be no refund made of the charges you will have paid prior to the treatment cycle commencing.

If you decide to keep all the eggs for yourself, even though eight or more have been obtained, you will then need to pay the full cost of the IVF treatment cycle.

Under the Human Fertilisation & Embryology Act (1990), as the egg provider, you may at any time vary or withdraw your consent altogether up to the time that an embryo containing your donated egg is used. This also applies to such embryos that have been frozen and stored for future use by the recipient.

March 2009