Oocyte donation for assisted reproduction
- Mark V Sauer, MD
Mark V Sauer, MD
- Professor of Obstetrics and Gynecology
- Columbia University College of Physicians and Surgeons
- Section Editors
- Robert L Barbieri, MD
Robert L Barbieri, MD
- Editor-in-Chief — Obstetrics, Gynecology and Women's Health
- Section Editor — General Gynecology and Female Reproductive Endocrinology
- Kate Macy Ladd Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
- William F Crowley, Jr, MD
William F Crowley, Jr, MD
- Section Editor — Female Reproductive Endocrinology
- Daniel K Podolsky Professor of Medicine
- Harvard Medical School
Oocyte (egg) donation is an integral part of modern assisted reproductive care. Originally offered to women with primary ovarian insufficiency (premature ovarian failure) or those who had genetic diseases who did not want to transmit the gene defect to their offspring, donated oocytes are now used by women with many reproductive disorders and commonly by women in later reproductive years . Approximately 20,000 attempts at pregnancy using in vitro fertilization (IVF) with donated oocytes or embryos are initiated annually in the United States .
Oocyte donation is at present the only effective therapy for the treatment of infertility in women with ovarian failure and for the vast majority of women of advanced reproductive age. Details of the IVF procedure are discussed in detail elsewhere. (See "In vitro fertilization".)
The first human pregnancy resulting from oocyte donation was reported in 1983 in a woman who was ovulatory (and therefore did not require hormone replacement), but infertile . The pregnancy ended in spontaneous abortion. Four months later, the first successful pregnancies from oocyte donation were reported in two women . Again, both women had normal ovarian hormonal secretion and therefore a normal endometrium.
Soon thereafter, a successful pregnancy was achieved in a woman with ovarian failure, who required estrogen and progesterone to prepare the endometrium to receive the ovum . Estrogen and progesterone were administered in a manner that mimicked the natural ovulatory cycle prior to conception, and were continued through the first trimester to support the developing pregnancy.
During the next few years, refinements in oocyte donation continued, and efficacy improved [6-9]. The refinements included:
- Sauer MV, Kavic SM. Oocyte and embryo donation 2006: reviewing two decades of innovation and controversy. Reprod Biomed Online 2006; 12:153.
- Centers for Disease Control and Prevention, American Society for Reproductive Medicine, Society for Assisted Reproductive Technology. 2012 Assisted Reproductive Technology National Summary Report. US Dept of Health and Human Services, Atlanta, 2014.
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- Buster JE, Bustillo M, Thorneycroft IH, et al. Non-surgical transfer of in vivo fertilised donated ova to five infertile women: report of two pregnancies. Lancet 1983; 2:223.
- Lutjen P, Trounson A, Leeton J, et al. The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure. Nature 1984; 307:174.
- Sauer MV, Bustillo M, Gorrill MJ, et al. An instrument for the recovery of preimplantation uterine ova. Obstet Gynecol 1988; 71:804.
- Sauer MV, Paulson RJ. Human oocyte and preembryo donation: an evolving method for the treatment of infertility. Am J Obstet Gynecol 1990; 163:1421.
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- Balmaceda JP, Alam V, Roszjtein D, et al. Embryo implantation rates in oocyte donation: a prospective comparison of tubal versus uterine transfers. Fertil Steril 1992; 57:362.
- Serhal PF, Craft IL. Oocyte donation in 61 patients. Lancet 1989; 1:1185.
- Sauer MV, Paulson RJ, Lobo RA. A preliminary report on oocyte donation extending reproductive potential to women over 40. N Engl J Med 1990; 323:1157.
- Sauer MV, Paulson RJ, Lobo RA. Reversing the natural decline in human fertility. An extended clinical trial of oocyte donation to women of advanced reproductive age. JAMA 1992; 268:1275.
- Kawwass JF, Monsour M, Crawford S, et al. Trends and outcomes for donor oocyte cycles in the United States, 2000-2010. JAMA 2013; 310:2426.
- Practice Committee of the American Society for Reproductive Medicine. Increased maternal cardiovascular mortality associated with pregnancy in women with Turner syndrome. Fertil Steril 2006; 86:S127.
- Practice Committee of the American Society for Reproductive Medicine, Practice Committee of the Society for Assisted Reproductive Technology. Guidelines on number of embryos transferred. Fertil Steril 2009; 92:1518.
- Muñoz E, Fernandez I, Martinez M, et al. Oocyte donation outcome after oncological treatment in cancer survivors. Fertil Steril 2015; 103:205.
- Girsh E, Katz N, Genkin L, et al. Male age influences oocyte-donor program results. J Assist Reprod Genet 2008; 25:137.
- Ford WC, North K, Taylor H, et al. Increasing paternal age is associated with delayed conception in a large population of fertile couples: evidence for declining fecundity in older men. The ALSPAC Study Team (Avon Longitudinal Study of Pregnancy and Childhood). Hum Reprod 2000; 15:1703.
- Yeh JS, Steward RG, Dude AM, et al. Pregnancy outcomes decline in recipients over age 44: an analysis of 27,959 fresh donor oocyte in vitro fertilization cycles from the Society for Assisted Reproductive Technology. Fertil Steril 2014; 101:1331.
- Robertshaw I, Khoury J, Abdallah ME, et al. The effect of paternal age on outcome in assisted reproductive technology using the ovum donation model. Reprod Sci 2014; 21:590.
- Frattarelli JL, Miller KA, Miller BT, et al. Male age negatively impacts embryo development and reproductive outcome in donor oocyte assisted reproductive technology cycles. Fertil Steril 2008; 90:97.
- Rieger D. Gamete donation: an opinion on the recommendations of the Royal Commission on New Reproductive Technologies. CMAJ 1994; 151:1433.
- Sauer MV, Paulson RJ. Oocyte donors: a demographic analysis of women at the University of Southern California. Hum Reprod 1992; 7:726.
- Sauer MV, Paulson RJ, Lobo RA. Pregnancy in women 50 or more years of age: outcomes of 22 consecutively established pregnancies from oocyte donation. Fertil Steril 1995; 64:111.
- Mechanick Braverman A. Survey results on the current practice of ovum donation. Ovum Donor Task Force of the Psychological Special Interests Group of the American Fertility Society. Fertil Steril 1993; 59:1216.
- de Ziegler D, Frydman R. Different implantation rates after transfers of cryopreserved embryos originating from donated oocytes or from regular in vitro fertilization. Fertil Steril 1990; 54:682.
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration. Title 21-Food and Drugs. Chapter I: Food and Drug Administration, Department of Health and Human Services. Subchapter L: Regulations under Certain Other Acts Administered by the Food and Drug Administration. Part 1271: Human Cells, Tissues, and Cellular and Tissue-Based Products.
- Practice Committee of American Society for Reproductive Medicine, Practice Committee of Society for Assisted Reproductive Technology. Recommendations for gamete and embryo donation: a committee opinion. Fertil Steril 2013; 99:47.
- US Food and Drug Administration. Donor Screening Recommendations to Reduce the Risk of Transmission of Zika Virus by Human Cells, Tissues, and Cellular and Tissue-Based Products: Guidance for Industry, March 2016. http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Tissue/UCM488582.pdf (Accessed on March 07, 2016).
- Sauer MV. Defining the incidence of serious complications experienced by oocyte donors: a review of 1000 cases. Am J Obstet Gynecol 2001; 184:277.
- Maxwell KN, Cholst IN, Rosenwaks Z. The incidence of both serious and minor complications in young women undergoing oocyte donation. Fertil Steril 2008; 90:2165.
- Bodri D, Guillén JJ, Polo A, et al. Complications related to ovarian stimulation and oocyte retrieval in 4052 oocyte donor cycles. Reprod Biomed Online 2008; 17:237.
- Melo MA, Garrido N, Alvarez C, et al. Antral follicle count (AFC) can be used in the prediction of ovarian response but cannot predict the oocyte/embryo quality or the in vitro fertilization outcome in an egg donation program. Fertil Steril 2009; 91:148.
- Nakhuda GS, Douglas NC, Thornton MH, et al. Anti-Müllerian hormone testing is useful for individualization of stimulation protocols in oocyte donors. Reprod Biomed Online 2010; 20:42.
- Bodri D, Guillén JJ, Galindo A, et al. Triggering with human chorionic gonadotropin or a gonadotropin-releasing hormone agonist in gonadotropin-releasing hormone antagonist-treated oocyte donor cycles: findings of a large retrospective cohort study. Fertil Steril 2009; 91:365.
- Sauer MV, Cohen MA. Egg and embryo donation. In: Textbook of Assisted Reproductive Technologies, 4th, Gardner DK, Howles CM, Weissman A, Shoham Z. (Eds), Martin Dunitz Publishers, London 2012. p.394.
- Younis JS, Simon A, Laufer N. Endometrial preparation: lessons from oocyte donation. Fertil Steril 1996; 66:873.
- Devroey P, Pados G. Preparation of endometrium for egg donation. Hum Reprod Update 1998; 4:856.
- Glujovsky D, Pesce R, Fiszbajn G, et al. Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes. Cochrane Database Syst Rev 2010; :CD006359.
- Sauer MV, Paulson RJ. Pelvic abscess complicating transcervical embryo transfer. Am J Obstet Gynecol 1992; 166:148.
- Bewley S, Wright JT. Maternal death associated with ovum donation twin pregnancy. Hum Reprod 1991; 6:898.
- Karnis MF, Zimon AE, Lalwani SI, et al. Risk of death in pregnancy achieved through oocyte donation in patients with Turner syndrome: a national survey. Fertil Steril 2003; 80:498.
- Ethics Committee of the American Society for Reproductive Medicine. Informing offspring of their conception by gamete donation. Fertil Steril 2004; 81:527.
- Paulson RJ, Hatch IE, Lobo RA, Sauer MV. Cumulative conception and live birth rates after oocyte donation: implications regarding endometrial receptivity. Hum Reprod 1997; 12:835.
- Ameratunga D, Weston G, Osianlis T, et al. In vitro fertilisation (IVF) with donor eggs in post-menopausal women: are there differences in pregnancy outcomes in women with premature ovarian failure (POF) compared with women with physiological age-related menopause? J Assist Reprod Genet 2009; 26:511.
- Jungheim ES, Schon SB, Schulte MB, et al. IVF outcomes in obese donor oocyte recipients: a systematic review and meta-analysis. Hum Reprod 2013; 28:2720.
- Sauer MV. Reproduction at an advanced maternal age and maternal health. Fertil Steril 2015; 103:1136.
- Sauer MV, Paulson RJ, Lobo RA. Oocyte donation to women of advanced reproductive age: pregnancy results and obstetrical outcomes in patients 45 years and older. Hum Reprod 1996; 11:2540.
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- Krieg SA, Henne MB, Westphal LM. Obstetric outcomes in donor oocyte pregnancies compared with advanced maternal age in in vitro fertilization pregnancies. Fertil Steril 2008; 90:65.
- Henne MB, Zhang M, Paroski S, et al. Comparison of obstetric outcomes in recipients of donor oocytes vs. women of advanced maternal age with autologous oocytes. J Reprod Med 2007; 52:585.
- Keegan DA, Krey LC, Chang HC, Noyes N. Increased risk of pregnancy-induced hypertension in young recipients of donated oocytes. Fertil Steril 2007; 87:776.
- Klatsky PC, Delaney SS, Caughey AB, et al. The role of embryonic origin in preeclampsia: a comparison of autologous in vitro fertilization and ovum donor pregnancies. Obstet Gynecol 2010; 116:1387.
- Letur H, Peigné M, Ohl J, et al. Hypertensive pathologies and egg donation pregnancies: Results of a large comparative cohort study. Fertil Steril 2016; 106:284.
- Cha KY, Koo JJ, Ko JJ, et al. Pregnancy after in vitro fertilization of human follicular oocytes collected from nonstimulated cycles, their culture in vitro and their transfer in a donor oocyte program. Fertil Steril 1991; 55:109.
- Russell JB, Knezevich KM, Fabian K, et al. In vitro oocyte maturation: Clinical applicability (abstract). Fertil Steril 1996; (Suppl):S22.
- Gunasena KT, Villines PM, Critser ES, Critser JK. Live births after autologous transplant of cryopreserved mouse ovaries. Hum Reprod 1997; 12:101.
- Gosden RG. Transplantation of fetal germ cells. J Assist Reprod Genet 1992; 9:118.
- Edwards JH, Benham JD. Views on donated ovarian tissue. Lancet 1994; 344:824.
- Seibel MM. Cadaveric ovary donation. N Engl J Med 1994; 330:796.
- Nagy ZP, Chang CC, Shapiro DB, et al. Clinical evaluation of the efficiency of an oocyte donation program using egg cryo-banking. Fertil Steril 2009; 92:520.
- Cobo A, Remohí J, Chang CC, Nagy ZP. Oocyte cryopreservation for donor egg banking. Reprod Biomed Online 2011; 23:341.
- Quaas AM, Melamed A, Chung K, et al. Egg banking in the United States: current status of commercially available cryopreserved oocytes. Fertil Steril 2013; 99:827.
- Kushnir VA, Barad DH, Albertini DF, et al. Outcomes of Fresh and Cryopreserved Oocyte Donation. JAMA 2015; 314:623.
- HISTORICAL OVERVIEW
- Current trends
- Special considerations
- - Turner syndrome
- - Advanced reproductive age
- - Cancer survivors
- - Advanced paternal age
- DONOR SELECTION
- CURRENT APPROACH
- - Protocol
- - Risks and complications
- - Potential complications
- - Disclosure
- PREGNANCY AND OBSTETRICAL OUTCOMES
- Pregnancy rates
- - Obese women
- Pregnancy outcome
- - Gestational hypertension
- ALTERNATIVE SOURCES OF DONOR OOCYTES
- Cryopreservation of oocytes and egg banks
- - Cryopreserved versus fresh oocytes