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donor’s eggs are used in the treatment of two recipient women, also known as acceptors. Thus each acceptor is entitled to two donations. However, if ovarian stimulation fails to produce sufficient eggs for donation to two recipients (the number of eggs is less than or equals five), they can still be used for one recipient. In this case the acceptor who has presented the donor of five egg cells or less only is entitled to one donation. As soon as a recipient is pregnant, she drops out of the allocation system and her place is taken by a new recipient. If however there is no resulting pregnancy, she is entitled to a second attempt, with (logically) other material. Just to be perfectly clear: if the acceptor becomes pregnant at the first attempt she has no right to a second donation, unless the pregnancy results in a miscarriage. Benefits and drawbacks It is not always easy for a couple with a donor to weigh the two donation options. What are the benefits and drawbacks In terms of treatment From a purely medical viewpoint, named donation may be seen as a benefit or a drawback. For the recipient couple In principle, a couple that supplies its own donor will automatically have exclusive use of all the eggs produced by their donor. If the donor produces a large number of eggs, this is a definite benefit. All the eggs are fertilized using the recipient man’s sperm and, if this produces more embryos than needed for transfer to the woman’s uterus, the surplus embryos will be frozen and stored. These can later be used if the first treatment fails to produce a pregnancy or if the couple wants another child at a later date. However, if the donor produces only a few eggs after ovarian stimulation, the benefit turns into a drawback. The smaller the number of ripe eggs available for fertilization, the smaller the chance of the treatment producing surplus embryos. If embryo transfer using all the available embryos fails to produce a pregnancy for the recipient woman, she will have to repeat the entire treatment cycle, either using the same donor (if she is willing) or with a new donor. DONATION For the donor The fact that the same batch of donated eggs can be used to help two women can be a strong motivation for the donor. She undergoes ovarian stimulation treatment with a positive mindset: the desire to donate her eggs to benefit other women. This positive 104
contribution can have an amplified effect in the exchange donation system, not only because the donation helps two recipients, but also because it increases the chances of pregnancy for the woman whom the donor originally set out to help. In terms of waiting list One undisputed advantage of named donation is that there is no waiting list. Once the couple has found a donor who meets all medical requirements, the treatment can begin. Synchronising the donor’s and the recipient’s treatment is more easily arranged too because direct arrangements can be made. There is indeed a waiting list for exchange donation, which varies according to the supply. On the other hand, the benefit of waiting should not be neglected. Because exchange donation entitles the woman to two attempts using freshly donated eggs, her chances of pregnancy at the end of the treatment are higher than through named donation. In terms of anonymity Then there is the argument of anonymity. By definition, named donation cannot be anonymous, whereas exchange donation is. As stated previously, the CRG strongly recommends the second option for a number of psychological reasons. Anonymity is a good way to safeguard both the donor and the recipient from disappointment, arguments and conflicts of interest. No matter how good their relationship today may be, there is no way of predicting what might happen in five or ten years’ time. This is especially the case if something goes wrong with the pregnancy or the child has a congenital disorder. Under these circumstances chances are that the relationship between the donor and recipient couple become very strained because of the feelings of guilt. However, conflicts cannot be excluded even if everything goes well. Differences of opinion may arise over how open the parents should be with the child regarding his or her origins. The recipient couple may expect the donor to remain emotionally involved with the child, whereas this may not be what the donor has in mind at all. Or the donor may want to remain emotionally involved throughout the pregnancy and birth, whilst the recipient couple have difficulty with this. All these potential psychological complications can be avoided by keeping the donation anonymous. Anonymous donation draws a clear line between the lives (and perhaps the family) of the donor and the recipients, and everyone’s attitudes are clear right from the start. DONATION 105
Page 1 and 2: THE MAIN POINTS All people who rely
Page 3 and 4: to allow the ‘harvesting’ of ri
Page 5 and 6: SPERM DONATION As mentioned above,
Page 7 and 8: EGG DONATION Egg donation offers th
Page 9 and 10: Finally, and strange as this may se
Page 11: In case of an uneven number of eggs
Page 15 and 16: EMBRYO DONATION A couple’s infert

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