Oocyte donation for optimal pregnancy outcomes

Oocyte donors may be known (non-anonymous donation, like in the UK) or unknown (anonymous donation) to the recipient. Both donor and recipient (as a couple) are subjected to full medical screening, counselling and investigations, and have to meet certain eligibility criteria before going ahead with treatment. Donors should have attained legal age in order to participate in egg donation. Preferably they shouldn't be older than 35 years owing to the decreased ovarian reserve and the higher risk for chromosomal abnormalities with advancing female age. Detailed medical and psychosocial histories of the donor should be taken. In order to streamline and police the complex process of oocyte donation, several organisations and fertility clinics worldwide have issued guidelines for best practice. The most recent of these are published by the Practice Committee of the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART). The selection of donors and the range of tests that need to be conducted may vary slightly from clinic to clinic and between countries. It is however the responsibility of the clinic to ensure that subjects enrolled in oocyte donation programmes (both as donors and recipients) undergo a thorough assessment for optimum pregnancy outcome.

The clinical pregnancy rates for oocyte donation can be as high as 70% but a carefully tailored preparation protocol should be followed. Further, couples should be warn that increased body weight (body mass index greater than 30 kg/m2), endometrial thickness less than 8mm at the time of embryo transfer and the administration of GnRH analogues before priming of the endometrium with oestrogen and progesterone can significantly reduce the chance of success.