Dedicated egg sharing, egg donor, and sperm donor programmes at The Bridge Centre

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Egg Sharing

Our programme was set up in response to the needs of two separate, but nevertheless complementary, groups of patients seeking help - that is, patients needing donated eggs and patients for whom the expense of fertility treatment excludes them from the treatment which they very much need. This problem of costs is compounded when more than one cycle of treatment is required to achieve a pregnancy. The national shortage of eggs for donation and the progressive increase in the number of couples seeking this type of treatment, presents opportunities for mutually beneficial treatment sharing.

Why is Egg Donation needed?

For a large number of women who previously thought they could never have children, Egg Donation offers new opportunities.

It offers hope to women who have lost their ovaries.
It offers hope to women whose ovarian function has been impaired following cancer, surgery, chemotherapy or radiotherapy.
It offers hope to women who have unexpectedly suffered premature menopause, which affects 1% of women under the age of 40. Thus, well over 110,000 women are affected in the United Kingdom alone.
It offers hope to women who have a high risk of passing genetic disorders on to their offspring via sex-linked diseases such as Duchenne Muscular Dystrophy or Haemophilia. Whilst such diseases are passed on by the female it is the male child who is affected. Rather than risk giving birth to a child who may die at an early age, the couple may request egg donation. As the donated eggs are fertilised by the male partner's sperm, the couple are given the chance of having a healthy child.

Unfortunately, there is a serious shortage of suitable egg donors. Most centres offering this treatment have waiting lists of over 2 years.

How Can Egg Sharing Help Both Couples?

By sharing her eggs with a woman who is unable to produce her own, the Egg Sharer gives another couple the chance of having a child, or the Egg Sharer could be giving the chance of a healthy child to couples with high-risk sex-linked genetic disorders. In return for this much needed help, the couple who is donating the eggs has access to an IVF cycle of treatment at no cost (except for a contribution to the cost of drugs, at a set price of £275).

This solution, however, raises ethical issues and we have ensured that the programme designed by The Bridge Centre adheres strictly to all the guidelines laid down by the Human Fertilisation and Embryology Authority (HFEA).

Acceptance criteria for the Egg Sharing Programme

You should be aware that not all couples are eligible to enter our programme. Before appointments can be made for you as a potential Egg Sharer it must be established that you fulfil the criteria for egg sharing. This includes having a blood test done for FSH (Follicle Stimulating Hormone) if you have not had one within the last six months. The test should be done on day three of your period, at the Bridge Centre, for a cost of £31.40, or your GP may be happy to do it. Please contact Jane Mortlock to discuss the programme and your suitability as an Egg Sharer.

The following conditions are given as a guideline: Donors must :-

be aged between 18 and 34.
have no personal or family history of inheritable disorders.
have no personal history of transmissible infection.
have had no more than 2 previous unsuccessful IVF attempts.
have had no history of previous low ovarian response to ovarian stimulation.
have both ovaries.
have a body mass index (BMI) less than 32.
have given appropriate consent.
have received appropriate counselling.
have undergone the screening tests mentioned below, including a normal FSH level of less than 8.
if possible, have a referring letter from their general practitioner.

Screening tests

A full medical examination will be done and a full history taken which will include details of your family history.

You will be asked to consent to the clinic's communication with your GP, who will be requested to give an opinion on your suitability as a donor. This information will include consideration of 'The Welfare of the Child', as required by The Human Fertilisation and Embryology Act (1990). You also will be expected to complete answers on a standard form about this issue. (See further information enclosed).

The Bridge Centre will perform the following investigations:

Blood tests:

Chromosome studies
Cystic Fibrosis
Sickle Test when appropriate
HIV
Hepatitis B and C
VDRL
Cytomegalovirus status
Rubella
Day 3 Hormone profile (FSH, LH)

Blood group Other Tests:

Cervical swab for Chlamydia
High vaginal swab to check for presence of vaginal infection
Pelvic ultrasound scan

In some cases these tests can be performed locally by your GP.

The male partner must have:

semen analysis at the Bridge Centre (see separate information).

a HFEA requirement

HIV
Hepatitis B
Hepatitis C

These three tests can be performed locally by your GP or at the Bridge Centre.

Counselling

A fertility counsellor will see all donor and recipient couples prior to treatment. This service will also be available at any time during or after treatment.

We appreciate that this is an emotionally stressful time for you and your partner and it sometimes helps to alleviate stress to talk to someone. The counsellors at the Bridge Centre are very experienced in the field of infertility. Anything you discuss with them will be in strict confidence.

Consent

After receiving information and counselling you will be requested to give your consent to egg sharing. You will be free to modify, or even withdraw, your consent at any time until the eggs are used, but should you do so, you will no longer qualify for a free IVF cycle.

In addition to the statutory consent required, two additional separate agreements will be drawn up, one between the Egg Sharer/donor and the Bridge Centre, and the other between the Egg Recipient and the Centre.

Treatment

Two clinicians will be involved, one responsible for the Egg Sharer/donor and the other one responsible for the overall care of the Recipient.

As advised by the HFEA, "each clinician will act as an independent advocate for their patient, ensuring that their respective needs and wishes are protected throughout the course of their treatment and clinical decisions are made in their best interest".

How are the eggs shared?

To ensure that egg sharing does not compromise the egg provider's treatment, and to ensure that the interests of both parties are respected, The Bridge Centre has drawn up an Egg Sharing Policy, which clearly states a fair, equitable and ethical approach for both parties.

The Bridge Centre's Egg Sharing Policy

If eight or more eggs are collected they will be shared equally between donor and recipient, and at random. In the case of an unequal number of oocytes, the donor will retain the additional egg.
If eight eggs or less are collected, the donor will keep a minimum of four eggs.
If ovarian response is low (i.e. three or less mature follicles) the cycle will be cancelled* and the donor will be discharged from the programme.

*Cancellation of the cycle

In accordance with our standard protocol for IVF, the cycle will be cancelled prior to egg collection if 3 or less mature follicles are available. In this case, you will be discharged from the Egg Sharing Programme.

How many cycles can an egg provider undergo?

If the first cycle is unsuccessful following embryo transfer, subject to a review by a doctor, two further attempts may be allowed.

N.B.

We are obliged to notify the HFEA of any babies born as a result of ovum donation.
It is therefore important to declare any donations made at other centres.
Once this number reaches ten the donor should not donate again unless it is to achieve a sibling pregnancy.
A donor may specify a lower limit than this if she wishes.

Will the donation be anonymous?

Yes.

The Human Fertilisation & Embryology Authority (HFEA) is required by law to keep, on its register, information about individuals who donate gametes (eggs or sperm) and patients who receive this treatment. When they reach the age of 18, any resulting children can apply for non-identifying information about the donor, e.g. ethnic background, eye colour, hair colour, build and height. You will be asked to complete the HFEA registration form at the time of your consultation with a nurse co-ordinator. The form allows you to give details of your occupation and interests, if you so wish. Information held on the register will be kept strictly confidential and may be disclosed by the HFEA only in the specific circumstances permitted by law.

What information will the recipient be given about me?

All information will be non-identifying.

We try to match a donor and recipient's ethnic background and physical characteristics as closely as possible but advise that the result of any matching cannot be guaranteed.

What information will I be given about the recipient?

None. All donations are anonymous. We do not advise you of the outcome of your donation.

Will I have a continuing responsibility to any child born following the donation?

No.

By law (HFEA Act, 1990) the person donating the eggs will not be the legal parent of any resulting offspring. At the time of the donation you relinquish all legal rights and claims over offspring that may result from the donated eggs.

Will I be held responsible if a child born from my donation is disabled in any way?

It is your responsibility to inform us of the possibility of any genetic or inheritable disease present in your immediate family.

Failure to do so is an offence.

It is the right of any child, disabled as a result of failure to pass on this information, to sue the donor for damages.

Most abnormalities, however, result from spontaneous mutation or difficulties at delivery, in which case the donor would not be held responsible.

Will I incur any additional cost?

Once accepted onto the Egg-sharing programme, your IVF cycle of treatment will be free of charge, except for:

a contribution to the cost of cycle and drugs, for which there is a set charge of £275.
the HFEA Licence Fee which is currently £100.

You will also be asked to pay for the following, if they are required:

ICSI
Subsequent frozen / thawed embryo transfer
Assisted hatching
Donor sperm
Anaesthetist present at Egg Collection
Any other special individual or personal medical needs

In addition, the partner of the 'Egg-Share Donor' will be charged for:

all pre-treatment screening investigations and tests, ie HIV, Hepatitis B & C
semen analyses, any back-up sperm freezing and short-term storage
PESA, TESE, freezing and storage following these procedures

The charges for all of the above will be at The Bridge Centre rate current at the time of the procedure concerned.

To register your interest contact Jane Mortlock, (Sharing/Donor Programmes Co-ordinator) by email or telephone 020 7403 3363.