Oocyte donation: insights gleaned and future challenges

Abstract

With the first successful report of an IVF pregnancy achieved via donor oocytes in 1984, the applications of assisted reproductive technology (ART) were further expanded to include women unable to conceive with their own oocytes. Today, oocyte donation makes up an increasingly large percentage of all ART cycles worldwide. Oocyte donation presents several unique challenges to clinicians as two separate interests, those of the donor and those of the recipient, must be represented. These challenges include successful preparation of the endometrium in donor oocyte recipients, the synchronization of donor/recipient cycles, and the optimization of ovarian stimulation while maximizing donor safety. Facing these challenges has not only allowed for the creation of successful donor egg programs but has also provided insights into many aspects of ART. Much of what we know about the window of implantation, frozen ET procedures, triggering of oocyte maturation, and fertility preservation has been learned through experience and investigations with donor egg cycles. Not only has oocyte donation, through its optimization and wide use, provided new treatment opportunities for patients, it has also become a critical scientific tool to study many aspects of menstrual cycle dynamics and implantation. Concomitantly, with its increased efficiency, it has also raised several clinical and ethical challenges. (Fertil Steril Ò 2018;110:988-93. Ó2018 by American Society for Reproductive Medicine.

Is It Possible to Expand Oocyte Donors by Decreasing Number of Oocytes for Own Use? Insights From a Large Single-Center Study

“…Therefore, in women with advanced infertility, the choice of whether to accept donated oocytes was a sensible decision with respect to both clinical pregnancy success rate and economic benefit ( 24 ). It can be speculated that oocyte donation cycles will become increasingly popular around the world ( 25 , 26 ). Therefore, the requirement of oocytes donated was urgent in many countries, especially in China, whose oocyte donation sources are limited.…”

Agonist triggering in oocyte donation programs—Mini review

“…3) Some reports indicated suboptimal hypophysis response, defined as a serum LH level lower than 12-15 mIU/ml measured 8-12 h after agonist triggering in young low-BMI donors. They postulated a possible connection of iatrogenically induced pituitary downregulation (LH <2 IU/L) caused by previous prolonged oral contraceptive pill (OCP) therapies with low LH levels on the day of GnRH-a triggering (47,48). The only risk factor, significantly confirmed, was the long-term hormonal contraception [odds ratio (OR) 20.97; 95% confidence interval (CI), 5.29-83.14; p < 0.0001) rather than the short-term OCP use as part of a fertility pretreatment (49).…”

Female Fertility Preservation: Current & Future Strategies

“…These include oocyte donation, gestational carriers (surrogates), and adoption. For patients with ovarian factor of infertility, oocyte donation with subsequent IVF is an established modality for providing reproduction [13] . The oocyte from the donor is fertilized with the partner's sperm, and the resultant embryo is then transferred into the female's uterus [13] .…”