Anonymous Oocyte Donation Research Articles

P-492 Providing implications counselling to SA anonymous oocyte donors donating to Australian recipients raising Australian DCC in an open- donor-identity context?

Abstract Study question How do counsellors manage mismatched expectations of stakeholders involved in cross-border oocyte donation between Australia and South Africa with different socio-legal frameworks regarding donor anonymity? Summary answer Cross-border oocyte donation can produce mismatched expectations due to different socio-legal frameworks around donor anonymity between two countries. Counsellors should alert stakeholders to these implications What is known already The demand for oocyte donation in Australia exceeds supply, influencing Australian women to undertake cross-border oocyte donation in South Africa. In Australia, oocyte donation is altruistic and open identity with guaranteed identity release. Conversely, South African oocyte donors are compensated and anonymous. The widespread utilisation of direct to consumer (DTC) ancestry DNA testing and internet-based forums to assist in the interpretation of these results has enabled recipients and donor conceived people (DCPs) to learn the identity of previously anonymous gamete donors. To better prepare stakeholders, some regulatory authorities require counsellors to discuss these implications with donors and recipients. Study design, size, duration Semi-structured in-depth interviews (lasting 45-60 mins) were conducted via zoom and in person in 2022 and 2023. The study included 9 South African infertility counsellors, 16 South African oocyte donors and 12 Australian recipients of cross-border oocyte donation in South Africa. Interviews were recorded and transcribed and transcripts were coded using NVivo software. Data were analysed using thematic analysis Participants/materials, setting, methods Infertility counsellors (9) were recruited through networks of SA fertility professionals. Research participant Australian recipients (12) were recruited through a Facebook peer fertility forum for recipients planning or having completed oocyte donation in SA. Research participant SA oocyte donors were recruited through Facebook advertisements and through snowball sampling resulting from recruitment advertisements placed in clinics and oocyte donor agencies Main results and the role of chance South African oocyte donors anticipated that they would remain anonymous. Some indicated that they would be open to contact should the legal framework in South Africa allow it. As Australian recipients were not required to undergo implications counselling with South African counsellors, the South African counsellors were not aware that recipients pursued the identity of their donors. The counsellors did not alert South African oocyte donors that Australian recipients and DCPs may engage in measures to determine their identity, including via DTC DNA testing and online sleuthing through forums. The Australian recipients believed donor conceived children had a right to know the donor’s identity and donor siblings’ identity, with some wanting early contact. Some recipients took steps to determine their donor’s identity and/or to discover whether their donor conceived children had donor siblings. They suggested that their children could pursue DNA testing in the future, if they wanted to know about their genetic origins. Limitations, reasons for caution The study findings are from 9 SA counsellors, 16 SA oocyte donors and 12 Australian recipients who agreed to be interviewed. They may not represent the views of all stakeholders involved in cross-border oocyte donation between Australia and South Africa. Wider implications of the findings Stakeholders involved in cross-border oocyte donation between anonymous donor and open identity settings should receive implications counselling to avoid a mismatch in the consequences of donor-conception. Trial registration number not applicable

#312 : Outcomes for Women Who Utilise Electively Frozen Oocytes

Background and Aims: Frozen oocyte thaw (FOT) cycles are becoming increasingly common within IVF clinics in Australia, as women choose to freeze eggs and delay using those eggs until a more suitable time. Typically, Australian women freezing eggs are older than those women who have been studied in overseas FOT cycles. The aim of this study was to report outcomes of FOT cycles. Method: We performed a retrospective cohort study of 141 FOT cycles (from 129 patients) over a 10-year period from January 2010 to December 2020, at a single IVF clinic in Adelaide, Australia. We assessed the outcomes of those cycles in terms of oocyte warm survival, ICSI fertilisation rates, utilisation rates, pregnancy rates and live birth rates. Results: The average age of women undergoing FOT cycles was 36.5 ± 4.9 years. The reasons for egg freezing cycles included male factor (45.5%), elective (44.1%), religious (6.3%), fertility preservation (2.8%) and anonymous oocyte donation (1.4%). From the 143 FOT cycles, 1094 oocytes were collected; 82% of oocytes survived the warm process and 62% fertilized normally. There were 59 fresh embryo transfers (5.1% cleavage and 94.9% blastocyst, 22.0% DET and 78% SET) and 32 frozen blastocyst embryo transfers (12.5% DET and 87.5% SET). The pregnancy rate per fresh transfer was 30.0% (18/59) and per frozen transfer was 37.5% (12/32). The live birth rate per fresh transfer was 27% (16/59) and per frozen transfer was 37.5% (12/32). The live birth rate per initiated FOT cycle was 11% (16/143). Conclusion: Rates of live birth per initiated FOT cycle at our clinic was 11%, similar to the ANZARD live birth rate for all fresh cycles initiated in 2020 (10.9%). We therefore conclude that results for frozen oocytes are equivalent to fresh oocytes and can use this information when counselling patients on the outcomes of FOT cycles.

P-579 Preliminary data on family relations in anonymous oocyte donation families: children’s perspectives at age 5 to 7 years

Abstract Study question Do children born in oocyte donation families perceive their relationships with their parents differently than children conceived trough ICSI? Summary answer No significant differences were found in the family relationships between children born in oocyte donation families (OACC) compared with controls (ICSI). What is known already Majority of the previous research concerning relationships in families using oocyte donation focused on the mothers’ perspective. Little is known about how children in these families view their family relationships. Studies investigating young children’s perspectives in donor-families (5-10 years old) indicate good parent-child relationships (Imrie, et al., 2021; Blake, et al., 2013; Casey, et al., 2013). Few of these studies involve young children conceived using anonymous oocyte donation. Study design, size, duration This study included 17 children born through anonymous oocyte donation in heterosexual parents and a comparison group of 13 children conceived ICSI using the heterosexual parents’ own gametes. Data were collected between August 2021 and January 2023. The sample is part of a larger ongoing case-control-study investigating family relationships and the wellbeing of both parents and their children in families created by anonymous oocyte donation. Participants/materials, setting, methods Children were 5 to 7 years old (M = 6.13; SD = 0.5) and had been born after assisted reproduction (ICSI with or without using anonymous oocytes) with their two heterosexual parents. All children were invited to the hospital to undergo biomedical and psychological testing, including the Family Relationship Test (FRT; English version: Bene and Anthony, 1985; Dutch version: Baarda and van Londen, 1985). Multiple blind evaluators were used. Main results and the role of chance No significant differences were found between children born in oocyte donation families (OACC) compared with controls (ICSI). Two-sampled-T-tests show no significant differences for (1) positive feelings (towards and received by children) to their mothers (OACC: M = 6.65, SD = 4; ICSI:M=8.85, SD = 4), fathers (OACC: M = 5.06, SD = 0; ICSI: M = 5.08, SD = 0) or themselves (OACC: M = 0.35, SD = 0.5; ICSI: M = 0.77, SD = 0), (2) negative feelings (towards and received by children) to their mothers (OACC: M = 1.47, SD = 0.5; ICSI: M = 1.92, SD = 4), fathers (OACC: M = 2.06, SD = 0; ICSI: M = 2.31, SD = 0.5) or themselves (OACC: M = 0.76, SD = 0; ICSI: M = 0.38, SD = 0) and (3) dependency to their mothers (OACC: M = 4.29, SD = 3; ICSI: M = 4.54, SD = 0), fathers (OACC: M = 2.82, SD = 1; ICSI: M = 2.69, SD = 2) or themselves (OACC: M = 0.53, SD = 0.5; ICSI: M = 0.85, SD = 0.5). Limitations, reasons for caution This study used multiple evaluators, which may induce a potential evaluators bias. The small sample size limits the validity of our findings to a whole population. As the study is still ongoing, the data to be presented will expand. Wider implications of the findings The findings are relevant to clinics offering anonymous oocyte donation, to (future) parents who used or who considerate using anonymous oocyte donation to create a family. Trial registration number not applicable

P-772 Three-dimensional folliculometry (SonoAVC) provides a better estimation of total and mature oocyte yields compared to conventional two-dimensional assessment in oocyte donors: a prospective, cohort study

Abstract Study question Does three-dimensional folliculometry (using SonoAVC) provide a better estimate of the number of retrieved and mature oocytes in egg donors compared to conventional two-dimensional assessment? Summary answer Three-dimensional folliculometry was superior to the two-dimensional ultrasound assessment and provided an excellent prediction (+/-20%) of total oocyte yield in almost two-thirds of participants. What is known already When used for monitoring ovarian stimulation, 3-D folliculometry has been shown to reduce inter-, and intra-observer variability and was significantly faster than conventional, two-dimensional ultrasound assessment (Vandekerchove F, 2014, Rei 2019). Although so far, no study has demonstrated improved clinical outcomes in IVF patients, the impact of 3D-folliculometry was not yet thoroughly evaluated in oocyte donation programmes, where expected total and mature oocyte yield is a crucial variable. Study design, size, duration Ninety-one consecutive oocyte donors were prospectively evaluated using three-dimensional folliculometry with SonoAVC software (E8, General Electric). A single operator (DB) performed all 3D ultrasound measurements immediately before starting oocyte retrieval and the oocyte retrieval procedure too. Two-dimensional measurement of follicles (average of two perpendicular diameters) was performed two days before egg retrieval by a single operator (NR) (Mindray DC7). Oocyte donors’ age (26.2±3.7 years), BMI (23.8±3.9), and baseline AMH (4.6±2.3 ng/mL) were also registered. Participants/materials, setting, methods Voluntary, anonymous oocyte donors were stimulated with a GnRH antagonist protocol and triggered with a GnRH agonist. Good, moderate, and poor prediction by ultrasound were defined as an oocyte/follicle count ratio of 80-120% (+/-0-20%), 60-79% or 121-140% (+/- 21-40%), and less than 60% or more than 140% (+/- more than 40%), respectively. For total oocyte yield, a threshold of all follicles 13 mm or above was used, both for the two- and three-dimensional assessment. Main results and the role of chance The number of total and mature oocytes retrieved was 22.2±9.4 and 19.0±8.3, respectively with an excellent average maturity rate of 86% (range: 44-100%). No donors were excluded from the study due to suboptimal visualization of ovaries with SonoAVC. For total oocyte yield; good, moderate, and poor prediction was achieved in 37, 44, 19% of donors with two-dimensional and in 63, 29, 8% of participants with three-dimensional folliculometry, respectively (p = 0.002). Significant underestimation of total oocyte yield (defined as more than 6 „missing” total oocytes) was less frequent with 3D assessment (12 versus 25% p = 0.022). For total oocyte yield, linear regression analysis showed a significantly higher r-square value with three-dimensional assessment (0.676 vs 0.278). For mature oocytes, the prediction was less precise than for total oocyte yield. Good, moderate, and poor prediction was achieved in 40, 30, 30% of donors with two-dimensional and in 55, 30, 15% of participants with three-dimensional folliculometry, respectively (p = 0.031). For mature oocytes, linear regression analysis showed a significantly higher r-square value with three-dimensional assessment (0.664 vs 0.282). The best SonoAVC threshold to predict total and mature oocyte yields was the sum of all follicles equal or above 13 mm and total follicle count between 24-13 mm, respectively. Limitations, reasons for caution Due to practical reasons, three- and two-dimensional measurements were not performed on the same day or with the same ultrasound equipment. In future studies, 3D-folliculometry could be used at the egg collection scheduling (2-3 days before the procedure) so that predictive information on oocyte yield would be available earlier. Wider implications of the findings Apart from reducing inter-observer variability and diminishing discomfort (faster examination time), 3D-folliculometry might have a significant role in the management of OD programmes by improving the prediction of total/mature oocyte yields. 3D-measurements performed before the procedure could also play a role in the quality control of the egg collection procedure. Trial registration number Not applicable

EGG DONATION: EXPLORING ATTITUDES OF STUDENTS TOWARDS DONATION

Conception with donated oocytes represents an important option for overcoming sterility, but brings with it numerous dilemmas, which have been dealt with differently in various European countries. In the Republic of Serbia, anonymous oocyte donation is legal, and donors include women from the general population, and women undergoing IVF. This is a new phenomenon in our society, for which the law requires promotion. In order for the campaign to be appropriate, it is necessary to learn about existing attitudes. This research was carried out with the aim of determining the attitudes of students towards egg donation (N = 503; 206 young men, 297 young women). A questionnaire was used, designed based on the scale used by Swedish authors to study the attitudes of potential donors (Skoog-Svanberg, Lampic, Bergh, & Lundkvist, 2003). The obtained results indicate that there are generally positive attitudes towards oocyte donation, but that most respondents are reserved regarding the issue of propagating donors in the media. Most of the respondents are unsure regarding donation from IVF, and when asked about donor anonymity and the right of the child to learn its genetic origin, they showed signs of oscillating and supporting contradictory options. Even though this study was carried out on a student population, it is possible to identify significant guidelines for the start of the promotion of voluntary egg donation in RS, as well as implications for future research.

In-vitro development of embryos derived from vitrified-warmed oocytes is delayed compared with embryos derived from fresh oocytes: a time-lapse sibling oocyte study.

Is there a difference in blastocyst formation between fresh and vitrified-warmed sibling oocytes and can this difference be attributed to changes in embryo morphokinetics? Between February 2016 and December 2017, 472 metaphase II (MII) oocytes in 67 donor-recipient cycles from 27 different healthy anonymous oocyte donors were allocated for fresh transfer (FSHO) (n = 220) to a synchronous recipient (n = 36) or vitrified (VITO) (n = 252) to be warmed and transferred to another recipient (n = 31). Embryos derived from the FSHO and their sibling VITO were analysed for morphokinetic development using time-lapse imaging, blastocyst formation and clinical outcome. Time-lapse analysis showed an overall delay in cleavage rate from the time of pronuclei disappearance up to the time of blastulation in the VITO compared with their sibling FSHO. Twelve morphokinetic variables were significantly different between the groups. On Day 5 significantly more FSHO embryos developed to blastocyst (expansion 1-6) and reached the full blastocyst stage (expansion 3-6) compared with the VITO embryos [53.2% (84/158) versus 40.0% (64/160); P = 0.0244 and 48.1% (76/158) versus 31.3% (50/160); P = 0.0028, respectively]. The embryo utilization rate was similar in both groups at the time of cryopreservation; 51.3% (FSHO) versus 45.0% (VITO) (P = 0.3124). The pregnancy rate per cycle was 47.2% (17/36) in FSHO patients and 48.4% (15/31) in VITO patients (P = 1). Limitations in this study: non-randomized, small study size and not powered to detect differences in clinical outcomes. Timing of development is altered and blastocyst formation is delayed in embryos derived from vitrified-warmed donor oocytes compared with their fresh sibling counterparts. Although preliminary results suggest that the clinical impact of this delay may be limited, this needs further investigation in larger randomized studies.

“I want us to be a normal family”: Toward an understanding of the functions of anonymity among U.S. oocyte donors and recipients

Background: Anonymity remains the more common practice in gamete donations, but legislation prohibiting anonymity with a goal of protecting donor-conceived children’s right to know their genetic origins is becoming more common. However, given the dearth of research investigating the function of anonymity for donors and recipients, it is unclear whether these policies will accomplish their goals. The aim of this study was to explore experiences with anonymity among oocyte donors and recipients who participated in an anonymous donor oocyte program and to understand the ways in which anonymity functions for them. Methods: Semistructured interviews were conducted with 50 women: 28 oocyte donors and 22 recipients who were recruited from an academic center for reproductive medicine in the United States. Results: Donors and recipients view anonymity both as a mechanism to protect the interests of all parties (recipients, donors, and donor-conceived children) and as a point of conflict. Specifically, three key areas were identified where both donors and recipients saw anonymity as having an important role: relieving anxieties about family structures and obligations; protecting their interests and those of donor-conceived children (while acknowledging where interests conflict); and managing the future. Conclusion: As gamete donation increasingly moves away from the practice of anonymity, examining why anonymity matters to stakeholders will be helpful in devising strategies to successfully implement identity-release options.

Blastocyst freeze-all strategy versus fresh transfer in anonymous oocyte donation cycles

Blastocyst freeze-all strategy versus fresh transfer in anonymous oocyte donation cycles

Estimating Frequency and Parental Origin of Embryo Aneuploidy: A Retrospective Analysis of Anonymous Donor Oocyte IVF Data

Since oocyte donors are typically a source of highly competent gametes, donor oocyte IVF is considered an effective treatment for diminished ovarian reserve. However, the aneuploidy rate for embryos originating from anonymously donated oocytes remains incompletely characterized.

Determining parental origin of embryo aneuploidy: analysis of genetic error observed in 305 embryos derived from anonymous donor oocyte IVF cycles.

BackgroundSince oocyte donors are typically young and believed to be a source of highly competent gametes, donor oocyte IVF is considered to be an effective treatment for diminished ovarian reserve. However, the aneuploidy rate for embryos originating from anonymously donated oocytes remains incompletely characterized. Here, comprehensive chromosomal screening results were reviewed from embryos obtained from anonymous donor-egg IVF cycles to determine both the aneuploidy rate and parental source of the genetic error. To measure this, preimplantation genetic screening (PGS) data on embryos were retrospectively collated with parental DNA obtained before IVF for chromosome-specific assessments. This approach permitted mitotic and meiotic copy errors to be differentiated for each chromosome among all embryos tested, thus providing information on the parental source of embryo aneuploidy (i.e., from the anonymous egg donor vs. sperm source).Results305 embryos generated for 24 patients who began IVF treatment in 2013. For oocyte donors (n = 24), mean (±SD) age was 24.0 ± 2.7 years (range = 20-29). For embryos with full chromosomal reporting (n = 284), euploidy was present in only 133 (46.8%). Considering all embryo chromosomes, the average error rate was 18%. 133 of 151 observed embryo aneuploidies (88.1%) were attributable to an oocyte donor source. Among all aneuploid embryos (n = 151), chromosomal errors from both genetic parents (i.e., oocyte donor and sperm source) were present in 57%. The average correlation coefficient across all pairs of chromosomal abnormalities (r = 0.60) suggests that chromosomes tend to have multiple and simultaneous errors (complex aneuploidy) even when oocytes from young donors are used.ConclusionThese data show that even when young donors provide oocytes for IVF, the probability of embryo aneuploidy remains high. The oocyte donor appears to make an important contribution to embryo aneuploidy even when her age is <30 yrs. If these findings are confirmed with larger, prospective studies, the routine integration of PGS with donor oocyte IVF cycles to identify single euploid embryos for transfer should be considered.

Cost effectiveness of utilizing cryo-bank oocytes versus fresh donor oocytes in an anonymous oocyte donation program

Advances in cryopreservation have led to comparable ongoing pregnancy rates in oocyte donor in vitro fertilization (IVF) cycles utilizing either cryo-bank oocytes or fresh oocyte donation. We evaluated the cost effectiveness of utilizing cryo-bank donor oocytes compared to that of fresh donor oocytes in an anonymous oocyte donation program.

Ovarian dysgenesis associated with an unbalanced X;6�translocation: First characterisation of reproductive anatomy and cytogenetic evaluation in partial trisomy 6 with breakpoints at Xq22 and 6p23

The aim of this study was to describe the clinical and laboratory findings associated with a previously unreported unbalanced X;6 translocation. Physical examination, reproductive history and cytogenetic techniques were used to characterise a novel chromosomal anomaly associated with gonadal dysgenesis. A healthy non-dysmorphic 23 year-old phenotypic female with primary amenorrhea and infertility presented for reproductive endocrinology evaluation. No discrete ovarian tissue was identified on transvaginal ultrasound, although the uterus appeared essentially normal. BMI was 19 kg/m2. Serum FSH and oestradiol were 111 mIU/ml and 15 pmol/l, respectively. TSH, prolactin and all infectious serologies were all normal. The karyotype of 46,X,der(X)t(X;6)(q22;p23) was determined following cytogenetic analysis of peripheral blood lymphocytes via fluorescence in situ hybridisation (FISH) with whole chromosome paint for chromosome 6, and a separate FISH analysis using a 6p subtelomeric probe. The patient was continued on hormone replacement therapy and underwent genetic counselling; the patient subsequently enrolled as a recipient in an anonymous donor oocyte IVF treatment. Translocations involving autosomes and chromosome X are rare. While female carriers of balanced X;autosome translocations are generally phenotypically normal, the impact of unbalanced X;autosome translocations can be severe. This is the first known report of an unbalanced translocation involving X;6. This abnormality was associated with ovarian dysgenesis, but an otherwise normal female phenotype. From this investigation, the observed developmental impact of the unbalanced translocation with breakpoints at Xq22 and 6p23 appears to be limited to ovarian failure.

Predictive value of antral follicle count among anonymous oocyte donors in an egg-sharing donor program

Predictive value of antral follicle count among anonymous oocyte donors in an egg-sharing donor program

Recipient screening in IVF: First data from women undergoing anonymous oocyte donation in Dublin

BackgroundGuidelines for safe gamete donation have emphasised donor screening, although none exist specifically for testing oocyte recipients. Pre-treatment assessment of anonymous donor oocyte IVF treatment in Ireland must comply with the European Union Tissues and Cells Directive (Directive 2004/23/EC). To determine the effectiveness of this Directive when applied to anonymous oocyte recipients in IVF, we reviewed data derived from selected screening tests performed in this clinical setting.MethodsData from tests conducted at baseline for all women enrolling as recipients (n = 225) in the anonymous oocyte donor IVF programme at an urban IVF referral centre during a 24-month period were analysed. Patient age at programme entry and clinical pregnancy rate were also tabulated. All recipients had at least one prior negative test for HIV, Hepatitis B/C, chlamydia, gonorrhoea and syphilis performed by her GP or other primary care provider before reproductive endocrinology consultation.ResultsMean (±SD) age for donor egg IVF recipients was 40.7 ± 4.2 yrs. No baseline positive chlamydia, gonorrhoea or syphilis screening results were identified among recipients for anonymous oocyte donation IVF during the assessment interval. Mean pregnancy rate (per embryo transfer) in this group was 50.5%.ConclusionWhen tests for HIV, Hepatitis B/C, chlamydia, gonorrhoea and syphilis already have been confirmed to be negative before starting the anonymous donor oocyte IVF sequence, additional (repeat) testing on the recipient contributes no new clinical information that would influence treatment in this setting. Patient safety does not appear to be enhanced by application of Directive 2004/23/EC to recipients of anonymous donor oocyte IVF treatment. Given the absence of evidence to quantify risk, this practice is difficult to justify when applied to this low-risk population.

The Number of Useable Embryos per Oocyte Retrieved is Reduced in Cycles Where More than Twenty Oocytes are Retrieved in Anonymous Egg Donors

BACKGROUND AND SIGNIFICANCE: The reduction of clinical outcomes in cycles where high numbers of oocytes are retrieved has been debated in the literature. The hypothesis that extremely super physiological estrogen concentrations may impair implantation has been discussed as has the direct effect on embryo viability. In order to be able to study the effect of high numbers of oocytes retrieved independent of the many variables infertility type brings, this study was performed on anonymous oocyte donors only.

Anti-Müllerian hormone testing is useful for individualization of stimulation protocols in oocyte donors

While the age of a donor is a fundamental factor to the success of donor IVF, no serum markers have been demonstrated to be useful in predicting variability of ovarian response in individual donors. Anti-Müllerian hormone (AMH) has been described as an accurate marker of ovarian response in patients undergoing IVF, but has not been applied to oocyte donors. AMH concentrations from 104 anonymous oocyte donors between the ages of 21-32 years were studied and IVF outcome parameters compared. AMH was correlated with several parameters including the number of oocytes retrieved ( r = 0.232, P = 0.024), the peak oestradiol concentrations ( r = 0.235, P = 0.024) and the need to decrease gonadotrophin dose in order to avoid ovarian hyperstimulation syndrome ( r = 0.274, P = 0.007). Receiver operating curve analysis was able to identify an AMH threshold that rendered about 70% sensitivity and 70% specificity for predicting the need to decrease gonadotrophin dosing. The clinical pregnancy rate was 77% per recipient and was not related to the donors' AMH concentrations. For oocyte donors, measurement of AMH appears most useful for determining gonadotrophin sensitivity in order to mitigate symptoms consistent with ovarian hyperstimulation.

Application of EU Tissue and Cell Directive screening protocols to anonymous oocyte donors in western Ukraine: Data from an Irish IVF programme

Anonymous oocyte donation in the EU proceeds only after rigorous screening designed to ensure gamete safety. If anonymous donor gametes originating from outside EU territory are used by EU patients, donor testing must conform to the same standards as if gamete procurement had occurred in the EU. In Ireland, IVF recipients can be matched to anonymous donors in the Ukraine (a non-EU country). This investigation describes the evolution of anonymous oocyte donor screening methods during this period and associated results. Data were reviewed for all participants in an anonymous donor oocyte IVF programme from 2006 to 2009, when testing consistent with contemporary EU screening requirements was performed on all Ukrainian oocyte donors. HIV and hepatitis tests were aggregated from 314 anonymous oocyte donors and 265 recipients. The results included 5,524 Ukrainian women who were interviewed and 314 of these entered the programme (5.7% accession rate). Mean age of anonymous oocyte donors was 27.9 years; all had achieved at least one delivery. No case of hepatitis or HIV was detected at initial screening or at oocyte procurement. This is the first study of HIV and hepatitis incidence specifically among Ukrainian oocyte donors. We find anonymous oocyte donors to be a low-risk group, despite a high background HIV rate. Following full disclosure of the donation process, most Ukrainian women wishing to volunteer as anonymous oocyte donors do not participate. Current EU screening requirements appear adequate to maintain patient safety in the context of anonymous donor oocyte IVF.

Evaluating the necessity for universal screening of prospective oocyte donors using enhanced genetic and psychological testing

To minimize the potential for harmful inheritable conditions, donors are rigorously screened according to standard guidelines, yet such guidelines may not be sufficient to exclude egg donors with certain known inheritable conditions. We compared universal screening of oocyte donors with Tay-Sachs, Fragile X, karyotype and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) versus standard American Society of Reproductive Medicine (ASRM) guidelines that do not include such testing. In this 12 year retrospective cohort study, results of enhanced universal screening of all anonymous oocyte donor candidates from 1997 to 2008 at a university hospital oocyte donation program were reviewed. Primary outcomes were the frequency of oocyte donor candidates excluded as a result of enhanced universal screening (Tay-Sachs, Fragile X, karyotypic analysis and MMPI-2) versus basic screening according to ASRM guidelines. Of 1303 candidates who underwent on-site evaluation, 47% passed the screening process, 23% were lost to follow-up and 31% were excluded. Genetic and psychological factors accounted for the most common reasons for candidate exclusion. Enhanced genetic screening excluded an additional 25 candidates (19% of all genetic exclusions) and enhanced psychological screening excluded an additional 15 candidates (12% of all psychological exclusions). Altogether enhanced screening accounted for 40 candidates (10%) of the total pool of excluded candidates. Although our study is limited by its retrospective nature and center-specific conclusions, we show that enhanced comprehensive screening can exclude a significant number of candidates from an oocyte donor program and should be encouraged to assure optimal short-term and long-term outcomes for pregnancies achieved through oocyte donation.

IVF for premature ovarian failure: first reported births using oocytes donated from a twin sister

BackgroundPremature ovarian failure (POF) remains a clinically challenging entity because in vitro fertilisation (IVF) with donor oocytes is currently the only treatment known to be effective.MethodsA 33 year-old nulligravid patient with a normal karyotype was diagnosed with POF; she had a history of failed fertility treatments and had an elevated serum FSH (42 mIU/ml). Oocytes donated by her dizygotic twin sister were used for IVF. The donor had already completed a successful pregnancy herself and subsequently produced a total of 10 oocytes after a combined FSH/LH superovulation regime. These eggs were fertilised with sperm from the recipient's husband via intracytoplasmic injection and two fresh embryos were transferred to the recipient on day three.ResultsA healthy twin pregnancy resulted from IVF; two boys were delivered by caesarean section at 39 weeks' gestation. Additionally, four embryos were cryopreserved for the recipient's future use. The sister-donor achieved another natural pregnancy six months after oocyte retrieval, resulting in a healthy singleton delivery.ConclusionPOF is believed to affect approximately 1% of reproductive age females, and POF patients with a sister who can be an oocyte donor for IVF are rare. Most such IVF patients will conceive from treatment using oocytes from an anonymous oocyte donor. This is the first report of births following sister-donor oocyte IVF in Ireland. Indeed, while sister-donor IVF has been successfully undertaken by IVF units elsewhere, this is the only known case where oocyte donation involved twin sisters. As with all types of donor gamete therapy, pre-treatment counselling is important in the circumstance of sister oocyte donation.

Impact of male age on the outcome of assisted reproductive technology cycles using donor oocytes

This study assessed the influence of the age of the male partner on the outcome of oocyte donation cycles. A total of 408 couples participating in 519 consecutive anonymous oocyte donation cycles were examined. Main outcome measures were fertilization rate, embryo quality, clinical pregnancy, implantation, miscarriage and live birth rates, as well as the total reproductive potential, which estimates the outcome from fresh and cryopreserved-thawed embryo transfers. A total of 241 cycles resulted in clinical pregnancy (48.5% of transfers). The mean embryo score for transferred embryos (ESTE) was higher in cycles resulting in pregnancy (P=0.003). Semen volume (P<0.001), sperm motility (P<0.001) and fertilization rate (P=0.04) decreased significantly with advanced male age, which did not correlate with mean ESTE or implantation rate. Fertilization rate was the only predictor of ESTE (B=16.066, P=0.012), whereas inseminated/retrieved egg ratio was the only predictor of implantation rate (B=0.555, P=0.039). Pregnancy was only predicted by ESTE (Exp(B)=1.023, P<0.001), which also was the only predictor of live birth (Exp(B)=1.017, P=0.009). There was no predictor of miscarriage (47 cycles, 9.1%) identified. Although semen volume, sperm motility and fertilization rate decreased with advanced male age, embryo quality, clinical pregnancy, implantation, miscarriage and live birth rates were not affected.