30th August 2013 | by Dr. Judith Daniluk
My mother recently asked me to be an egg donor for her best friend – a woman who has been like a second mother to me. She and her new partner desperately want to have a child, but she’s been told her eggs are too old. I’d love to help her and know she’d be a fabulous mom. But I’m 23 and in school, and I’m feeling overwhelmed by the decision. What should I do?
This month’s Ask an Expert question has been answered by our site creator, Dr. Judith Daniluk, a leading researcher and counsellor in the field of women’s sexuality and reproductive health. Learn more about Dr. Daniluk here.
It is understandable that you feel a bit like you’re between a rock and a hard place over this request. Clearly you love and are loyal to your mother. It sounds like you also have a very close relationship with your mom’s friend (let’s call her Sandy, to make this easier), who has been “like a second mother” to you. It is understandable that you don’t want to let either of these important women in your life down. But to be able to make an informed decision about whether you are comfortable donating your eggs to help Sandy become a mother, you actually need to separate your loyalty to your mother and your relationship with Sandy, from the decision to donate, or not to donate your eggs.
Let’s start with looking at the egg donation process. The process of egg donation is not a simple one, and not without risks. In considering whether or not you want to become an egg donor, it is critical that you understand the time (typically 3 – 4 weeks) and effort required, as well as the risks associated with the process. Essentially, the medical process for egg donation is the same as the first part of an in-vitro fertilization (IVF) cycle. The first step involves taking some pretty powerful hormones so the doctors can gain some control over your pituitary gland (which is involved in regulating ovulation). Then you are required to inject your belly with what are known as “superovulation” medications, which are essentially powerful hormones that cause several eggs in your ovaries to mature and be ready to be released. During this time, you’ll be closely monitored through blood tests and ultrasounds, to determine when your eggs are ready to be “harvested”. Harvesting your eggs involves a medical procedure where you are given light sedation, then the eggs on your ovaries are aspirated through a needle that is injected through the wall of your vagina. The harvested eggs are then whisked off to the lab, so that they can be fertilized with Sandy’s partner’s sperm.
In terms of discomfort, some women find that the medications they have to take during the process cause headaches, bloating, and sometimes short-term memory loss. The injections can also become uncomfortable, especially when having to be repeated for several days. As for risks, there is some concern about the long-term consequences of the hormones used in stimulating egg production (e.g. increased risk of breast or ovarian cancer), but there isn’t enough long-term follow-up research on egg donors to know for certain the extent of these risks. It is also unclear whether the egg donation process has a negative effect on a woman’s future fertility. That is one of the reasons some clinics insist on, or prefer, that egg donors have already had their children. The one known risk in this process is hyper ovarian stimulation (OHS). Typically, a woman’s ovary releases one egg a month during her regular cycle. With the drugs used to stimulate ovulation, there may be 10 to 15 eggs that are ready to be “harvested” during an egg donation cycle. However, in very rare cases, the hormones overstimulate the ovaries, resulting in an excessive number of eggs being produced (30, 40 or more). This is a very serious and painful condition, which results in excessive fluid build-up in the abdomen. If left untreated, it can be life threatening.
The next important consideration needs to be your feelings about the outcome of your donation. You need to ask yourself some serious questions. If your donation is successful and results in Sandy and her partner having a child or children (since they could have twins or they could freeze any extra embryos and use them in the future to add to their family):
- Can you be comfortable with the fact that this child or these children will be your genetic offspring but you will have no official role in their lives?
- Can you be comfortable setting emotional boundaries on your relationship with these children, perhaps having a “special” relationship with them but not a maternal role?
- Can you live with Sandy and her partner’s decision about choosing to disclose or not to disclose your identity to their child(ren) when he or she is old enough to understand?
- Can you live with the fact that once you donate your eggs, you will have no legal or moral authority over the future use of the embryos created from your donation?
- If, in the future, you are unable to have children, can you live with knowing that you have genetic offspring but are not a mother? Will you wonder if your decision to donate your eggs contributed to your infertility?
If your donation is not successful, can you be comfortable setting limits on your willingness to undergo the donation process a second or third time? These are not easy questions, but they are important. Before making a decision to donate your eggs, you would be well advised to do some research on the egg donation process, speak with a fertility specialist, and spend some time with a counsellor, who can help you work through the kinds of questions I posed above.
Finally, after working through these important issues, if you feel you are not comfortable donating your eggs to Sandy, you need to have a candid conversation with your mother about your reasons for declining to be an egg donor for Sandy. As much as you may want to help Sandy become a mother, your decision should not be based on a sense of obligation. The physical, personal, and emotional consequences of egg donation are too significant. Ultimately it is your body and your life, so it must be your decision.