Trounson and colleagues reported the first pregnancy after transfer of a donated, oocyte fertilized in vitro to a cyclic recipient in 1983. The following year, the same group reported the achievement of a pregnancy in a patient with primary ovarian failure.
Main Indications for Oocyte Donation
Women without ovarian function
1) Premature ovarian failure
Almost 50% of all oocyte recipients suffer from premature ovarian failure (POF). The most commonly accepted definition of POF is ovarian failure before the age of 40 years- strictly, it is ovarian failure two standard deviations before the mean age of menopause of the study population. It is estimated that 1-3%of women experience premature menopause. This is associated with 10-20%of cases of primary amenorrhea and up to 18% of cases of secondary amenorrhea. The main causes of premature ovarian failure are:
1) Idiopathic: in the majority of cases of premature ovarian failure no definite etiology cabn be established;
2) Genetic, e.g. Turner’s syndrome, pure gonadal dysgenesis and familial
3) Immunological, e.g. DiGeorge’s syndrome;
5) Iatrogenic, including surgical oophorectomy, chemotherapy and radiotherapy.
2) Resistant ovary syndrome
This syndrome is characterized by amenorrhea, normal secondary sexual characteristics and high levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH). It is thought that resistant ovary syndrome could be due either to a lack of sensitivity of the gonadotropin receptors or to a defect in the adenylate cyclase system. Sometimes spontaneous pregnancies occur, suggesting that the sensitivity of the receptors to gonadotropins can be reversible.
Women with ovarian function
Carriers of genetic diseases or chromosomal abnormalities
Couples at risk of having children with fatal or severely disabling inherited diseases may request oocyte donation. Although antenatal diagnosis is available for an increasing number of these conditions, for some couples termination of pregnancy is unacceptable. Recent advances in preimplantation diagnosis have enabled couples to undergo In Vitro Fertilization (IVF) and preimplantation embryo biopsy and transfer of normal embryos.
Repeated IVF failures
This could be due to:
1) Poor response to superovulation drugs;
2) Repeated failure of oocyte recovery;
3) Repeated failure of fertilization due to poor oocyte quality;
4) Repeated failure of implantation of apparently normal.
Older women undergoing IVF – embryo transfer (IVF-ET) should receive adequate counseling about the likelihood of achieving a live birth. Those patients with reduced ovarian reserve or poor oocyte quality should be offered alternatives, including oocyte and embryo donation.
Screening of Donors
It is essential that donors are screened for genetic and infectious diseases to prevent transmission of disease to recipient or their offspring.
Oocyte or ovum donation is an accepted form of assisted conception treatment. It offers an excellent opportunity for women to achieve a pregnancy and live birth. This group includes women with premature menopause, genetic diseases, recurrent ivf failures of IVF treatment and older women.