Gamete donation

 

Introduction. The search for a child is not always easy and, in fact, although it is a far from automatic step, around 20% of women with infertility problems have to resort to heterologous procedures to become a mother. Heterologous fertilisation is a medically assisted procreation procedure involving the use of gametes (oocytes and/or spermatozoa) from a donor and/or a donor outside the couple. The gametes mainly come from banks in other European countries. Donors are selected in accordance with criteria established by European regulations that ensure the possibility of using oocytes and sperm in heterologous treatments in absolute safety. Compatibility between donors and recipients includes ethnicity, hair colour, eyes and blood group. In Italy, the child cannot know the donor or the donor; this is only possible in the case of a disease found in the born child that has some advantage in a genetic investigation in the male or female donor.

 

Indications. Egg donation is not an automatic step for every couple, but a process that should only be initiated after thorough examinations have been carried out and an inability to conceive otherwise found. The egg donation procedure is intended for those who:

 

• do not produce quality oocytes due to age orendometriosis, which affects 10% of the female population and is considered one of the main causes of infertility

 

• suffer from early menopause or surgical menopause due to the removal of both ovaries, e.g. for cancer

 

• comes from repeated failures having failed to conceive with any other PMA technique

 

• suffers from genetic diseases that can be transmitted to the unborn child, such as Cystic Fibrosis.

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​​ How it is performed. In egg donation, the ova of the anonymous donor are fertilised in vitro with the semen of the couple's male partner in order to obtain embryos to be transferred into the recipient's uterus. Prior to retrieval, the donor undergoes ovarian stimulation with hormones to increase the production of mature oocytes, while the recipient undergoes endometrial preparation with oestrogen to make the uterus more receptive to embryos. Once the mature gametes (oocytes) have been selected and recovered, In Vitro Fertilisation is carried out with the sperm of the recipient's partner. At this point all that remains is to carry out the transfer of the embryos into the uterus of the woman undergoing treatment and wait the classic 15 days before performing the pregnancy test and checking the success of the therapy. In the event of success, the pregnancy will follow its natural course just as it would for any other pregnant woman.

Prognosis. The procedure, usually intended as a last resort to realise many couples' desire for parenthood, has very high success rates when compared to other medically assisted procreation techniques. A godsend in short!

 

Conclusions. In heterologous IVF programmes, also called heterologous treatments, gamete donation (egg or sperm) is used when one of the two parents is infertile and, consequently, a gamete from a third person, the so-called donor, must be used to achieve a pregnancy. In April 2014, the Constitutional Court (sentence 162) declared illegitimate the ban on heterologous fertilisation (with gamete from a person outside the couple) imposed by Law 40/2004 on PMA. As of today, therefore, even in Italy, couples who have no real and documented possibility of conceiving a child due to problems of sterility or incurable infertility may use the donation of gametes, both male (spermatozoa) and female (oocytes) external to the couple itself to undergo medically assisted procreation techniques. This procedure in Italy is only lawful for couples of different sexes, married or cohabiting with diagnosed infertility. Neither single women nor same-sex couples may use gamete donation.