Infertility is a coin with two sides – it can affect either the man or the woman. For men, it usually takes the form of low sperm count or inhibited sperm motility. There are possible treatments for this, but today we focus only on a female infertility issue: ovarian failure. We spoke with fertility expert Dr. Ajanta Narvekar who explained egg sharing, an option for women who are unable to produce healthy eggs on their own. Egg sharing programs involve egg donation by fertile patients – who receive subsidized IVF treatments in return – with infertile recipients who can afford to pay fully for the IVF treatments.

In order for this arrangement to work, Narvekar says, donors must have completely healthy ovarian function, so that the eggs they produce are viable; in other words, the donor is undergoing IVF because of an infertility issue on her partner’s side. Recipients, on the other hand, are specifically suffering from ovarian failure and need a donation of viable eggs in order to conceive. Through egg sharing, the chance of pregnancy is high, as the donor is usually young, with healthy eggs, and the recipient’s uterine lining is prepared specifically to receive the fertilized donor eggs.

This is an amazing scientific procedure that often makes the seemingly impossible, possible: It significantly increases the chance of becoming a parent for many women who would have been unable. But it’s not without physical (and possibly emotional) ramifications; therefore, Narvekar explains, ethnic profiles and physical characteristics of the donor and recipient can be closely matched, for the comfort of the future family.

The procedure of egg sharing

It seems like a big concept, but the procedure for egg sharing is fairly simple, and Dr. Narvekar broke it down for us. When sharing eggs, both the recipient and the donor are receiving IVF treatments, and their menstrual cycles are purposely synchronized. The recipient is given a hormone replacement treatment that readies the lining of her womb for the implantation of fertilized donor eggs.

A minimum of 12 to 15 eggs are collected from the donor, and they are then shared with the other couple. The donated eggs will be inseminated with sperm from the recipient’s partner, while the remaining eggs will be inseminated with sperm from the donor’s partner. Both couples’ embryos will be transferred to the respective women’s uteri.

Two weeks after the transfer, the recipient can take a pregnancy test to see whether the pregnancy is viable. Assuming it is, the recipient’s treatment then shifts focus to preparing her uterine lining to carry the pregnancy – a concern that the donor likely does not have – through continued hormone replacement treatment. Recipients should continue the prescribed hormonal supplements through the third month of pregnancy; after that, the placenta takes over the production and regulation of the necessary hormones.

The ethics of egg sharing          

As mentioned above, this process is not without physical and emotional considerations. Therefore, Narvekar says, ethical safeguards must be in place to ensure the safety and well-being of all participants in an egg-sharing arrangement:

• Clinicians must inform participating couples that egg sharing does not guarantee a 100% success rate for the donor.
• Women with poor ovarian response or poor egg quality should not be considered as donors.
• Both women’s partners should be consulted and must provide their consent to participate in this course of IVF treatment.
• While fertility treatment centres that support such programs will try to match physical traits and backgrounds of the recipient and donor couples as much as possible, all participants must be informed that the completeness of the match cannot be guaranteed.
• The donor and recipient details must be strictly confidential and completely anonymous. In fact, even the donor and recipient couples cannot know each others’ identities.
• Finally, all participants must be informed that sometimes the process does not generate enough eggs to be shared.  If this happens, the donor gets priority, and the donor couple will proceed with treatment using those eggs.