Oocyte donation — recent trends and concerns

Department of Obstetrics and Gynaecology, Monash University, 246 Clayton Road, Clayton, VIC 3168. E Carl Wood, MB BS, FRCS, FRACOG, Professor, and Director of Monash IVF at Epworth Hospital. Reprints: Professor Carl Wood. Since the world's first donor egg birth in 1984, 1 127 pregnancies have resulted from 666 donor egg treatments in Australia. The live birth rate of 15.9% per treatment and the outcome of pregnancies from the use of donor eggs is unremarkable, the rates for miscarriage (20%), ectopic pregnancy (2.4%), stillbirth (0.8%) and live birth (76.4%) being comparable with those for other patients undergoing in-vitro fertilisation (IVF).2.3 Despite the acceptance of donor oocytes by nearly alllVF units, donor egg cycles during 1979-1990 have resulted in many fewer pregnancies (127) than IVF with donor sperm (547 pregnancies).2 The difference may be related to the later development of the use of donor eggs as a method of overcoming infertility, to the difficulty of diagnosing defective oocytes compared with defective sperm as a cause of infertility, or to doubts wives may have about the involvement of another woman, particularly if she is known, in the conception. Gallup polls show that approval by the community of the use of donor sperm and donor eggs is similar (55% and 56% respectively)so there may be no social or cultural influences discriminating between the acceptance of eggs compared with sperm. Concerns about egg donation (indicated by an approval rating of only 56%) reflect social and ethical issues rather than insoluble problems with the technique. Oocyte quality deteriorates with increasing age. 5 The use of donor eggs to reverse the natural decline in fertility with age was demonstrated in a study of 100 women whose average age was 44 years (range, 40-52 years), 27 of whom achieved live births." Reversal of agerelated infertility was supported further by