“Donating an egg is not like donating a child” Juan José Guillén: “Donating an egg is not like donating a child” Doctor Juan José Guillén is the director of the Egg Donation Programme in EUGIN (OVODON) and is in charge of coordinating the team which follows up the donation: the gynaecologists who see the donors, the nurses who provide the medicine, the psychologist who evaluate the process and rule out possible psychological disorders and lastly, the team of biologists who carries out In Vitro fertilisation in the laboratory. On a daily basis the clinic receives egg donors wanting to help women who cannot have children for different reasons. For approximately two weeks donors undertake a pharmacological treatment which consists of administering hormones that stimulate the ovaries so that they produce more than one egg. These eggs are donated to women who have difficulties in conceiving by their own means and are fertilised with the sperm of the patient’s male partner or that issued from a sperm bank, if necessary. Doctor Guillén has explained in detail what the egg donation involves, what steps to follow and has given his opinion on the gynaecological and ethical aspects of this procedure. How long have you been working in egg donation? I have been in charge of the Egg Donation Programme in EUGINE since 2001 and my experience has been very satisfying because this Assisted Reproduction procedure has increased considerable. It Works very well, donors are happy and the results are excellent. Has egg donation changed? The truth it has changed. Different centres have different donor stimulation procedures. We follow our own guidelines because the results obtained are very positive and donors receive treatment for fewer days than with other guidelines. What does it involve? We use a short protocol which is reduced to two weeks whereas in other centres it is around three weeks. Moreover, our system provides workshops for donors to learn to inject the medicine so that it is not necessary for the donor to come to the clinic more than three times. In this way she can continue with her daily routine. What should donors know before beginning the treatment? They should understand the importance of what they are about to undergo – thanks to them another woman can be a mother. And you only know the importance of this when you want to become one and you cannot. Moreover, they should be informed about the process which goes hand in hand with egg donation, understand that it is not easy and can cause some minor inconvenience. What inconveniences are there? The donor has to undergo a gynaecological check-up, a series of analyses, genetic examinations and the treatment. However, it is important that she knows that the majority of patients are satisfied both in the short and long term and that problems she may have are minor. What does the donor have to know about the ethical implications of the donation? Donors should understand that they are donating a cell with genetic material but in no case are they donating a child because without the male cell there would be no embryo. Another concern is whether the donation can endanger the donor’s own future maternity. She has to know that she will be able to become a mother if she is not already. When is the egg donation considered successful? The donation is successful if the donor does not have any problems and a sufficient number of eggs is obtained for the recipient. Complete success is when the recipient becomes pregnant, which is the principal aim of the donation. And a failure? It would be a failure if the results of the stimulation cycle were unsatisfactory, with few eggs and of bad quality, or if the donor had problems which would lead to her hospitalisation, a very unlikely case. It is a considerable responsibility for the donors because they have to follow certain protocol and not skip a step... That is right, the donors take on an obligation with involves responsibility on their behalf and yes, they are responsible. Actually, for the number of donations we have there are very few cases where the patients do not follow the guidelines or leave the treatment half way through. This success is not only shared by the donors but also by the whole team of the Egg Donation Programme who continually try to improve the process. What difference is there in donating genetic material and an organ? Do donors understand this? It cannot be compared. It is important to understand when with the egg donation only one cell with genetic material is donated. This cell has to meet another cell with genetic material, be fertilised and then develop into an embryo which will grow inside the recipient’s body. So, donors should not see the egg donation as the donation of a child. How is this explained to the donor? The concept of the child is a much more complex concept. The embryo is transferred to develop inside the recipient’s body and she is the only person who should have the concept of being the mother. What is for sure is that the recipient’s child will have half of the donor’s genetic information. Can we compare an egg donor to a blood or organ donor? From a biological point of view none of the three donations is more important than the other. We can say that they are all the same as they each provide material which can be vital for a particular person at a particular time. I think that the person who donates the liver, blood or eggs should be very proud and feel satisfied with the donation because it will help somebody. Is it more difficult to be suitable for egg donation than for sperm donation? With sperm donation the donor also has to undergo a check-up but the difference is that the sperm sample collection is a much easier procedure. What is the main reason to donate eggs? Many donors do it because of the economical reward but it is not the only reason. In many cases there are other incentives. Many of them have relatives or friends with reproductive problems as these are more and more frequent in our society where women decide to have a child at a later stage of their lives. How do the donors react when they find out that the recipient became pregnant? The majority are very pleased. I mean, they share in a small way the excitement everybody has to see a woman with fertility problems become a mother. Do the donors repeat the experience? In fact there are many girls who repeat it and we have to explain to many of them that they cannot do it again, as the law states that when they have had six children by means of Assisted or non-assisted Reproduction, they cannot donate anymore.