What is egg donation?
Naturally, women produce one mature egg each month. If it is fertilised it will become an embryo and will develop during the pregnancy. However, if it is not fertilised, it is lost during the period.

A healthy woman has, from birth, around 400,000 oocytes in her ovaries. These oocytes are the immature form of future eggs. During the whole fertile period of her life, only one in every thousand (no more than 400) reach maturity and therefore have the possibility of being fertilised.
Each month, several oocytes start, at the same time, a development process that finishes on the day of ovulation. Only one of them at that time becomes a mature egg, while the rest atrophy and become useless. In this way the woman’s body prepares for the pregnancy, if it is her wish to become pregnant. If this is not the case, the egg is unnecessary and is eliminated with the menstrual bleeding.
Egg donation can be defined as the handing over (anonymously, freely, and altruistically) of the eggs of a woman so that another woman can have a baby. These eggs come, therefore, from a natural reserve that exists in the ovaries and that usually are never needed.

Therefore, egg donation, although in theory consisting of the handing over of something belonging to another person, does not involve in itself the definitive loss of something unrecoverable. It could also be said that it is a way of making use of some of the eggs that a woman will never make use of.
The female egg carries the chromosome pattern of the woman in the same way that the sperm carries that of the man. However, all of us are unique and unrepeatable because in the moment of fertilization of the egg, a mixture of the genetic information of the mother and father occurs in a procedure which means that the combination of characteristics from both progenitors is always different.
Besides, maternity in itself is a long process in which the future individual maintains an intimate relationship with its mother. During this process, it receives not only the nutrients necessary for its development but also immunological protection from the woman who is carrying it.

Finally, only the love that the parents offer a newborn baby in the heart of the family that wants the child, gives this individual its condition of being a person.

To put it in other words, if the donation of an egg provides an important, irreplaceable part in the creation of a new being, then the fertilization with the man’s semen and later the happy ending to the whole gestation process, without forgetting, finally, the upbringing of the new being in the heart of the family where it is wanted and loved, is also irreplaceable.

Who can benefit from egg donation?
Eggs proceeding from donation are the only possibility that exists for some women to have their own child. This occurs in those cases where no medical or surgical treatment exists which would enable a couple to conceive their own child naturally.
There are various reasons why a woman might need to rely on the donation of eggs but to summarise, there are two main groups: women who do not have eggs in their ovaries or those who are at risk of passing on genetic disorders to their offspring.

Who are the women who do not have eggs?
In this first case, the most common reason why a woman does not have eggs available is a situation called early menopause. This appears before the normal age and consists of the menopause coming between 15 and 20 years before it would usually occur. That is to say, a woman goes through the menopause when she is still very young and if she has not yet had children, there is no way she now can without recurring to a donation from a fertile woman.
Thanks to epidemiological investigation, we know that approximately 5% of women develop this pathology, a number much greater than people not versed on this subject would imagine.
On other occasions, the cause is a medical one, as is the case of those women who have had their ovaries removed due to a tumour, for example. Once re-established, these women could not have their own children if not thanks to the donation of eggs from another woman.

In what cases can a woman not use
her own eggs?
There are certain cases where a woman cannot have children because her own eggs are not apt for this. This is due to certain genetic anomalies in which the eggs do not have the capacity to engender healthy children due to a defective chromosomatic pattern.

In other cases it is not advisable from a medical point of view for a woman to have children due to the risk of transmitting a hereditary disease from her branch of the family. This may occur in certain cases such as haemophilia in which blood coagulation is affected.

Egg donation procedure
Eggs can be donated by any woman who wishes to do so, as long as she fulfils all the conditions established by law.
Once a donor has been found, and with the aim of carrying out the donation, the menstrual cycles of the two women must be synchronised. Therefore the donor and the recipient must be in the same stage of their period, which can be achieved by means of an appropriate pharmalogical treatment which enables the cycle to be regulated easily and efficiently.

The donor
Naturally, only one egg is developed each month in the woman’s ovaries. For this reason, and with the aim of guaranteeing the efficiency of the donation, the donor undergoes treatment to stimulate her ovarian cycle and make more than one egg mature in the cycle for donation. Some do not evolve normally and do not reach maturity, while others will not be fertilised for reasons that we still do not know.
The control of the treatment is carried out via a series of scans and hormonal analyses. Later on, just before the time of ovulation, the eggs are obtained directly from the ovaries by echographic aspiration.

The recipient
Given that the eggs cannot be stored, the ovarian cycle of the recipient must be synchronised with that of the donor, in such a way so that they coincide in the moment of ovulation, which is appropriate, both for the retrieval of eggs from the donor and for conception in the recipient.
For this reason, the recipient of the eggs receives appropriate medication which will prepare the endometrium to receive and accept the embryo. The endometrium is an epithelium which is found on the inside of the uterus and which allows the embryo to find a suitable environment in which to embed itself. When a woman does not become pregnant, the endometrium degenerates and is eliminated each month with the period.

How are donated eggs used?
The most commonly used procedure is known as in vitro fertilization (IVF). This is a technique which is often used nowadays to treat fertility problems in sterile couples and consists of cultivating eggs obtained from the donor together with the semen from the partner of the recipient in a special laboratory environment.
Later, the embryos obtained are transferred to the inside of the uterus of the recipient, where they go on to develop if the implantation is successful. Normally, two or three are transferred, because usually only one of them takes, and if all is well, goes on to develop during pregnancy.
When there are also problems derived from the man (as is the case of a poor sperm count), another complementary treatment is also used called intracytoplasmic sperm injection (ICSI). This consists of a very delicate microscopic manipulation technique in which the sperm is introduced manually into the egg. This egg, once fertilized, is then transferred, as in the previous case, to the uterus of the recipient.

Laws on Donation
Having children is a right recognised in the Spanish Constitution. In this way, donation is a means of permitting those women who are sterile due to pathologies or situations that do not have any other medical treatment, to become mothers. These women can thereby find a solution to their problem that otherwise would lead them inevitably to adoption as their only way of having a child.
The donation of eggs is a procedure authorised by our legislation. To be precise, there are two legal texts, amongst others, that regulate this practise.
Law 35/1988 on assisted reproduction techniques is the legal framework which regulates the help that medicine can offer to solve the problems of sterility or infertility in a couple, both from a medical, ethical or judicial point of view.
The Royal Decree 412/1996 is the text that details this law with reference to all the aspects of the process of the donation of female gametes (eggs).
To summarise, these texts establish that the donation of gametes (eggs) for the ends authorised by the law (in this case, in order for a sterile woman to have a child) is a free, formal and secret contract between the donor and the medical centre, that is put in writing. The law also states that the donation can never involve financial or commercial gains and specifies the studies and sanitary controls that must be carried out on both donor and recipient with the aim of guaranteeing that both are in good health.
Egg donors must be between the ages of 18 and 35, be legally capacitated and be of good physical and mental health. Donation must be formalised via a written contract, after the donor has received full information on the whole procedure. It must also be a voluntary act which the donor carries out without being forced or tricked into it in any way. Lastly, there must be a guarantee of total secrecy and all the information will be treated and kept in the strictest confidentiality.
In the case of the donor already having children, there must not be more than six of them and in no circumstances could they have more than six as the fruit of the donations.
The legal texts also specify that the maximum phenotypic and immunological similarity between the donor and the recipient must be guaranteed. That is to say, they should have the same blood group and physically not be very different from each other.

How can one become a donor?
The legislation specifies that women who wish to do so can donate their eggs if they fulfil the following requisites:
• They are over 18 and under 35 years old.
• They are in good physical and mental health.
• They sign the corresponding contract.
• They are legally capacitated to give their authorization.
To become a donor a woman must go to a centre which has a donation programme and follow a process in which they receive all the necessary information and their mental and physical state of health of the donor is evaluated.
For this reason, the candidate will be given a medical examination which will include the following personal and family background details and a physical examination which will check information referring to:
• Height, weight.
• Skin colour (pale, dark).
• Eye colour (brown, blue, green, hazel, black, other).
• Hair colour (blonde, light brown, dark brown, black, red, other).
• Hair texture (straight, wavy, curly, other).
• Blood group and Rhesus factor (A, B, AB, O, +, -, OTHER).
• Race

All donors will also be tested for the following:
• Blood group and Rhesus factor
• VDRL or similar test to detect syphilis
• Analysis to detect hepatitis
• HIV marker detection test
• Clinical study to detect toxoplasmosis, rubella, herpes virus and cytomegalovirus
• Clinical study to detect Neissaria gonorrhoea and chlamydia trachomatis infection.

This means that the woman who is a candidate to donate eggs undergoes a complete, free medical and gynaecological check-up. This check-up, necessary in order to guarantee her state of health for the donation, allows her to obtain specific information on her physical and analytical state.

Compensation
An act such as the donation of eggs can give a level of personal satisfaction that depends on the ideals of each person and in itself can undoubtedly justify the donation.
Also, the fact of being included in a donation programme permits the woman to know about her state of health, given that in order to be an egg donor, she must be in good health, and to undergo medical examinations and analysis.
On the other hand there also exists the possibility that the donor receives compensation in kind or economical compensation for the possible inconvenience that the procedure may cause her. At the present time this compensation is of arround 900 euros, depending on the number of visits, travelling allowance, and the number of times that she has had to eat out, for example.
If the donor so wishes, this compensation can be given to a charity, for example a children’s home or a women’s help group.

Egg donation and solidarity
When a woman wishes to become pregnant and cannot use her own eggs, she can consider the possibility of  adoption or a donation programme.  If she chooses the donation, she will be included in a waiting list and she has to wait until another woman decides to donate her eggs which can then be fertilized with the semen of her partner and thereby have the child that she wants.
In this way, this woman can have the child that without the possibility of donation she would not have been able to conceive. Thanks to the donation, she can enjoy her pregnancy in its entirety and conserve the whole maternity experience including the gestation and birth processes.
Donation is an act of solidarity because it is an anonymous act, voluntary and altruistic. That is to say, because no direct recognition or gratification from the person benefiting from it is expected.
Anonymity guarantees the privacy of both the donor and the recipient and also helps to justify the donation itself.
Altruism gives the donation a free giving character in that no gratification is expected. With this condition, which is also explicit in the law, there is a guarantee of the absence any kind of marketeering being involved in the donation, and any possible commerce is avoided and with that the advantage of access to donation for economic reasons.
The voluntary character is required, lastly, to avoid the donation being conditioned by force or any other type of pressure that could go against the right to free choice in one’s own acts. It must be very clear that the donor is acting in a totally voluntary way.