Poor Amh and Egg Donation- When to Opt for ?

Recently we often come across young couples suffering from insufficient eggs with no evident reason.Such sudden surge can be due to multifactorial reasons ranging from genetics to environmental impact.Definitely we as humans and as science has certain limitations and cannot regrow whats lacking or deficient.We correlate with parameters like AFC,AMH,FSH as per female age to decide whether we can take chance for IVF with own eggs or have to directly go for egg donation.Its hard to advise but as doctor I feel its better to be clear and transparent to patient.Ultimately decision they can take based on facts with open eyes and mind

What’eggDonation?

Egg donation is a type of  Test Tube Baby  procedure where an egg is taken from a fertile young lady preferably under 30yrs and sperm is taken from intending husband and both are  united outside the body in laboratory and the resulting embryo (baby) is transferred into the uterus of the intending woman.

Egg donor- is woman who donates eggs(andey)

Recepient-woman who receives eggs in form of embryos(Bhrun)being transferred into her womb(Garbhasay)

Innovation- Trounson and colleagues from Australia first reported an egg donation cycle in 1983

This  concept has enabled millions of woman all round the globe to get pregnant who are not able to get pregnant  using their own eggs. Egg donation has brought a new hope to many couples who otherwise would have remained  childless.

Who all in need of Egg Donation ?

1)Premature ageing of ovary(Premature ovarian failure)-when there is early ageing or lack of eggs, reasons can be- Idiopathic (unknown), after ovarian surgery like removal of ovaries prematurely due to multiple reasons, In cancer patients after chemotherapy ,Radiotherapy

2)Genetic reasons like- Thalassemia, galactosemia 3)

Down syndrome or any other chromosomal disorders translocations (karyotyping)

4)Repeated  IVF failure due to poor egg quality

5)Menopausal, perimenopausal(females who are not getting monthly periods)

Oocyte donation is the most successful technique for achieving pregnancies in perimenopausal women. 

How female differs from male in fertility- Do you know that ???? 

 A women is born with a fixed no of eggs in her ovaries and these are depleted in the course of her  reproductive years(15-45yrs) unlike men whose sperms(shukranoo) are formed every 3 months so a man even of 80yrs can make a lady pregnant unlike a women after 45yrs has get almost nil chances to get pregnant as her own eggs are exhausted because her eggs are formed only once in her life time(at the time of birth) . New egg formation does not occur afterbirth and there are no medication or injection for new eggs to form( Concept of stem cells on research  and DHEA with variable evidence)

What’s the success rates and how it differs from normal pregnancy?Anything to worry ?

  The pregnancy after an egg donation cycle is like a normal pregnancy follow up. The success of egg donation cycle is approximately 45-50% per attempt . The success is not 100% because the implantation (Growth of the baby inside the womb) is under God’s  control and there are no medication at present which would  assure 100% implantation. The process of IVF can make babies outside the human body till 2-3days max 5 days and there after the babies (Embryos) are transfer back inside the womb and the further growth inside is dependent on God wish .Is it safe to go for donor and what all screened ?The egg donors are screened for infectious disease,genetic diseases along with baseline workup along with detailed psychological  evaluation .What are legal issues?The recepient couple should be aware that they would become the legal parents of any resulting children/child.Donor selection is based strictly as per ICMR guidelines and ART Bill(law of land)

Risksto baby born ?

The children / child born through a egg donation cycle does not carry any increase in chance of abnormal child.    The ethical, moral , legal and medical issues hav ebeen addressed time and time again, yet the debate goes on. Strict guidelines and protocols are necessary. Within the complexity of these issues, continued efforts have to made to improve the outcome of egg donation program for both recepient and donors.