Do you have what it takes to be an egg donor?

While in the United Kingdom (UK) for her master’s degree in 2012, Pumla Nabacwa was referred to a fertility clinic for a certain procedure. As she waited at the reception for her turn to see the gynaecologist, she overheard two women (both aged about 35 years) talking about their struggles with infertility and how they had tried to conceive but in vain.

From the conversation, Pumla, then 28 years old, learnt that the women needed egg donors but the available ones were white. When it was her turn to see the gynaecologist, Pumla asked if she could donate her eggs.

Tests

She went through a series of tests and screening including blood work, physical and psychological health tests and after two days, she was contacted by the hospital. She had met all the criteria needed to donate and was asked to go back to the clinic at her convenience. The next day, she walked into the clinic and started the process that would last a month. 

“I had to put aside all my fears since my goal was to help those women and many like them that were struggling to have children. I was given hormone stimulating injections, with which I injected myself on the abdomen twice a day for 30 days and thereafter, the doctor harvested 27 eggs,” she says, adding that three months later, she donated another 25 eggs.

Requirements

According to Dr Edward Tamale Ssali, a gynaecologist at Women’s Hospital International and Fertility Centre in Bukoto, Kampala, there are two types of donors. 

“One who is known to the recipient; most preferably a relative or friend or an anonymous person whose details are only known by the hospital. An anonymous donor is usually preferred in the African setting because this remains a secret between parents. In the West, the child has a right to know about the donation as soon as they turn 18 years.”

Egg donation is a process in which a fertile woman donates an egg (oocyte), to another woman to help her conceive. The egg donors give eggs to a clinic for a recipient to be mixed with a partner’s sperm, or donor sperm, and used in assisted fertility treatment techniques such as In Vitro Fertilisation (IVF). The donor should be between 21 to 35 years of age.

The process 

The process starts with one’s declaration of interest to donate the eggs. One must be willing to undergo several tests, starting with a background study where the doctor will ask questions about your family history.

The doctor will screen one for hepatitis, HIV, Sickle cell disease, hemophilia, sexually transmitted infections, chronic illnesses such as diabetes, mental health and many other diseases that can be transmitted to the child from the mother.

Dr Joseph Nsengiyumva, a gynaecologist at Bethany Women’s Hospital in Kampala, says a baby girl at birth has about two million eggs but by puberty, they may have reduced to about 500. A hormonal test (ovary reserve test), before donation is also done to ensure you have more than enough eggs to donate.

In Uganda, you must have a letter from the LC1 chairman to track your criminal record, a national ID card for proof of your age, passport size photos and when all the criteria is met, the donor goes through pre-donation counselling. Then, one will sign a consent clearly stating that they are donating willingly.

“I was given injections and give strict guidelines. I would self-inject after every 12 hours for a period of 30 days and would go to hospital for review twice a week. Here, an ultra sound scan would be used to see if the eggs are increasing in size and number, making them strong and viable,” Pumla says.

Caution

The donor is also given fertility drugs that stimulate the ovaries to produce several eggs at once. During the donation cycle, donors stand risk of pregnancy before the eggs are retrieved. It is a good idea to avoid intercourse or use a barrier contraceptive, such as a condom.

During the cycle, the donor goes through frequent blood tests and ultrasound examinations to monitor their reactions to the medications. The hormonal stimulation process requires one to eat a healthy diet, although there are no food restrictions except for smoking and minimal alcohol consumption. 

Pumla says there is a bit of discomfort since one suffers from bloating, swelling of the stomach and fluid retention due to the hormones although these stop after the eggs are harvested. On day 26, the doctor confirms the date of harvesting, which is an outpatient procedure that takes a few hours.

Dr Ssali says: “Before the eggs are retrieved, the donor receives a final injection in preparation for the procedure and is put under sedation. A transvaginal ovarian aspiration is done to remove the eggs from the donor’s ovaries. An ultrasound probe is inserted into the vagina and a needle is used to remove the eggs from each follicle.”

Eggs can also be harvested for women before they undergo chemotherapy, radiotherapy, those who have not found the right partners or are first focusing on career, frozen and made available when they need them. This, Dr Nsenyimva says, costs Shs5m.

The cost

Pumla donates her eggs free of charge. “In the UK, I was given an allowance or a refund for transport costs to and from the hospital twice a week for review, and buying healthy foods. 

Dr Nsengiymva says: “You can only receive a donation of about Shs500,000 to Shs1m as a refund but not payment for the service. The service is paid for by the recipient who pays Shs1.5m and this is billed as part of the Shs18m to Shs22m (depending on the fertility clinic you go to) which is charged for In vitro fertilisation.”

Criteria

One must sign a contract stating that they do not get to know who the recipient is. “In the UK, the donor remains anonymous and the child is only allowed to contact you after the age of 18. What I get to know is the number of my eggs that have been fertilised and have resulted in children, their date of birth and gender,” says Pumla.

Her prayer is that at the right age, her children are told about the possibility of contacting her. She updates her information with the fertility centre every time she changes contact or residence so that she does not miss this opportunity. 

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