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Egg-donationIn egg donation, eggs are borrowed from a young woman (less than 33 yrs of age) called the donor, with her consent. These eggs are then fertilized with the sperms of the husband of the recipient woman and the resultant embryo (the earliest form of the baby), is inserted into the womb of the recipient. The success rate of this procedure is in the region of 30 to 40%. In fact, many women till the age of 50-55 have become pregnant by this technique. You will be surprised that the oldest woman pregnant by this procedure is 69 year old, residing in Italy. At Babies And Us, the oldest women who has conceived with this technique is 62 years of age. This is probably the oldest woman to have become pregnant, in India.

IVF Odisha is an anonymous egg donation centre that provides personal attention and support to both egg donor and recipient. Check the online information about Egg Donation Clinic, Egg Donation & Egg Donation Centre in India. Please visit www.infertilityindia.com.

Who can qualify for Egg Donation?
A.In this day and age more and more career oriented women are getting married late in life. By the time they start planning to have children, they are nearing the fourth decade of their life (40 years). Fortunately, at this age, many women can conceive naturally. However nearly 10 to 15% women fail to conceive within a year's time. These women who are more than 37-40 years of age then resort to treatment of infertility by their gynecologist. If they still do not become pregnant they take help of newer technologies like IVF - In Vitro Fertilization (test-tube baby) or ICSI - Intra Cytoplasmic Sperm Injection.

egg-donation-3Women after the age of 40 tend to have fewer eggs in their ovaries or the quality of the eggs they produce may be poor. Thus, even new technologies like IVF and ICSI may not ensure a successful pregnancy. Furthermore, after the age of 40 to 42, many women stop producing eggs as they enter the stage of Perimenopause (decreased periods) or menopause (stoppage of periods). Till now, such women could only have a baby through the wonderful route of adoption. However, in the last ten years, a new technique of egg donation has come as a blessing to many such women.

B. In India, preference is given to younger couples to adopt children. Couples over the age of 45 can adopt, but find it difficult to do so, because of Governmental preference for younger parents. Such couples can tremendously benefit by egg donation.

C. Egg donation can also be perfomed on women who have had multiple cycles of test-tube baby (IVF or ICSI) and have still failed to conceive and become pregnant.

D. Besides elderly or menopausal women, egg donation can be done in younger women whose ovaries have prematurely failed or in young women who have undergone radiation or chemotherapy for cancer. Radiation or chemotherapy destroys the eggs and hence these women have a failure of their ovaries.

E. Egg donation is also used in patients who are carrying major chromosomal defects so that they do not pass the genetic defect to their children.

F. Patients suffering from severe Tuberculosis and severe Endometriosis may also produce poor quality eggs and hence can be treated by egg donation.

How are the Donors screened?
Generally, eggs are borrowed from healthy women less than 30-35 years of age and who are not suffering from any illness or genetic disorders. These young women, also called donors, are specially screened for AIDS and Hepatitis. Their family history is taken, to rule out any genetic problems. The donor can be married or unmarried. However, married donors with children would be preferable, primarily because they will have established their ability to bare children.

How is the procedure done?
The Babies And Us staff will coordinate the cycles of the donor and recipient to accomplish a fresh embryo transfer whenever possible. Synchronization of cycles includes using a series of medications to facilitate a hospitable uterine environment for the transfer of embryos. During egg donation, the donor is given injections to produce many eggs. When these eggs are ripe, she is given a short anesthesia and the eggs are removed from inside the vagina without giving a cut on the abdomen. The donor can return home three to four hours' after the procedure. The eggs are then fertilized with the recipient's husband's sperms in the laboratory, either by IVF or ICSI and kept in the incubator for two days.

Incase the recipient's husband's sperm is of poor quality; the eggs can be fertilized by the technique of Intra Cytoplasmic Sperm Injection (ICSI). Two days later, a four-celled embryo is formed. Three days later, a eight-celled embryo is formed or five days later a multi-celled Blastocyst is formed. This embryo (small baby) is then transferred back to the womb either at the four cell, eight cell or the Blastocyst stage.

30 to 40% of such women will become pregnant. Incase they fail to become pregnant they can have a repeat egg donation cycle. Many women undergo two to four cycles and achieve their goal of a child.

Who can be a Donor?
A. As easy as the method may sound, the biggest problem faced by both doctors and patients is the availability and source of egg donors. Ideally, the best donor would be her own sister or near relative from her side (not from husband's blood relative). We have done such cases successfully in Lilavati Hospital. However, in this day and age of small nuclear families many times it is difficult to get such donors.

egg-donation-2Further more, it is very important that if there is a sister donating eggs, there should be a very good mental understanding between the sisters. The donor is not anonymous in this case, and thus many a time there are possibilities of inter-personal conflicts arising when the child becomes older.

We also accept recipients who have identified their own non-anonymous donors.

B. The other and the most acceptable donor would be a voluntary unrelated donor. There are a lot of women who may just out of altruistic (philosophical) reasons donate eggs to women who are suffering from the trauma of infertility. It is important to popularize such egg donation. However, even in an advanced society like Britain's, there is a great dearth of voluntary egg donors, in spite of extensive advertisement in the press.

By voluntary egg donation, we mean donation of the eggs by the donor without expecting any monetary or other reward in return.

C. The third area, which can be a source of donors can be a paid donor. You may be surprised that this is legal in USA and young college girls are paid as much as US$6,000 for donating their eggs. But in a protestant society like Britain's, this form of donation is considered illegal and unethical. Even in the Indian society, where there is no law on egg donation at present, such kind of paid donation may not be socially and culturally acceptable. Clinics in India do not practice paid donation.

Recently the Govt of India has appointed Indian Council of Medical Research to legalize infertility practice in this country including that of egg donation, embryo donation, semen donation & surrogacy. The ICMR has legalised paid egg donation and surrogacy. 

In all the groups of related, voluntary or paid donors, there is a certain degree of risk the donor is exposed to. The donor is given multiple injections to produce eggs, as well as a shot anesthetic. She is also exposed to the risk of surgical egg removal.

D. Hence, there evolved a new concept of shared egg donation which started in Britain but is now popular in the USA and also in India. There are many young women who are infertile due to other reasons and who also need the procedure of IVF or ICSI.

However, they cannot afford to spend money for these procedures. Many of these women produce 8 to 10 eggs during their treatment. These patients are asked to share some of their extra eggs with the recipient. This is done by taking the informed consent of the young woman. In return, a part of the expense of medical treatment of the young woman is borne by the recipient. Thus, both the donor as well as the recipient who need IVF, are benefited, without any extra amount of risk to the donor. The anonymity of both-the donor and the recipient- is maintained so that they don't know each other. With the help of this technique, many young women who cannot afford IVF can mother a child. The same goes for elderly women who can afford IVF and can have a child.


egg-donation-1The process of egg sharing is an excellent example of symbiotic relationship between women, one with a physical need and one with a monetary need, with the ultimate common goal of bearing a child. It is a safe, effective, successful, legal, ethical and socially acceptable method of advanced reproductive technology.


We at the Babies And Us Fertility, IVF & ICSI Centre generally indulge in family related donors or egg sharing.

We hope that more and more voluntary donors will come forth, to help needy infertile patients become pregnant.

What is the age limit of the recipient?
In general, any woman with a medical or genetic indication for using an egg donor can be a recipient, if there are no medical contraindications to pregnancy. Our current age limit is 55 years. The decision to utilize donor eggs is made in association with staff and consultants. If a male factor exists, donor egg with ICSI is also available. Generally a psychiatrist and a physician would assess a recipient. This is done to gauge the mental and physical fitness of the patient. This analysis is very important to withstand the pressures of childbirth.

What is the background of Recipients?
Babies And Us fertility Centre is renowned for its egg donation techniques. Our patients hail from all over the country. They are from different walks of life. Our unit facilities are also utilized by NRI patients (Non Resident Indians) from USA, UK, Africa, Middle East, Sri Lanka & Far East(Singapore). We are also getting some patients from other nationalities who hail from Asian countries..
surrogate motherSurrogacy is an arrangement between a woman and a couple or individual to carry and deliver a baby.  Women or couples who choose surrogacy often do so because they are unable to conceive due to a missing or abnormal uterus, have experienced multiple pregnancy losses, or have had multiple in vitro fertilization attempts that have failed. The advantage of gestational surrogacy to the parents is that the embryo is created from the woman’s egg and the man’s sperm, so it is biologically theirs. Surrogacy is a method of assisted reproduction. The word surrogate originates from Latin word surrogatus (substitution) - to act in the place of. The term surrogacy is used when a woman carries a pregnancy and gives birth to a baby for another woman. Surrogacy is gaining popularity as this may be the only method for a couple to have their own child and also because adoption, process may be a long drawn out process.

What are the Types of Surrogacy?

1.  IVF / Gestational surrogacy

2. Traditional / Natural surrogacy


IVF / Gestational surrogacy - This is a more common form of surrogacy. In this procedure, a woman carries a pregnancy created by the egg and sperm of the genetic couple. The egg of the wife is fertilized in vitro by the husband's sperms by IVF/ICSI procedure, and the embryo is transferred into the surrogate's uterus, and the surrogate carries the pregnancy for nine months. The child is not genetically linked to the surrogate.

Traditional / Natural surrogacy - This is where the surrogate is inseminated or IVF/ICSI procedure is performed with sperms from the male partner of an infertile couple. The child that results is genetically related to the surrogate and to the male partner but not to the female partner.

To whom Surrogacy is Advised?

A. IVF Surrogacy

1. Primarily, IVF surrogacy is indicated in women whose ovaries are producing eggs but they do not have a uterus. For e.g., in the following cases:

a) Congenital absence of uterus (Mullerian agenesis)

b) Surgical removal of the uterus (hysterectomy) due to cancer, severe hemorrhage in Caesarian section or a ruptured uterus.

2. A woman whose uterus is malformed (unicornuate uterus, T shaped uterus, bicornuate uterus with rudimentary horn) or damaged uterus (T.B of the endometrium, severe Asherman's Syndrome) or at high risk of rupture, (previous uterine surgeries for rupture uterus or fibroid uterus) and is unable to carry pregnancy to term can also be recommended IVF surrogacy.

3. Women who have repeated miscarriages or have repeated failed IVF cycles may be advised IVF surrogacy in view of unexplained factors which could be responsible for failed implantation and early pregnancy wastage.

4. Women who suffer from medical problems like diabetes, cardio-vascular disorders, or kidney diseases like chronic nephritis, whose long term prospect for health is good but pregnancy would be life threatening.

5. Woman with Rh incompatibility.

B. Traditional Surrogacy

1. Women who have no functioning ovaries due to premature ovarian failure. Here egg donation also can be an option.

2. A woman who is at a risk of passing a genetic disease to her offspring may also opt for traditional surrogacy.

Is Surrogacy right for you?
For some couples opting for surrogacy is a very straight forward decision, while, for others there are lots of things to be considered and thought about before taking the decision. There are lots of complex issues involved. It is an emotional roller coaster ride for the couple, the families and friends. It is a decision where the 'right' and the 'wrong' are very individual things. An infertility specialist or a counselor can help the couple seeing things in the right perspective. Other options such as, adoption or further infertility treatment can also be considered.

What are the screening criteria for surrogate? How is a surrogate chosen in India?
surrogacy1Medical Tourism's network of hospitals in India, has a very meticulous and stringent criteria for choosing a surrogate. The surrogates are between 21-35 years of age. They are married with previous normal deliveries and healthy babies. Detailed medical history, surgical history, personal history, and family history is looked into. History of blood transfusion and addiction is also taken. It is made sure that the surrogate has an uneventful obstetric history (no repeated miscarriages, no ante-natal, intra-natal and post-natal complications during previous pregnancies). The surrogate and her partner are screened for infectious diseases like sexually transmitted diseases, Hepatitis B, Hepatitis C, HIV, VDRL. Thalassemia screening is also done. Detailed pelvic sonography is done and other tests for uterine receptivity are performed to ensure maximum chances of success. A detailed financial and legal agreement is then drawn up between the surrogate and the commissioning couple.

What does India IVF surrogacy procedure involve?
For IVF surrogacy in India, matching of cycles of the genetic mother and the surrogate is done by adjusting menstruation dates by oral contraceptive pills. When the cycle starts, the surrogate is put onto estrogen tablets to prime the uterus. The protocol used for the genetic mother is day 2 protocol or day 21 protocol, depending on the age of the genetic mother and the other test results. For the day 2 protocol, called the antagon protocol, oral contraceptive pills are given in the previous month. On the 2nd day of the periods, gonadotropin injections are started. USG Monitoring is done daily.

When the size of the follicle reaches 14 mm, the genetic mother is given an antagon injection to prevent the surge of the endogenous hormones. For the day 21 protocol, called the long protocol, GnRH analogues are started on day 21 of the previous cycle. Once the genetic mother gets her periods, gonadotropin injections are started. In both the cases, the patients are monitored daily. When the follicle reaches 18 mm size hCG trigger is given. The surrogate is started onto progesterone tablets on the day of hCG injection that is given to the genetic mother. Oocyte (egg) retrieval is done 36 hours later, which is generally day 12 or 13 of the cycle. On the same day the genetic father gives his semen sample. The eggs of the genetic mother are fertilized with sperms of the genetic father in the laboratory by IVF / ICSI procedure. The resulting embryo is then transferred into the womb of the surrogate under ultrasound guidance. The surrogate is then put on luteal support using progesterone tablets / injections, and pregnancy is confirmed 15 days later.


What is the nine-months journey like, with Indian surrogate?
The surrogate is treated as a high risk pregnancy and is cared for by 2 consultant gynecologists in our hospital. Appointments are scheduled with the consultants every three weeks for the first 6 months, then every 15 days for the next 2 months and then weekly / biweekly in the last month. Blood tests and ultra sound are done as and when required. Routine blood tests like hemoglobin, blood group, VDRL, HBsAG & HIV are done. Special care is given, and tests are done to pick up any obstetric or medical complications like hypertension, diabetes etc., at the earliest. 2 doses of injection Tetanus are given during pregnancy. The baby's growth is monitored stringently. Ultrasound is done at 6 weeks to confirm pregnancy and the viability of the baby, then at 12 weeks to assess growth and certain parameters like nuchal thickness. At 18 -20 weeks, a detailed level III ultrasound is done to detect any abnormalities in the baby. At 16 weeks, after councelling and with the consultation of the genetic parents, amniocentesis is performed, if the genetic mother's age is more than 35 years. At 28 weeks and 34 weeks, color Doppler is performed to assess the growth of the baby and rule out intra uterine growth retardation. Fetal well being tests, like non stress test, are done as per the requirement. Detailed information is given to the surrogates about nutrition and diet during pregnancy. They are regularly provided with supplements from the hospital.

Thus, adequate care and precaution is taken, to ensure that sufficient and optimum nutrition reaches the baby. We have a LDRP (Labor Delivery Recovery Puerperium) room for delivery which is equipped to handle any obstetric emergency. Our NICU setup is also completely equipped to handle any neonatal complications, with a neonatologist who is available round the clock. We keep the couple posted on the progress of the baby and send them ultrasound pictures and blood reports as and when they are done.

What is the success rate of surrogacy in India?
The success rate (carry home baby) of surrogacy is around 45% in case of fresh embyos. In case of frozen embryo's it is about 25%. High success rates and low medical costs are the highlights of surrogate pregnancy in India. No wonder many couples from the US, Australia, the UK, and other European countries seek surrogacy in India.


What are the different ways children born through surrogacy may receive breast milk?
surrogacy fertilityJust because the baby is born through surrogacy, it does not mean he or she cannot receive breast milk and the many health benefits it provides. Breast fed babies have been found to have higher IQs, are better protected from leukemia and are less likely to have problems regarding obesity. Breast milk protects babies from getting diarrhea, ear infections and respiratory disorders such as asthma. Premature babies who receive breast milk are more protected from infections and high blood pressure later in life. Breast milk contains the protein CD14 which works to develop B cells, which are immunity cells that are essential for the production of antibodies in an infant, to build the babies immunity system.

The babies may drink breast milk acquired through a milk bank, breast milk donor may be located or the intended mother may induce lactation before the birth of the baby. Induced lactation has been embraced by the nursing community as a welcome method to enhance the bonding relationship between a new mother and baby born through surrogacy. Prolactin and oxytocin are the two pituitary hormones that cause lactation to occur. They may be stimulated despite the woman's inability to carry a child. Lactation may be induced in a number of ways, and the amount of milk a non lactating woman can produce through inducement varies from woman to woman. The most common way women induce lactation is through manual or mechanical stimulation. With this method lactation is induced by massage, nipple manipulation and sucking either by the baby or breast pump. The second common method used is hormone therapy whereby a woman uses herbal remedies such as Fenugreek or is prescribed medications such as Domperidone and Metoclopromide (Reglan*) to induce and increase her milk supply. Induced lactation milk, skips the colostrum phase. and resembles mature breast milk.

Manual stimulation of lactation usually takes between two and seven weeks and hormone therapy usually takes between one to four months. For this reason intended mothers usually begin during the final trimester of their surrogate mother's pregnancy.

What are the advantages of surrogacy?

a) This may be the only chance for some couples to have a child, which is biologically completely their own (IVF surrogacy) or partly their own (gestational surrogacy)

b) The genetic mother can bond with the baby better than in situations like adoption.
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Team IVF Odisha

drpltripathy
Dr. P. L. Tripathy
Obstetrician & Infertility Specialist
  • Dr. Neeraj Pahlajani
    Obstetrician & Infertility Specialist

    dr sameerpahlajaniDr. Sameer PahlajaniInfertility Consultant & Sonography ExpertDr Dibyajit_MohantyDr. Dibyajit MohantyMD, Obs. & GynecDr Sasmita_DasDr. Sasmita DasMD, Obs. & Gynec