With the introduction of third party reproduction, there has been a change in the traditional concept of reproduction, third party involves the use of sperms, eggs, or uterus. (surrogacy)

SELECTION / INDICATION

DONOR SELECTION AND EVALUATION

Screening of gamete donors has to be done independently in registered ART bank.
Oocyte donors should be 21-34yrs of age with at least one living child of minimum 3yrs age.

If a prospective donor is over 34yrs of age, the age of the donor should be revealed to the recipient as part of informed consent discussion regarding cytogenetic risks and effect of donor age on pregnancy rates.

EVALUATION

Medical and reproductive history and routine medical examination should be done.
A complete general physical examination should be performed including pelvic examination.

Anonymous versus known donors. pragmatic considerations such as difficulty in recruiting suitable donors support the use of known oocyte donors. Psychological evaluation and counseling should be recommended to the donor and her partner.

Psychological consultation should be required for individuals in whom there appear to be factors that warrant further evaluation. In the case of known donors, related issues such as potential impact of the relationship between donor and recipient should be explained.
Screening and testing of oocyte donors should be including HIV, HBsAg, syphilis STI’s.

Record Keeping- it is necessary to maintain permanent records of each donor’s initial selection process, and subsequent follow-up evaluation.

All individuals involved in ovum donation should be explictly advised of the risks and adverse effects of ovarian stimulation, retrieval, and this process should be documented by informed consent.

Donor Selection & Evaluation

INDICATION

Premature ovarian insufficiency- is a term used for women with hyper gonadotropic amenorrhea prior to 40yrs of age.

CAUSES

Turner syndrome Genetic

associations Galactosemia

Radiotherapy

Pelvic surgery

Small X chromosome defects

FSH receptor mutations/ LH receptor mutations

Autoimmune polyendocrinopathy

Isolated autoimmune ovarian failure FRAXA

premutation

Enzyme defects-P450c17

Ovarian Surgery Iatrogenic

chemotherapy

Natural menopause-between 45 -55 yrs and remains a controversial indication for oocyte donation
Repeated implantation failure due to poor quality oocytes. Genetic defects- single gene defect
Balanced translocations.

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