Why Egg Donation Is Truly A Sisterhood of Grace

Part II

Following on from our previous blog, we continue our chat with Embryologists and Director of HART & Egg Donations South Africa, Kimenthra Raja, and Egg Donation Coordinator, Kinny Ramoeng; who are taking us through the “ins and outs” of the egg donation process.

To recap: Kimenthra (Kim) has been an Embryologist for over two decades, whilst Kinny has been in her field for seven years. Both women are passionate about the work they do in empowering and changing the lives of thousands of families in South Africa. 

Recap on Part One here.

What is the difference between freezing eggs and donating eggs?

Kim: Freezing eggs (or fertilised eggs known as embryos) is a process where a woman is the only one who will have access to her eggs at any stage of her life. Donating eggs means that eggs are available to a potential family who wants (or needs) donated eggs to conceive a child.

Once an applicant is approved, what are the next steps?

Kinny: The applicant will come in to see us. Once their application form for egg donation has been approved, the next step is to go for a medical screening, which includes an ultrasound, a psychological evaluation, and a genetic/ hormone screening. The medical screening gives a potential donor valuable insight into their current health status at no cost to them. They will also see our psychologist or social worker, as the process must be a fulfilling one, not just for the recipient, but for the donor as well. 

Can a donor donate more than once? 

Kinny: There’s a limit to how many live births can come from egg donations. One egg donor can have six.

Kim: An egg donor can donate three times and create three sets of twins – that’s six children, and then they are done! On the flip side, a donor could donate seven times and create two children. Seven is the maximum.

Are donors paid to donate their eggs?

Kim: Yes, there is compensation a donor gets for donating her eggs. Every time she donates, she will receive R7,000 for her time and effort.

If a woman wanted to be a donor, would she have to come off birth control?

Kinny: No, most doctors would probably prefer they get off the injection; however, it is okay if they are on contraceptives.

Would a donor need to refrain from sexual activities?

Kim: Yes, because they might end up pregnant and not just with one, but with twins!

Once the donor starts her treatment, can she produce more than one egg in her cycle?

Kinny: Yes absolutely! It is so crucial that donors take extra precautions if they were to engage in sexual activities. In our view, however, it would be best is to abstain during that time.

What happens when a recipient chooses their perfect egg donor?

Kim: Once we have gone through the egg donor application process, a recipient will pick their favourite donor from the database. Kinny will immediately contact the donor to let them know they have been chosen.

What if a donor has an irregular cycle?

Kinny: If they are not already on any form of contraceptive, they will be put on an oral contraceptive to regulate their cycle. The pill is also used to sync both the donor and the recipient’s cycle because they would both be taking medication, in tandem. This ensures that the recipient’s uterus is ready when the embryos are ready.

If the recipient’s pregnancy is unsuccessful, would the donor have to go through the treatment process all over again? 

Kim: In an ideal situation, we would get a good harvest of eggs in a cycle. 12-15 is ideal.

Kinny: Yes, and in some instances, we can get 40! So once we have the eggs ready, we will fertilise the eggs with either the recipient’s husband or the sperm donor’s sperm in the lab.  

We allow the embryos to fertilise for five days, and then we will inject two good embryos into the patient. If there are any good quality embryos left, we will freeze them.

Should the recipient not get pregnant from the two that we used, we will use the frozen embryos.

Your work with that couple might be done, but in the meantime, we have plenty of other couples who are looking for eggs donors. If a donor is selected, then they will go through that process again. 

We do have a lot of patients who come in a few years later, asking for the same donor they used previously. 

People have this idea that donating is taboo because you’re ‘giving away your child.’

Kim: We are very mindful of this. That’s why egg donation is such an individual matter. No one can tell you what to do with your body.

A woman can decide the importance they want to place on their eggs. It depends on their cultural background, their philosophy in life, and why they would want to participate in donating. I don’t think it is fair to judge anyone wishing to donate their eggs or those who do not feel comfortable donating either.

Does the donor get to decide what is done with the eggs? Or does the clinic make the final decision?

Kim: As an agency, we recruit donors for fertility purposes only. However, within that, a donor has the right to say who they want their eggs to go to.  

Perhaps a donor may only want their eggs to be available to a South African couple or maybe to a gay couple or a single woman. A donor has the right to say who they desire their eggs to go to.

Do you think donors generally donate their eggs for the money?

Kim: Donors do it for the money, but it’s not the only reason. A lot of our donors who come in with that motivation have a change of heart once they’ve completed their donations.

Does the treatment make donors moody, or sore during menstruation?

Kinny: There are general PMS symptoms but nothing more than what any woman has experienced in their lives.  

There is no moodiness, however, tender breasts, feeling bloated and mild headaches are all common. 

A donor does not have to take time away from work or change their lifestyle; they can continue as usual. It is advisable not to partake in exercise on the day of your egg retrieval because a donor may feel crampy and tender.

Does the egg retrieval process hurt?

Kinny: A lot of donors say they feel mild cramping, like period pains, but the actual procedure of retrieving the eggs is done under general anaesthetic.

If I was a 32-year-old who wanted to donate, could I?

Kim: Our cut off age is 29, so we would have to take guidance from our recipients as most of them seek younger donors.

Have you had donors who have started the treatment but didn’t finish because they changed their minds?

Kinny: I’ve been doing this for seven years and I have never encountered this. This is part of the reason why the questionnaire and psychological screening is vital because we get a good sense right from the start, of the type of person the applicant is.

What do you want a potential recipient and donor to know about egg donation?

Kinny: Egg donation is an empowering process, and I sincerely believe that donating eggs is a sisterhood of grace because a younger woman is effectively giving a precious gift to a potentially more mature woman. It’s a beautiful privilege to be a donor. 

Kim: Our donors are extremely special to us. Without them, we wouldn’t have moving stories to tell. We have close one-on-one relationships with our donors and recipients. It is a journey for our donors as much as it is for our recipients. We meet the donor and recipient, and immediately there is an authentic connection. From that moment, both are never alone throughout and beyond the process. 

Kinny: It’s truly transformative, for us all. We love our egg donors and recipients very much!