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| Egg Donor Screening |
Because standardized screening guidelines have not been developed, practices vary between clinics. A potential donor should undergo a thorough physical and psychological evaluation in order to protect her own health and that of any future biological offspring.
Donors will generally be asked to complete a detailed medical history to identify any genetic abnormalities or diseases. Prospective donors will also undergo a fertility evaluation to verify the capacity of their ovaries to produce eggs. This consists of a physical examination and pelvic ultrasound. A more extensive physical exam, blood tests, and cultures will also be performed once a physician has verified a donor's ability to produce healthy eggs. The American Society of Reproductive Medicine (ASRM) recommends that donors be tested for the following:
The recipient couple or clinic should pay for the costs of these tests. Women should be disqualified if they exhibit risk factors for HIV infection or test positive for syphilis, hepatitis B/C, or HIV I-II. Donors should not be genetic carriers of a major mendelian disorder, have evidence of spina bifida or heart malformation, or carry chromosomal abnormalities that could affect eggs.
Donors should be sure to inform their physicians about any menstrual abnormalities or hormonal imbalances which could be a sign of a pituitary tumor. While very rare, these tumors can be aggravated by the drug Lupron and could lead to a stroke and brain damage during ovarian hyperstimulation.
The ASRM recommends that all prospective donors undergo a psychological evaluation during screening to limit the possibility of emotional harm. Psychological screening is generally aimed at identifying emotional problems, evaluating donor motivations, and verifying that women have a thorough understanding of the physical, psychological, and legal risks that could result from donation. Some programs interview partners, friends, and family members of potential donors to confirm the presence of adequate social support. Others may administer psychological tests such as the MMPI to donor candidates.
Common reasons for exclusion following psychological screening include a current psychiatric disorder, inappropriate motivations for donation, a chaotic lifestyle, or unrealistic expectations from the donation process. Women with a history of psychiatric medication use, depression, counseling, sexual abuse, social introversion, or miscarriage are more likely to be turned away from a donor program.
Ethical Considerations Related to Screening
Screening can be a highly personal, invasive, and time-consuming process. In order to ensure a high quality of informed consent, potential donors should be fully advised about the risks and discomfort involved in egg donation before undergoing any tests or interviews. Screening and risk counseling should occur during separate sessions, and potential donors should be allowed a "cooling off" period before consenting to undergo the procedure.
Potential donors should verify that their medical and psychological information will be kept private. The ASRM also recommends that genetic testing be used only to screen for diseases that would have "severe medical consequences for recipient and offspring."
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