'Egg donation enabled me to have the family I had longed for'
More couples are choosing this treatment, but will there be consequences for the children, asks Liz Kearney
For 10 long years, Sarah and her husband had been trying to start a family, with no success.
It should have been straightforward. They were both healthy and only in their 30s. But after a decade of disappointment, doctors broke some devastating news. Sarah's eggs were of such poor quality that even IVF was unlikely to help her conceive.
In the past, women with poor-quality or scarce eggs would have had to accept that they'd never have a baby, or else start thinking about adoption.
But these days there's another increasingly popular option -- egg donation. If Sarah was willing to travel abroad and use eggs donated by another woman mixed with her husband's sperm, she could carry and deliver her own child and finally have the baby she longed for.
It would come at a high price, though. At the world-renowned Shady Grove Clinic in Washington where Sarah was treated, donor programmes cost €26,000.
In return, you get excellent success rates, and a tempting guarantee -- a baby, or your money back. The centre is linked in Ireland to the Cork Fertility Clinic, which delivers aftercare for the mum-to-be and has to date sent 25 Irish couples to Washington with remarkable success.
Cork Fertility Clinic medical director Dr David Waterstone says of the 25 couples treated there so far, there have been 22 babies and two current pregnancies, while one woman is still undergoing treatment.
The Cork/Shady Grove option is one of an increasing number available to Irish women. Clinics around the country have links to donor programmes across Europe, the UK and the Ukraine where donor eggs are readily available.
With no way of tracking the number of babies born in this way, it's hard to say how many couples are choosing this route, but experts believe it's likely to be hundreds every year.
Egg donation is permitted in Ireland, but medical guidelines prohibit the payment of donors, so unless an infertile woman can find a sister or friend who's happy to give her an egg, donors are hard to come by.
But they're not unheard of. The well known Irish writer Maria Duffy donated her eggs after watching an RTé documentary about infertility.
"We had our four children and felt very blessed, and watching the programme really affected us," she remembers. Maria was so moved, she contacted the SIMS fertility clinic in Dublin and said she wanted to donate eggs.
SIMS matched her with someone on their waiting list, and explained in detail the process involved. Essentially, Maria would be going though a cycle of IVF, with hormone treatments and daily injections, and then, under a local anaesthetic, the eggs would be retrieved from her.
Those eggs would be mixed with the recipient's partner's sperm in the lab, and then implanted in the recipient.
"The clinic went to great pains to make me realise what a big thing it was," says Maria. "They wanted to make sure I knew that while it would be my biological child, I would have no legal rights. But I was very sure that regardless of what was involved, I wanted to do it."
Maria donated her eggs to a woman whose name she never knew. "I just knew basic details about her -- how long she'd been waiting, that sort of thing. When I rang the clinic nine months later, I was delighted to find out she'd had a baby, although I don't know if it was a boy or a girl. It really was one of the best things I ever did."
Deciding to pursue the egg donation route is a big decision for couples -- and not something done lightly. Clinics recommend counselling for couples to fully understand the implications of the process -- both for themselves and for their child.
"For the couple about to embark on egg donation, coming to terms with the idea of it is about acceptance," says Ann Bracken, fertility counsellor at Dublin's SIMS clinic. "And not just about accepting the decision to proceed with this course of action, but accepting the loss of not having a genetically shared child.
"After that, their attitude towards the donor is very important: they must feel positive towards them, but at the same time I don't want them to overthink the donor."
And couples must be prepared for the future. What questions today's donor egg babies might have about their own history and heritage 20 years from now are anyone's guess.
Egg donation is most common in countries where the donor's anonymity is protected by law. But many argue that children born as a result of egg donation should have the right to track the biological parents.
There are no easy answers. Sarah's little boy is now two. She plans to tell him, when he's old enough to understand, how he was conceived, but he'll never know exactly who his biological mother was, because US law protects donor anonymity.
While not revealing donors' identities, Shady Grove say it is extremely choosy about donors and excludes the 95pc of applicants who do not meet the clinic's medical and psychological requirements. Prospective donors are excluded for reasons including a family history of diabetes, depression, or alcohol abuse.
Genetic screening excludes gene carriers for conditions like cystic fibrosis. Donors are even psychologically tested.
But it's not about creating designer babies, says Shady Grove director Dr Gil Mottley. "We are looking for the best heritage for our patients and we are out to create the healthiest baby we can," he says.
"Many donors are young mothers who have had their own families, or medical professionals who have seen patients suffer and feel that they can give something back in a unique way. Yes, they are compensated, but really it is a combined motivation. There are daily injections and different appointments to attend, and it's a big commitment."
Sarah will be able to hand her son a 10-page document, compiled by the fertility clinic, with details about what kind of a woman the donor was -- what she liked, what she didn't like, what colour her hair was, how many siblings she had. Sarah feels this is enough.
"I think about that amazing woman all the time," says Sarah. "I might not know her name, but I do know a lot about her."
"I think biology is overrated," says Maria Duffy. "The woman who received my eggs carried that baby, delivered that baby, and is now bringing it up. That baby couldn't be more hers." She'd be happy, she says, for the child to contact her if he or she wanted to in the future.
For Sarah's part, the rewards of having a longed-for family of her own outweigh the potential pitfalls of donation.
"People get too hung up on making a baby, but what you're really doing is making a family.
"Egg donation is nothing to be ashamed about. Society makes people uncomfortable with this step. But our lives have been unbelievable for the past two years. It is the most incredible thing that has ever happened to us. I have a beautiful boy, and I have the happy ending that I always wanted."