MAL 34:20 MAL34 | Page 16

GYN CHRONICLES Egg Donation Dr. Maureen Owiti R ecently one of the major dailies in Kenya carried a story on the plight of egg donors. It may be a controversial story but this is what comes to mind at present moment. Jane Mureithi (not her real name) is a 40 year old lady. She is currently on her second marriage after the first ended in acrimony due to lack of off springs. Her first marriage was for seven long years that initially started blissfully but when a baby was not forthcoming there was a paradigm shift especially after the initial test and her first husband were found to be fine. She had always had irregular cycles and when she was much younger had been reassured that the cycles would stabilize. Treatment after treatment failed and soon her husband and his family turned on her. She was an outcast, the barren woman! Her husband got a second wife who conceived soon after the marriage and then the physical abuse started. That was the straw that broke the camel’s back. She left and filed for divorce, which luckily her husband did not contest. She never knew that she would ever marry again but out of the blues came Steven whom she was very honest with from the word go. She is among the lucky few as 2nd time is a charm and she married the love of her life, who has been very understanding of her situation. They have been married for years and have had several procedures including IVF to try and get a baby. On evaluation due to her age and hormone levels and noting previous failed cycles with own egg she is advised the best option is a donor egg. She goes through the donor profiles and chooses one donor. The cycles for the donor and Jane are synchronized and she is down-regulated (her natural cycle is stopped) with a hormone. She had also been started on other vitamins and blood pressure medication. On the D day her donor starts menstruating and she is also put on estrogen pills. Jane goes for serial ultrasound scans and is told her lining is growing well. Eventually the donor has her egg collection and Steve Being a fertility specialist I feel egg do- nation offers a solution to some women, noting that very few women, even those who are advised, opt for this method and should be left as an option as we increase the safety for donors and advocate for the rights of both the donors and recip- ients. 14 MAL34/20 ISSUE provides the sperm. On the next day they are informed that there are 14 fertilized embryos that are doing well and on day 3; 12 embryos are growing. A decision to freeze 10 and transfer 2 embryos is made. Then sets in progesterone injections, pessaries, steroids, and a long 14 days. On the way to the hospital for pregnancy check with the beta HCG blood test she is nervous and a long 2 hours before the news. The doctor asks what she thinks the results are and she is honest she is praying it is positive. Fortunately she was positive and that marked the end of one long chapter and the beginning of yet another long journey. Nine months to be precise, Jane and Steven were blessed with a bouncing baby girl after an elective Caesarean section. Jane is lucky and if not for the help of the donor her only other option would have been to adopt. Becoming an egg donor is not a walk in the park. The women chosen to be egg donors have to fulfill very strict criteria: be between the age of 18-35 (some centers prefer 25-30); BMI should not be more than 30; have a regular menstrual cycle; have both ovaries; cannot use contraceptive implants or psychoactive drugs; lack of substance abuse in medical history; no inheritable genetic disorders in family history; and must have good and healthy diet. After a history has been taken some tests are done on the ladies namely: HIV, Hepatitis B and C, Syphilis (Treponema