Egg donation

Egg donation is an established medical option for couples whose IVF with their own eggs is not succeeding. It is the most effective option when the woman’s eggs are depleted, or too few and of too low quality to produce a pregnancy.

The resulting child is the biological child of the father, is carried by the mother, and is legally the child of the couple.

When egg donation is considered

Egg donation is indicated in specific situations:

Premature menopause or premature ovarian insufficiency — the woman no longer has eggs
Advanced maternal age, when the chances with her own eggs are minimal
Repeated failed IVF attempts with the woman’s own eggs, when the embryos produced are of low quality
Genetic disorders transmitted from the mother that can pass to the child
Chemotherapy or radiotherapy that has depleted the ovarian reserve
Poor ovarian response despite repeated stimulation

Chances of success

The key difference between egg donation and IVF with own eggs is that success depends on the donor’s age, not the recipient’s.

Live birth per embryo transfer: approximately 50%
Cumulative live birth per donor cycle: over 70%

These rates remain essentially the same regardless of the recipient’s age up to about 50 — because the eggs come from a young donor. The uterus retains its ability to carry a pregnancy well beyond the age at which the quality of one’s own eggs declines.

The donor — selection and screening

In Greece, the egg donor:

Is aged 18-35 years (required by law)
Meets strict medical criteria
Undergoes psychological assessment
Is screened for infectious diseases (HIV, hepatitis B and C, syphilis)
Undergoes mandatory genetic screening per Greek MAR Authority guidelines: karyotype, molecular testing for α, β and δβ thalassaemia, cystic fibrosis, fragile X syndrome; further tests depending on family history
Is compensated for her expenses and time — not for the eggs themselves

Anonymity: in Greece, egg donation is mutually anonymous — the donor does not know to whom she is donating, and the couple does not know the donor’s identity. Only non-identifying phenotypic matching is allowed (hair colour, eye colour, blood group).

The procedure step by step

Cycle synchronisation of donor and recipient with hormonal medication.
Donor stimulation with gonadotrophins to produce multiple follicles.
Egg retrieval from the donor under light anaesthesia.
Fertilisation of the eggs with the husband’s sperm (or donor sperm if needed).
Endometrial preparation of the recipient — either with oestrogen and progesterone or within a natural cycle.
Embryo transfer into a well-synchronised endometrium — usually a single embryo.
Pregnancy test 12-14 days after transfer.

Fresh or frozen donor eggs

Two approaches are widely used in egg donation:

Fresh cycle: the donor’s and the recipient’s cycles are synchronised pharmacologically, and the eggs are fertilised immediately after retrieval.

Frozen donor eggs (egg bank): donors provide eggs that are cryopreserved through vitrification. The recipient chooses from the available stock, without waiting for cycle synchronisation, with greater flexibility and a wider selection of donors.

With modern vitrification, success rates are equivalent between fresh and frozen donor eggs — any difference is clinically negligible.

The legal framework in Greece

Under current Greek law (Law 3305/2005 as amended) and the guidelines of the National Authority for Medically Assisted Reproduction (ΕΑΙΥΑ):

Maximum recipient age: 54 years
Mutual anonymity is mandatory on both sides
Maximum number of births per donor: 10
Written consent from both spouses is required
The child has the right to access non-identifying medical information about the donor through the Authority, solely for reasons related to their own health

The whole procedure is supervised and regulated by the National Authority for Medically Assisted Reproduction (ΕΑΙΥΑ).

Summary: what to remember

Egg donation is an effective option with high birth rates.
Success depends on the donor’s age, not the recipient’s.
Birth rates remain consistent (≈50% per transfer) regardless of recipient age, because they depend on the donor’s age. Obstetric risks, however, increase at advanced ages (≥45 years). In Greece, the law permits egg donation up to a recipient age of 54.
In Greece the procedure is mutually anonymous and tightly regulated.
The maximum recipient age is 54 years.

Questions for your doctor

Given my history, is egg donation the right choice now, or does it make sense to continue with my own eggs?
What are the success rates at your centre?
How long is the expected waiting time from application to embryo transfer?
What psychological aspects should we be aware of as a couple?
How is phenotypic matching done?