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Do I Need to Use an Egg Donor if I Have PCOS?

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Updated October 03, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Just because you have PCOS, it doesn’t mean that you will need to use donor eggs if undergoing infertility treatment. Donor egg is a specialized treatment regimen where the eggs from either an anonymous donor or someone you know are retrieved surgically, fertilized in the lab with your partner’s sperm, and the resulting embryos are transferred back into your uterus.

Using donor eggs to conceive raises a lot of issues that can have a profound impact on both your family and the resulting child. Obviously, this is a very advanced form of treatment and not one to be entered into lightly. Most clinics have a list of screening requirements for both the recipient and her partner that must be completed before pursuing this type of cycle. In fact, the American Society of Reproductive Medicine and most specialists will even require an evaluation with a specially-trained reproductive psychologist before undergoing this treatment.

PCOS alone is not an indication for the use of donor eggs. You may be a candidate, however, if your ovaries are missing or damaged, you have low ovarian reserve, you have a genetic condition that will be passed on through your eggs, or you are not medically able to undergo the ovarian stimulation required to retrieve your eggs. For example, if you had surgery for PCOS, like ovarian wedge resection or ovarian drilling, damage to the ovaries may make them unable to produce enough follicles in response to the medication.

In most cases, the first line of treatment for a young woman with anovulation related to PCOS is taking an oral medication called clomid. Sometimes clomid is given in conjunction with metformin, a drug used to treat insulin resistance and which is thought to possibly induce ovulation in women with PCOS. Other options include injectable drugs coupled with intrauterine insemination or in vitro fertilization (IVF).

If your doctor recommends using an egg donor for one of the above indications, like poor ovarian reserve, selecting a donor is an important part of the process. There are many egg donor agencies that advertise a roster of perfect, Ivy-league educated, artistic, and athletic donors. While that sounds nice, even more important is a donor’s pregnancy rate and overall fertility. That is what will get you pregnant -- not where she went to school. It’s important to remember that the values and environment in which you raise your child will play a significant role in how he or she turns out, not just genetics. Using donor eggs is expensive and there’s no guarantee that the cycle will work. You’ll want everything stacked in your favor when you undergo this process.

Many fertility centers maintain a pool of donors that they work with, or they may send you out to a specialized donor egg agency. If you are unhappy with the selection at your fertility center, you may even want to check out a few agencies yourself. However, before signing on with an agency, make sure you ask a lot of questions about their process and the “what-ifs.” What happens if the donor doesn’t pass your center’s medical screening -– are you still obligated to use one of their donors or will you get your money back? What if she doesn’t respond well to the medication? Also, make sure that you understand all of the paperwork that you sign and read it for yourself.

Whichever donor you select, you can rest assured that she has undergone a strict medical exam and testing for infectious diseases. The Food and Drug Administration provides guidance and regulations on the use of donated eggs. Every donor must be thoroughly screened for HIV, hepatitis B and C, syphilis, chlamydia, gonorrhea, West Nile virus, and other infectious diseases. She should also take a urine drug test, undergo a psychological evaluation and be tested to see if she is a carrier for several of the most common genetic diseases. All of the testing should be completed within thirty days of the egg retrieval to ensure that she is free from infection. Ask your clinic about their adherence to FDA and state department of health regulations -– they should be in complete compliance.

Using an egg donor is a big decision and one that shouldn’t be taken lightly. While in some cases, it provides the best chance for pregnancy, getting a second opinion might be warranted, especially if you are unsure or uncomfortable with the decision.

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