TAILIEUCHUNG - Oocyte Donation: State of the Art

Oocyte donation is now an integral part of the armamentarium of the infertility specialist. At its inception, it was intended as therapy for women with premature ovarian failure, or those with heritable genetic defects. However, as experience accumulated, oocyte donation as a treatment has been extended to women with a variety of defects in oocyte production or function. The largest group of women now undergoing treatment with oocyte donation consists of those with age-related decline in fertility. . | 18_ Oocyte Donation State of the Art Anne Z. Steiner and Richard J. Paulson Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology Women s and Children s Hospital Keck School of Medicine University of Southern California Los Angeles California . INTRODUCTION Oocyte donation is now an integral part of the armamentarium of the infertility specialist. At its inception it was intended as therapy for women with premature ovarian failure or those with heritable genetic defects. However as experience accumulated oocyte donation as a treatment has been extended to women with a variety of defects in oocyte production or function. The largest group of women now undergoing treatment with oocyte donation consists of those with age-related decline in fertility. Additionally techniques learned from oocyte donation including endometrial preparation and embryo-endometrial synchrony have been applied to other infertility treatments including frozen embryo transfer and in vitro maturation of immature oocytes. HISTORY The first successful human oocyte donation was reported in 1983. At the time of ovulation a fertile donor was inseminated with the recipient partner s sperm. Uterine lavage was performed on the fifth day after the luteinizing hormone LH peak. The recovered embryo was then transferred to the uterus of the infertile patient. After several attempts a pregnancy was successfully initiated and a singleton birth at term was achieved 1 2 . 381 382 Steiner and Paulson Unfortunately this method known as ovum transfer was inefficient 3 . Attempts to enhance the efficiency of the process by administering fertility medications to the donors were unsuccessful and led to retained pregnancies in the donors 4 . The first use of standard in vitro fertilization IVF methodology for oocyte donation was also reported in 1983 however this pregnancy ended as a miscarriage 5 . Subsequently Lutjen et

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