WITH 30 patients awaiting donor eggs to aid conception, a local fertility centre went on a drive for donations but was immediately overwhelmed as hundreds of Jamaican women responded.

Dr Sharifa Frederick, clinical director at Caribbean Fertility Centre, says the country is seeing a noticeable shift in its reproductive practices as demand for Jamaican donor eggs grows.

She said that the fertility centre hosted a drive in September to find donors for 30 patients waiting for eggs to begin their procedure. To her surprise, hundreds of women turned up and applied to donate their eggs in exchange for US$2,500 to US$3,000 compensation.

“I thought that Jamaicans were very traditional and we wouldn’t get a lot, so we had been doing a lot of ads on social media; but we have hundreds of women who are reaching out to us — even via e-mail. Our phone lines are ringing constantly. We can’t even keep up because of the demand from these applicants. It has been overwhelming,” Dr Frederick told the Jamaica Observer.

“We have had to cut down on the social media push because we just can’t keep up. Sometimes we have to put out that, ‘Okay now, we are not taking any new persons right now.’ The [reception] is overwhelming,” she said.

According to the Hugh Wynter Institute for Reproductive Healthcare & Endoscopic Surgery, which operates on the grounds of The University of the West Indies, Mona, egg donation is the process of collecting eggs from a donor that are fertilised using the sperm of the intended male parent. The fertilised egg, now called an embryo, is then transferred to the recipient woman to achieve a pregnancy.

The practice was developed in the 1980s, initially for women with ovarian failure or premature menopause. Later it was extended to women who carried a genetic disease, ovulating women who appeared to have issues with their eggs, and couples who failed to conceive after multiple in vitro fertilisation (IVF) attempts. Jamaica adopted the practice in 2007.

Dr Frederick shared that the demand for eggs in Jamaica has grown, particularly among women 40 to 50 years old who delayed having a family until they met the right partner or were financially stable. Due to their age, she said, it is more difficult for them to conceive, and so they are seeking alternatives.

Additionally, she said there are couples who struggle with fertility issues and are requesting egg donors to make their dream of having a family possible.

“There are just as many women coming for donor eggs as there are for in vitro fertilisation [the joining of a woman’s egg and a man’s sperm in a test tube or elsewhere outside the body], or even more. There are actually more requests for donor eggs. Our success rates with pregnancies in this situation is over 70 per cent, and some situations reaching 90 per cent,” she told the Sunday Observer.

“We have a lot of clients who are requesting [it] because their ovarian reserve is very low or non-existent, and so they now want to seek donor eggs. We saw that there was a need for a local market for donor eggs. Persons want to have Jamaican eggs, and so we have egg drives every now and then, where we have young persons come in and they donate their eggs,” said the clinical director.

Dr Frederick explained that the egg donation process is relatively simple. The target donors are women 20 to 30 years old because the younger a donor is, the more viable their eggs.

The clinical director said that in some instances the patients who receive the eggs prefer to have the donor be a university graduate or someone currently enrolled in university. However, donors who did not pursue tertiary education are also welcomed, she said.

“They would come in for myriad investigations. We would have to do psychological evaluations, we have to take their medical history, we have to examine them, and we do an ultrasound. We do a blood test to make sure they are fertile — that’s the first blood test that we do — and then we do hormonal testing and we do viral testing,” she told the
Sunday Observer.

“All of these things are general health checks, so they have the advantage of learning about their own fertility. We can pick up certain disorders that are there and, of course, if we pick up certain things, they would not be eligible, but at least they would be armed with the knowledge,” she said.

When the egg donor’s menstrual cycle begins, Dr Frederick said they are placed on stimulation medication to help the ovaries produce eggs. She explained that every month a female produces one egg, and the stimulation medication — given for about 12 days — would help the body to produce more than one egg. The eggs would be retrieved on the 13th day.

For each donation, a minimum of 12 eggs are retrieved. Women are only allowed to donate up to three times and must take at least a one-month break before they can again donate.

She explained that because Jamaica is a small country the cap on the number of donations per person is to avoid inbreeding, which is the production of a child between two people who are closely related.

“You are really only supposed to have three families bearing children from one donor in a climate like this. We don’t want ‘X’ donor to have 10 children out there running around, because then there is the increased chance of inbreeding. You don’t want to border on abuse of the body at the same time,” said Dr Frederick.

She clarified that the procedure would not deplete the donor’s egg count entirely or make them infertile. However, the limit is needed to ensure that donors are protected.

She said psychological evaluations for donors are also important to ensure that donors understand what they are signing up for and are willing to go through with the process.

“We do a psychological evaluation to make sure that they are socially, mentally, and emotionally prepared, and that they won’t have any regrets. We can’t assure them of that, but it’s just to make sure that they are not the kind of person who is kind of fickle and will have some form of regret later on in life. They have to be strong; they have to know what they are doing and they have to know what it is about,” she told the Sunday Observer.

After these evaluations, more women are willing to undergo the procedure than drop out, Dr Frederick said.

“Most times, the drop-out is because they are ineligible because their fertility testing shows that they don’t qualify, or they have some disorder like sickle cell or they have a seizure disorder,” she explained.

The process for recipients is somewhat similar, with fertility and health tests done to ensure the couple or woman requesting the eggs is eligible to rceive a donation.

“For the female, we do health checks on her to make sure she is medically fit to become pregnant. We also do tests on her uterus and her tubes to make sure they are also healthy to receive an embryo. The male partner has to be healthy as well, so we do investigations for him — blood, urine, and we do a sperm count to make sure. You need healthy eggs and healthy sperm to form a healthy embryo,” said Dr Frederick.

The intended family or individual would also get a profile of the donor, containing details about their hair texture, education level, height, weight, and medical background. Once they have chosen their donor, the intended mother would be prepped for implantation, said the clinical director.

“She would be put on oestrogen medication for 10 days, then progesterone for five days, and once the lining is ready, the partner will come in to fertilise the egg. The embryo will grow to the blastocyst stage and then we will do an embryo transfer. Ten days later, they do a pregnancy test,” she explained.

The intended family or individual would receive a minimum of six eggs. However, only one or two eggs would be transferred.

“More often than not, a donor egg will result in a healthy embryo, so we transfer two to ensure that [just] in case one is not so hot, then the other one might catch. We don’t transfer more than two because if both catch, then she will end up with twins, and we wouldn’t want her to end up with higher multiples by transferring [more than] two,” Dr Frederick explained, adding that the recipients have the option to freeze the remaining eggs.

She noted that the procedure is relatively expensive, with patients paying US$10,000 to US$14,000 to access donor eggs, depending on their requirements. However, she said more women are accepting this new way of having a family.

“When you first introduce it to them, they are like, ‘Oh, but it’s not my genes; it’s not my baby.’ But as I tell them, once you get pregnant, there is something called epigenetics which determines which genes from that embryo is going to be turned on and off, so you do have some kind of genetic part to play with that embryo,” she explained.

“There is also the aspect of bonding. As that baby is growing inside of you, you’re bonding. That baby is getting all of your blood supply, so by the time they are ready to deliver, most of these women are so happy. I’ve never had a case where someone has felt like the baby is not their own,” she told the Sunday Observer.

“I think we are coming around. I think we are becoming a bit more Westernised. I don’t know what it is, but I think it is that people just see the need for it, and they accept it as something natural,” she reasoned.