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Published by: outdash2 on Oct 20, 2013
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Estabishing Maternity in Egg Dnatins: A Haakhic Perspective
Dr. Ephraim Hollander 
I. Medical Background 
e rst successfu cyte (egg) dnatin was perfrmedin the eary 1980’s; this success ushered in a new t fr thetreatment f intractabe infertiity.
In cnjunctin withimprvements made t cnventina in vitr fertiizatin
 (IVF), the prcedure has becme safer and ess invasive,thus making it mre attractive t ptentia dnrs.Currenty, IVF utiizing a dnr egg accunts fr 10% f a IVF prcedures dne in the .S.
outcmes have beendescribed psitivey, impantatin and pregnancy rates f egg dnr cyces have been fund t be as gd as r betterthan cnventina IVF cyces.
Risks assciated with egg dnatin are primariy due t mutipe gestatins, but
1 Kein J, Sauer MV. ocyte dnatin. Best Pract Res Cin obstet Gynae-c 2002;16:277-291.2 In vitr fertiizatin is an assisted reprductive techngy invving var-ian stimuatin, egg retrieva, fertiizatin, embry cuture , and the transfer f the embry t the uterus.3 Kein ibid. 2784 Ibid. 285Dr. Ephraim Hander received his medica degree frm the Abert EinsteinCege f Medicine f Yeshiva niversity. He is currenty cmpeting aninternship in Interna Medicine and wi cntinue nt a residency in Radigy.
Verapo Yerape 
there is as an assciatin with higher rates f pregnancy-induced-hypertensin and cesarean sectin. Dr. Jeery Kein, a practicing reprductive endcringist, cncudesthat “egg dnatin tday is assciated with the highestsuccess rate amng the assisted reprductive ptins andhas awed patients with therwise intractabe infertiity an pprtunity t cnceive.
ere is a wide range f medica indicatins fr utiizing cyte dnatin, incuding wmen with premature varianfaiure r reduced varian reserve; wmen ver the age f 45 requiring cnventina IVF; wmen with repeatedy faied IVF attempts r abrtins; and wmen with geneticdiseases such as Turner’s syndrme.
In the past, cupes with heritabe diseases were the primary users f dnr eggsbut the advent f preimpantatin genetic diagnsis (PGD),a prcedure in which the embry underges genetic testing prir t impantatin, shud reduce the need fr dnreggs. e mst cntrversia use f dnr eggs is fr wmen wh are past nrma menpause. Research has shwn thatder patients have achieved simiar utcmes t yungerpatients.
Hwever, there are signicant nancia andpsychscia cnsideratins fr der patients that mustbe taken int accunt, and therefre mst prgrams imitrecipient age t 55.e primary surce f dnr eggs has changed ver theyears. Frmery, extra eggs frm IVF cyces were the majrsurce f dnr eggs (and this surce remains the ny ega
5 Ibid. 2866 Ibid. 2787 Ibid. 279
Establishing Maternity in Egg Donations: A Halakhic Perspective 
methd in Israe).
Currenty, eggs frm wmen knwn tthe recipient r annymusy recruited are the mst cmmnmethd f btaining dnr eggs in the .S
Dnrs knwnt the recipient may incude cse friends, sibings, parents,r even chidren frm a previus marriage. Annymusdnrs are screened fr desired phentypic characteristics f the receiving cupe. A prper histry and physica f dnrsshud screen fr any infectius disease, heritabe cnditins,and diseases ike diabetes, atherscersis, and famiia cancers. Additinay, prtcs require the dnr t be ess than 35years d and preferaby ess than 30 years d. Risks t thednr are generay minr, usuay cnsistent with patientsunderging a cnventina IVF cyce with a wer risk f ovarian Hyperstimuatin Syndrme (oHSS).
A study f 1000 dnr cyces shwed seven serius prbems eading ttw hspita admissins fr oHSS, but n fataities.e ga f the egg dnatin cyce is t synchrnize themenstrua cyces f bth the dnr and recipient. At thestart f the cyce, the dnr is given injectabe hrmnes frrecruitment f mutipe eggs, ang with GnRH agnists rantagnist t prevent an lH surge
in the dnr.
Atthe same time, the recipient is given at east tw weeksf estrgen t prime the uterus fr pregnancy. Prir timpantatin f the embry, prgesterne is administered
8 Ibid. 2819 Ibid.10 oHSS is a cmpicatin f verstimuatin f the vary frm many fertiity medicatins that eads t varian enargement, uid accumuatin inthe abdmen, nausea, and diarrhea. Severe cases can ead t uid buidup inthe ung space and respiratry distress.11 e hrmna event that eads t vuatin12 Kein ibid. 284

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