“How many have I donated?”. The first thing Alide asks upon awakening from anesthesia is the number of eggs she has managed to donate. “Twenty-three, they tell me, and I can’t be happier. I would have done it, and I would do it again, immediately.” Alide is the invented name of the first girl (31 years old, doctor) who voluntarily resorts to egg donation in Lombardy. It happens in July 2021, yet in Italy it has been possible since 2014, when the donor selection criteria were established. Few, however, know it and so the donors can be counted on the fingers of one hand.
In addition to misinformation, there is also the issue of reimbursement, not foreseen in Italy (in Spain it is a thousand euros), and the distrust of a path consisting of various tests, hormonal stimulation and sedation intervention. Egg donation is generally the last resort for women who, due to infertility problems or pathologies, cannot use their own eggs for pregnancy.
“I would do it again because I was fine and because nobody does it and knows it. I am a doctor, yet I was not informed,” says Alide, a donor of nature, already blood and on the list for the bone marrow. The desire to donate eggs stems from the experience of two friends: “For fertility problems, both had resorted to heterologous fertilization, so I decided that I wanted to help women like them”.
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To do this, he turns to the Niguarda in Milan, one of the centers where it is possible to undertake a path of heterologous and home to a bank dedicated to the conservation of gametes. “At first everyone told me I was crazy, then they understood and supported me. One of my mum’s fears, for example, was that I would waste my eggs. But hormonal stimulation, the doctors explained, leads to maturation of all the eggs. oocytes that would normally be activated anyway, but then lost, in an ordinary menstrual cycle “. Alide’s first visits begin in the summer of 2019, then due to the pandemic the path is interrupted and postponed several times, until July 2021, when she finally manages to donate. In normal situations, the process takes about a month.
“The Italian law is quite strict when it comes to donations,” he explains Maurizio Bini, head of the Diagnosis and Therapy of Sterility and Cryopreservation of the Niguarda Hospital. “Each donor must undergo clinical and genetic checks, to verify that there are no infectious or hereditary diseases, and a psychological evaluation to confirm the voluntary nature of the act and ensure that the decision does not arise from psychosis or personality disorders”.
If all these steps are passed, the donor is “enrolled” and subjected to subcutaneous hormonal stimulation for a fortnight. “In these two weeks, blood tests and ultrasounds are done to monitor the maturation of the eggs, all on an outpatient basis, trying to satisfy the patient’s needs as much as possible”, continues Bini. “When it is ascertained that the oocytes are mature, the gametes are taken with a transvaginal needle under anesthesia. To minimize post-operative discomfort, we use a simple hormonal stimulation protocol, which allows the reduction of ovarian size as soon as possible.”
“I would have liked to infect some friends, but there is a lot of mistrust and I have not succeeded”, is Alide’s regret. “I have not had any side effects and I have not lost days of work, but few really know what it consists of and that it is a quick and safe intervention”.
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Adding to the fears is the lack of a culture of giving and remuneration. “In Italy, donors are not reimbursed, it is one of the very few countries where this happens”, emphasizes Bini. “The national gametes destined for heterologous fertilization present in our banks come almost all from egg-sharing procedures, that is, from women who perform hormonal stimulation for themselves, often in a private center, and, if they manage to get pregnant, donate the leftover eggs, or they are imported from foreign banks. Six eggs cost us around € 2,900-3,000. Reimbursing our donors would be the best way. Most of the countries orient themselves between € 900 and € 1,500 “.
Giulia Scaravelli, head of the national register of medically assisted procreation of the Higher Institute of Health, assures that “a technical table has been set up at the Ministry of Health and that work is currently underway to launch awareness and information campaigns”. Today a woman who wants to donate her own eggs, where can she do it? “In public hospitals where heterologous can be accessed and where there is a gamete conservation bank, such as the Niguarda in Milan, the Careggi in Florence, the Sant’Orsola in Bologna and the Santa Maria degli Angeli in Pordenone , but also in affiliated private centers and in private individuals. For now there are still few and above all in the North, but soon we will ensure that accessibility and information increase “.