Late motherhood is a reality of our times and has led more and more women to resort to reproductive medicine to achieve the much-desired pregnancy. After the age of 35, the probability of a woman getting pregnant naturally drops by half. And when the quality of her eggs is insufficient to achieve pregnancy, the most viable option is egg donation.

"There is a growing trend according to the current social and economic context for later motherhood. Since female fertility begins to decline more sharply after the age of 35, many of our patients face a reality they did not expect: they will not be able to get pregnant with their own eggs," says Filipa Santos, a psychologist at IVI Lisbon, in a statement. Accepting this situation and considering treatment with donated eggs is a path that "can be challenging, which implies deconstructing a series of beliefs and processing genetic mourning." Therefore, "we recommend to all people who are faced with this possibility to have a psychology consultation and eventual psychological follow-up, when necessary".

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Normally, a woman who finds herself in this situation goes through different phases in the emotional process, which can range from rejection, to sadness, to uncertainty and progressively to acceptance. The loss is reflected in the so-called 'genetic mourning', which is characterized by the acceptance that a person will not pass on their genetics, and therefore their family's, to their children. These are common reactions, but they can have a significant impact on the way a person sees themselves in the present moment and also how they project themselves into the future, but they can benefit from psychological support.

Filipa Santos reveals that, during the consultation, the most frequent concerns are how they will feel as mothers of the baby, if there will be differences in motherhood without a genetic bond, what the origins and motivations of the donors are, what feelings may arise if there are differences in physical characteristics, whether or not to share this decision with the people closest to them and, in the future, how to approach it with the child. "Psychological counseling is essential at this stage, in order to promote a properly informed and conscious decision-making, and also to support the emotional impact of the whole process," she adds. In her opinion, it is important to let emotions flow and share with partners (when they exist) and/or with the closest family or friends, without any prejudice. Doing so can be liberating and facilitate greater acceptance. Egg donation is a possibility, a choice," she explains.

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Patients who are indicated for egg donation are generally women who have postponed motherhood, who have premature ovarian insufficiency or who have undergone surgery on the ovaries. In addition, this treatment may also be indicated for women with hereditary diseases or a history of repeated failures in in vitro fertilization (IVF) with their own oocytes.
"For many women, it is not the situation they idealized. Many blame themselves for having postponed motherhood. It is essential to give them time to accept, reconsider, express emotions, and then make the decision when it makes the most sense to them," she explains.

The doubts that generate the most concern

Will my child look like me? How is the donor chosen? The lack of information about the process is something that generates anxiety. As the subject is not openly discussed, these women tend to keep all these anxieties and uncertainties to themselves. What few know is that there is a bond that is born with the decision and that grows, from the transfer to the birth, as Filipa Santos points out: "The bond they will have with the baby will be unique, enhanced by epigenetics, that is, there is a relationship between mother and child during the gestational period, a prenatal bond that will leave its mark after birth and in the future relationship". This bond ends up facilitating the woman's transition to her role as a mother with the emotional and physical changes that this first phase implies.

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But after all, how does it all happen? According to Tetyana Semenova, a gynecologist and head of the egg donation unit at IVI Lisbon, the donor is chosen according to phenotypic criteria (physical characteristics, such as skin tone, eye color, hair color, height, weight), blood group and the genetic compatibility between the husband/donor and the donor (a test is performed that studies the presence of genetic mutations considered more frequent in a certain population).

Once the donor is chosen, IVF is performed and the embryos are created. Then the process of preparing the woman's endometrium to promote the subsequent implantation of the embryo begins, explains Dr. Tetyana Semenova. The embryo transfer can be performed in the natural cycle or in the cycle using medication. The success rate with egg donation is around 90%, after three attempts.

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