Donor Programs at Yaal Fertility Centre, Chennai

Which type of donation is appropriate depends entirely on where the obstacle lies.

Egg donation is used when a woman’s own eggs are not viable — because of premature ovarian failure, significantly diminished ovarian reserve, repeated IVF failure with her own eggs, age-related decline in egg quality, or a genetic condition she does not wish to pass on. Eggs from a screened donor are fertilised with the male partner’s sperm, and the resulting embryo is transferred to the recipient. The recipient carries the pregnancy and gives birth to the child — a point worth stating clearly, because it is often not understood. The genetic link to the mother is absent; the pregnancy, the birth, and the motherhood are entirely hers.

Practically, an egg donation cycle requires synchronising two people: the donor undergoes ovarian stimulation and egg retrieval, while the recipient’s endometrium is prepared to receive the embryo at the right moment.

Sperm donation is used in severe male factor infertility where no viable sperm can be obtained even surgically, where the male partner carries a genetic condition, and by single women and same-sex female couples. Donor sperm may be used in IUI, where the woman’s fertility is otherwise normal, or in IVF or ICSI where it is not.

Embryo donation involves receiving an embryo donated by another couple — typically one who completed their own IVF treatment and had surplus frozen embryos. It is used where both partners have gamete problems, or where repeated cycles with donor eggs or donor sperm have not succeeded. Neither parent has a genetic link to the child, but the recipient carries and gives birth to the pregnancy.

Screening is what makes a donor programme trustworthy, and it is where the difference between a rigorous clinic and a careless one is most consequential.

Donors at Yaal Fertility Centre are assessed across several dimensions:

• Medical history and physical examination — a full personal and family medical history, to identify conditions that could be inherited or that would make donation unsafe for the donor.
• Infectious disease testing — blood screening for transmissible infections, to protect both the recipient and any resulting child.
• Genetic testing — screening for genetic conditions that could be passed to a child.
• Hormonal evaluation — in egg donors, to assess ovarian reserve and the likely response to stimulation.
• Psychological assessment — to confirm the donor understands what donation involves and is giving genuinely informed consent.

Only donors meeting the criteria are accepted. Matching to recipients is then made on physical characteristics and blood group.

It is important to be straightforward about what screening can and cannot do. It substantially reduces the risk of a transmissible infection or a screened-for genetic condition. It cannot guarantee a healthy child — no screening can, whether the conception is donor-assisted or entirely natural. Any clinic implying otherwise is misleading you.

Donor conception in India is governed by the ART (Regulation) Act, 2021. This legislation sets the rules for donor screening, consent, confidentiality, record-keeping, and who may access donor treatment. These are statutory obligations, not clinic preferences, and they exist to protect donors, recipients, and the children who result.

Two aspects matter most to prospective parents.

Confidentiality. Under Indian law, donor identity is kept confidential. Neither donor nor recipient learns the other’s identity, and records are maintained securely. This is a materially different arrangement from some other countries, where donor-conceived people may have a legal right to identifying information about their donor when they reach adulthood. If this distinction matters to you — and for some families it matters a great deal — it should form part of your counselling discussion rather than being discovered later.

Eligibility. The Act sets out who may access donor treatment and under what conditions, including requirements relating to marital status and age. These eligibility rules are legal requirements and they do change, and they determine what is available to you regardless of clinical suitability. We will tell you plainly where you stand under the law as it currently applies.

Counselling is a required and genuinely valuable part of this process, not a formality to be signed off. It is where the questions that have no purely medical answer are addressed: whether and how you would tell a child about their conception, how you feel about the absence of a genetic link, and whether both partners are truly of one mind. Couples who work through these questions before treatment tend to be far more settled afterwards than those who defer them.

Donor egg IVF has among the highest success rates in reproductive medicine — typically 60–70% per transfer cycle — and the reason explains a great deal about fertility in general.

The single greatest determinant of IVF success is egg quality, and egg quality is governed overwhelmingly by the age of the woman whose eggs they are. Donor eggs come from young, healthy, screened women with good ovarian reserve. So the embryos created from them are, in the main, high quality — and the chance of implantation and a healthy live birth reflects that.

The important and often surprising consequence is this: with donor eggs, success depends far more on the donor’s age than on the recipient’s. A woman in her mid-forties using donor eggs can have success rates approaching those of the young donor, because the limiting factor — her own egg quality — has been removed. Her uterus, unlike her ovaries, remains capable of carrying a pregnancy well beyond the age at which her eggs cease to be viable.

For a woman with premature ovarian failure or severely diminished ovarian reserve, this is why donor eggs are so often recommended. It is frequently the difference between a very low chance of success with her own eggs and a genuinely good chance with donated ones.

That is a hard conversation to have, and it is not one to rush. But when a couple has been through repeated failed cycles with their own eggs, being told the truth about the odds is a kindness, not a cruelty.

The medicine here is comparatively straightforward. The feelings are not, and it does nobody any favours to pretend otherwise.

Most people arrive at donor conception having wanted a genetically related child, and having to let go of that is a genuine loss. It is common to feel grief, ambivalence, guilt, or a sense of failure — and to feel these things while also wanting to go ahead. Both can be true at once. It is also common for two partners to arrive at acceptance at quite different speeds, which can be a strain in itself.

The questions that most often need working through are:

• Will we tell our child how they were conceived, and if so, when and how?
• Will we tell our wider family? What will we say if we are asked?
• How do I feel about my child having a genetic link to someone I will never meet?
• Are we truly both ready, or is one of us going along with it for the other?

There are no universally right answers, but there is a strong consensus that these are better confronted before treatment than after a child arrives. This is precisely why counselling forms part of the process, and why we would rather you took the time you need than proceeded before you were ready.

What can be said with confidence is that the great majority of parents through donor conception describe the bond with their child as complete and unqualified. Carrying a pregnancy, giving birth, and raising a child are not lesser experiences for the absence of a genetic link — and the parents we see describe themselves, without reservation, simply as parents.