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The Sofia Hospital of Obstetrics, Gynaecology and Reproductive Medicine offers an egg cell donor programme.

Whom is the Egg Cell Donor Programme intended for?

Women unable to produce their own egg cells or whose egg cells are impaired or carry genetic disorders are encouraged to take advantage of the Sofia Hospital donor programme.

Donor egg cell recipients are most often at an advanced reproductive age (40 or above). The procedure for In Vitro Fertilisation of donor egg cells enjoys a high degree of success because the egg cells used are from young and healthy donors with proven fertilities.

Donors voluntarily cede any rights to their egg cells and the embryos and children stemming from them. Recipients have the full rights to donated egg cells and embryos stemming from them. They may be frozen, passed onto another recipient or used for research.

What are the Steps in an In Vitro Procedure using Donated Egg Cells?

1. Selecting and Researching Egg Cell Donors followed by matching donors to recipients. Egg cell donor candidates are selected to strict legal and medical standards. Only 18 to 34s may donate egg cells when they are not related to the recipient. Donors have to have given not less than one live birth. Each donor undergoes a thorough medical alongside a thorough gynaecological examination, gives a detailed personal and family history of illnesses, goes through blood and urine testing, psychological tests, and genetic consultations. Donoring history is also checked as the law does not allow the birth of more than five children from a single donor’s egg cells, including the donor’s own children. The ultimate decision on whether candidates may become donors is taken by a specialist committee.

2. Preparing the Recipient’s Uterine Lining to match the donor’s stimulated cycle. This involves hormone applications. The period includes several transvaginal ultrasound examinations and hormonal blood tests that give information on the endometrial reactions. Occasionally the uterine endometrium fails to respond to hormone stimulation and all embryos are then frozen for use in a subsequent cycle.

3. Stimulating the donor’s ovaries with hormones to encourage the production of more follicles and egg cells. On very rare occasions, egg cells might fail to be aspirated. Egg cell numbers and quality cannot be guaranteed.

4. Inseminating and fertilising the donor’s egg cells. On the day when donor egg cells are aspirated, the recipient’s partner releases seminal fluid through masturbation. Our embryologists prepare the seminal fluid to inseminate the egg cells.
Where the partner may fail to release seminal fluid within a reasonable time, donor sperm may be used or egg cells may be frozen without having been inseminated. It is best if the partner is prepared in advance to release seminal fluid on the day and if the Hospital team is aware in advance of any possible problems with seminal fluid release on the day. They can work around the problem, for instance by freezing sperm ahead of the day.

Once egg cells are aspirated, they are mixed with the partner’s or donor’s sperm to be inseminated. If prior testing shows that sperm is unable to inseminate egg cells in the usual manner, a sperm may be injected directly into the egg cell in a process known as ICSI. There is no guarantee of fertilisation at any stage or with any option, however.

5. Transferring an Optimum Number of Embryos into the Recipient’s Uterus. After consulting the treating physician and being made aware of Bulgarian Law, the recipient sets the number of embryos to be transferred and/or frozen. Embryos are transferred into the uterus through a catheter. On rare occasions embryo transfer may be impossible and embryos would then be frozen. Applying progesterones helps implant embryos into the uterus. When patients choose blastocyte transfer, they take the risk of embryo transfer failure because it is possible that no embryo would develop to this stage.

6. Freezing Remaining Good Quality Embryos. This is recommended to provide additional opportunities for pregnancy. An additional informed consent form is signed prior to embryo freezing.
The entire in vitro fertilisation procedure with donor egg cells takes place in stages and does not involve hospital stays. There are several clinic visits, each lasting not more than two or three hours.

Success Rates

Success with in vitro fertilisation procedures depends on diverse factors, with precise chances of pregnancy impossible to calculate for individual cases. Successful pregnancy cannot be promised as a result of in vitro fertilisation procedures. Average success rates after transfers of embryos stemming from donor egg cells are 50 to 60 percent.
In vitro fertilisation may result in the birth of children with abnormalities, as does normal fertilisation, yet the incidence of inborn anomalies is not significantly different to that in the general population.


The law deems the process of egg cell donation strictly confidential and does not permit donors’ identities to be revealed. Recipients’ identities are also protected, save when strictly defined close relatives (sisters and cousins) may donate to each other. Recipients do, however, receive information on donors’ medical, genetic and psychological characteristics.