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The donor egg program is a variation of in vitro
fertilization, where eggs from a selected donor are
used to create a pregnancy in the recipient.
Recipients are usually women who are no longer
producing viable eggs on their own, or who have
genetic reasons for not using their own eggs. The
donor will undergo ovarian stimulation and surgical
egg retrieval. The eggs will then be fertilized with
the recipient’s partner’s sperm, or that of a sperm
donor. The resulting fertilized embryos will be
transferred to the recipient’s uterus and hopefully
develop into a pregnancy. As with all assisted
reproductive technologies, pregnancy cannot be
guaranteed.
Read More About the Donor Egg Program:
Preparation for Pregnancy
Taking folic acid can
help prevent neural tube or spinal cord defects in
the baby. We recommend you take at least 800mcg
(0.8mg) of folic acid daily, beginning one month
before you may become pregnant. Folic acid is
readily available in prenatal vitamins. If you have
had a baby with neural tube defects, talk with the
doctor about the dosage of folic acid that may be
right for you. Moderate exercise is good for you
physically and can help reduce your overall stress
during the process. Eat a balanced diet, keep your
caffeine intake to 2 or 3 caffeinated drinks per
day, and minimize alcohol intake. You should not
consume any alcohol after your embryo transfer.
Women attempting pregnancy should clearly not smoke,
and should also consider limiting your intake of
caffeine to 150mg per day. You will also be screened
for immunity to Rubella (German measles) and Varicella (chicken pox). If you do not have immunity
to these diseases, vaccination may be recommended
due to the possible serious complications in
pregnancy.
Congenital Anomalies and Miscarriage
Birth
defects and miscarriage can be caused by too many or
too few chromosomes. Congenital anomalies occur in
3-5% of infants born. Risks of these anomalies
increases with age, and diagnostic procedures such
as amniocentesis or chorionic villi sampling in the
first trimester are routinely recommended for women
35 years of age and over. However, because the eggs
from the donor are typically 31 years old at most,
your risks are the same as for the younger age
group. Your donor will be screened for certain
genetically linked diseases such as Cystic Fibrosis
or Tay Sach’s disease if her ethnic background
includes groups at risk. Miscarriage can occur for
many reasons, and is still a risk even with the
supportive medications you will be given. There is
no way to completely rule out or prevent birth
defects or miscarriage. Some studies have indicated
an association with increased risk of miscarriage
and birth defects with IVF and ICSI, but other
studies have not shown such an increase.
Screening of Recipient and Partner
You will be
scheduled for an ART screening appointment with one
of our physicians to discuss the donor egg option in
detail. You will also speak with one of our donor
egg coordinators. Before you begin a cycle, you will
have the following laboratory tests performed: Blood
type and Rh, Rubella titer, Varicella titer, RPR
(test for syphilis), HBsAg (Hepatitis B surface
antigen), HCAb (Hepatitis C antibody), HIV (Human
Immunodeficient Virus,). You may also have a saline
infusion sonogram or hysterosalpingogram to check
your fallopian tubes, ovaries and uterus. If you are
45 years of age or older, we will request additional
health evaluations be performed. The recipient’s
partner will have most of these screening blood
tests and a semen analysis as well. If you have had
any of the above-mentioned tests performed in the
last six months please bring copies of the results
along with you to your ART screening appointment.
Donor Selection
At your screening appointment the
Donor Egg Coordinator will discuss the donor
screening and selection process in detail. The
anonymous donors are between the ages of 21-31, and
have been thoroughly screened for medical and
genetic illnesses and have also been screened by a
Counselor with an extensive background in fertility
related counseling. You will be placed on a waiting
list, and when you near the top, a selection of
donor profiles will be sent to you, and completion
of your screening tests will be arranged. You may
also choose to use a known donor. This is usually a
friend or family member willing to donate for you.
They will have to undergo the same screening process
as an anonymous donor. When your final donor
selection is made the rest of the cycle planning
will proceed.
Financial
As with other forms of ART, you will
usually have to pay the majority of the cost up
front. We will have you meet with one of our
financial counselors to discuss costs and payments
in detail.
Coordination of Donor and Recipient Cycles
Recipients will usually be placed on birth control
pills and an injectable medication called lupron.
These will regulate and control your menstrual cycle
so we can coordinate it with the donor’s
stimulation. You will later be placed on an estrogen
patch and injectable progesterone to support your
uterine lining and prepare it to accept the embryos
before transfer. Blood tests and ultrasounds will be
performed to check your uterine lining and your
response to the medications. The donor will also be
regulated with a birth control pill, and then her
stimulating drugs will be started.
Monitoring of Donor Stimulation
Each day
beginning on cycle day 6, your donor will be
required to have an ultrasound to follow follicular
growth in the ovaries. Eggs are too small to see on
ultrasound, but the size of the cysts, or follicles,
that surround them increases as the eggs mature.
There have been no harmful effects to developing
eggs from ultrasound. She will also have a blood
test to measure estradiol levels. We will call you
regularly with updates on the donor’s progress.
Day of HCG Injection for Donor and Egg Retrieval
When ultrasound and blood estradiol levels indicate
that ovulation is approaching, your donor will be
given an HCG injection at a specified time in the
evening. The egg retrieval will usually be performed
36 hours after the HCG injection is given. The
donor’s eggs will be recovered by sonographic egg
retrieval. If partner’s sperm is being used, he will
be scheduled for a semen collection the same day as
the retrieval. On the day before the Donor’s Egg
Retrieval you will stop lupron injections and begin
progesterone injections as luteal phase support. The
donor coordinator will give you specific
instructions about your medications during the
cycle.
Culture and Fertilization
A preliminary report on
the number of eggs obtained will be given to you and
your partner following the egg recovery. Not all
follicles aspirated can be expected to yield an egg.
The eggs obtained are usually of variable quality
and maturity. Once the eggs and sperm are in the
laboratory, an embryologist will complete
preparation for fertilization and intracytoplasmic
sperm injection (ICSI). This is a specialized
procedure where an individual sperm is placed in
each egg to achieve fertilization. Not all eggs will
be expected to fertilize. The Embryologists or one
of the nurses from the Fertility Center will contact
you the day after egg retrieval with a preliminary
report on fertilization and instructions for the
embryo transfer. Embryos will remain in culture for
3 to 6 days before transfer.
Embryo Transfer
Your embryo transfer will occur 3
to 6 days after the egg retrieval. You will have an
opportunity to speak with the embryology staff and
the physician about your embryos prior to the
transfer. You will also be given medication to
reduce cramping during the procedure, so someone
will need to drive you to and from the transfer. You
will be positioned on a table in our procedure room
as though you were going to have a pelvic exam. You
will need to have a full bladder for the transfer. A
very fine catheter will be placed through the cervix
into the uterus and the embryo or embryos will be
transferred into the uterine cavity with ultrasound
visualization. After the embryo transfer you will
rest for about 15-30 minutes. After leaving the
clinic your activities should be minimal. You should
remain resting flat for the first 48 hours following
the embryo transfer. After that you can gradually
resume your normal activities. You should avoid
heavy lifting, strenuous or high impact activities,
and sexual intercourse and orgasm until the
pregnancy test.
Embryo Freezing
Any normally developing embryos
can be cryopreserved (frozen) for future use. Your
options regarding embryo freezing and storage will
be reviewed with you prior to the active cycle. Both
partners will need to sign a separate consent before
the cycle agreeing to embryo cryopreservation.
Pregnancy Test and Follow-up Appointment
You will be scheduled for a quantitative blood pregnancy test
about 15 days after egg retrieval. If you are not
pregnant an appointment will be scheduled to discuss
the cycle. We hope, as you do, that you will be
successful. If you conceive, you will remain on your
supportive medications until approximately 10 weeks
of pregnancy. We will perform your first obstetrical
ultrasound at about 7 weeks, and then we will
recommend routine prenatal care from an obstetrician
of your choice.
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phone number: 206-515-0000
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