EGG DONATION
Egg
donation is an option for women suffering from advanced
maternal age, poor egg
quality, or premature menopause. diminished ovarian
reserve. Donor oocyte recipients may have non-functioning
ovaries from radiation treatments, chemotherapy, and genetic
abnormalities. Patients with abnormal clomiphene challenge
testing, or prior IVF cycles resulting in poor egg/embryo
quality are excellent candidates for donor oocytes as well.
We perform a 30
second office hysteroscopy to evaluate the recipient's uterine cavity prior to
a donor oocyte cycle. If fibroids
or polyps are found, they are removed before the donor egg cycle to maximize the
likelihood of embryo implantation. Many studies have demonstrated that the uterus
does not become less receptive with aging. Egg donation works equally well for
a recipient in her twenties or forties.
Egg
donors may be known or anonymous. Patients may provide their
own donor, often a close friend or relative. More commonly
egg donors are anonymous. Donors are 21 to 32 years of age,
in good health, with normal ovarian reserve. They undergo
extensive medical and psychological screening. Donors are
tested for sexually transmitted diseases including HIV,
Hepatitis B and C, and syphilis. Cervical cultures are also
performed to test for Chlamydia,
Gonnorhea, Mycoplama, and Ureaplasma. A thorough medical
history and physical exam is performed. Each prospective
donor undergoes a full battery of psychological screening
tests and an interview with a psychologist is performed.
Donors are compensated $5000 for their time and inconvenience.
Our practice has a philosophy of openness regarding oocyte
donation. You will have access to all of the donor's extensive
personal, medical, sexual, and family history, except for
identifying information.
As
with normal pregnancy, timing is everything when it comes
to egg donation. We synchronize the recipient's cycle with
the donor's cycle, so that a receptive uterus is insured
when the embryos created through donated eggs are ready
to be transferred. The recipient takes subcutaneous Lupron
injections to suppress here ovaries. If the recipient has
no ovarian function (premature menopause)
Lupron is not used. Once the Lupron has created a menopausal-like
state (typically after 10 days) transdermal estrogen patches
are started. The estrogen dose is increased every few days
to mimic a normal menstrual cycle. When the donor is triggered
to ovulate, the recipient lowers her estrogen dosage and
begins taking Progesterone,
which causes the uterine lining to become sticky for an
embryo to implant.
The
egg donor undergoes ovulation
induction using a highly successful combination of Lupron
and FSH injections. Donors are followed meticulously with
serial bloodwork for estrogen and progesterone, as well
as ultrasound
monitoring of ovarian follicular growth. When the lead follicles
reach 16 to 20mm, the donor takes hCG to mature her eggs.
Thirty-six and one half hours after hCG administration,
eggs are retrieved, painlessly under transvaginal ultrasound
guidance.
On
the day of egg
retrieval, the recipient's husband or partner will produce
a fresh semen sample. The sperm is then added to the culture
dishes containing the donor eggs. Intracytoplasmic
sperm injection (ICSI) may be indicated if the husband's
semen
analysis is abnormal. Donor
sperm is available to single women, and for women whose
husbands or partners have no sperm.
Embryo
transfer is performed three days after the egg retrieval.
On occasions, a day 5 "blastocyst" transfer may
be used. The embryos are placed into the recipient's uterus
under transvaginal ultrasound guidance. Our practice's pregnancy
rate is approximately fifty percent per oocyte
retrieval among our infertile patients undergoing IVF with
their own eggs. With oocyte donatation, pregnancy rates
approach 60 percent per retrieval. Because these donated
eggs are normal, and come from young women, we typically
transfer two embryos.
The recipient continues estrogen patches and progesterone
for two weeks after embryo transfer, when a pregnancy test
is performed. The donor is placed on oral contraceptive
medication after the egg retrieval, to speed up the process
of returning the ovaries to their normal unstimulated state.
If you are interested
in learning more about our donor egg program, or would consider being an anonymous
donor, CLICK HERE.
