Third Party Reproduction

The term “third party reproduction” refers to the use of a third party’s eggs, sperm, embryos and/or uterus to enable an individual or couple experiencing certain types of infertility to become parent(s). In order to help patients who require the use of a third party to achieve their dream of parenthood, RMA of Philadelphia has egg donation, sperm donation and embryo donation programs as well as a gestational carrier (or surrogate) program.

Third party reproduction is a complex process requiring consideration of medical, emotional and legal issues. At RMA of Philadelphia we work with a team of psychologists, attorneys and agencies that specialize in third party reproduction to help support our patients through all facets of the treatment process.

Egg Donation

Egg (oocyte) donation is an important option for many patients, and is recommended for women who have age-related infertility, poor egg quality, premature menopause or diminished ovarian reserve. Also, women who have certain genetic diseases are also excellent candidates for donor eggs.

About Egg Donors

Egg donors may be known or anonymous. Patients may provide their own donor, often a close friend or relative. More commonly, however, egg donors are not known to the egg recipient. Anonymous donors are between 21 to 32 years of age, in good health, with normal ovarian reserve. They undergo extensive medical testing and a thorough medical history and physical exam is performed. Each prospective donor also undergoes a full battery of psychological screening tests and an interview with a psychologist. Donors are compensated $5,000 for their time and inconvenience. 

For anonymous donors, we will maintain strict confidentiality of the donor’s and recipient’s identities; however, the egg recipient will have access to all of the donor's extensive personal medical, sexual and family history.

We precisely synchronize the cycles for both the recipient and donor, so that the recipient’s uterus is fully prepared for the embryos created with the donor’s eggs. The recipient is treated with estrogen and progesterone, to prepare her uterus.

Donor Egg Recipients

On the day of egg retrieval, the recipient's husband or partner will produce a fresh semen sample. The sperm is then combined with the donor eggs. Intracytoplasmic sperm injection (ICSI) may be indicated if the semen analysis is abnormal.  Donor sperm is available to single women, and for women whose husband or partner has no sperm. Embryo transfer is performed three days after the donor egg retrieval.  Because donated eggs are healthy, and come from young women, we typically transfer two embryos.

Embryo Donation

The use of donor embryos provides individuals or couples the opportunity to become pregnant with embryos donated by patients who have previously undergone in vitro fertilization at RMA of Philadelphia. Typically, embryo donors have completed building their family and have cryopreserved embryos that they wish to donate to others experiencing infertility. Embryo donors are pre-screened to ensure they are without identifiable genetic disease; they are also screened for sexually transmitted infections. For anonymous donors, RMA of Philadelphia will maintain strict confidentiality of the donor’s and recipient’s identities; however, the embryo recipient will have access to all of the donor's extensive personal medical and family history.

In order to prepare for embryo donation, the recipient undergoes an evaluation of her uterine cavity. She is then treated with estrogen and progesterone in order to prepare her uterus to receive the embryos.

Sperm Donation

There a number of indications for the use of donor sperm. Donor insemination can be used when the male partner has severe semen abnormalities. The use of donor sperm for severe male factor infertility has decreased significantly over the past several years with the increased utilization of intracytoplasmic sperm injection (ICSI) for the treatment of male infertility. Donor sperm can also be used if the male partner is a carrier or is affected with a significant genetic defect, and the couple wishes to avoid passing this on to their children. More commonly, donor sperm are used by single women or lesbian couples who desire pregnancy.

Insemination using donor sperm has been practiced for over a century. With the emergence of HIV-AIDS in the 1980s, donor insemination has been performed exclusively with frozen and quarantined sperm. Current guidelines recommend that sperm be quarantined for at least six months before being released for use.

Insemination is timed to occur at the time of ovulation. Blood work and ultrasound is often done to help pinpoint the opportune time for insemination, which can be done during a woman’s natural cycle or in conjunction with an ovulation induction cycle. The procedure is simple and is performed in our offices. A very thin, flexible catheter with the prepared sample is placed through the woman’s cervix into her uterine cavity. This very brief, painless procedure places all of the motile sperm in the uterine cavity, close to the entrances to the fallopian tubes, where fertilization typically occurs.

Gestational Surrogacy

A surrogate or carrier is a woman who carries a pregnancy for another couple or woman. There are two types of surrogacy or carrier arrangements. In traditional surrogacy, the surrogate is inseminated with sperm from the male partner of the intended parent couple (donor sperm may be used as well). In this case, the surrogate is donating her uterus and eggs. In gestational surrogacy, the surrogate carries a pregnancy created by transferring one or more embryos created with the sperm and egg of the intended parents (though donor sperm and/or donor eggs may also be used).

Use of a gestational carrier is indicated for a woman who has normally functioning ovaries but who lacks a uterus secondary to surgery, or has congenital uterine abnormalities. Gestational surrogacy is also an appropriate treatment for women with a medical contraindication to pregnancy such as diabetes, heart or kidney disease. Gestational surrogacy has been used in women with poor obstetrical outcomes and recurrent miscarriage.

Gestational surrogates can be relatives or friends of the intended parents who volunteer to carry a pregnancy for them. Alternatively, gestational surrogates can be identified through agencies that specialize in recruiting women to become surrogates. The surrogate undergoes extensive medical testing and a thorough medical history and physical exam is performed. Each prospective surrogate also undergoes a full battery of psychological screening tests and an interview with a psychologist.

RMA of Philadelphia synchronizes the cycles for both the surrogate and genetic mother. The genetic mother undergoes ovarian stimulation and egg retrieval. On the day of egg retrieval, the recipient's husband or partner will produce a fresh semen sample. The sperm is then combined with the donor eggs. Intracytoplasmic sperm injection (ICSI) may be indicated if the semen analysis is abnormal. Typically, two or three of the resulting embryos are then transferred into the surrogate’s uterus, which has already been prepared with estrogen and progesterone.

If you are interested in learning more about our third party reproduction programs, please contact us at info@rmaphiladelphia.com.