Egg Donation Process for Recipients - Northern California Fertility Med Ctr

Egg Donation Process for Recipients

We have put together steps to guide you through Egg Donor IVF. From what to look for in an egg donor until embryo transfer day, we are here to help you!

Donated eggs have made it possible for thousands of women, who might have otherwise never had the opportunity, to experience the wonder and joy of pregnancy and childbirth. If you have been advised to consider undergoing IVF with egg donation, Northern California Fertility Medical Center can help.

Candidates for IVF with Egg Donation Include:

  1. Women whose eggs have a very low chance of responding to fertility medication (decreased ovarian reserve) due to factors including increasing age, premature menopause, past exposure to chemotherapy medications, or for unexplained reasons.
  2. Women over age 40 who still have eggs that can be retrieved from their ovaries but have a high chance of a having chromosomally abnormal embryos due to the age of their eggs. Embryos can be tested for chromosomal abnormalities by PGS (preimplantation genetic screening) also known as CCS (comprehensive chromosomal screening). However, if all of the embryos are abnormal such that there are no chromosomally normal embryos for transfer, a woman may choose egg donation rather than continue to proceed with successive cycles of IVF using her own eggs.
  3. Women who are carriers of a severe genetic condition which has a high chance of being passed to their biological children.
  4. Males who wish to have a biological child, using their own sperm. This includes, a male without a partner or a male in a same-sex relationship. The man’s sperm would be used to fertilize donor eggs, and a resulting embryo or embryos would be placed into the uterus of a gestational surrogate, who would carry and deliver the child for them.

Preparation of the Recipient for the Treatment Cycle Includes:

  1. Documentation of a normal mammogram for all women 40 years of age or older.
  2. Documentation of a normal Pap smear within the year prior to initiation of treatment.
  3. Consultation with the woman’s primary care physician or obstetrician if she is 45 to 51 years of age, to be sure she does not have a medical condition that could potentially make carrying a pregnancy too dangerous for her or the fetus. This would also include documentation of a normal electrocardiogram and normal chest X-ray.  Women must be 51 years of age or younger in order to undergo in vitro fertilization with egg donation in our practice.
  4. Pelvic ultrasound
  5. Office hysteroscopy or 3D saline sonogram to check that the uterine cavity is normal.
  6. Semen analysis of the male partner to be sure he has adequate numbers of sperm to fertilize eggs.
  7. Infectious disease screening for both of the recipient partners or for the potential single parent.
  8. A consultation for both partners (or for the potential single parent) with a clinical psychologist/counselor to discuss emotional aspects of using donor eggs, prior to initiation of the cycle.

Selection of an Egg Donor

The egg donor may be a person known to the recipients, including a family member (such as a sibling), a friend, or may be a known donor from an egg donor agency.

Alternatively, the donor may be an anonymous donor from the donor pool of Northern California Fertility Center or from another agency. Egg donation with an anonymous egg donor is more common than a known donor. The recipient(s) would know much about the donor, but not her identity. An anonymous donor does not know anything about the recipient(s).

The choice of obtaining eggs from a known donor vs from an anonymous donor would be made by the recipient(s).

Screening of the Egg Donor Includes:

  1. Medical and genetic history questionnaire, reviewed by a nurse coordinator and a physician.
  2. A physical examination and pelvic ultrasound performed by a physician
  3. Genetic consult with a genetic counselor and blood draw for recommended genetic carrier screening.
  4. Evaluation by a clinical psychologist/counselor as well as psychological testing.
  5. Baseline hormone screening, drug testing, including alcohol and tobacco, and infectious disease screening as required by the FDA.

Medications and Monitoring For the Recipient and Egg Donor for a Fresh Embryo Transfer

The recipient (or gestational carrier) and the egg donor will be started on oral contraceptives for approximately three weeks in order to synchronize their menstrual cycles. This allows synchronization of the recipient’s uterine lining for transfer of embryos created from the donor’s eggs at a time that will maximize the chance for embryo implantation.

After the birth control pills are stopped, the recipient will be on medications, including Lupron and estrogen, to ready her lining for embryo transfer.  The recipient will have ultrasounds performed to be sure her uterine lining has reached a thickness deemed adequate for embryo transfer.  If the lining does not reach the desired threshold for transfer, the embryos will be frozen for a planned frozen/thawed transfer at a future date.

After stopping birth control pills, the donor will be taking ovulation stimulating medications along with a GnRH antagonist medication to prevent her from ovulating before the eggs are mature. She will be monitored by ultrasounds and estrogen blood levels. Once the eggs are deemed mature, she will receive a final injection to allow scheduling of the egg retrieval, which will take place approximately 36 hours after that injection. The egg retrieval will be accomplished under light anesthesia in the operating room at Northern California Fertility Center and takes approximately 15 minutes to complete.  She will stay in the recovery room for about 45 minutes and will be discharged home in the care of a family member or friend.

While the egg retrieval is taking place, the male partner of the recipient couple will provide a sperm specimen which will be used to fertilize the eggs (unless previously frozen/thawed sperm is to be used).

Once the eggs are fertilized, an embryo or embryos will be transferred to the uterus of the recipient or gestational surrogate 5 days after the egg retrieval. The recipient will continue estrogen and will also be placed on progesterone, both of which are needed to support a pregnancy. These medications are most often continued for 9 weeks from the time of the transfer and then the placenta makes all the hormones needed and the medications are stopped.

If there are extra embryos, these will be frozen for a potential future thaw and embryo transfer.  If the plan was not to perform an embryo transfer on the cycle of the egg retrieval, all of the embryos will be frozen five to six days following the donor’s egg retrieval. A plan will be formulated for a transfer of thawed embryos to the recipient’s or gestational surrogate’s uterus at a future date.  This may require medications to prepare the uterine lining or may on occasion be performed on a natural cycle.

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