Who are candidates to use donor eggs?
The reality is that any woman desiring to become pregnant has the option of pursuing donor eggs. Unfortunately, the majority of women who use donor eggs have significantly diminished egg quality. Women with the following conditions or situations are typical candidates for donor eggs:
- Early menopause or premature ovarian failure (POF)
- Extremely poor egg quality
- History of genetic disease
- Ovaries do not respond to stimulation
- Hormonal imbalence
- Over the age of 40
What is the process for selecting an egg donor?
The first step is to decide the characteristics you prefer in an egg donor. The egg donor could be a family member, friend, or someone anonymous. Any potential egg donor should be screened as follows:
- History of birth defects or hereditary diseases
- Medical and social history
- Physical examination
- Psychological screening
- Testing for sexually transmitted diseases
What is the process for the egg donor?
The egg donor will experience ovary stimulation using the same medications that a woman would use to stimulate her own egg development in planning for in vitro fertilization. Ovulation induction will be done using a combination of drugs. These medications will help prevent ovulation from occurring too ealry and also help stimulate the productoon of multiple eggs in the ovary. The donor will be monitored through ultrasound and blood work to determine when her follicles have developed. The hormone hCG is then administered and the eggs are retrieved about two days later.
What is the process for the recipient couple?
Ideally, the recipient’s cycle will be synchronized with the donor’s cycle. This is accomplished by administering a combination of two or three hormonal medications. Lupron® is administered shortly before the period is expected to start in order to suppress the natural cycle. Estrogen is added shortly after the period starts and changed daily until the recipient’s and donor’s cycles match. Hormonal medications will be used to manipulate a regular 28-day menstrual cycle and keep the recipient and donor on the same cycle. Being on the identical cycle offers the best chance of having the lining of the recipient’s uterus prepared to support the embryo.
The male partner will provide a semen sample on the same day that eggs are retrieved from the donor. The semen and eggs are fertilized in a laboratory using in vitro fertilization.
Progesterone treatment begins on the day after eggs are retrieved from the donor, and Lupron® injections are discontinued the day before the embryo transfer. The embryo transfer normally occurs two-five days after the eggs were initially retrieved. A blood test will be performed 10 days later to determine if pregnancy has occurred. The recipient should also be aware of early signs and symptoms of pregnancy. Most donor recipients will also stay on both progesterone and estrogen until about 10 weeks into the pregnancy, when the placenta can provide these hormonal needs on its own.
What is the success rate of pregnancy using donor eggs?
The success rate will vary depending upon age of eggs, retrieval process, quality of semen, and the overall health of the women involved. In most cases, younger eggs are preferable. Up to 48% of women using donor eggs will experience pregnancy. Unfortunately, approximately 15-20% of women will miscarry.
What are the risks related to egg donation?
Egg donation carries the same risks as in vitro fertilization and embryo transfer and there is a 20-25% chance that the pregnancy will involve multiples. Pregnancies from donor eggs carry the same 3-5% risk of birth defect as natural pregnancy.
The medications involved may have side-effects. Some women experience hot flashes, feelings of depression, headaches, and sleeplessness.
In rare cases, donors may experience ovarian hyper stimulation syndrome which involves a painful swelling of the ovaries. Other symptoms include nausea, vomiting, abdominal pain and shortness of breath. Contact your healthcare provider immediately if you experience any of these symptoms.
Common Questions and Concerns:
How much does the process cost? Total costs typically range from $15,000 to $20,000. It is important to find out what is included and what is not included in the fee structure: donor fees, in vitro fertilization, embryo transfer, medications, embryo freezing, etc.
What are the legal concerns? Laws tend to vary from state to state, but there should be little concern about parental rights. No matter whether the donor is known or anonymous, legal contracts can be written that remove all parental rights of the donor.
How many eggs should be retrieved, fertilized, and transferred? In most cases fertility specialists will remove as many eggs as possible during the retrieval process. This provides the opportunity for additional procedures if the first attempt is unsuccessful. The number of embryos that should be transferred during any single IVF cycle has been the subject of much discussion and debate. Some experts believe that transferring no more than four embryos per IVF cycle will yield optimal results in order to reduce the risk of multiple pregnancies and other complications. Transferring four embryos instead of only one or two increases the probability of a successful pregnancy. However, there is the possibility that all four embryos could implant. It is important to discuss these options with a fertility specialist.
Compiled using information from the following sources:
RESOLVE: The National Infertility Association, http://www.resolve.org
American Society for Reproductive Medicine (ASRM), http://www.asrm.org