Egg Donation - Egg Donor Application and Eligibility

To become an IRMS egg donor, you must be a healthy, non-smoker between the ages of 21 and 32. The egg donation process begins with an application requiring detailed personal medical information about you and your immediate family. If you an eligible egg donor, you will be scheduled for a consultation with a donor team nurse and a Personality Assessment Inventory (PAI). You will be required to undergo ultrasound monitoring and blood work on day three of a menstrual cycle to determine baseline hormone levels and your suitability for ovarian stimulation. You will meet with IRMS’ psychologist and, finally, receive a complete physical, including but not limited to a pap smear, cultures for sexually transmitted diseases such as chlamydia and gonorrhea, and the following blood work:

• CBC
• HgB Electrophoresis
• Hepatitis B and C
• HIV Screens
• Chemistry Profile
• Type and Rh factor
• Urine Drug Screen
• RPR (VDRL)
• Tay Sachs (for donors of Jewish descent)
• Cystic Fibrosis (for donors of Jewish or Caucasian descent)

If the results of your screening indicate your suitability for egg donation both physically and psychologically, and you have not donated eggs more than three times previously, you will be added to the egg donor list and become eligible for matching with a recipient couple. If you have previously donated with us, and you responded well to ovarian stimulation by producing a large number of eggs, you will be considered for a shared egg donor cycle – one in which your eggs will be given to two recipient couples. Some testing, including drug screening, must be completed prior to each egg retrieval.

As you pass through the various steps in the egg donation process, your progress will be tracked on an egg donor checklist, to ensure that each requirement has been met at the appropriate time. As you proceed through evaluation and treatment, the steps on the list will be carefully monitored.

Your actual donor egg cycle will begin after the egg donor program coordinators match you with a recipient couple, based on a number of relevant criteria. A donor nurse will order the medications you will need and schedule a session with you for detailed, personal instruction on the steps associated with the cycle, proper timing and administer of medications, and duration of your treatment. As the process continues, medications will be used to synchronize your donor egg cycle with the recipient's, so she is ready to accept the embryos a few days after your eggs are retrieved and fertilized.

 

Cycle Synchronization

Once you are matched, you will be asked to call us on the first day of menses, and to visit our office on the third day to assess your ovarian function and begin the monitoring process. Blood will be drawn to determine your hormone levels and you will be instructed to begin birth control pills. This medication will regulate your hormone levels, preventing ovulation. In effect, your reproductive cycle will be on hold to help put you in step with the recipient and prepare for the Suppression Phase of this process.

 

Suppression

During the Suppression Phase, you will continue taking birth control pills and begin injections of Lupron, as instructed by your donor nurse. This is called a "pill-Lupron overlap," since you will be taking both medications daily. Lupron will "turn off" your body’s natural ovarian stimulation process. Once you stop the pill, you will continue the Lupron. A menstrual period should begin 1-3 days after stopping the pill, while you are still taking the daily Lupron injections. Once menses starts, you will visit us for evaluation and instructions to begin your stimulation medications. The Lupron will continue until two days prior to the egg retrieval.

 

Stimulation

A woman normally develops and releases one egg per month, a process regulated by hormones secreted by the pituitary gland. Stimulation medications are injectable drugs, called gonadotropins, taken once or twice daily. They replace your natural and follicle-stimulating hormone (FSH) to trigger a very precise, uniform stimulation that promotes production of multiple follicles and high quality, mature eggs.

You will visit us for monitoring, usually on Day 3, 6 and 8 of the stimulation cycle, and then daily after that. Ultrasounds will track the number and size of your follicles, and blood work will indicate estrogen levels, allowing the donor team to determine when your eggs are mature. While all of this occurs, the recipient's hormones have been suppressed with medication to regulate her cycle and keep her from producing her own follicles and eggs. She also has begun estrogen to thicken the lining of her uterus.

When your follicles are ready, you will be given the exact time (usually between 10 p.m. and 3 a.m.) to take your intramuscular injection of human Chorionic Gonadotropin (hCG). The next morning you will visit us for your final monitoring and your retrieval will be scheduled for approximately 35 hours after the injection. The purpose of hCG is to help the eggs separate from the wall of the follicles and float in the follicular fluid, ready for retrieval. At the same time, the recipient will start additional medications, including intramuscular progesterone injections, to prepare her body for embryo transfer and implantation.

For more information about infertility medications and injection instructions, visit the medications page in our web site.

 

Cycle Monitoring

You will be monitored carefully, through ultrasound examinations and blood tests, to determine your response to the stimulation drugs. While taking your medication, you must visit our office in the early morning every 1-3 days so our staff can track the development of your follicles. When they have matured, you will be told the exact time to take your intramuscular injection of hCG, to prepare for egg retrieval. The timing of the hCG is critical to the egg retrieval. Without it, the eggs will not be able to be removed from the ovaries.

 

Egg Retrieval

Some 34.5 to 39 hours after the final injection, you are scheduled for egg retrieval. This process takes place in our surgical suite located in the Atkins Kent building across the street from our clinical offices. This painless procedure will take about 30 minutes, during which time you will be under intravenous anesthesia, monitored by an anesthesiologist. Using an ultrasound probe to visualize your follicles, an IVF team physician will insert a needle through the vaginal wall, reaching the follicles and drawing out the fluid containing the oocytes. The eggs are transferred immediately to the embryology laboratory and you will be sent to the recovery room.

You will be allowed to leave a few hours after the procedure. However, you must have an escort, as it is unsafe to operate a motor vehicle or machinery following intravenous sedation. You also will be instructed to rest, resume your normal diet and drink plenty of fluids. You should avoid aerobic activity for the remainder of the day, and refrain from unprotected sexual intercourse until after your next menstrual cycle, as you will be extremely fertile and pregnancy could result. It also will be very important that you take the full, four-day course of the antibiotic prescribed to you on the day of the retrieval, to preclude infection.

You will be prescribed an antibiotic to takes for four days to preclude infection. Your menstrual period will begin in approximately 14 days and, after that, when the medications will no longer be affecting your system, you will return for your final visit and ultrasound.

 

Risks and Side Effects

You will be fully apprised of all of the possible risks of being an egg donor as part of the informed consent process, which occurs before your cycle begins. Most egg donors generally do not have problems with blood sampling and hormone injections. However, some experience local discomfort, redness or bruising at the injection sites. Injections can be painful and the side effects of medications may include breast tenderness, fluid retention, a bloated feeling, moodiness and/or tenderness in the ovaries.

In less than 1% of all IVF cases, an egg donor may form ovarian cysts that could rupture, a twisting of the ovaries that may require surgery, or experience ovarian hyperstimulation syndrome (OHSS). The latter, associated with enlarged ovaries and fluid in the abdomen, can lead to dehydration, large amounts of fluid accumulation in the abdominal and lung cavities, blood clotting disorders and kidney damage.

Monitoring during your stimulation cycle is extremely important, as it allows our physicians to closely regulate medications to minimize your discomfort and side effects. However, in a relatively small number of cases, they cannot be avoided. Although very rare, there are potential risks associated with egg retrieval that could require surgery, including infection and injury to blood vessels or other structures. Any possible links between stimulation drugs and ovarian cancer continue to be a subject of extensive researched. However, a positive causal effect has not been established.

Sometimes egg donors become ambivalent or uncertain regarding the decision to donate eggs, or they experience anxiety about the medical procedures. If this happens to you, our psychologist is available for emotional support and counseling. However; in our experience, most oocyte donors experience a great deal of personal satisfaction from giving infertile couples the opportunity to have a child, and many of them return to donate again.

 

Other Considerations - Egg Donation

The Time Commitment and Other Requirements
The egg donor screening process takes two-to-three weeks, with additional three-to-four weeks for the egg donation process. Egg donation begins with a blood test on or before the 21st day of the your menstrual cycle to determine ovulation. The medication protocol begins with daily Lupron injections, which induce a period in approximately one week. The first day of bleeding is called cycle day 1. The next visit is for blood tests and ultrasound monitoring on the third day of the cycle (CD3). Subsequent visits will be followed, usually on day 6, day 8 and then daily. They are scheduled between 6:30 and 8 a.m. and take about 15-to-30 minutes.

From cycle day 1 until the next menstrual period, you should abstain from sexual intercourse, as you will be extremely fertile during this period of time. If intercourse does occur, condoms and foam should be used to prevent pregnancy and infection.

You will be required to schedule a full day for egg retrieval. Although we are able to estimate the day the retrieval will take place based on your cycle, the exact date of the procedure will depend on how your body responds to your medication. As a result, you must be prepared to stop all usual activities for that day on relatively short notice. The entire procedure and recovery period can take up to four hours.

Before you leave, you will receive prescription antibiotics, to take for four days to avoid infection. You will be discharged to an escort, as it is unsafe to operate a motor vehicle or machinery following intravenous anesthesia. For the remainder of the day, you should rest, resume your normal diet, drink plenty of fluids and avoid aerobic activity. It is important that you refrain from unprotected sexual intercourse until after your next menstrual cycle, as you will be extremely fertile and pregnancy could result. In addition, your risk of infection may be increased by sexual intercourse.

You can expect your menstrual period to begin in approximately 14 days. After that, when the medications will no longer be affecting your system, you will return for your final visit and ultrasound. However; we do ask that you check in with us within 24-to-48 hours after the procedure, and that you call us immediately if you have any discomfort or questions.

Egg Donor Compensation
All of the medical, psychological, pharmaceutical and other costs associated with egg donation will be paid by the recipient couple. In addition, the egg donor will receive $8,000 per cycle to compensate you for your time, effort and inconvenience.

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