Egg donation is a medical procedure that requires much thought on the part of the donor and time involved by both parties. Before a woman can be considered as a recipient, there are many other infertility treatments to try. Egg donation is often used as a last resort after these treatments fail. Another possible reason for egg donation is if the woman had experienced early menopause, which is before her 40th birthday IVF with donor eggs. The only reason for egg donation not to be considered as a treatment option is if the woman’s infertility is caused by problems with the uterus, such as severe uterine fibroids (or growths in the uterus wall) or even a tilted uterus.
Once a woman decides to donate eggs, she must fill out an application for an egg donation company, which can be many pages long and usually asks for a medical history including any sexually transmitted diseases, a sexual history, general health questions, allergy summary, an educational history, personality summary, favorites as a child and adult and many other things. The application includes everything the donor would tell her significant other and more. The company then reviews the application and based on the information provided, the woman will either be accepted or rejected. If a woman is accepted, she is then contacted by a Donor Coordinator who may ask for more information or for some elaboration on her application answers. If a woman is not accepted, she is still contacted and given the reason for her rejection.
After acceptance into the program, a profile is made of the donor. It includes things found on the application, such as likes/dislikes, favorites as a child and/or adult, personality aspects, physical characteristics (hair color, eye color, height, race) and photographs of the donor, ranging in age from an infant to adulthood. Photographs of the donor’s children may also be included in the profile, if she chooses to add them. This profile may be posted online through the company, or is kept strictly as a hard copy for local couples only. Most donors have their profiles online through the donation company as this provides a better chance of being chosen to donate. Once a couple choose a donor, there are legal aspects to be taken care of, such as the legal agreement between donor and recipient protecting both parties’ rights to anonymity and a legal document stating the recipient will take care of the donor’s medical, legal and some travel expenses. Some companies or recipients may not pay for travel expenses, so the donor should be sure to read the contract very carefully before signing. Once all the legal aspects of the donation are taken care of, the recipient’s fertility doctor will contact the donor and set up an appointment for the screening.
This screening includes a physical examination, blood tests for genetic disorders, STDs, alcohol or nicotine use and others, a visit with the Egg Donor Coordinator for an overview of the entire process and a visit with the center’s social worker to be certain that the donor has taken into account all the emotional aspects of the egg donation. After this screening, the donor’s part in the process is minimal until the last 2 or 3 weeks of the cycle. At that time, depending on the doctor’s decision, she will either begin taking drugs to encourage the development of eggs or begin Lupron injections to suppress her menstrual cycle, making it easier to synchronize it with that of the recipient. If the doctor decides to begin developing eggs immediately, the donor will go into the doctor’s office for the drug syringes and a nurse will show her where and how to do the self-injection procedure. The needles themselves are similar to the ones used by diabetics to inject insulin and the drugs are injected just under the skin of the abdomen or thigh. The donor may be a little nervous giving herself the injections at first, but this is completely normal and fades with time. While she is taking the medication, the doctor’s office will closely monitor the donor to make sure her body is responding well to the treatment. This involves 5 or more early morning vaginal ultrasounds and blood work drawn. If the doctor decides to synchronize the donor’s and the recipient’s menstrual cycles, the donor will begin Lupron injections to suppress her cycle until it is in sync with the recipient’s. Once this occurs the donor will begin the injections to stimulate egg development. Then the donation experience will follow the previous example. Once the eggs are sufficiently developed, the donor will receive an injection to trigger ovulation.
The eggs will be collected approximately 34 to 36 hours after the injection. This procedure involves anesthesia but no cutting will take place. The eggs are collected via the vagina. This is similar to the vaginal ultrasounds the donor received earlier. A needle is attached to the ultrasound probe. The doctor uses the ultrasounds to guide the needle for egg collection. After this procedure, the donor will spend one to two hours in a recovery room, then she can go home for further recovery. It is recommended that a donor bring a friend to this procedure to drive them home, due to the anesthesia making it dangerous for the donor to drive after the procedure. An antibiotic is frequently prescribed to prevent infection and it is recommended that the donor schedule a follow-up exam and ultrasound for one week following the egg collection.
After collection, the eggs are examined and then mixed with sperm collected from the male partner of the recipient. The fertilized eggs are then placed in a special growing medium and incubated for three to five days. Several of the resulting embryos are then transplanted into the recipient and the rest are frozen. Approximately 2 weeks following the embryo transplant, the recipient receives a blood pregnancy test. If the transplant was successful and the recipient is pregnant, she will receive hormone supplements for 6 to 10 weeks to maintain the pregnancy until her body begins producing hormones in sufficient amounts.