EGG DONOR PROGRAM OVERVIEW
Egg donors are women between the ages of 19 and 29 years of age who have been screened to insure good general, reproductive health and psychological stability. Egg donation treatment is always combined with in vitro fertilization (IVF), the process of placing eggs and sperm together in the laboratory to stimulate fertilization and embryo development. When a woman’s own eggs will not allow for successful IVF treatment, donor eggs may be substituted. At an IVF treatment facility, the IVF and egg donation treatments are performed by a reproductive endocrinologist and take place at the practice’s on-site surgical center in the main office.
Normally a woman produces one mature egg each month and loses several immature eggs; through the use of medications, several follicles, or egg sacs, can be induced to develop mature eggs for retrieval. The process of IVF and egg donation requires that the donor take a series of injectable medications, which induce the growth of multiple ovarian follicles. These follicles, which contain eggs (oocytes), are removed vaginally and the eggs can then be donated to a known or an anonymous recipient.
Screening for Egg Donor Candidates
By your interest and commitment, as well as meeting a series of strict medical and psychological standards, you may qualify and participate in our egg donation program. Program qualifications include the following:
Women between the ages of 19-29
Height and weight within normal range
No smoking or drug use
Previous delivery preferred
Your health insurance information will be placed on file for use in case of emergency along with specific donor insurance provided by the clinic for your care during the donation process. No out-of-pocket costs, associated with this program, are charged to the egg donor.
Preliminary screening steps include filling out a detailed medical history form, which covers information about your general health, surgeries, gynecological history and family medical history. Potential donors are also required to have an initial interview with the Donation Coordinator and a comprehensive gynecological exam with a women's health practitioner. Psychological and genetic pre-screening is also conducted. We strongly suggest that your partner/spouse be involved in your decision to donate and be present during your psychological visits.
Please note: If you are not fluent in English, you are required to bring an interpreter to all office visits.
Preparing to Donate
Once selected, you will begin the process. You will be advised about the fertility medication injections that you will administer at home for a series of up to 21 days. The entire process encompasses between one to three months of planning, followed by about three weeks of cycling time. During the actual treatment phase you will be seen at an IVF treatment facility for monitoring, including about 4-7 of blood work and vaginal sonograms to gauge your egg production.
Medications for your treatment will also be provided, consent forms will be signed and your obligations during treatment will be clarified and reviewed. All consent forms must be signed by you and your significant other (if applicable) prior to initiating your treatment cycle. You will have an IVF teaching appointment with both the doctor and coordinator to review these documents and have any questions answered. You are to avoid the possibility of pregnancy during treatment by abstaining from intercourse during your IVF cycle.
Your Treatment Cycle
Your treatment will start during the menstrual cycle before the planned oocyte donation cycle. You may be placed on birth control pills during this cycle to suppress the egg development and to prevent the possibility of pregnancy. You will begin therapy with daily doses of Lupron subcutaneous injection, according to your specific treatment calendar. The purpose of this medication is to ensure that you do not ovulate too early. The Lupron will continue until further notice, or until the actual egg retrieval procedure. When bleeding occurs from initiating Lupron (about 10-12 days after starting) you will return to the office for an ultrasounds and blood test. If these tests are normal, you will initiate therapy with gonadotropins (Follistim, Gonal F, Bravelle, Menopur, Repronex or low dose HCG).
Transvaginal ultrasounds will be performed at an IVF treatment facility. An ultrasound is a process whereby high frequency sound waves are transmitted through tissue. As the ultrasound waves strike the tissues, they project a white image on the ultrasound screen. Follicles are fluid-filled sacs inside the ovaries that can be visualized on ultasound. Sometimes a follicle does not contain an egg. The number of follicles does not always correspond with the number of eggs retrieved. We monitor the number of follicles and their size with each ultrasound.
After approximately three to four days of injectable gonadotropin medications you will be coming in about every day or every other day for ultrasounds and blood tests. The blood test to used measure the level of estradiol that is being produced by the lining of the follicle. In addition, progesterone and LH levels may be monitored during your treatment.
It is critical that you be on time for your morning appointments. These appointments are scheduled from 8:30 to 10:30 a.m. After review, you will be notified of any change in medication doses and when to return to the office.
When the physician determines you are ready for retrieval, you will be instructed to inject the hCG Trigger shot. This injection is given intramuscularly at a predetermined scheduled time. The retrieval will occur 36-37 hours following the injection. This medication ripens the developing eggs and initiates ovulation. Ovulation will occur 38 to 42 hours from the time of injection. Many women experience mild abdominal discomfort after the hCG due to ovarian enlargement and think they are ovulating.
Lupron (Leuprolide Acetate) is an analog of gonadotropin releasing hormone (GnRH). When given as a subcutaneous (just below the skin) injection, it will stimulate the “turning-off” of your pituitary gland. We are able to take advantage of the suppressive actions to improve the recruitment of multiple follicles and prevent premature ovulation. Room temperature storage is advised until the bottle is opened at which time it should be refrigerated. One bottle should last the duration of your IVF cycle. You should always follow the doctors prescribed dose and contact us at once if you have questions. A consistent time within the same hour each day should be chosen to give the injection.
Side effects are short term. Hot flashes may be felt when your estrogen level lowers, but this will disappear when you begin your gonadotropin injections. Rarely, patients experience transient headaches as well.
Follistim, Gonal F, Bravelle, Menopur, Repronex and low dose HCG are names for gonadotropins. They stimulate the ovaries directly to cause multiple follicles to grow at one time. Most of these injections are available sub-q (just under the skin) but there may be a need in your case to administer them IM (in the muscle). Your physician will decide what is best for you.
Side effects may include abdominal distention or discomfort, bloating, mood swings, fatigue or restlessness, which is relieved in most cases by the egg retrieval. The medications come in ready to administer pens or vials of powder, which need to be diluted with sterile water or saline. Occasionally, several vials may be mixed in one syringe at one time for your dose.
Human Chorionic Gonadotropin (hCG) is a hormone that is similar to the biological effect of an LH surge, which induces ovulation. HCG initiates follicular changes triggering ovulation approximately 38 to 42 hours later. This medication is a vial of powder and must be mixed with sterile water just before injecting intramuscularly (in the muscle). Room temperature storage is recommended.
You should have nothing to eat or drink after midnight the night prior to your retrieval. You will arrive at your IVF treatment facility one hour before retrieval to speak with our nurse anesthetist and have any last-minute questions answered. You may wear your wedding rings, but please make sure to arrive without jewelry, nail polish, make-up or contact lenses.
Shortly before your retrieval a nurse will escort you to our pre-operative suite. You will be asked to empty your bladder completely, undress and put on a gown. The nurse anesthetist will confer with you and answer any questions you may have regarding your anesthesia. When we are ready, an intravenous line (IV) will be started and you will be taken into the procedure room and asked to be seated on the procedure table. Next, you will receive medication to make you feel relaxed and sleepy. With the ultrasound as guidance, the ovarian follicles (hopefully containing eggs) are retrieved. The procedure takes about 30 minutes, including a short recovery period in the office. When the nurse feels your condition is stable, you will be discharged. Patients are not allowed to drive themselves home after retrieval, so please arrange transportation prior to your procedure. We recommend that you spend the rest of the day quietly at home. Women are given detailed discharge instructions and encouraged to begin oral contraceptives. Most women feel fine the next day and normal periods generally return in about 2 weeks.
Retrieval (harvesting of the eggs) must occur before ovulation or the follicles will be empty. Thus, the retrieval is timed to occur before this happens. You should also be aware that there is a serious risk of becoming pregnant if you have unprotected intercourse at this time.
You may experience some pelvic tenderness, feel tired or sleepy from the medications you received during the procedure. You will also have some light vaginal spotting. Extra Strength Tylenol usually controls any discomfort you may experience.
The medications used during the egg retrieval may not be eliminated from your body for up to 24 hours. You may feel “hung over” or just not your normal self. During this period we ask that you DO NOT:
Drive a car, operate machinery or power tools.
Drink any alcoholic beverages.
Make any important decisions.
A regular diet can be followed after your oocyte retrieval, as long as you are not nauseated. If you experience nausea, restrict your diet to clear liquids and crackers until the nausea subsides. It is usually best to avoid spicy foods for at least 24 hours.
You may be started on birth control pills to help the ovaries regress back to normal size and to avoid pregnancy. You should refrain from sexual intercourse until after your next menstrual period. You should also refrain from strenuous activity during those two weeks. If you have any questions about a particular activity, please contact your physician.
After your egg retrieval, contact your physician if any of the following occur:
Fever greater than 100.4 F that lasts more than two hours.
Excessive vaginal bleeding.
Unusual and increasing pelvic area discomfort.
Difficulty with urination or change in bowel activity.
Nausea, vomiting or diarrhea
Sharp or shooting pains.
Pain or burning with urination.
Unusual back pain.
Maximizing Chances for Success
Avoid all medications other than Tylenol. If you are taking other prescription medications check with us prior to beginning your treatment cycle.
No smoking or alcohol use.
No more than two caffeinated beverages per day.
Avoid a change in diet or weight loss during your treatment cycle.
Refrain from intercourse during ovulation induction and until you are advised that you may resume sexual activity.
Normal exercise may continue unless enlargement of your ovaries produces discomfort.
Avoid hot tubs or saunas.
We recognize that your decision to be an egg donor is a tremendous gift! The American Society of Reproductive Medicine (ASRM) does not allow participants to be ‘paid’ for their eggs, though it is clearly recognized that a donor should be compensated for their time and commitment to the program. Red Rock Fertility Center offers $3000.00 for non-college graduate donors and $4000.00 for college graduates. Compensation is distributed to the donor upon completion of the cycle, following the point of egg retrieval. For more information about the Egg Donation Program at Gestational Concepts, please call us at 702-625-0016.
Once again, thank you for your consideration in joining our egg donor program. If you are interested in becoming an egg donor, please fill out our online HIPAA compliant and secured electronic form. All information received will remain completely confidential. Please call 702-625-0016 if you have any further questions.