Becoming a Parent With Donor Eggs

There are times when it requires a gift from another person, to build a family. IT may be donor sperms or donor eggs to become a parent. There can be multiple reasons for this, but we at Coastal Fertility focus solely on making your dreams come true. We are proud to have brought life to Orange County (with over 3,000 babies) since 1982. We would love to assist you in this wonderful journey of starting your family.

There are various steps in the egg donation process. Both the egg donor and recipient have responsibilities throughout the process. Let’s have a detailed look at each of the steps involved in egg donation.

Recipient/Gestational Carrier Screening

Before selecting an egg donor for the process, the egg recipient (either the intended mother carrying the pregnancy or the surrogate) must complete the following clinical and psychological evaluations:

• Mid-cycle ultrasound and post-menstrual hysteroscopy in order to assess the uterus, ovaries and cervical canal.
• Measurement of the uterine cavity to prepare for placement of embryos at the time of embryo transfer. ‘Trail transfer’ or ‘mock embryo transfer’ are other names to this process’.
• Sperm sample of the male partner to verify adequate sperm parameters.
• Screening for infectious diseases of all parties.
• Genetic screening, if ethnicity indicates increased risks.
• One basic counseling session on egg donation with a therapist.
• Meeting with a clinical coordinator to discuss medical procedures in detail.
• Meeting with Coastal Fertility’s egg donation program expert to discuss potential egg donor candidates and requirements.

In addition, the following exams may also be recommended:

• Prior to any treatment, a screening mammogram for all women.  Documentation of a normal mammogram for women 40 years and older is essential.
• Within a year of treatment, screening for cervical cancer.
• Letter of clearance from the patient’s obstetrician and primary care evaluation for women 45 and older.

Egg Donor Selection and Screening

There are two ways to select an egg donor. Intended Parent may select a known donor for eggs, such as a friend or family member. They may also use a third-party egg donation agency that provides anonymous egg donors from their database. Coastal Fertility has partnered with RSMC to facilitate the egg donation process.

Every agency has its own unique process for evaluation. Below is an overview of Coastal Fertility’s selection and screening process. Our program follows a rigorous egg donor screening protocol involving the steps below:

Application and Preliminary Program Acceptance

It requires all potential egg donors to complete an application online. After they have completed the application, we will notify them within 3 business days if they have been accepted.

We will create their profile after their acceptance into our program. This will highlight their greatest qualities giving the Intended Parent an opportunity to learn more about our donors and donor eggs. After the completion of their profile and there is a match, we will present it to our Intended Parents. Preliminary screening is necessary for egg donors at Coastal screening.

The process needs to complete this before their acceptance into our program and addition to our database. Our preliminary screening includes an extensive medical check-up and genetic history questionnaire. During the screening process, a vaginal ultrasound, psychological assessment, and testing will also be carried out.

The Screening Process

Upon selection, there will be a schedule for the egg donor for pre-cycle screening. During this screening, the egg donor will need to undergo some tests provided by the FDA (Food and Drug Administration). They will also need to take some other additional medical and psychological evaluations. The pre-cycle evaluations include:

• Thorough psychological evaluation. This ensures that the donor is comfortable with this significant commitment
• Medical history and ultrasound evaluation
• Comprehensive infectious disease testing along with nicotine and drug testing

Synchronization of the Donor and Recipient/Gestational Carrier Cycles

The next step in the egg donation cycle involves careful coordination between an egg donor and recipient’s cycle. This makes sure that she is ready to receive the donated eggs at a designated time.

Upon completion of the screening process for both the donor and recipient, each will begin a predetermined dose of oral contraceptive. After two or three weeks, depending on the blood tests results, both will be given Lupron. This is a synthetic hormone that will turn off the normal menstrual cycle temporarily and prevents ovulation.

Ovarian and Endometrial Stimulation

Both the egg donor and recipient will need to continue their dose of Lupron. We then inject these hormones just beneath the skin with a very fine needle. The recipient will start taking injections of 17 beta-estradiol hormones (Del-Estrogen) to prepare her uterine lining for embryo implantation. At the same time, the egg donor will begin injections of hormones. These will stimulate ovulation to increase the number of egg-containing sacs called follicles.

Throughout this process, both involved parties will receive regular monitoring. The egg donor will have to go through blood tests and ultrasounds. With this the physician can Significantly monitor the growth rate of follicles and hormone levels. The egg recipient will also be monitored through periodic testing of estradiol levels and ultrasounds. This makes sure that her uterus is ready for embryo implantation.

Once the physician determines the optimal time for egg retrieval, the donor will receive a final injection of hCG. This is also called ‘trigger shot’. It’s a hormone which will help the eggs mature and detach for the retrieval process.

Egg Retrieval

The eggs undergoes a retrieval during a minor surgical procedure, which will be performed under mild anesthesia. A physician will guide the needle through the vaginal wall directly into the ovaries, with the help of an ultrasound image. We then collect Follicles into a test tube and send to our IVF laboratory.

This process takes approximately 30 minutes and during this time discomfort is generally minimal. After the retrieval of the eggs, the donor will stay at the clinic under the care of our nurses for 1 or 2 hours and then discharged.  It is okay to resume light daily activities the next day.

Sperm undergoes the collection procedure the same day as the egg retrieval. The eggs will undergo the insemination process in our laboratory on the day of egg retrieval.

Donor Eggs Fertilization and Embryo Transfer

Eggs mature for several hours in the Petri Dish. Then sperm adds up to begin the process of insemination. Insemination is followed by fertilization several hours later when the sperm enters the egg. Upon fertilization, the eggs are inspected by the embryologist to determine how many of them have fertilized. We notify the Intended Parent opting for donor eggs on the same day, usually by a telephone call.

The transfer of embryo(s) into the uterus is performed typically 3 to 5 days after the egg retrieval. Although, it depends on the number of embryos available for transfer.

The embryo transfer is a brief and painless procedure that requires no anesthesia. Insertion of catheter is done through the cervix into the uterus. The embryo is then released into the uterine cavity of the recipient. The recipient is maintained in a recumbent position for 15 minutes after which she is free to go home.

If a sufficient quantity of quality embryos remains, they may be frozen for subsequent transfer.

Post Embryo Transfer Management

After a successful embryo transfer, the recipient will receive daily injections of Progesterone. It helps to support the lining of the uterus so that embryos may implant. Progesterone is taken for two weeks following the embryo transfer and through early pregnancy. Usually, it is discontinued 10 weeks after the embryo transfer or about 8 weeks into pregnancy.

Approximately, two weeks after the embryo transfer, the recipient must take two pregnancy tests to confirm the pregnancy. If the result is positive, then the hormone injections will continue for more than 8 weeks. After that the placenta will supply all the hormones necessary to sustain the pregnancy. We will also perform Ultrasound examinations. This is to diagnose pregnancy status between 5 to 6 weeks after the embryo transfer.

If the Recipient Does Not Conceive

In the event that a pregnancy test shows negative results; we encourage our patients to follow up with their physician as soon as they feel like they are ready. We can then review cycles and plan possible next steps. It can be emotionally hard, but a follow-up visit is important. In this case, all the hormone medications will be discontinued. Menstruation will ensue within two weeks.

To learn more about becoming a parent through donor eggs visit us at www.coastalfertility.com or call us at 949-726-0600.