In Vitro Fertilization (IVF)
What is IVF
Ovarian Hyperstimulation
Egg Retrieval
Fertilization & Embryo Culture
Blastocyst Transfer
Cryopreservation
Candidates for IVF
Prerequisites
Psychological Impact
Cost
 Assisted
Hatching
Sperm
Injection (ICSI)
Preimplantation Genetic
Diagnosis (PGD)
PGD for Aneuploidy
PGD for Single Gene
Disorders
Egg
Donation
Candidates for Egg Donation
Who are the donors
How do we select egg donors
What screening is involved
Procedures and Medications
IVF Cycle
Fertilization & Development
Embryo Transfer
Follow-up Care
Intrauterine
Insemination (IUI)
Pre-Operative
Instructions
Laparoscopy/Hysteroscopy
Post-Operative
Instructions
D&C and/or hysteroscopy
Laparoscopy
Laparotomy/myomectomy
Glossary
of Terms
Out of Town
Patients
Cycle Monitoring-local doctor
Nashville
Weather
Nashville Visitor Info
Hotels
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Egg Donation
Who is a candidate for the oocyte donation program?
You may want to consider oocyte donation if you
don't produce eggs on your own, if you carry a genetic disorder, or
if your own ovaries have responded poorly to ovulation induction in
the past. Previous chemotherapy, ovarian surgery, premature
menopause, and absence of ovaries from birth are some of the common
reasons why ovaries are absent or function poorly. To be considered
as a recipient for donor oocytes, you must have a uterus and its
shape should be relatively normal.
Who are the donors?
Egg donors are women
between the ages of 21 and 30 years of age, who are screened to
insure good general and reproductive health, genetic history, and
psychological stability. They are screened for hepatitis B and C,
Cystic Fibrosis mutations, and sexually transmitted diseases (such as
HIV, Chlamydia, Syphilis, Gonorrhea, and CMV).
Many of our potential donors have friends or relatives who
have experienced infertility, and/or have children of their own and
understand the significance of their gift.
While similar in principle to sperm donation, egg donation is
significantly more difficult. The egg donor will experience
considerable inconvenience, discomfort, and risk. Egg donation
involves the same steps required for in vitro fertilization. Donors
will receive daily hormone injections, frequent ultrasounds and
bloodwork, and will undergo vaginal ultrasound-guided egg retrieval.
How do we select egg donors? |
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Anonymous Recruited Donors:
We recruit a
certain number of young healthy donors by advertisement and
word of mouth. Some have called NFC without seeing any
advertising to inquire if we have an egg donation program. The
egg donor will not meet the recipient or know whether or not a
pregnancy occurred from the recipient's cycle. We feel
strongly that anonymous donors should be compensated
financially for their time, discomfort, and risk. |
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Related or Known donors:
A related donor is usually
a sister of the recipient. A non-related, or known donor, is
usually a compassionate friend. The screening process is the
same as for anonymous donors. However, since the donor and
recipient know each other, it is strongly suggested that a
legal contract regarding the egg donation be drawn up by an
attorney and signed by all parties. |
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What screening is involved for the recipient? |
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Initial consultation with physician:
At the initial consultation all aspects of egg donation will be discussed with you and your partner. If you have not been seen in our office before, you will need to send us your medical records in advance. |
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Physical Exam:
If you are 40 years old or
older, a physical exam performed by your internist or family
doctor is strongly recommended to ensure good general health.
This should include tests to rule out diabetes and heart
disease. |
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Screening Bloodwork:
Wife: HIV, hepatitis B and C, blood type and Rh, RPR, rubella titer, and CMV.
Partner: HIV, antisperm antibody
test, and
blood type and Rh |
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Semen Analysis and/or Sperm Penetration Assay and Semen
Culture:
To be scheduled by your partner 2-4 weeks
prior to the initiation of the treatment cycle. |
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Consultation with IVF Nurse Coordinator:
Prior to
the treatment cycle, a consultation will need to be scheduled
with the IVF nurse coordinator. At this consultation, you will
receive complete instructions regarding the individual
treatment protocols and medications. Instructions will also be
given concerning Lupron and progesterone injections for the
patient or for the person who has agreed to give necessary
injections. |
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What procedures and medications are involved?
If
you still have menstrual cycles, the medication will begin on
menstrual cycle day 2 with the use of an oral contraceptive agent.
Depending on your individual circumstances, this medication may be
given for a varying period of time (often 2 weeks) to prevent
ovarian cysts from forming in response to Lupron. Lupron is then
given for 10-14 days. If you are not having menstrual cycles, Lupron
is not necessary.
You will also receive two hormones: estrogen and
progesterone. The estrogen is given as a pill or an intramuscular
injection, and
progesterone is given as an intramuscular injection. These
medications mimic a natural menstrual cycle and produce a uterine
environment receptive to a developing embryo.
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Egg Donor's IVF Cycle
The embryo transfer
will be scheduled to coordinate with the donor's cycle, in order to
achieve a fresh embryo transfer. The ovaries of the donor will be
stimulated, through daily administration of hormones, to produce
multiple oocytes. The effect of this stimulation is carefully
monitored with blood tests and ultrasound examinations. When these
tests indicate that mature oocytes are present, the donor is ready
for the next step.
There is a chance although rare, that the cycle may be
canceled because of the donor's inadequate response to the fertility
drugs. There is also no guarantee that eggs will be retrieved from
the donor.
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Fertilization and Embryo Development
On the day
of the donor's egg retrieval, your husband will need to produce a
sperm sample. This sample is prepared in our embryology lab and then
placed in a petri dish with the donated eggs and incubated. The
following day you will receive information regarding fertilization
of the eggs. If fertilization has occurred in one or more eggs, then
an embryo transfer will be scheduled for five days after the egg
retrieval. The embryologist will give more detailed information
regarding the status of your embryos at the time of the embryo
transfer.
Regrettably, about 2% of the time there are no embryos to
transfer. Sometimes no eggs are produced or retrieved. Eggs may not
fertilize, or once fertilized, may not develop.
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Embryo Transfer:
The embryo transfer
is similar in discomfort to having a pap smear test. A small
catheter is placed into your uterus through the cervix, and the
embryos are passed through the catheter using gentle pressure.
After the embryo transfer, we ask that you rest for
one hour before going home. We require that someone else drive you
home. When home, you will begin 48 hours of bed rest. You may return
to your normal routine (excluding strenuous activities) after the
two days of bed rest are over.
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Follow-up Care:
Following the embryo
transfer, you will remain on the estrogen and progesterone to
sustain the early embryo. If you are definitely not pregnant, we
will ask you to discontinue the medications. Starting a period
before your scheduled blood pregnancy test is not always an
indication that you are not pregnant. Therefore, regardless of
whether you have started your period, we always ask that a blood
pregnancy test be performed.
Resources:
www.asrm.org/Patients/patientbooklets/thirdparty.pdf
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