What Procedures & Medications are Involved with the Donor Egg Cycle Medical Process?
Fertility Medications Needed for the Recipient
If you have menstrual cycles, medications may begin on menstrual cycle day 3 with the use of a birth control pill. Depending on your individual circumstances, this medication may be given for a varying period of time (often 2 to 3 weeks) to prevent ovarian cysts from forming. Lupron is then given for 10-14 days. If you are not having menstrual cycles, Lupron may not be necessary. If you are using a fresh egg donor, your cycle will be synchronized with hers in order that your endometrium (lining of the uterus) will be receptive to the embryo when it is time to do the transfer. If you are using frozen eggs, the cycle may be scheduled at your convenience once eggs are reserved.
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.
The Egg Donor’s IVF Cycle Consists of Multiple Steps Leading up to Egg Retrieval
If a fresh embryo transfer is planned, the transfer will be scheduled to coordinate with the donor’s cycle. If a recipient chooses to use frozen eggs, the transfer is planned according to her schedule and the egg thaw date.
Fertility Medications for the Egg Donor
After the donor passes infectious disease screening for a second time, her ovaries 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 to trigger ovulation and the egg retrieval is scheduled.
There is a chance (although rare) that the cycle may be canceled because of the donor’s inadequate response to the fertility drugs, and rarer still is the possibility that no eggs would be retrieved. Of course, if you are choosing to use frozen donor eggs, the donor has completed her cycle and your cycle will not have to be synchronized, which allows for greater scheduling flexibility and we can guarantee eggs are available.
The IVF Lab: Fertilization and Embryo Development
On the day of the donor’s egg retrieval or the day of the frozen egg thaw, the male partner will need to produce a sperm sample. This sample is prepared in our embryology lab and ICSI is performed on the donated eggs which are then 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 1-2% 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.
Donor Egg Cycle 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 embryo or 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 recommend that someone else drive you home, and require this if you have taken medication.
When home, you will begin 48 hours of bed rest. You do not have to lie flat on your back, you may rest on your couch or in a recliner. The main principle is that you are doing minimal activity during this 48 hours. You may return to your normal routine (excluding strenuous activities) after the two days of bed rest are complete. More than two days of bed rest is discouraged.
Follow-up Care: After the Embryo Transfer
Following the embryo transfer, you will remain on the estrogen and progesterone therapy in order to sustain the early embryo. A blood pregnancy test will be done 12 days after a day 5 transfer. If you are not pregnant, we will ask you to discontinue the medications. Starting a period before your scheduled blood pregnancy test does not mean that you are not pregnant. Therefore, regardless of whether you have started your period, we always ask that a blood pregnancy test be performed. If the first test is positive, usually two more blood tests are performed 2-3 days apart to monitor the growth of the early embryo.
Pregnancy After a Donor Egg Cycle
You will have an ultrasound at approximately 6 and 8 weeks gestation to monitor the growth of the embryo. You will be referred back to your Obstetrician between 8-10 weeks gestation for prenatal care. A letter will be sent to your Obstetrician with the age of your donor at the time of egg retrieval which is essential for prenatal screening for birth defects.
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