The IVF cycle is performed on your donor using one or more fertility drugs to increase the number of eggs produced. Multiple follicles (the part of the ovary that contains the eggs) are needed to increase the number of eggs retrieved, thereby increasing the number of embryos developed and hence the chances for conception.
The process begins with the synchronization of both donor and recipient’s menstrual cycles and may require using the medication Lupron. Your donor will also be taking daily injections of Follistim or Gonal-f to encourage this multi-follicular development. Follicular maturation is evaluated by daily blood levels and ultrasound. At a time determined by the physician, an injection of Lupron is given to bring the eggs to final maturity. Approximately 36 hours after this injection, your donor will undergo the egg retrieval that is done in our OR on an outpatient basis.
You will be hormonally synchronized to your donor using Estrogen and Progesterone. Your endometrial receptivity will be evaluated similarly using blood tests and ultrasounds. In addition, the angle and depth of your cervix and uterus will be determined using a catheter identical to the one that will be used for the actual embryo transfer.
Aspiration of follicles for eggs is performed through an ultrasound guided approach under IV sedation. The retrieval consists of aspirating the ovarian follicles and identifying the eggs in the follicular fluid under a microscope. The eggs are then held in an incubator until the time of insemination in the laboratory. On the same day your partner will be expected to produce a sperm sample that will be used to inseminate the eggs.
The embryo transfer may be done 3-5 days after the retrieval. The physician performing the transfer will discuss with you and your partner the status of your embryos and the number to be replaced. At RMA of Michigan we choose to do elective single embryo transfers (ESETs) most of the time. However, the physician will review your embryo’s quality and quantity with you prior to transfer. You may be offered the opportunity to cryopreserve any remaining embryos that continue to develop normally, for possible transfer in future cycles.
You will come to the office for the transfer and the procedure will be done in the OR under sterile conditions, in a reclining position with legs up, as if having a pap smear. The transfer is easy and virtually pain free in most cases. Following the transfer you may return home to relax for the remainder of the day.
Approximately 1 week after the retrieval date you will come back to the office to check your Progesterone level and one week after that for a pregnancy test. If you are pregnant we will follow your progress for an additional 4-5 weeks before discharging you to your own obstetrician.
There are many questions our patients ask as they explore the option of egg donation. Following are some of the most common questions we receive:
Candidates for egg donation include married or single women with one or more of the following conditions: premature ovarian failure, malfunction of the reproductive organs, chromosomal abnormalities, genetic disorders, removal of the ovaries or radiation to the ovaries, and advanced maternal age. Also, IVF patients who have had a poor response to stimulation or poor quality eggs may also be candidates.
Your initial consultation will include a meeting with one of the physicians to review your medical history and may include a physical exam, blood testing, ultrasound, Pap test and cultures. On that day or a later date you will also be scheduled to meet with a nurse coordinator to review the program in detail, discuss the required testing (see recipient screening tests below) for you and your partner and to schedule your consultation with our psychologist. Your visit will conclude with a financial consultation to review the cycle costs, insurance reimbursement and payment schedules. Allow approximately 3 hours for this initial visit.
Standard testing per the American Society for Reproductive Medicine (ASRM) guidelines include screening for sexually transmitted diseases, infectious diseases such as Hepatitis and HIV, and hormonal evaluations, among others. The uterine cavity will be evaluated using several methods to ensure its receptivity at the time of embryo transfer. Since pregnancy puts added stress on a woman’s body, if you are 45 or older, you will need to obtain medical clearance before starting in our program and may need to do some additional testing.
Donors can be either Known (family member/friend) or Anonymous. Anonymous donors are viewed by clicking on a secured link through our website. You will be given a password to view the profiles of the available donors. Once you have selected your donor you will talk with the egg donor coordinator to discuss next steps. Depending on what donor you select there could be a waiting period for that particular donor.
Donors must undergo extensive physical and psychological testing before they are accepted into our program. Anonymous donors must be 21-28 years of age while known donors do not have an age limit. It is important to note that known donors, regardless of their age, must have sufficient ovarian function to respond adequately to stimulation. A woman may donate a maximum of 5 times. If you choose to use an anonymous donor you will be given a complete medical history of the donor and her family as well as a thorough description of her physical characteristics.
IVF using donated eggs can be quite expensive. First, the recipient of the eggs must pay for the blood tests, medications and ultrasounds for both parties. Then the donor receives compensation for donating. Depending on the recipient’s insurance, some of these fees may not be covered. If her insurance does not cover any of these expenses, one cycle of IVF with donor egg can cost over $20,000.
Many different types of women chose to become donors. Often, the donor is a young mother or a full time student who finds donation a way to supplement her income and satisfy her unselfish desires at the same time. All donors undergo thorough screening before being accepted into the program.
Here at RMA, we carefully recruit and screen young women who meet our stringent criteria. Some recipients may prefer to use an outside agency to select a donor. This is certainly an option and we will work with outside agencies. These agencies may have carefully screened their applicants, or they may not have done screening at all. In these cases, we will review the donor’s records and if necessary, we may request that the donor undergo additional tests.
Yes, provided that she undergoes the same screening tests (HIV, hepatitis, psychological screening, etc) that any other donor would undergo.
Yes, she would be called a “gestational carrier”. In many cases like this, the patient may have a friend or relative who is willing to carry the pregnancy. Both women would need to undergo screening and evaluation, and then their hormonal cycles would need to be synchronized much like a donor egg cycle. We have extensive experience with these specialized procedures.
Convenience – You have immediate availability to a donor pool with excellent pregnancy rates. A traditional donor cycle process could take up to six months or longer to complete depending on the patient. California Cryobank donors have already been screened and have completed their egg retrieval. Their eggs have been frozen and are ready for selection.
Affordability – A frozen egg donor cycle has a lower cost than a 1:1 fresh donor cycle due to some of the fees being shared between more than one recipient.
Experience – California Cryobank capitalizes on the collaboration of Fertility Experts from across the country sharing best practices.
Success Rates – Success rates with a frozen cycle are nearly as good as a fresh cycle. California Cryobank also offers an Assured Refund Program which provides a 100% refund if the recipient does not have a successful delivery. This option makes the cost of treatment more predictable and protects the recipient financially. The cost is slightly more than twice the cost of a single cycle and allows the recipient to persevere with treatment for up to six cycles. If treatment is unsuccessful, a full refund is provided.
If you are interested in scheduling a consultation please contact our fertility clinic at (248) 619-3100.