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IVF with Egg Donation
1. What screening do recipient couples need?: The recipient couple will be screened for infectious diseases, such as HIV, Hepatitis B & C and for sexually transmitted diseases such as Gonorrhea, Syphilis, CMV and Chlamydia.
2. How is an egg donor matched to the recipient?: If egg donation is being provided by an anonymous egg donor, recipients are matched with a suitable donor by the fertility clinic. A record is taken of the physical characteristics, ethnicity, medical history, personality traits and IQ of donors to help fertility clinics match recipients with the most suitable donor.The fertility care clinics that we are partners with typically seek female university students who are willing to donate their eggs free of charge.
3. Do recipients and egg donors need to take fertility drugs?: Once the egg donor and the recipient pass all the necessary screenings, both the egg donor and the recipient will be prescribed an injectable medication (such as Lupron) as well as oral contraceptives to synchronize the recipient and the egg donor’s menstrual cycles.
4. What preparation is needed before embryo implantation?: The recipient will be given hormone replacement therapy, such as progesterone pessaries, or oral estrogen tablets that will allow the body to imitate the natural ovulation cycle- the ovaries produce hormones that thicken the uterus in preparation for implantation of a fertilized egg. This hormone therapy will prepare the recipient for the transfer.
The recipient will then take hormone supplements for about 7-10 days, at which time her blood hormone levels and endometrium (the lining of the uterus) will be carefully monitored. When the recipient’s uterus has thickened sufficiently, the donor will be given hormones that will cause her ovaries to produce several eggs at a time. This is called donor stimulation.
5. When is sperm collected?: Once the egg donor is ready to have her eggs retrieved, the recipient’s uterus will be in an ideal condition for implantation. At this time, the sperm donor or the recipient’s partner must provide the lab with sperm for insemination, which will enable fertilization. If assisted sperm retrieval is needed, the donor may provide the sperm before eggs are collected. Frozen sperm will be thawed and prepared for insemination at the time of egg collection.
6. When do patients stop taking fertility drugs?: The recipient will continue taking oral estrogen until the embryo is transfered and she will also start progesterone vaginal suppositories, the final hormone the ovaries would produce to complete the thickening of the uterus.
7. How are eggs collected?: Eggs are usually collected by the guidance of an ultrasound, which usually takes about 30 minutes. The doctor will insert a thin needle through the vagina into each ovary. The eggs will then be drawn into the needle. More often than not, eggs are collected by laparoscopy (a small telescope with a light attached). This procedure involves making a small incision in the stomach and extracting the eggs with a fine needle, as before.
8. How are eggs fertilized?: Once the sperm and egg are collected, the sperm is injected into the egg through the process of ICSI. A thin, hollow needle is pierced through the cell membrane, and is loaded with a single sperm. The sperm is then injected into the cytoplasm of the oocytes to allow fertilization.
9. When are embryos transfered?: The embryo transfer can occur 1-5 days after fertilization occurs, depending on factors that the couple will discuss with the embryologist, such as low sperm count and embryo development. Same day embryo transfer, in which the embryos are transferred about 4 hours after fertilization, is becoming more common, since it allows recipients to undergo the procedure on an outpatient basis. Although embryologists are also recommending that the recipient wait until day five to transfer the embryo, which is known as the blastocyst stage. The blastocyst transfer has also become quite common as it increases chances of successful implantation and decreases the likelihood of multiple pregnancies.
10. What is the insemination process?: This process is the last stage of the IVF procedure. It is usually painless and does not require any anesthesia. The embryos are transferred into the uterus through the cervix with a catheter. Typically 2-4 embryos are transferred into the uterus to increase the chances of pregnancy. If done successfully, the patient can go home and should rest for the remainder of the day. A pregnancy test will be given 12-15 days after the embryo transfer. If the IVF is successful, a normal pregnancy can be carried out.
*Note: It is often the case in IVF with egg donation that more embryos are produced than can be used in one cycle. When this happens, those embryos can be frozen and preserved for future use.
Also note that for both menstruating women and menopausal women, the treatment stages are the same. Both must take medication prior to the embryo transfers.
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