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Egg Donation – Recipient Information
The typical egg donor falls into one of three categories: anonymous donor; patient-donor; and designated non-anonymous donor.
Anonymous Donor
Our program primarily follows the anonymous donor model. This has been standard for sperm donation for decades. While no identifying information about the donor is revealed, detailed personal, medical and family profiles are provided to recipients in the process of selecting a donor. Our donors are committed to the concept of anonymity and would not be interested in participating in the program in any other way. In most cases, anonymity best protects the privacy and interests of both the donor and the recipient.
Patient Donor
In some cases, young infertility patients undergoing IVF are willing to donate some of the extra eggs produced during ovarian stimulation for a reduction in their own costs. If a satisfactory match can be made, this arrangement can be highly rewarding for both the donor and the recipient. While patient-donors are less frequently available, the cost of these types of arrangements is less than that of compensated donors.
Designated Donor
Some couples strongly prefer to pursue conception with eggs donated by someone they know. This designated non-anonymous donor can be a young, fertile family member or close friend. We are open to this type of arrangement provided that the prospective donors meet our standard screening criteria and provided that thorough psychological counseling and evaluation are completed for all participants. While in-family donation can be a satisfactory solution for some couples, it may also have profound effects on long-term family dynamics. Assessment by an experienced mental health professional is required for the best outcome. Follow-up sessions with a counselor after either a successful or failed egg donation procedure is strongly recommended.
How is the Right Donor Selected?
We make every effort to find a donor that the recipient couple will feel entirely comfortable with. We guide you through this difficult and unique process. Using your preferences, priorities and exclusions, we try to identify donors who generally meet your requirements and who are available within your time frame. We then provide you with detailed personal, family, educational and medical information about a few donors. We give you as much information as possible without compromising confidentiality. The final selection is made jointly.
What are the Recipient’s Treatments?
In addition to a semen analysis, a current HSG (dye study of the uterus) or hysteroscopy to evaluate the uterine cavity, and blood tests for both partners, the woman may be tested for rubella and STDs. If there is any question that the male partner may not be present around the day of egg retrieval (which can be a few days earlier or later than expected), then a backup specimen of his frozen sperm should be sent to our program well in advance of the scheduled treatment.
Preparation of the recipient’s uterine lining for implantation is key to the success of PRIDE. If she has no periods or ovarian function, the recipient is placed on a protocol of estrogen replacement to build up the uterine lining. One or two blood tests and ultrasounds are done in our office to monitor response to the medications. Dosage adjustments are made as necessary. Once the date of egg retrieval is set, the recipient adds twice-per-day injections of progesterone-in-oil, vaginal progesterone or oral progesterone (or any combination of these). It is most important that the recipient does not start progesterone until specifically instructed by our office. If the recipient has periods, and therefore ovarian function, her own hormone production first needs to be suppressed so that it does not interfere with the above hormone replacement protocol. Therefore, women with ovarian function receive either Lupron or Synarel, which suppressed ovarian function, before starting estrogen and progesterone.
The hormone preparations, estradiol and progesterone are identical to the hormones which your body would naturally produce during spontaneous pregnancy. There is no need to worry about their possible adverse effects on the developing fetus because these hormones are exactly the same as the one produced in all human pregnancies. Unfortunately, the FDA requires that a warning about be included in the package about the use of any hormones during pregnancy. However, this policy does not distinguish between artificial hormones (such as those found in birth control pills) and natural hormones necessary to prepare the uterus for embryo implantation and pregnancy.
Schedule of Medications
Before the treatment cycle begins, you will be given a preliminary schedule of medications. In most cases, this schedule will need to be modified during the actual treatment cycle to achieve perfect synchronization with the egg donor’s cycle. Occasionally we perform a trial cycle to test whether the standard protocol results in good uterine lining. In these cases, an endometrial biopsy may also be performed. In most cases, however, the standard protocol prepares the uterine lining well, so that a trial cycle and biopsy are not necessary.
Donor Treatment
The egg donor will undergo the first two phases of IVF: controlled ovarian hyperstimulation and egg retrieval. They receive a series of daily injections of gonadotropins to stimulate their ovaries to produce multiple eggs. During this time, they are closely monitored with frequent blood tests and ultrasounds to determine the optimum day of egg retrieval.
Out-of-Town Recipients
Since the treatment of the donors is more time-consuming than prepping the recipients, PRIDE lends itself well to patients in the Central New York region. However, with a world-side shortage of qualified egg donors, many recipients may travel from out of state or abroad. We have developed a system of evaluating potential recipients through review of past medical records and telephone interviews with them and their local gynecologists. This system allows most of them to travel to Syracuse for only 5 to 7 days during the actual treatment cycle. Accommodations close to the CNY Fertility Center are available.
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