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The Egg Donation Process...

The Egg Donation Process...
Posted By: Ziggy Jones on August 14, 2005

...From the Donor's Perspective

Application and Eligibility
A woman is eligible to become a donor if she is a healthy, non-smoker between the ages of 20 and 30. The process begins with an application, which includes detailed personal medical information about the donor and her immediate family. This information is reviewed as part of the screening process.
Once a potential donor has met our various medical and other screening criteria, she is accepted into our Program. The ovum donation process begins once our program coordinators have matched a donor with a recipient couple, based on relevant criteria.
Hormone Stimulation
A woman normally develops and releases one egg per month, a process regulated by hormones secreted by the pituitary gland. In an egg donation cycle, the donor receives an injection to suppress secretion of her own pituitary hormones. She then begins daily injections of hormonal medication(s), similar to those produced by her body during a menstrual cycle. Taken over a period of approximately two weeks, these drugs stimulate her ovaries to develop multiple follicles containing eggs. Hormone stimulation increases the chances for success in a donor egg cycle by increasing the number of oocytes available for fertilization and replacement, as embryos, to the recipient. In most cases, the donor produces enough eggs for two recipient couples.
While the donor is taking these drugs, the recipient's hormones also are suppressed with medication to regulate her cycle and keep her from producing her own follicles and eggs. While the donor's oocytes are developing, the recipient is taking estrogen to thicken the lining of her uterus. When the eggs are ready, the donor receives an intramuscular injection timing the release of the eggs. At the same time, the recipient starts additional medications, including intramuscular progesterone injections, to prepare her body for embryo transfer and implantation.
Cycle Monitoring
The donor is monitored carefully, through ultrasound examinations and blood tests, to determine her response to the stimulation drugs. While she is receiving these medications, she will be scheduled for almost daily morning visits to our office. This also allows us to closely track the development of the follicles containing her eggs. When they have matured, an injection triggers the final ripening process.
Egg Retrieval
Approximately 35 hours after the donor has received the final injection, she is scheduled for egg retrieval. She is sedated and monitored by an anesthesiologist, while one of our physicians uses an ultrasound probe to visualize her follicles. In a process that lasts approximately twenty minutes, a specialized needle is inserted through her vaginal wall, reaching the follicles and drawing out the fluid containing the oocytes. The eggs are transferred immediately to the embryology laboratory and the donor is sent to the recovery room.


Fertilization
Sperm of the recipient couple, or in some cases donor sperm, is collected on the day of retrieval and joined with the donor's eggs in a special medium, encouraging fertilization and development. In cases where the sperm is likely to have problems penetrating the outer shell of the egg, fertilization is aided by a micromanipulation technique known as intracytoplasmic sperm injection (ICSI). With this procedure, a single sperm is injected directly into the core of the oocyte. Whether or not ICSI is used, the eggs that fertilize will do so in just a few hours. However, the embryos are stored and allowed to develop for another few days before transfer to the recipient.
Risks and Side Effects
Most donors generally do not have problems with blood sampling and hormone injections; however, some experience local discomfort, redness or bruising at the injection sites. Injections can be painful and the side effects of medications may include breast tenderness, fluid retention, a bloated feeling, moodiness and tenderness in the ovaries. Rarely, a donor may form ovarian cysts or hyperstimulation, a condition associated with enlarged ovaries and fluid in the abdomen. Also in extremely rare cases, clotting of the blood vessels may Physicians will closely regulate medications to minimize the donor's discomfort and side effects; however, in some cases, they cannot be avoided. Although very rare, there also are risks with the egg retrieval procedure, including infection and injury to blood vessels or other structures that could require surgery.
On-site psychologists are available for emotional support and counseling to the donor and recipient couple.
Donors are fully apprised of all of the possible risks of being an oocyte donor as part of the informed consent process.
Other Considerations
The Time Commitment
The donor screening process takes two-to-three weeks, with an additional three-to-four weeks for the egg donation process. Oocyte donation begins with a blood test on or before the 21st day of the donor's menstrual cycle to determine ovulation. The medication protocol begins with a Lupron injection, followed by a normal period one week later. The next visit is three days after menses, followed by daily visits for blood tests and ultrasound examination. These visits take 15-to-30 minutes and are scheduled between 7:00 and 9:00 a.m. The donor is required to schedule a full day for egg retrieval and although we will be able to estimate, the exact date of the procedure will depend on how her body responds to the medication. As a result, she must be prepared to stop all usual activities for that day on relatively short notice. Following the procedure, the donor spends about an hour in recovery before being released to someone who can escort her home, where she must rest for the remainder of the day. The donor process is completed with a follow-up exam two weeks later, when the effects of the medications have worn off.
Donor Compensation
All of the medical, psychological, pharmaceutical costs associated with the donor's treatment are paid by the recipient couple. Donors are not paid for their eggs which are a gift, but for their time and inconvenience.

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