Egg Donation Summary
Stages of Egg Donation
Egg donation, also known as oocyte or ovum donation, is a process that enables a woman to donate her eggs to another woman (recipient) who is not able to produce viable eggs on her own, or for couples or individuals in which there is no egg provider (e.g. single men or gay male couples). To enable this process, both the egg donor and egg recipient (or gestational carrier) are required to undergo medical treatment so that eggs may eventually be donated. Egg donation involves a process called in vitro fertilization (IVF), in which donor eggs are fertilized in the laboratory and the resulting embryos are transferred into the recipient or gestational carrier. With the benefit of advanced reproductive technology, egg donation offers one of the most successful treatments for any type of infertility.
In the case of donation to an infertile woman, an egg donor is enabling the recipient to experience pregnancy – an opportunity she would not otherwise have. Women who seek an egg donor are unable to become pregnant using their own eggs, either because of a medical condition or because they are attempting pregnancy at an older age, when a woman's own egg supply begins to decline. Many of these women have undergone repeated cycles of IVF and experienced significant frustration. While the egg donor is being compensated for their egg donation, know that this act is nevertheless a true gift that will enable another woman or couple to have a family.
Donors who choose Pacific Fertility Center's egg donation agency are supported throughout the screening and treatment process. Our physicians, nurses and counselors are committed to making this process as comfortable and manageable as possible for our egg donors. Thank you for considering egg donation.
- What are the steps involved in becoming a PFC donor?
- What type of time commitment is expected?
- What happens once selected as an egg donor?
- What happens after the egg donation process?
What are the steps involved in becoming a PFC donor?
Fill out our online application and questionnaire
For an individual interested in becoming an egg donor with our agency, we ask them to begin by completing our online application. This includes a questionnaire that asks detailed questions about their own health and genetic history and that of their family; their educational background and the reasons they are seeking to donate their eggs. This questionnaire will serve to introduce the potential egg donor to the prospective parents. Because in some cases, a close physical resemblance is important to the prospective parent, we will also ask the prospective donor to provide good quality photographs of themselves through the years, and photographs of their children, if they have any.
Participate in a donor screening
After the potential egg donor online application has been reviewed, we will contact them to begin a donor screening process. They will be asked to meet with an agency staff member, as well as with a certified genetic counselor, our licensed Marriage and Family Therapist and one of our physicians.
Questions to consider before choosing to donate
The donor screening process enables us to evaluate potential egg donors. It is also an opportunity for the prospective donor to evaluate the donation process and decide whether egg donation is right for them. Because donation requires a commitment to a medical protocol over a period of time; and most significantly, a commitment to another person, this process involves careful decision making. In order to make sure that they feel entirely comfortable with their decision, we will ask them to think about various aspects of the donation process. Here is an overview of the types of questions and issues we will ask them to consider:
- Should your donation result in the birth of a child, are you comfortable knowing that another family will raise a child (children) genetically related to you?
- Do you feel that egg donation is something you will share with a partner or future partner?
- Is your current partner/spouse supportive of your donation?
- Are you willing to consider future contact with the child or children, especially in the case of medical emergency (for example, in the event that you are a match for an organ transplant)?
- Do you want to know the outcome of your participation? (Are you more comfortable being anonymous, or would you prefer having a 'known' cycle?)
- Are you comfortable donating to gay or lesbian parents?
- Are you comfortable with the medical procedures and the potential medical risks of egg donation?
Fertility evaluation process
As part of this screening process, prospective donors undergo a fertility evaluation, consisting of a physical examination and trans-vaginal pelvic ultrasound (an ultrasound examination of the uterus and ovaries). Lab work during the evaluation includes a blood draw, saliva sample and/or cheek swab to confirm blood type and that there are no common genetic mutations which could be passed on to progeny.
The physicians, counselors and staff at our Northern California San Francisco Bay Area fertility clinic are available to discuss the screening and preliminary testing process with our donors at anytime.
With Pacific Fertility Center's Egg Donor Agency, all egg donors are anonymous to the recipient (the exception is known egg donors, such as friends or sisters). Profiles of accepted egg donor candidates can only be viewed by potential recipients, using secure passwords to the Egg Donor Agency website once the preliminary screening is successfully completed.
Once the screening process is completed and the prospective donor is accepted into our egg donor program, their profile will be available for Pacific Fertility Center patients to view online. Only PFC patients intending to do an egg donation cycle are given passwords to view our egg donor profiles. All identifying information will be removed from the donor's profile for their protection.
Once a recipient has made a selection of a donor candidate, we will ask that donor to come in for a full physical exam and final screening.
What type of time commitment is expected?
From the time of the donor's selection as an egg donor through completion of treatment, the time commitment is anywhere from 6 weeks to 2 months, depending on where the donor is in their menstrual cycle when selected. During this time, we will ask the donor to come to our clinic for pre-cycle screening, cycle monitoring and egg retrieval. We estimate they will need to travel to our clinic between 5-10 times. For donors that live out of town or state, they will travel to our clinic up to three times. The third and final time will be for egg retrieval and will plan to stay for approximately one week.
What happens once selected as an egg donor?
For the donor, there are three basic steps in the process from this point forward.
- Pre-cycle screening in our clinic
- Synchronizing the cycles of the donor and intended parent, and donor stimulation cycle to produce multiple eggs for donation
- Egg retrieval
Once the donor has been chosen by a recipient as their egg donor, our agency will contact them to schedule a series of pre-cycle screening appointments. This process consists of a second meeting with our Marriage and Family Therapist, another physical exam and ultrasound and additional lab work to test for sexually transmitted diseases such as HIV, Hepatitis and Syphilis.
Pre-cycle screening appointments are usually scheduled to take place in one day and will require a 2-3 hour time commitment at our clinic. If the donor lives out of town, we will facilitate travel accommodations, for same-day travel if possible. In the event that same day travel is not possible, our agency will arrange a hotel stay for the evening before or after the donor's appointments. Our agency will arrange and pay for all donor air travel. For those traveling by car or using public transportation, we will reimburse them for expenses such as mileage, bridge tolls, and parking.
The pre-cycle screening will also include a meeting with a clinical nurse coordinator, who will explain the egg donation process in more detail, answer any questions the donor may have and map out their treatment cycle. The Pre-cycle visit also includes a complete physical examination and ultrasound with one our physicians as well as detailed discussion of the rare but potential medical risks of the process.
Synchronization and Stimulation
In this initial stage, both donor and recipient will begin medication to synchronize their menstrual cycles to the same time table. This conformity is necessary in order for the recipient to receive the donor's fertilized eggs at the appropriate time.
While the egg recipient receives treatment to prepare her body for pregnancy, the donor will prepare their body to produce multiple eggs for donation. This process involves a few different medications that will serve to control their menstrual cycle and promote the growth of multiple eggs on their ovaries.
Some of the medications the donor will receive during this time are given by injection. While this may be a daunting concept at first, please know that our nurses will carefully instruct and council them throughout the medication process. Our staff is available to our donors anytime they need assistance with dosage, scheduling or administering the medication.
Throughout the donor's treatment, they will receive regular monitoring so that we can gauge their response to treatment, adjust medication as necessary and determine when they are ready for next steps.
Monitoring donor treatment involves two basic procedures:
- Vaginal ultrasound. This is a painless procedure involving a very thin probe inserted into the vagina. The ultrasound enables the doctor to obtain a clear image of the size and number of egg follicles developing on the donor's ovaries.
- Blood testing to measure hormone levels. As eggs begin to grow on the donor's ovaries, they will produce increasing amounts of the hormone estradiol (estrogen). By testing the amount of estradiol in your blood, doctors can gauge the level of stimulation occurring in the ovaries.
In order to control the donor's cycle and promote the growth of multiple eggs on their ovaries, they will receive the following medications:
Birth Control Pills
During this stage of treatment, donors will be started on a low dose birth control pill. They will be on the birth control medication for approximately 14 – 21 days. During this time, the egg recipient will likewise be on birth control medication. This process serves to synchronize donor and recipient cycles for eventual egg donation.
Approximately 2-3 weeks after beginning birth control pills, the donor will begin a medication called Lupron. Lupron serves to temporarily 'shut off' the body's natural production of ovulation hormones, so that we may more carefully control their cycle and prevent them from ovulating before the appointed time. Lupron is given by subcutaneous injection (just under the skin with a very small needle). Lupron will continue daily for a period of approximately 20-30 days.
Some patients experience mild side effects from Lupron. These are temporary and may include hot flashes, mild headaches or fatigue. Headaches are the most common side effect of Lupron and are usually very mild and respond well to Tylenol. Learn more about Lupron.
Approximately 14 days after starting on Lupron, the donor will begin a series of medications called gonadotropins, which will stimulate their ovaries to produce multiple eggs. Gonadotropin medications, which include Follistim, Menopur and Gonal-F, all contain an active form of the FSH (follicle stimulating hormone), the main hormone responsible for producing mature eggs in the ovaries.
Like Lupron, gonadotropins are injected subcutaneously (just beneath the skin). Donors will be asked to take this medication daily for approximately 10-14 days. Side effects from gonadotropins are rare. Most patients experience minimal, if any, side effects from gonadotropins. If an individual is prone to premenstrual syndrome (PMS) they may feel similar side effects such as breast tenderness, abdominal bloating, headaches and/or mood swings. In very rare cases (1-2% of patients) a condition called Ovarian Hyperstimulation Syndrome (OHSS) may occur. This causes enlargement of the ovaries accompanied by abdominal discomfort and/or pain. With careful monitoring, OHSS is commonly avoided altogether. All side effects commonly cease 2-4 weeks following the treatment cycle. Learn more about gonadotropins.
hCG (Human Chorionic Gonadotropin)
When monitoring indicates that the donor's egg follicles have developed sufficiently, they will receive one injection of a medication called Human Chorionic Gonadotropin (hCG). This last medication in their cycle is a natural hormone that works to fully mature the eggs and trigger ovulation approximately 34-42 hours after hCG injection. When they receive the hCG injection, we will schedule the egg retrieval procedure. Because ovulation and egg retrieval occur so soon after the hCG injection, the timing of this step is crucial to the donation process. We will work closely with the donor to make sure that they are comfortable with their medication protocol during this important step.
Approximately 36 hours after receiving the hCG injection, the donor will come into our clinic for an egg retrieval procedure. Because anesthesia is used for the egg retrieval, it is completely painless. For the procedure, a vaginal ultrasound probe fitted with a tiny needle is passed through the wall of the vagina and into each ovary. The needle punctures each egg follicle and removes the egg through a gentle suction. The egg retrieval procedure is brief, taking a half hour or less. Once the procedure is concluded, we ask that our donors rest at our clinic until the anesthesia wears off completely. They may feel some minor cramping in the ovaries that can be treated with appropriate medications. Because they will have received sedation, it is required to have someone drive them home following the procedure. As is common with most any surgical procedure, we also ask that someone be with our donors for a minimum of 12 hours following the retrieval in order to make sure there are no complications from the anesthesia or the procedure. It is fine to resume light activity following the egg retrieval. If the donor lives out of town and has to take a flight home, they may fly on the day following the egg retrieval. A nurse will contact them by phone on the day following the retrieval. Our donors are encouraged to contact us anytime.
Because fertility medication is still present in the donor's system, they will be more fertile in the days prior to and for several days following the egg retrieval procedure. We advise that donors avoid sexual relations seven days prior to the egg retrieval and for two weeks after the retrieval (until they get their next menstrual period).
The donor compensation is remitted immediately following the egg retrieval, either in person on the day of the retrieval or via Fed Ex.
What happens after the egg donation process?
While most egg donations are anonymous, our donors have nonetheless created a valuable connection. Their donation will now begin a long-hoped-for process for another individual or couple.
Eggs are placed in a specialized substance (culture media) in the Petri dish. The embryologist next analyzes the semen sample provided by the male partner and isolates the most optimal sperm for fertilization. Sperm are added to the eggs in the Petri dish. In some cases, the embryologist will perform additional laboratory procedures such as ICSI to enhance chances of fertilization. Within 24 hours, the eggs will fertilize. After this point, they are referred to as embryos.
Embryos will develop in the laboratory for 3-5 days, at which point they will be transferred to the recipient or gestational carrier in a brief and painless procedure.
The PFC Egg Donor Agency team hosts free egg donor webinars. Click here to learn more and sign up.