Initiating the process of having a baby through egg (ovum) donation may seem complicated at first, but take comfort in knowing that our experienced physicians, nurses, counselors, and staff will guide you step-by-step through the entire process.
Why Use Donor Eggs?
An increasing number of people choose ovum donation when traditional fertility therapies are unsuccessful or when hormonal tests indicate poor reproductive potential. Using an ovum donor may be appropriate for patients whose ovaries were absent at birth or were removed or damaged by surgery, chemotherapy, or radiation. It is also an option for patients who would like to eliminate the risk of passing on a known genetic condition they carry.
Because the chance of achieving a live birth is strongly related to the age of the egg, using donor eggs can often substantially increase the likelihood of having a baby from IVF. At UCSF, the chance of achieving a live birth from a single ovum donation cycle is greater than 60%. Furthermore, because many cycles using donated eggs result in surplus embryos to freeze, the cumulative pregnancy rate including subsequent frozen embryo cycles is approximately 80% at our practice.
Having a baby using a donor egg provides couples with the opportunity to experience pregnancy, childbirth, breastfeeding and having a child who is genetically connected to the father. Egg donor recipients have control over many aspects of the process, including when to try to become pregnant, the choice of the ovum donor and, once pregnant, the uterine environment provided for the child.
Choosing an Egg Donor
An important step in the ovum donation process is choosing a donor. At UCSF, we respect that the process of determining the right donor is a uniquely personal decision. We have several resources, including a psychologist with expertise in fertility and family building, to assist in the decision-making process.
There are two basic types of ovum donors:
Known donors: A known donor is usually a relative or a friend. All known donors must pass minimum screening criteria. They may or may not receive compensation for their egg donation.
Recruited donors: These are usually young women with excellent reproductive potential who are compensated for the time and effort involved in assisting patients to become pregnancy. Recruited donors may be found through egg donor agencies or through the UCSF Center for Reproductive Health in-house donor program.
Using a Donor from the UCSF CRH Donor Program
The team at UCSF recruits and screens a pool of in-house donors who are available for selection by our patients. The cornerstone of our program is our highly selective and comprehensive screening process. In recruiting and screening donors, we adhere to the guidelines of the American Society for Reproductive Medicine, the United States Food and Drug Administration and our own institutional Board of Ethics.
Our donors are recruited and screened by our Donor Program Team, which includes a reproductive endocrinologist, a clinical psychologist, certified genetic counselors, and program coordinators. Donors become available for matching only after their screening has been fully completed and candidates are deemed to be suitable candidates per all guidelines. This includes a review of medical and family history, a thorough physical examination, genetic and mental health screening, and testing for infectious diseases.
Our multidisciplinary team works together to ensure that donors in our pool are eligible candidates for donation. This means that you are unlikely to experience the disappointment of carefully choosing a donor from an agency only to find out they are ineligible once they are medically screened. By choosing an in-house donor, you will benefit from the ease of working closely with one center for all your needs during your treatment cycle. You may also find that working with a donor from our internal program is often less expensive than working with an agency donor.
Choosing an Agency Donor
We do collaborate with many ovum donor agencies, and we are happy to assist you in coordinating a cycle with an agency donor. The benefit of going through an outside agency is access to a larger pool of donors to select from. However, agencies often only perform partial screenings on their donors, so our program usually needs to do additional screening according to our standard policies. If you are interested in using a donor from an outside donor agency, we will provide you with a list of recommended donor agencies we have worked with in the past. We recommend that you ask the agency about their policies and procedures for recruitment and screening directly. Donors from outside agencies must have a mental health screening arranged through the agency and must meet specific criteria for eligibility, such as recent infectious disease screening, in order to proceed with a cycle with our center. Once selected, the donor will undergo an exam performed by one of our physicians prior to cycle planning.
What Is the Egg Donation Process?
Consultation The first step for prospective patients is to consult with one of our reproductive endocrinologists who will perform an evaluation and then discuss the various treatment strategies available to you. Our physicians strive to help guide you in understanding all aspects of the options available. If you decide to proceed with an ovum donor cycle, your physician will discuss what is required to prepare for your cycle.Your physician will also perform a medical evaluation and physical examination to ensure that your health is not likely to be jeopardized by pregnancy.
Cycle preparation In order to optimize the success of an ovum donor cycle, your physician will order several tests that seek to identify and correct any abnormalities that could interfere with fertilization and/or implantation. These tests include a detailed semen analysis, a saline sonogram (a test which evaluates the uterine cavity) and basic blood work evaluating blood count, blood type and thyroid function. In consideration of your overall health, we also require that you are up-to-date with recommended health screenings, such as the pap smear and mammogram (if over 40). Though women achieve high success rates with ovum donation throughout their 40s, the risks during pregnancy increase as age approaches 50. Additional testing may be required to ensure that you enter your pregnancy in optimal physical condition. This testing includes a screen for diabetes, an EKG and clearance by a perinatologist (high risk obstetrician). You will also need to meet with our psychologist to discuss your plans to proceed with an ovum donor cycle and to review the various decisions you will face as you go through the process. You will also discuss what to expect in the future once you have a child with the help of ovum donation.
Selecting a donor UCSF donors: If you are working with the UCSF in-house program, our donor coordinator can help you navigate our web-based donor profiles. You will have access to photographs and information about the donor’s background, medical history, educational level, and family history. We will discuss with you any relevant findings from the screening process itself, including genetic screening and testing, mental health screening, infectious disease results, and physical findings. You may select a donor who will do a fresh cycle, in this case, you would receive all the eggs from their retrieval, or you may select frozen eggs from our cryo-bank. If you have selected a donor for a fresh cycle, the donor coordinator will confirm the donor’s availability for donation during the time period requested. Some of the donors have other patients interested in them, and there can be a wait before they are available. Once the donor selection process is complete, information about your donor will be given to your physician and nurse coordinator, and your cycle will be arranged. Agency donors: If you select a donor from an outside agency, the agency will send information about the donor to our office for cycle coordination.
Synchronization It is important for the donor and recipient to be synchronized such that the recipient’s uterine lining is be ready for implantation at the time that the donor’s eggs are retrieved and fertilized. This is usually accomplished by administration of birth control pills to synchronize the ovum donor and recipient’s cycles. When the cycles are synchronized, the donor is instructed to take medications to stimulate the growth and maturation of a cohort of eggs, and is monitored by ultrasound and blood tests over the course of 10-14 days until the eggs are ready for retrieval. Meanwhile, the recipient will also take medication to prepare the uterine lining for embryo implantation.
Egg retrieval and embryo Transfer Once the donor’s eggs reach the point of maturity, an egg retrieval is scheduled. The recipient’s partner or selected sperm donor will need to provide a sperm sample on the day of the egg retrieval for insemination of the eggs. When the embryos reach the proper stage for transfer, the recipient will have it transferred into the recipient’s or the gestational carrier’s uterus. We typically recommend the transfer of one or two embryos from donor cycles. The decision of how many embryos to transfer will be discussed in detail with you by your physician, as the transfer of a single embryo will reduce the risk of a twin gestation. Additional high-quality embryos that are available from the cycle can be frozen and preserved for transfer at another time.
Egg Donor FAQs
Our donors are between the ages of 21 and 33. To maximize the likelihood of success, we recommend that you choose a donor who is under the age of 35. Other factors related to likelihood of success are having previously carried a pregnancy to term, or having previously completed an ovum donor cycle with positive results. Other factors that many patients consider are physical characteristics, ethnic background, family medical history, educational background, and personality characteristics. Our team can help you with any questions you have about the selection process.
Our in-house donors undergo an extensive screening process. Prospective donors complete a detailed questionnaire that is reviewed by our team. Donors that meet specific criteria will be invited to undergo additional screening by our team. A reproductive endocrinologist the donor’s medical screening, while our psychologist conducts the donor’s psychological screening.
Our board-certified genetic counselor screens for family history of birth defects or hereditary diseases via a comprehensive family history intake. The prospective donor must also undergo a physical exam, urine cultures and blood tests to rule out the presence of infectious diseases such as HIV, Hepatitis B, Hepatitis C, gonorrhea, and chlamydia. In addition, our donors are screened for over 170 autosomal recessive conditions as well as their blood type. The ASRM and FDA guidelines are followed for all screening procedures.
Donors are often willing to meet recipients. If you would like to request a meeting, please let us know, if the donor agrees we will arrange this for you. The meeting is an opportunity for you to thank the donor for her donation and to build a bridge of goodwill for possible future communication. Meetings are facilitated by our clinical psychologist. They can only take place after an official match has been made.
The first step is to discuss your known donor with your reproductive endocrinologist. He or she will help determine if your known donor is a good candidate. Known donors are usually younger than 35 years old, in good health, and have a healthy family background.
Your donor will sign a consent form in which she relinquishing all rights and responsibilities regarding the donated eggs. In California, the woman who delivers the baby is the legal mother except in pre-arranged gestational carrier arrangements. Thus, for women using ovum donation to conceive, there is no need to file any legal documents to establish the parentage of the child.
Laws regarding the use of donor ovum vary in different states and countries. We can provide resources for legal assistance if desired.
Ovum donation can be a wonderful way for those who are unable to conceive on their own to become parents. Nonetheless, arriving at the decision to pursue ovum donation can be a difficult process. Patients often come to this decision after giving a lot of thought to what becoming parents means to them. patients may consider other options at this time as well, including adoption or not having children. Our psychologists are available to help you think through your thoughts and feelings about the varied family building options available to you.
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