Information for Egg Recipients
We would like to thank you for choosing the Advanced Fertility Center of Texas. We are proud to have a high success rate and a low rate of multiple pregnancies. We hope to make becoming an egg-recipient a wonderful experience for you.
Step 1 - Evaluation of the Recipient
The initial evaluation includes:
· An initial meeting with the physician during which the necessary tests will be ordered: Hepatitis B, C, and HIV, RPR, TSH, Prolactin, Rubella, and other test which may be specific for you. We may ask you to have an updated mammogram and a pap smear.
· A physical exam as well as a request to have a medical clearance for a pregnancy from your primary care physician if necessary.
· A sonohysterogram will be performed which includes an ultrasound along with an injection of saline into the uterus to evaluate the uterine cavity and view the ovaries.
· We will ask your partner to undergo STD testing and a sperm analysis. If necessary we may ask your partner to give us another sperm sample for storage.
Step 2 - Donor Selection and Screening
Prospective recipients of donor eggs may choose a known donor, such as a close friend or relative, or an anonymous donor chosen from our egg donor database. There are pros and cons to either method. A known donor often provides a closer sense of kinship and a deeper knowledge of the donor's past health and lifestyle choices. If the known donor is a relative, this choice will strengthen the genetic linkage between the child and the parents. Known donation, however, may make disclosure issues for the recipient couple more problematic. Having a known donor may also create more conflicts if issues arise during the treatment plan. We prefer to have donors that are less than 34 years old and have at least 10 or more follicles (eggs) on their vaginal ultrasound. This is to minimize the risks of Down syndrome and increase the chance of conception. An anonymous donor allows the parents to choose a female who already understands the egg donation process and will feel no obligation to have a relationship with the child after its birth. There may also be a donor who has proven to provide several quality eggs and embryos and a high chance of a successful pregnancy.
If you choose an anonymous female from our egg donation database, you can rest assured that she has completed an in-depth questionnaire about her medical, personal, and obstetrical histories. She will also have had infectious, genetic screening and even a urine drug screen to ensure that her donor eggs are as healthy as possible. The donor must also pass psychological testing to qualify her as an appropriate candidate.
You may also choose donors that reside in other cities. We can usually find a location for their monitoring so that they will only need to be present at our facility during the last two days of ovarian stimulation.
Step 3 – Genetic Testing for Donors
Genetic testing plays an important role in the evaluation and screening of potential egg donors. Certain genetic testing is done routinely by Advanced Fertility Center on their donors. All donors will undergo cystic fibrosis screening. African American donors undergo screening for sickle cell anemia. Donors of other ethnic backgrounds may go additional screening.
Step 4 - Synchronizing the Donor and Recipient
Your donor coordinator will set up a calendar for both you and the donor after all the tests are completed. In preparation to receive donor eggs, we typically use oral contraceptives as well as a medication called Lupron for donor and recipient to synchronize your menstrual cycle so that you are 3-5 days ahead of the recipient. This is the time needed to extract the eggs and grow the embryos.
Step 5 - Donor Stimulation and Recipient Hormone Replacement
Once the donor and recipient are synchronized the donor will initiate injectible medications to grow her eggs and the recipient will start with an estrogen regimen to prepare the uterine lining. During that process, we will ask you to have about 3 or more estrogen blood tests and two to three ultrasounds to insure that you are ready to receive the embryos.
Step 6 - Retrieving Donor Eggs
The donor will undergo egg retrieval using intravenous sedation and through a small needle through the vagina, the eggs will be harvested. At the same time you will be asked to start another medication called progesterone for the final preparation of the uterus.
Step 7- Fertilization of the Eggs, Embryo Culture and Embryo Transfer
At the same day of donor egg retrieval, the recipient's partner will provide a semen sample that is processed and used to fertilize the donor eggs. After twenty four hours it becomes an embryo that is cared for in the laboratory for 3-5 days before it is transferred to the recipient. It has been our practice to transfer two embryos so that to have a small risk of twins of about 25%. We may elect to transfer more than two embryos if necessary. Excess embryos that are suitable for transfer may be cryopreserved for future use.
Step 8- Early Pregnancy Maintenance
Once the embryo transfer is complete we ask that you maintain bed rest for at least 48 hours. For our out of town patients, we ask that you refrain from flying for about five days. You will continue the estrogen and progesterone hormones until the pregnancy test which will be scheduled in two weeks. After the pregnancy test, you will be asked to continue estrogen and progesterone therapy to maintain your pregnancy for another eight weeks.
