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There are numerous steps in the donor egg IVF process, which are discussed below.
Both known and unknown donors are required to sign
a donor consent form. The egg retrieval is an outpatient surgical
procedure, which involves ultrasound-guided aspiration of the
follicles. An anesthesiologist is present during this procedure.
All donors receive a full explanation and instructions concerning
the retrieval. The donor must have someone to drive her home after
the egg retrieval.
A preliminary report on the number of eggs obtained
will be given to the recipient couple as soon as possible after
the egg retrieval. Not all follicles aspirated can be expected
to yield an oocyte (egg). With ovarian stimulation using fertility
medications, mature, immature, and/or post-mature oocytes are
recovered. The average number of oocytes obtained from our egg
donors is 18 eggs, ranging from 4 - 66 eggs per retrieval.
Ideally, a sperm sample is provided to the laboratory
the same morning of the egg retrieval. In normally fertile males,
the sample is produced by masturbation. We provide a private collection
room on the 1st floor in the ARTS department. If sperm collection
problems are anticipated, please advise our office. A "backup"
sample may be obtained at home and frozen in case of ejaculatory
failure on the day of the egg retrieval.
Once the embryology laboratory receives the donor's eggs,
they will be placed in special fluid media and allowed to remain
there for approximately 4 to 6 hours. The sperm specimen will
be prepared, and then incubated with the egg(s) for approximately
16-18 hours.
The egg(s) will be evaluated at approximately 16,
40, and 64 hours (days 1, 2, and 3 after the egg retrieval) after
the time of insemination to determine fertilization of oocytes
and embryo development. We will contact you by telephone on a
daily basis, and embryo transfer will be scheduled 3-5 days after
the egg retrieval procedure.
 Approximately 70% of the eggs retrieved will fertilize,
and approximately 50% of the fertilized eggs will continue to
grow to day 5 or 6. Approximately 30% of couples undergoing oocyte
donation will have excess embryos to freeze for future use. Also, please review our IVF success rates page for more information.
When normal development of the embryo(s) has occurred,
the recipient will be scheduled for embryo transfer. The male
partner should come with the recipient to the transfer.
A very soft, flexible catheter will be placed through
the cervix inside the uterus and the physician will transfer the
embryo(s) into the uterine cavity. This is a painless procedure
and no anesthetic is required. Patients are asked to remain in
a reclining position in the recovery room for one-hour post retrieval.
Patients are welcome to bring food, books, a small radio with
headset, etc. to occupy them during the rest period. After leaving
the clinic, activities should be minimal. Patients are asked to
"stay off their feet" for the first 24 hours following
embryo transfer. Afterwards, patients can resume activities, which
are non-stressful or physically tiring.
If more than 2-3 good quality embryos develop, cryopreservation may be employed to preserve the excess embryos for use in a future
cycle (s).
Progesterone supplementation begins the day after
the donor receives her hCG shot to induce ovulation -- usually
4-6 days before embryo transfer -- and will continue through the
first pregnancy test. The second pregnancy test occurs 14 days
after the egg retrieval. With a positive pregnancy test, the fertility
nurse will provide additional follow-up and medication instructions.
With pregnancy a genetic amniocentesis may be recommended for
some women.
If the pregnancy test is negative, a follow-up appointment
should be scheduled with the physician. This visit summarizes
the treatment cycle, discusses future plans (future IVF cycles
or other infertility options) and gives patients the opportunity
to ask questions.
Approximately 50% of pregnancies resulting from oocyte
donation result in multiple gestation, even when 2 embryos are
transferred. Sometimes, a triplet gestation (2%) results after
only 2 embryos are transferred because of monozygotic (single
embryo splitting or 'identical') twinning.
If there is insurance coverage for IVF, our
office will file claims for services provided, however services
provided to the egg donor must be paid by the recipient couple.
Our office will not file a claim for any test or procedure conducted
on the egg donor, although we will provide documentation for services
provided. Our office will also collect for the anesthesiologist
who bills our office for anesthesia services provided to the egg
donor. The policy was created to ensure confidentiality of the
egg donor.
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