The donor egg IVF
procedure helps women with absent or nonfunctioning
ovaries to become pregnant using another woman's eggs. The
ovaries may fail to function because of advanced age (reduced
ovarian reserve), chemical exposure (chemotherapy),
high dose radiation therapy, hormonal disease, genetic disease,
or explained reasons.
 The
donor process involves retrieving eggs from an egg donor
who has undergone ovarian stimulation to cause the production
of numerous eggs. These eggs are combined with sperm from
the partner in an IVF procedure. Micromanipulation procedures,
such as intracytoplasmic
sperm injection (ICSI), are often performed on the egg
(s) prior to incubation. The resulting embryos are placed
in incubators until ready for transfer, usually 3-5 days.
After incubation, the embryos are transferred into the uterus
of the egg recipient.
Eggs are donated by either an unknown or known
donor. A known donor is often a family member or close friend.
The initial evaluation of the donor includes a history and
physical examination, and a psychological evaluation by
a qualified counselor or psychologist.
Other tests will be performed to assure the
safety of the recipient. These tests include, but are not
limited to, tests for Chlamydia, hepatitis, gonorrhea, syphilis,
HIV (the virus that causes AIDS), and others. Also, hormonal
testing is performed to assure the viability each potential
donor.
Ovarian Stimulation
Controlled ovarian hyperstimulation is performed
to produce several oocytes (eggs) for retrieval. This is
accomplished by the use of gonadotropins (fertility
drugs, FSH), which directly stimulate the follicles
within the ovaries. These hormones are usually given by
subcutaneous injection.
FSH can cause the ovaries to enlarge, even
massively on occasion. Blood work and ultrasound studies
are performed to monitor every ART patient's stimulation.
An injection of hCG (Ovidrel,
Profasi, or Pregnyl) is given to stimulate ovulation
and cause egg maturation. The eggs are retrieved 36 hours
later. Side effects (hyperstimulation) are most likely to
occur after the hCG injection therefore patients are instructed
to limit physical activities and intercourse for approximately
2 weeks following the injection.
Hyperstimulation may require admission to the hospital to
maintain safe fluid and electrolyte balances. One indicator
of hyperstimulation syndrome is weight gain. Patients are
instructed to monitor their weight and notify us if they
gain more than 3 pounds in one day or greater than 5 pounds
in 3 days. We should also be notified if there is no urine
output in any 6 waking hours. To prevent reduced urine output,
patients are instructed to maintain adequate fluid intake
with water, juices, and perhaps Gatorade.
Many donors experience pelvic/abdominal pressure
and even swelling following the retrieval, which will last
for 1 - 2 weeks. If it becomes severe for any period of
time contact our office.
Oocyte Retrieval Procedure
The oocyte retrieval is performed under conscious
sedation with minimal discomfort once the follicles are
mature. The retrieval is accomplished by guiding a long
needle through the vaginal wall into the ovarian follicle.
The needle is guided by use of ultrasound, the same as will
be used to monitor the growth of the follicles during stimulation.
The retrieval carries some risks but they are
minimal and infrequent and are discussed with every ART
patient. Injuries to the bladder, bowel, or major blood
vessels are the major concerns and repair of these injuries
may be necessary. Bleeding is not a significant concern
unless one of the major blood vessels is injured. Infections
can occur but are minimized by the use of antibiotics, which
are given starting the day prior to the procedure. Conscious
sedation carries the risks of drug reactions, cardiac arrhythmia,
blood pressure variations, respiratory problems and other
lesser events. An anesthesiologist administers the sedation
and is capable of monitoring and caring for these rare problems.
Other Risks/Complications
Infections are a possibility with any tissue
donation, including eggs. Testing is done on every donor;
however, there could still be an underlying infection, which
could be transmitted, to the recipient. HIV, hepatitis,
or other viruses are the infections of most concern. These
infections may not show up on the initial testing, especially
if they are recently acquired.
There is a rare possibility that no viable
eggs will be retrieved. Also, events out of our control
could result in the loss of eggs/embryos. Care is taken
to prevent any natural disasters that might occur.
Financial Arrangements
Financial counseling is available through our
office manager. Generally, the donor must be compensated
in addition to the charge for the IVF procedure.
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