I Want to be an Egg Donor.
Being selected as an egg donor leads to a very exciting and rewarding journey in turning a dream of becoming parents into reality. It is essential for you to be truthful, both to yourself and the fertility clinic, about your past experiences and why you are interested in becoming an egg donor.
The Ultimate Gift
Most recipient couples have experienced substantial emotional and financial anxiety while trying to conceive a child on their own. Without the help of exceptional egg donors, these couples may never have the opportunity to build a family.
Step by Step—
1. Fill out application
Egg donation application includes a confidential questionnaire disclosing information about your family history, personal health history, sexual activity, drug usage, medical background, medications, child bearing history, educational background and areas of talent and/or interests outside your profession.
2. Consultation/Initial Screening
The clinic will review your application, and if you pass this initial screening, you will go through an interview with the donor coordinator. If your medical profile and family history are free of abnormality and/or objectionable traits, a physical examination including laboratory tests will be performed.
3. Medical and Genetic testing
Before you are accepted as an egg donor you will be required to undergo medical and psychological screening.
General medical screening—You will undergo a physical examination, pelvic exam and blood tests to check your hormone levels. An Ultrasound will be used to examine your uterus, ovaries and other pelvic organs. These tests might reveal an existing health problem. If anything is found, ask about your options for treatment.
You will complete a detailed medical and psychological history about yourself and immediate relatives. It will include questions about your use of cigarettes, alcohol, and both prescription and illegal drugs. Many programs conduct unannounced drug tests during the screening and donation process.
Infectious disease screening—To minimize the risk that a donor egg could cause illness in the recipient, donors are tested for a variety of infections.
During your pelvic exam, a small scrape from your cervix will be taken to test for gonorrhea and chlamydia. Blood will be drawn to test for Syphilis, Hepatitis B and C, and HTLV1 (a very uncommon virus that is associated with some cancers). Blood tests are also taken to see if you have been exposed to HIV.
Screening for inherited disease— Most egg donation programs try to learn all they can about a donor’s genetic makeup in order to minimize the chance that a baby will have a birth defect or serious inherited disease. You will be required to provide your complete medical history. You will be asked medical questions about your biological parents, grandparents, brothers and sisters. The program may tell you what information to collect, or they may have you work with a counselor to identify:
- Any birth defects that required surgery or resulted in medical problems (such as a cleft lip or a heart defect).
- Certain genetic disorders (such as Huntington’s disease, hemophilia, Tay Sachs disease or sickle cell anemia).
- Inherited diseases that are of special interest to a recipient because of her own family history.
- Any major medical problems, surgeries or psychiatric complications.
Psychological screening— Donating eggs requires you to confront complex ethical, emotional and social issues. The screening process should help you evaluate your desire to donate and to think through these issues.
You should have a chance to ask questions and express any concerns. In most programs, you will meet with a mental health professional to discuss your life circumstances, your support system, your feelings about the donation, and related issues. In addition, many programs ask donors to take psychological tests.
Another goal of psychological screening is to make sure that you will fulfill the complex requirements of egg donation. Failure to follow instructions can endanger your health and jeopardize the procedure. The program also wants to minimize the chance that you will have regrets or psychological problems, or find the procedures traumatic.
4. Egg Recipient Selection
Once you have completed all requirements to become a donor, your profile will become a part of a donor registry. If your profile is chosen by a recipient, the cycling/stimulation portion of the egg donation process will begin.
Typically, egg donation programs use anonymous donors in which program team members match a recipient with the donor who most closely resembles features such as ethnicity, height, body build, skin type, eye color, and hair color. Once a possible match has been found, the recipient is given further information about the donor and decides whether to proceed or wait for another donor.
In some programs, recipients are given information about several possible donors and select the match they would like to pursue.
5. Legal Process
Once you are medically cleared by the doctor after passing the above screenings, you will go through the legal process. The egg donation IVF clinic will assign you an attorney to review and finalize a legal contract to be signed by you and the recipient. Upon receipt of all signed contacts, the recipient’s attorney issues a legal clearance letter, enabling the doctor to begin the medical cycle.
6. Medication/Synchronize Cycles
A medications calendar will be created for you by the doctor. As the contract has been signed, you will then be able to begin taking fertility medications, which will stimulate your ovaries to produce and grow the eggs.
Stopping your normal cycle— You may be prescribed a medication for one or more weeks to temporarily halt your ovaries normal functioning. This makes it easier to control your response to fertility drugs.
Stimulating egg production— In the ovarian hyperstimulation procedure, egg donors receive a series of hormone drugs which cause her ovaries to produce multiple mature eggs during one menstrual cycle. The drugs prescribed in this phase are called gonadotropin-releasing hormone agonist analogues. These medications must be injected (either under your skin or into a muscle). Treatment will start on a specific day of your cycle and continue for about ten days. You will be shown how to inject the medications.
You can become pregnant during the cycle, if you have unprotected intercourse. This could occur if some of the eggs are released before retrieval, or if the doctor is unable to retrieve all of the mature eggs. Ask your doctor about restrictions on intercourse during the donation cycle.
Recipient Hormone Replacement—During a natural ovulation cycle, a woman's ovaries make hormones that prepare the lining of the uterus for implantation of a fertilized egg. Prior to ovulation, the dominant hormonal signal from the ovary is estrogen. Estrogen causes the endometrial lining to develop and induces receptors for progesterone production.
To prepare the recipient, it will be necessary for her to take hormone replacement therapy to establish the correct thickness of her endometrial lining for optimal implantation. While the recipient's uterus is being prepared for the embryo transfer, the donor is undergoing stimulation of her ovaries so that one or more eggs may be harvested. The average donor produces 8-10 eggs under this type of stimulation.
Monitoring your progress— During the donation cycle, you must have frequent blood tests and ultrasound examinations to track the developing eggs and to see how you are responding to the hormones. When the eggs have matured, they begin to stimulate ovulation. To get the egg donor to ovulate, you will be administered a final, one-time injection of Human Chorionic Gonadotropin (hCG) and egg retrieval will be scheduled to take place approximately 35 hours later.
7. Egg Retrieval
The eggs will be removed from your ovaries in a minor surgical procedure called transvaginal ovarian aspiration. An ultrasound probe will be inserted into your vagina. A thin needle attached to the probe will be inserted into each follicle. Using suction, the egg and liquid inside each follicle are removed. You may be given painkillers, sedatives or anesthesia during the retrieval, which lasts about 30 minutes. When all the eggs have been retrieved, you will recover for a few hours before going home. You must have someone drive you home. Afterwards, you will need to rest for the day. Often, it takes several days of restricted activity to recover.
If you are traveling for the egg retrieval, expect to be near the cycling facility for approximately 4-7 days. This amount of time will vary depending on the recommendation of the doctor.
Once scheduled for egg retrieval, the recipient will begin supplementing progesterone to prepare the uterus creating the optimum environment for embryo transfer. Egg retrieval is performed while the donor is sedated, using ultrasound-guided aspiration to harvest all the mature follicles.
Once egg retrieval is completed, the egg donor process is complete. The egg recipient enters the IVF stage of the egg donation process.
8. Follow-up care
You will be provided instructions about what to do if you need further medical attention. In some egg donation programs, donors return for one or two exams. You may also be scheduled to meet with a counselor.
Who Cannot Become an Egg Donor?
The American Society for Reproductive Medicine suggests that a woman should not donate eggs if she:
- Has a serious psychological disorder.
- Abuses drugs or alcohol or has several relatives who do.
- Currently uses psychoactive medications.
- Has significant stress in her life.
- Is in an unstable marriage or relationship.
- Has been physically or sexually abused and not received professional treatment.
- Is not mentally capable of understanding or participating in the process.
Who Will Use My Eggs?
Egg donation is a treatment option for women who do not produce enough normal eggs but are otherwise able to be pregnant. Some of these women have malfunctioning ovaries or entered menopause at an early age or are at an age when they produce eggs less readily, even with fertility drugs. Others have attempted IVF but produced poor quality eggs or embryos after several attempts.
Women or couples may also decide to use donor eggs because they are aware of an increased risk for inherited disease in their biological offspring. Most often, donor eggs are used by women in their advanced stage of life and are attempting to become pregnant.
Egg donation IVF clinics also provide egg donation to women or men who are trying to become pregnant without a partner that require donor eggs; and potentially donor sperm and gay singles or couples who looking to build a family with egg donation and Surrogacy.
Some egg donation IVF clinics also match an egg donor with more than one recipient.
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