Egg donation is known by a few different names such as oocyte or ovum donation. It is part of a process known as in vitro fertilization or IVF. To date, assisted reproductive technology ("ART") with egg donation is one of the most successful treatments performed in programs for any type of infertility. The recipient of the donated eggs is able to experience a normal pregnancy and delivery.

In preparing to donate through our egg donor program, you, as the prospective donor, will undergo a thorough psychological and physical examination. As an egg donor, it may prove to be a rigorous but also rewarding process, knowing that your participation may help in the creation of a family -- of a child -- that is much wanted and very much loved by the recipient couple.

You need to consider many factors when making the decision to participate in our egg donor program. Are you comfortable providing extensive (non-identifying) information about yourself and your family? Have you thought about the possibility that your donation will result in the birth of a child or children, specifically, children genetically related to you? Have you considered whether or not this procedure is something you will tell a future partner about? How supportive is your current partner or spouse? How supportive is your family? Is this something you will share with them? Why or why not? Have you considered any future contact with the child or children -- especially in the case of a medical emergency such as a match for an organ transplant? Have you thought about whether or not you want to know the outcome of your participation? Our egg donation program is anonymous unless both parties desire a meeting. Are you more comfortable being anonymous or would you prefer having a "known" cycle? As you can see there are many facets that you need to evaluate to determine if ovum donation is the right choice for you.

The egg donor program we offer to recipients is called a "single cycle" and is when all the eggs retrieved will be fertilized and transferred to one recipient. When you decide to enroll in the Pacific Fertility Center Egg Donor Program you are automatically made available for an anonymous single cycle.

Stage One: Selection/Screening

The first step is to complete a very detailed application, which serves as your introduction to the prospective parents. The application asks for you to relate in-depth your family health history, personal habits, hobbies, interests, education, employment and fertility information. It is important to obtain as much information as we can for the prospective parents because this is all that they will have to draw on in their child's future. Your anonymity is protected when we receive your application because we delete your identifying information in the application (name, address, etc.) and assign you a confidential number. If you are accepted into the program, a copy of the file is then placed in our egg donor database for our prospective parents to review. Our egg donor database is set up to be anonymous between both parties so you may not ever meet or speak with the recipient couple. If you are amenable to meeting or having a confidential call (where only first names are exchanged) between parties you may so indicate on the application, however, please understand that both you and the recipient must be in mutual agreement on the matter.

Appointments are scheduled at our agency to allow prospective parents the opportunity to review the egg donor database. The egg donor datbase is also available to prospective parents via a highly secure website. In addition to the copy of your application, the couple will be able to see photographs of yourself and your children, which further helps them in making a selection -- especially in cases where a close physical resemblance is important to the prospective parents. Your choice of photos is important and they should be of good clarity and ideally, will present you throughout the years. (Photos will be returned if you so indicate when you send them in to be scanned).

Prior to your inclusion in our egg donor database, you will be required to have an appointment with our licensed Clinical Counselor. This appointment will last approximately one hour. As well, you will need to have some preliminary blood tests performed. After this preliminary screening, if you are declined as an applicant, please note that under no circumstances are we at liberty to reveal the reason or reasons that your application is turned down.

Once in the Egg Donor Database and a Recipient selects you, the Donor Coordinator will call you to confirm your selection and schedule you for the day of pre-cycle screening which will take place at the medical center, Pacific Fertility Center (PFC). If you live outside of the Bay Area, we will arrange the necessary travel accommodations for you.

The pre-cycle screening will include a psychological consult and a consult with a Clinical Nurse Coordinator who will map out the upcoming treatment cycle (basically the person who tells you the "who, what, when, where and why" of the cycle). This is followed by a medical consult that includes a pelvic examination and ultrasound. And, finally, your blood will be drawn to test for HIV, Hepatitis, Syphilis and other sexually transmitted diseases (screening required by California law).

Stage Two: Synchronization and Stimulation

Once all parties are screened, you will customarily be started on low dose birth control pills. The purpose of taking the pill is to help get your cycle synchronized with the recipient's cycle. You may spend 14-21 days or longer on the pill after which the clinic will have you begin Lupron (leuprolide acetate) injections or Synarel nasal spray. Lupron is self-administered by needle injection in the abdominal wall or upper thigh, just underneath the skin. This is called a subcutaneous injection. Synarel is taken as a twice-daily nasal spray. You will receive injection instructions from the medical staff at the clinic. If at any time you are not clear on how to give the injection or how much medication to take, you should call the clinic directly. Lupron and Synarel are synthetic hormones, which work to temporarily suppress the pituitary gland so that the stimulation of your ovaries can be more completely controlled. In more basic terms, the Lupron/Synarel will shut down your ovulation, putting you in a short-term menopausal condition, which may cause the following side effects: hot flashes, mild headaches or a sense of fatigue. Of course, you may not have any side effects at all -- hormones can cause different reactions in each person. Your Lupron or Synarel will continue daily for a period of approximately 20-30 days. There are no adverse effects on a pregnancy or any long-term adverse effects for you.

After 14 days injecting Lupron or using the nasal spray Synarel, you will begin a series of injections using hormones called gonadotropins like Gonal-f, Follistim, Repronex or Menopur. At this time you will be using both Lupron or Synarel and Gonal-f or Follistim as well as Repronex or Menopur. The active ingredient in Gonal-f/Follistim/Repronex/Menopur is known as follicle stimulating hormone (FSH) because it works to increase the number of follicles developing in the ovaries. The follicles are the fluid filled sacs within the ovaries that contain the eggs. These hormones are injected directly under the skin of your abdominal wall or upper thighs (subcutaneous injections). You will be required to give the shots on a daily basis for a period of about 10-14 days. You will receive the necessary medical instruction from the clinic. Again, if you are unsure of dosage or process of how to give the shot, please contact the clinic directly. A missed injection can have disastrous effects on cycle outcome. The dose of Gonal-f/Follistim/Repronex/Menopur may be adjusted during the cycle depending upon the response of the ovaries.

Fertility medications have been used extensively for over twenty years and are not associated with any type of cancer, birth defect, or increase in miscarriage. Side effects of gonadotropins are secondary to their action on the ovaries and are related to ovarian stimulation. If you are prone to premenstrual syndrome (PMS) you may feel some of the side effects attributed to the gonadotropin injections. These effects are usually mild and may include allergic sensitivity, breast tenderness, abdominal bloating, headaches and/or mood swings. You may even gain a few pounds, which will only be a temporary weight gain as it is when you have PMS.

In rare cases (1-2%), over stimulation of the ovaries may occur. Ovarian Hyperstimulation Syndrome (OHSS) generally causes enlargement of the ovaries accompanied by abdominal discomfort and/or pain. In severe cases it could lead to hospitalization. It is expected that these symptoms will cease 2-4 weeks following the treatment cycle. The physician at PFC will discuss any concerns you may have about OHSS at the time of your initial consultation.

Monitoring

IVF cycles are monitored in two ways: vaginal ultrasound and hormone blood tests (blood draws). Monitoring is necessary in order to assess the growth and development of the follicles and to minimize the possibility of Ovarian Hyperstimulation Syndrome (OHSS). At the start of injections and after about seven days of gonadotropins, frequent ultrasound monitoring and blood tests begin.

Ultrasounds allow the physician to obtain an image of the follicles as they grow and develop in the ovaries. Both the number and size of the follicles can be determined by ultrasound, which is essentially a painless procedure. You may feel the pressure of the transducer in your vagina; however, this is not harmful to either your organs or the developing eggs.

As follicles develop, the ovaries secrete increasing amounts of the hormone estradiol. The level of estradiol indicates the degree of ovarian stimulation and is used in conjunction with the ultrasound to adjust the dose of medication and to time the HCG injection (short for "human chorionic gonadotropins"). HCG is a natural hormone and works to stimulate ovulation; it has been used safely for many years.

HCG is your final injection and this initiates the final stage of maturation and timing of the egg retrieval.

Stage Three: Egg Retrieval

The egg retrieval will occur about 36 hours after the injection of HCG. Egg retrievals are usually scheduled early in the morning (between 7:30 a.m. and noon). The method by which the eggs are retrieved at PFC is an ultrasound directed needle aspiration. This is a procedure, performed under anesthesia, such that you will be totally comfortable and pain-free. The ultrasound probe with a needle guide is placed in the vagina, which allows an aspiration needle to be inserted through the upper portion of the vagina directly into the ovary. The ultrasound image allows the physician to accurately guide the needle into each follicle for aspiration or "suction". As the fluid is aspirated, the egg is released and collected in the laboratory.

The retrieval process takes approximately 15-30 minutes. Following the retrieval you are asked to remain at the clinic for one to two hours to recover from the anesthesia. You must plan on having someone available to drive you home as you have been under the effects of anesthesia and cannot (by law) drive yourself home or take public transportation. You must be accompanied home. When you are released from the clinic you may resume light daily activities. It is very common to experience some cramping and spotting following the process and the clinic will prescribe the appropriate pain medication. You will be scheduled for a care call with the nursing staff the day following the retrieval. You should be cautious of increased fertility for several days prior to the egg retrieval and for several days after the egg retrieval and should avoid sexual relations seven days prior to the egg retrieval and for two weeks after the retrieval (until you get your next menstrual period).

The donor fee is remitted following the egg retrieval. If the Donor Coordinator is available to hand deliver the fee, you will receive it on the day of your retrieval and, if she is not able to personally deliver it to you, it will be sent via Fed Ex for prompt delivery.

Stage Four: Fertilization and Embryo Transfer

Once the eggs are retrieved, the laboratory staff will begin the process of fertilization (the union of the sperm and egg). It is a very complex process and takes place in the laboratory adjoining the clinic. The retrieved eggs are immediately examined by the embryologist and then placed in a specialized culture medium and allowed to remain there undisturbed for 2-3 hours. A semen sample is prepared using different laboratory techniques with the more vigorous, motile sperm, which are then added to the medium containing the eggs. By the following day the eggs will have fertilized. The fertilized egg is now called an embryo. An embryo transfer will usually take place after the embryos have developed in the laboratory for three to five days.

The embryo transfers take place at the clinic and is a very simple procedure -- it requires no anesthesia and lasts only minutes. The embryos are placed in a thin catheter, which is then passed through the cervix into the uterine cavity, and it is there that the embryos are gently deposited. Following the transfer, the recipient remains resting for about 15 minutes and returns home to routine activity. We will not know the outcome for at least two weeks following the transfer. If you would like to know whether or not a pregnancy results, we can make those arrangements.