Becoming an Egg Donor
Thank you for your interest in becoming an Oocyte (egg) donor at California IVF. The goal of our program is to provide eggs anonymously to women unable to produce quality eggs on their own. Ovarian failure is one of the leading causes of infertility and may occur for many reasons. Delayed child-bearing, radiation or chemotherapy therapy for cancer, autoimmune diseases and surgical removal of the ovaries are a few of the causes of decreased egg quality. Women of advanced age are also candidates for donor oocytes. Donor oocytes provide couples with a chance of achieving a pregnancy that is 75% to 85% on the first attempt. Frequently there are extra embryos that can be frozen and used in the future to further increase the chances of having a baby.
Donating eggs will require a commitment of time and attention to details. Couples with whom you may be matched will be investing a large amount of money for each cycle. In addition to their financial investment, people become emotionally committed to their treatments. It is extremely important that you are willing to complete the process once begun. Please let us know if at any time you decide that you no longer wish to participate in this program, and your profile will be removed from the registry.
Once you are given an introduction to the screening and treatment process, you will be given the opportunity to proceed. The screening process will involve blood work, an ultrasound, and a psychological evaluation. For the psychological evaluation, you will meet with a psychologist who will talk with you about why you want to be a donor, and her staff will administer a psychological test called the MMPI. The interview and test are not difficult or threatening. Additional tests may be required in certain circumstances. You will not have to pay for any of the testing or screening procedures. We do however, encourage you to use your current health benefits to receive your annual Pap smear screening and routine gynecological exam. Copies of this information should be requested and brought with you to your initial appointment. For more information on the various evaluation tests click here.
After all of this screening you may be informed that you have not been accepted as an egg donor. This does not mean there is anything wrong with you. We are concerned about many issues including the possibility that you may regret your participation. Once all of the screening is completed, and you have been accepted into the program, we will enter you into our donor registry if appropriate.
We will utilize the information that you provide on your health history and application form to tentatively match you with a prospective recipient. Once a tentative match has been made, we will contact you to ask if you are still willing to be a donor. If willing, we will ask you to visit to our clinic where you will meet with one of the coordinators. The coordinator will instruct you on injection technique and the details of the medications you will take. During a cycle, you will be required to give yourself several injectable medications. You may choose to have a friend or partner administer these medications. These injections are very important to the success of the cycle and it is very important that they be given as directed.
Once you have been accepted as a donor we will determine where you are in your menstrual cycle. We will utilize a medication called lupron to help coordinate you and your recipients’ cycles. If you are taking oral contraceptive pills, we will overlap the lupron and the pills for a few days, and then have you stop the pills. Before beginning lupron you will be required to come to the clinic in the morning for an ultrasound of your ovaries, a physical exam, and a blood tests, including a pregnancy test. Once the pregnancy test has been confirmed as negative you will give yourself (or have a friend give to you) an injection of lupron. We use a form of lupron that will last for 30 days. Lupron will suppress your reproductive hormones and allow us to have control of the timing of your cycle. Usually within a week of starting lupron you will have a menstrual period. It may be a few days late, and may be heavier than normal. When this period occurs please call our office and we will give you instructions about when to begin the next medication. Side effects of lupron include hot flashes, vaginal dryness, and headaches. These will diminish when you start the gonadotropins. If you have not had an egg retrieval within 30 days of the lupron shot we will instruct you to begin daily injections of a small amount of lupron. These are similar to insulin injections, and are usually not uncomfortable or difficult to give.
Gonadotropins are medications that will stimulate your ovaries to produce multiple mature eggs in a cycle. It is given via an intramuscular injection every evening for anywhere from 10-18 days (the average time is 12 days). There are several brand names of gonadotropins available and we will supply you with the medications, syringes, and needles. You will also receive instructions for mixing and injecting your brand of medications. A common dose of gonadotropin is 150 to 225 international units (IU) each evening. We will instruct you how much medicine to take, and what days you are supposed to take the medication. After taking injections of gonadotropins for 7-9 days, you will come in for your first monitoring visit. All of our monitoring visits take place in the morning and there is very little flexibility in scheduling thes appointments. At each visit you will have an endovaginal ultrasound to monitor the progress of your ovaries' response to the medicine, and you may have blood drawn for an estrogen level (also to monitor your response to the medicine). At each visit we will discuss with you your progress and arrange your next visit. We will usually need to see you several times throughout your stimulation phase. Once the follicles (cysts containing eggs) on your ovaries have reached the desired size you will be instructed to administer the third type of medication - HCG.
HCG (human chorionic gonadotropin)
We will instruct you to take HCG in the evening 2 days before egg retrieval. It is very important that you take this injection at the exact time instructed as we will plan the egg retrieval for 36 hours later. HCG will cause the eggs to become mature and be released from the wall of the follicle. It is important we perform the retrieval before the eggs are ovulated into the abdomen. After the HCG you will not take any more injections.
You will not be able to drive on this day. Please make arrangements for transportation to and from the hospital. On the morning of the oocyte retrieval you will be taken to the recovery and observation area. From there, the nurse will instruct you to change into a gown and they will insert an IV catheter in your arm. Through this IV we will administer medications that will make you very sleepy during the egg retrieval. We use very potent medications that make the procedure essentially pain free. Most women are not able to remember any details of the retrieval. The egg retrieval is performed using an endovaginal ultrasound with a needle guide attached. A needle is passed through the back wall of the vagina and into the ovary and the eggs removed. A typical egg retrieval takes 10-15 minutes. After the retrieval you will return to the recovery area to rest for about 1/2 hour. Once you feel awake, have something to drink, and empty your bladder, the IV will be removed and you can go home. You cannot plan any other activities on the day of retrieval. Cramping and spotting are not uncommon for 1 to 2 days after the procedure. We can provide pain medications to assist you with recovery in the unlikely event that you have more pain than expected after the procedure.
We may not be able to remove all of the eggs during the retrieval which means you could easily become pregnant. We strongly suggest that you use a barrier form of contraception (Foam, diaphragm, condoms) and abstain from intercourse until after you have a period. After the egg retrieval you will probably start a period within 10-14 days. At this time you may return to your normal form of contraception.
There are several complications that may occur while participating in a cycle of egg donation. The primary ones to be aware of include Ovarian Hyperstimulation Syndrome (OHSS). The risk of Ovarian Hyperstimulation exists any time these medications are used. Most people will feel bloated, have some abdominal tenderness and a temporary 5-10 LB weight gain. In severe cases, patients may require IV fluids, pain medication, hospitalization and monitoring to prevent severe medical complications. This occurs rarely (1%) of the time. If you have regular periods you are not at high risk for developing ovarian hyperstimulation syndrome. There is a risk of causing bleeding within the ovary which could require a blood transfusion, but this is extremely rare. There is a higher chance of ovarian torsion (twising of an ovary requiring surgery to fix the ovary), but this is very rare. There is not thought to be an increased risk of ovarian cancer from use of infertility medications. Newer studies suggest that the risk of ovarian cancer is not increased by the use of gonadotropins, but the studies are not designed to detect very small risks. Use of birth control pills and pregnancy can both decrease your risk of ovarian cancer. We would be happy to answer any questions you may have.
We will ask you to sign consent forms prior to beginning a cycle that will detail the risks and responsibilities involved with oocyte donation, conscious sedation, and egg retrieval.
You will receive compensation for your time and inconvenience. Donors are not compensated for the quality of the egg, social/ethnic background, or the results of the procedure. The compensation will be subject to taxation and we will provide you with a Form 1099 at the completion of your procedure. Donors are not eligible to participate in more than 6 cycles includng cycles completed at other centers. Dishonesty about the number of cycles completed at another center is grounds for disqualification from the donor program.
FDA Regulations and Donor Tissues
The Food and Drug Administration (FDA) has regulatory oversight of donor tissue programs, including donor eggs. The FDA regulations require us to ask very specific questions regarding health history, sexual history, and other health related activities. Our clinic has completed inspections in the past and will have additional inspections in the future to confirm compliance with the FDA regulations. Compliance with the regulations is necessary to minimize the health risks to the recipient parents. This will require the completion of additional questionnairs which you may have already completed, and repeat blood tests to confirm the absence of infectious diseases. Donors are not billed for the testing and evaluation.
If you have any questions or would like to meet with us to discuss becoming a donor, please do not hesitate to call. There is no cost to you and no obligation to proceed. There is no greater joy than sharing a gift of life with another woman.