For some patients, the path to parenthood requires help from an egg or embryo donor. There are several indications for egg or embryo donation, including:
Severe diminished ovarian reserve or premature ovarian insufficiency
Prior chemotherapy or radiation
Advanced reproductive age
Absent ovaries (congenital absence or prior oophorectomy)
Multiple failed IVF cycles
History of poor or abnormal fertilization
Arrested embryo development
Female carrier of a genetic condition in couples not pursuing preimplantation genetic diagnosis
Single men, same-sex male couples and transgender individuals
There are many important decisions in the process of selecting an egg or embryo donor. We recognize that this path requires a considerable investment of time, energy and money, not only for screening and medical treatment, but also for egg bank or agency fees and other expenses for the involved parties. Our multidisciplinary team has the experience necessary to help you navigate this path and to develop a customized treatment plan specific to your family’s needs.
Egg Donor Recipient
There are several options available when looking for an egg donor:
Known donors identified by the patient
Anonymous donors identified and screened through the Ovatures program
Anonymous donors identified through an independent agency
Anonymous donors who have already donated and frozen eggs at an egg bank
Each of these options have their relative advantages and disadvantages, and the team at RMA will help guide you through the process of selecting the right one for your family. Some of the many factors to consider include the cost of treatment, time to successful match, availability of ethnically diverse or otherwise appropriate donors, desire to maintain kinship through a known donor arrangement, planned family size, and whether or not it is important that subsequent children be full siblings. The Physician, Nursing and Mental Health teams at RMA can help you explore these issues to determine the best path for you.
Our Embryo Donation Program was established by couples who have successfully completed their own families and have chosen to help individuals and/or couples, by donating these embryos to the program. Our embryo and recipient matching process is similar to the egg donation process, and will allow you to review detailed profiles of donors, including medical and family history, relevant genetic testing, and motivations for embryo donation. With shorter matching times and delivery rates nearly 20% higher than the national average for embryo donation, this is another effective option to start or grow your family, particularly for patients who do not require a genetic link to the child.
Donated embryos may have already undergone Comprehensive Chromosome Screening (CCS) prior to embryo freezing. This testing determines whether an embryo has the correct number of chromosomes and is capable of developing into a healthy pregnancy. CCS may decrease miscarriage rates and also improve the live birth rate per transfer. In addition to testing the health of the embryo by looking at 22 chromosomes, CCS also tests the sex chromosomes, making it possible to determine whether a particular embryo is male or female. Some patients prefer to know this information when selecting an embryo to transfer.
Every path is different—whether you choose to pursue known or anonymous egg donation, or embryo donation, RMA is here to support your decisions and facilitate a successful outcome.
Take the next step toward parenthood. Speak to an RMA-FL patient liaison today, 407-804-9670.
DONOR EGG OR EMBRYO RECIPIENT PROCESS
Screening the Donor
RMA-FL’s Ovatures Egg Donation Program recruits donors from the Florida area and offers exceptional live birth rates, along with a relatively short donor and recipient matching process. Ovatures egg donors undergo an extensive medical, genetic and psychological screening process using standards established by the American Society for Reproductive Medicine and the U.S. Food & Drug Administration. Potential donors undergo rigorous infectious disease screening, genetic testing, physical exam and history, and personality assessment. We also work with egg donors from several trusted agencies across the United States. If a recipient decides to work with an outside agency, we will screen the donor to the same standards as one from our own program.
Alternatively, patients can work with an egg bank to use frozen donor eggs. Using an egg bank may shorten the time spent in the donor matching process, as the donors have already been screened and completed their cycle, so the eggs are immediately available. This process allows you to choose your own egg donor from a data bank. While infectious disease screening is standardized for all egg banks, genetic testing can be variable.
Embryo donors likewise undergo infectious disease screening and genetic testing, and are required to meet with our Mental Health team prior to donation.
Screening the Recipient and Partner
Donor egg or embryo recipients undergo routine infectious disease screening and uterine cavity evaluations with saline sonogram or hysteroscopy to confirm there are no intrauterine polyps, fibroids or scar tissue. For couples planning donor egg treatment, partners likewise undergo infectious disease screening and genetic testing to assure an appropriate match with the donor.
Couples/individuals will also meet with the Mental Health team to discuss relationship and family dynamics, age-appropriate ways to disclose to their children how they were conceived, and issues related to anonymity and possible search for biologic siblings in the future. Couples will also meet with a Genetic Counselor to discuss the potential match and if any additional testing is warranted.
Women undergoing donor egg or embryo treatment must complete a prep cycle, in which the uterine response to hormones that will be used in the actual transfer cycle will be determined. Estrogen supplementation is taken to grow the uterine lining. Once the target endometrial thickness and pattern is reached, oral progesterone is then used to end the prep cycle and bring on a period. Following successful completion of this prep cycle, the recipient is then placed on the RMA-FL donor waiting list or can execute a contract with a donor egg bank for purchase and shipment of frozen eggs, provided that other testing is complete.
Couples complete an intake form that reviews their matching priorities—anything from eye color or ethnicity, to educational background, family history or hobbies. Similarly, donors have completed a profile for recipients to review. Recipients who choose an anonymous donor through the RMA-FL Ovatures Egg Donation program will have their name placed on a waiting list until a suitable match becomes available.
When a donor becomes available, the recipient will receive a full report on the candidate. She can choose to accept or decline the match for any reason without compromising her position on the wait list. Agency donors likewise are matched based on recipient priorities, but the process can vary considerably from agency to agency. For patients matching through an egg bank, online databases with detailed profiles are available to review in real-time; many of these banks have donors cycling from across the country, so the profiles can be added or deleted continuously as new donors become available and other recipients lock in a match.
Treatment Cycle: Donor Egg Retrieval/Thawing and Fertilization
Coordination of the egg donor stimulation cycle with the recipient transfer cycle is no longer routinely done, which allows the time necessary for the embryos to undergo Comprehensive Chromosome Screening (CCS) and cryopreservation for subsequent transfer. Not only does this improve pregnancy rates, but it also allows the embryos to be created independent of the time for transfer, which permits greater scheduling flexibility.
Once the eggs are retrieved from the donor, or shipped from the egg bank to RMA-FL to be thawed, sperm is placed directly with each egg for fertilization. Embryos then grow for five to six days in culture and are frozen for future use. It is also possible to biopsy the embryos prior to embryo freezing, for subsequent CCS testing to determine whether an embryo has the correct number of chromosomes and is capable of developing into a healthy pregnancy.
CCS may decrease miscarriage rates and also improve the live birth rate per transfer. Despite the donor’s young age, as many as 1 in 5 eggs may contain the wrong number of chromosomes. In addition to testing the health of the embryo by looking at 22 chromosomes, CCS also tests the sex chromosomes, making it possible to determine whether a particular embryo is male or female. Some patients prefer to know this information when selecting an embryo to transfer.
Treatment Cycle: Recipient
Once embryos are available (either through fertilization of fresh or frozen donor eggs, or through matching into the Embryo Donation program), the recipient is ready to start her transfer cycle. This mimics the prep cycle, with the exception that instead of taking an oral progesterone to bring on a period, daily intramuscular progesterone injections are given to prepare the uterine lining to accept an embryo and maintain the pregnancy.
From the first day of medication to the day of embryo transfer, it is approximately three to four weeks. Occasional monitoring visits for blood work and/or ultrasound are necessary to evaluate cycle progress and time the transfer appropriately.
Embryo Transfer, Pregnancy Monitoring, and Transition to Obstetric Care
Once the uterine lining is ready for implantation, the recipient is ready for the frozen embryo transfer, which is a brief procedure done under ultrasound guidance without anesthesia. Normal daily activity following the transfer is encouraged. Nine days after the transfer, the first pregnancy test is performed.
If pregnancy results, the first ultrasound is done seven to ten days later. Once the recipient reaches approximately eight weeks of pregnancy, care is then transitioned to a local obstetrician for the duration of pregnancy and delivery.
For more information on donor eggs in FL, please contact us today.