OVUM DONOR MEDICAL PROCEDURE

Donor Preparation for Egg Retrieval

A woman's ovaries usually release only one egg per cycle in a process know as ovulation. In order to retrieve multiple eggs from the donor's ovaries, the donor will be given hormonal medications to induce her ovaries to produce several mature eggs. This technique is known as controlled superovulation and is performed because pregnancy is more likely to result if more than one egg is fertilized and transferred to the recipient's uterus. Sometimes several fertilized eggs at one time may be transferred to the recipient in hopes that one will attach to the uterine lining. While this increases the risk for a multiple pregnancy, it also increases the chance that at least one egg will attach and pregnancy will be established. The number of fertilized eggs to be transferred should be determined by each individual program based on the results that program has with establishing pregnancy complicated by multiple gestation.

A combination of hormonal medications is given to the Donor for about two to three weeks prior to the egg retrieval. As the eggs mature, their development will be monitored by ultrasound and blood hormone levels. When the eggs are mature, ovulation is triggered by an injection of human chorionic gonadotropin (hCG). For more information on the drugs used for ovulation induction, consult the ASRM patient information booklet titled Ovulation Drugs.

Procedure

Approximately 36 hours after the hCG injection, the eggs will be retrieved from the Donor, usually by transvaginal ultrasound aspiration. The eggs are graded for maturity and prepared for fertilization in the laboratory. The recipient's male partner produces a sperm sample by masturbating (or Donor sperm may be used.) The sperm is processed and added to the eggs to allow fertilization to occur. For further details on egg retrieval and IVF, please refer to the ASRM patient information booklet titled IVF and GIFT: A Guide to Assisted Reproductive Technologies.

Preparation of the Female Recipient

While the Donor is going through the egg stimulation process, the recipient will have her menstrual cycle synchronized with the Donor's cycle. This is done by giving the recipient hormones. The recipient's uterus must be ready to receive the embryos within a few days after the eggs are retrieved from the Donor and fertilized in the laboratory. If the cycles are not synchronized, the embryos will not implant in the recipient's uterus.

If the recipient is menstruating naturally, she may be given a hormonal medication to temporarily suppress her menstrual cycle. When the Donor begins taking the hormonal medication to stimulate her ovaries to produce several eggs, the recipient will be given the hormone estradiol to make the lining of her uterus (endometrium) grow thicker in preparation to receive the embryo. Estradiol may be given as pill, a patch, or injection. During this time the recipient may be monitored using ultrasound and blood tests.

When the Donor is given the hCG injection necessary to cause her ovaries to release the eggs, the recipient will be given the hormone progesterone in addition to the estradiol. Progesterone causes specific changes to occur in the endometrium so that the embryo will be able to implant. Progesterone may be given as pill, vaginal suppository, or by injection.

Two to three days after the Donor's eggs are fertilized in the laboratory, the resulting embryos are ready to be transferred to the recipient's uterus. The embryo transfer is usually performed in an office setting. The recipients lies down, and the doctor passes thin catheter containing the embryos through her vagina and cervix and deposits them into her uterus.

The recipient continues to take the estradiol and progesterone until a pregnancy test is performed, usually two weeks after the embryo transfer. If the pregnancy test is positive, the estradiol and progesterone are continued to support the early pregnancy. Blood levels of estradiol and progesterone may be monitored during this time. Extra embryos not transferred may be frozen. If pregnancy is not achieved, these frozen embryos can be thawed and transferred later in additional attempts to achieve pregnancy.

All information for this section is taken with written permission from the American Society for Reproductive Medicine's Booklet, entitled "Third Party Reproduction (Donor Eggs, Donor Sperm, Donor Embryos, and Surrogacy), A Guide for Patients." (c) 1996