Egg Donation Cycle
Information About Egg Donation
Like IVF cycles, the egg donation cycle commences at the beginning of the woman’s menstrual period. (In the case of egg donation, this is the donor’s cycle.) Prior to synchronization with the egg donor, the intended mother will undergo a practice cycle during which she will take estrogen tablets and progesterone suppositories in order to for us to determine whether the thickness of her uterine lining will be satisfactory for embryo implantation. We will also conduct a practice embryo transfer.
The following is a general guideline for egg donation. The steps are grouped into the three main phases of the IVF process, with additional notes specific to the donor and the intended mother. Details may vary based on the needs of both the egg donor and the intended mother.
Prior to synchronization with the egg donor, the intended mother will undergo a practice cycle during which she will take estrogen tablets and progesterone suppositories in order to for us to determine whether the thickness of her uterine lining will be satisfactory for embryo implantation. We will also conduct a practice embryo transfer.
Ovarian Stimulation and Egg Retrieval
Donor and intended mother: On day 2 or day 3 following the donor’s and the intended mother’s respective onset of menses, a baseline ultrasound examination and blood test is done in our office.
2 to 4 weeksDonor and intended mother: The two women’s cycles are synchronized using oral contraceptives and/or Lupron. Oral contraceptives help start the ovarian suppression process and are continued for 2 to 4 weeks.In order to achieve ovarian suppression, Lupron is begun about two weeks before the start of ovarian stimulation and overlaps with the oral contraceptives. To ensure that ovarian suppression has been achieved, another office visit for ultrasound and blood testing is scheduled approximately two weeks after starting Lupron.
8 to 12 days
Once both donor and intended mother have achieved low estrogen levels, treatment continues as follows:Donor: Begins daily dosage of injectable fertility medications, while the Lupron is continued at a lower dose. The medications are usually self-administered subcutaneously (under the skin) using a short needle. Occasionally, we may need to change the dose of medication during the day, therefore, we recommend that patients take their injections in the evening.Recipient: Begins oral estrogen therapy.
Day 5Donor: On day five of stimulation, regular office visits start. These continue every one to two days until egg retrieval takes place. An ultrasound and blood test for estradiol are performed at each visit. The patient must call at the end of the day for results and to receive further medication instructions.Recipient: Based on the donor’s monitoring, the intended mother’s cycle is adjusted to the donor’s cycle.
Between day 8 and 12Donor:
When the follicles are large enough, final egg maturation is triggered with an injection of human chorionic gonadotropin
(hCG). The timing of the hCG dose is very important, as egg retrieval is performed thirty-six hours later.
36 hours following hCG injectionDonor: The egg retrieval procedure takes less than thirty minutes, however, the entire appointment will take approximately two hours.Recipient: Begins progesterone suppositories on the day of the donor’s egg retrieval.
Fertilization and Embryo Culture
Day of egg retrieval
Recipient’s male partner: Sperm are obtained from the intended mother’s male partner on the day of retrieval and occasionally the morning after egg retrieval if fertilization was suboptimal.In order to optimize sperm quality, it is recommended that the male partner abstain from ejaculation for two to seven days prior to the first sperm specimen. Typically, this will mean abstinence after the donor’s seventh day on fertility medication.
Day of egg retrieval
Sperm are placed in a dish with the egg or injected directly into the egg (ICSI
) to achieve fertilization.The eggs are checked the next day to determine which ones are fertilized. Excess fertilized eggs, now called embryos, can be frozen at this time.
Day of embryo transferIf indicated, assisted hatching is conducted in order to facilitate hatching and implantation. This is accomplished by making a small hole in the outer shell of the egg.
Preimplantation Genetic Diagnosis – PGD
3-5 days after retrieval
If indicated, Preimplantation Genetic Diagnosis
(PGD) is done when the embryo reaches the 8-cell stage (day 3 of development) or the blastocyst stage (day 5-6 of development). PGD can reveal certain genetic conditions and gender with results in one to two days.
Embryo Transfer and Progesterone Support
3 to 5 days after egg retrieval
The embryo transfer is a simple procedure performed by placing a soft catheter containing the embryos through the cervix under ultrasound guidance. It does not require anesthesia, however, Valium is administered to help relax the pelvic muscles. Therefore, it is important that patients arrange for a ride home. Patients are asked to arrive thirty minutes prior to embryo transfer and must remain in bed for fifteen minutes following the procedure.
Recipient: Since the ovaries are not producing any hormones during the egg donation process, it is important that the intended mother continue estrogen and progesterone until advised to stop.
Day 14 and 21
Blood is drawn on the mornings of day 9 and day 12 following the transfer. The patient will be contacted later in the day with the results.Donor: The donor should expect her normal period approximately 7-14 days after egg retrieval.