Once you have decided to become involved with our program and signed a Fertility Helper Profile Review Agreement, IARC® will send you ovum donor profiles. Each profile is a compilation of information obtained from an 18-page application that has been completed by the fertility helper. The majority of our donors wish to remain anonymous. Most of our donors are from the midwestern United States, but we change our advertising regions regularly to ensure a wide selection of candidates. Each donor completes a detailed questionnaire about her age, height, weight, ethnic background, religion, education, and her present family situation. Each donor profile includes pictures of the donor and her children. Because the rate of babies born with genetic defects in the normal population is approximately 2-5%, we request a thorough family history (back to the fertility helper's maternal and paternal grandparents) to reduce the possibility of genetically-inherited disease or illness. IARC® screens each donor through a telephone or personal interview (if possible) to review all data and to explain our program so she has a full understanding of her involvement. If you want to have continued contact with your donor or do not want anonymity, please advise IARC®, and we will try to find a donor who will meet your needs. IARC® makes reasonable attempts to contact all egg donors on an annual basis to receive updated medical information which can be shared with the parents of the babies born through our program.
Every ovum donor must undergo a psychosocial interview/assessment with a licensed clinical counselor. This helps the donor to fully understand the future emotional consequences of her decision. It also helps her to understand the intended parent's experiences with infertility, and we find that her personal commitment to the program increases.
Additionally, the American Society for Reproductive Medicine (ASRM) recommends that ovum donors complete the Minnesota Multiphasic Personality Inventory if any areas of concern are identified in the initial psychosocial assessment. The MMPI-2 is the most widely researched and clinically used of all personality tests. Originally developed to identify emotional disorders (still considered its most appropriate use), this test is now used for many other screening purposes and is translated into more than 100 languages. If you wish your ovum donor to complete this test, IARC® will coordinate it for you. However, the cost of this test is approximately an additional $500 (plus travel and expenses). IARC® will organize MMPI testing and/or IQ testing only upon the client's request. Some medical clinics will also require psychological screening of the intended parent(s).
You and your donor must also undergo medical testing before any fertility treatments can occur. A list of medical testing requirements will be given to each participant, and the results must be reviewed by the fertility doctor. Apart from a full medical history and physical examination, all donors are screened for HIV (AIDS virus), hepatitis B antigen, syphilis (VDRL), rubella titre, blood group and Rh type, cystic fibrosis, and provide cervical cultures for chlamydia and gonorrhea (GC) and other conditions. Specific ethnic groups will be screened accordingly (i.e.-African Americans/Sickle Cell screen, Jewish/Tay Sach's screen, etc).
The idea behind IVF/ovum donation is to harvest as many mature, good-quality eggs as possible. Large numbers of eggs retrieved do not always mean a large number of resultant embryos since some eggs may be too immature or too mature to develop into an embryo. With a normal semen sample, you can expect a fertilization rate of approximately 80% of the mature eggs.
The ovum donor of your choice is placed on a combination of fertility medications to increase the number of eggs produced in one cycle and to enable the doctor to synchronize her cycle with that of the potential mother. These medications are given by injection and start 21 days after the first day of her menstrual cycle. Close to the time of ovulation, the ovum donor will travel to the fertility center where she will receive daily blood tests and ultrasounds. According to the results of these tests, her medication can be adjusted to improve her egg production and to reduce the chances of hyperstimulation (which is a potential side effect of fertility drugs).
IARC® will organize all travel arrangements and will organize payment of all expenses for the donor from your Expense Escrow Account. Instructions will be given to all parties about medications and retrieval dates. The potential mother will take Lupron to help synchronize her cycle to that of the ovum donor, and Estrace will be given to increase the uterine lining so that it can accept the embryo for implantation.
Transvaginal egg retrieval is now accepted as the preferred and safest route for egg collection. This will be done by the doctor with embryologists, anesthetists, and ultrasonographers assisting. A Transvaginal Probe is inserted into the donor's vagina, and a needle guide is placed onto the probe to allow direct and accurate access to the follicles. The eggs are removed through this needle guide. Each egg donor is given sedation before the egg retrieval through an intravenous (IV) line in the back of her hand. Most patients experience some discomfort; approximately 10% of the patients sleep through the procedure.
Oral antibiotics are routinely given to reduce the risk of infection, and an antibiotic cream covers the area before and after egg retrieval to prevent any possibility of a pelvic infection. On the day of the retrieval, the father will need to produce a sperm sample for insemination of the eggs. If the sperms' final count and motility are not adequate for conventional IVF, intra-cytoplasmic sperm injection (ICSI) can be done. This is a procedure which actually injects one sperm directly into the cytoplasm of one egg. (There is an additional fee for this procedure.) The embryos are usually incubated for 3 days before the embryo transfer occurs. If the fertility specialist recommends a blastocyst transfer, the embryos must be incubated for five days.
The number of embryos to be transferred is discussed between the parties and physician. Typically, one or two embryos are transferred per attempt depending on the embryo quality and the physician's recommendation. The remaining embryos are frozen for later use. Embryo transfer is a painless procedure that usually takes about 5 minutes. One patient described it as a "fancy pap smear." On the day of the embryo transfer, the potential mother is asked to remain lying down for 45 minutes and then to take it easy for the rest of the day. She does not have to be flat on her back. She can be on the couch with her feet up. She is allowed to get up and go to the restroom, shower and eat, but, for the most part, the doctor usually prefers that she remain quietly sitting or lying down for 48 hours following the transfer. Exercise programs, sexual intercourse, and heavy lifting should be avoided for one week, after which time she can return to her regular routine.
A pregnancy test by your local doctor will be required 14 days after the embryo transfer. Please let us know the results. If your pregnancy test is positive, your local doctor will attend to your prenatal care and delivery. Please let us know when your baby has arrived. It gives us a wonderful feeling to share your happiness!
Frozen embryos will be stored at your fertility clinic; you may want to return to have another genetically-related child. Please note also that IARC® reasonably attempts to contact our egg donors on an annual basis to receive updated medical information which can be shared with the parents of the babies born through our program.
If your pregnancy test is negative, you can return to the fertility clinic at your convenience for frozen embryo transfers until all of your embryos are used. Usually, clients make the arrangements directly with the fertility clinic, but we can assist you!