Egg quality has remained one of the major determinants of successful IVF. Egg quality diminishes over age 35 and significantly declines over the age of 39, yielding a low chance of successful pregnancy in an otherwise healthy woman capable of carrying a pregnancy. Egg donation allows a couple to experience a significant increase in their rate of pregnancy with ability to experience a pregnancy and delivery. In egg donation IVF, the donor of eggs may be anonymous or she may be a sister, close friend, or relative or the infertile woman. The egg donor is given fertility medications to stimulate her ovaries to produce multiple eggs. Hormone replacement is used to synchronize the recipient to the egg donor's cycle. Just prior to ovulation, using standard IVF techniques, the eggs are retrieved from the donor's ovaries and fertilized with sperm of the recipient couple.

There ends the donor's brief but important role. In the IVF lab, the donor's eggs are mixed with the sperm of the father to be. Up to four embryos are transferred to the infertile woman's uterus, two or three days later. Hormone support is administered for the first couple of months to maintain the pregnancy. A pregnant recipient of donor egg IVF has a reduced rate of miscarriage or Down's syndrome.

HISTORY OF EGG DONATION

Donor egg IVF was initially developed to treat women with premature ovarian failure, women who didn't have any eggs and couldn't become pregnant. The applications of this new technology have greatly expanded. Donor egg IVF is now used for women who are carriers of genetic diseases, women who have had multiple failed cycles of IVF, women with impaired ovarian function, or for older healthy women. This treatment also heightens the chance of pregnancy for women whose attempts at IVF have revealed a poor response to fertility medications, or eggs that did not fertilize well or form viable embryos.

BENEFITS OF EGG DONATION IVF

One of the main benefits of this new reproductive technology is its high rate of success. The principle seems to be that the age of the egg, not the uterus, is the critical factor. Success rates for donor egg IVF can be three to ten times higher than with regular IVF. Much of this success is due to the use of young, normally fertile donors.

Donor egg IVF offers some possible advantages over adoption. One is that couples have complete control of the pregnancy. The woman can be sure of getting excellent prenatal care And be sure to avoid alcohol, tobacco, illegal drugs, or unnecessary medications.

WHO ARE THE EGG DONORS?

Most IVF programs that use egg donors tend to use healthy, bright, responsible people. Potential donors are carefully screened for hereditary diseases, high-risk behaviors, or other medical problems. Most donors have been pregnant before, and are young and healthy. Generally, donors are compensated for all that they go through - the ultrasound exams, blood tests, and egg retrieval. Most egg donors do it because motherhood has been very positive for them and they want to share with others who haven't been able to do this on their own.

Rotunda - The center for human reproduction is proud to announce its comprehensive Egg Donation program utilizing the team approach. Donors are thoroughly screened both medically and psychologically in the effort to assess whether they meet the stringent guidelines established by the professional staff. There is new hope for women who have premature ovarian failure, age, or genetic considerations. The success rate using donor eggs is far greater for these women than In Vitro Fertilization, where they use their own eggs. Although the odds are significantly better, they unfortunately are not 100%.

Recipients are interviewed and counseled regarding the medical and psychosocial implications of the process. Introductions and matches are made by consent of both parties. Egg donation is said to be a new reproductive cure which enables patients to achieve their dream, to bear and nuture a child. Egg donation provides a means for the medical community to turn back the biological clock of women nearing the end of their reproductive years.

The old tradition of donation is based on anonymity, secrecy, and non-disclosure. However, there is one question that emerges as the foremost in recipients minds when they begin to contemplate egg donation. The issue of anonymous verses non-anonymous donation. Tradition and experience have led us to develop a program that offers only anonymous donors.

Whether one turns to egg donation or not, depends on the medical diagnosis. In consultation with your physician, the decision should be made whether you are psychologically prepared to be a candidate. This means being ready to make a commitment to parenting a child that is genetically related to only one of you. It also involves asking yourself and your partner some hard questions, which deserve some very honest answers. These questions will be extremely difficult ones. Who to tell or not to tell; when to tell; the non-genetic relationship disclosure issues, and what to tell the child, are all important questions that need to be discussed.

If you have any questions concerning the Egg Donation Program, please feel free to call our office for more information. We look forward to working with those patients who find egg donation to be their option and making their experience a rewarding one.

Medical Protocol

Perhaps a preface to this guide should be a reminder that fertility and achieving a pregnancy is not an exact science. There are so many unknown factors influencing fertility, that even with all the advances in reproductive technology, conception remains as much an art as a science.

Each doctor has his own protocol, and the couple or donor's reaction to the drugs may result in a change in protocol. Following is a sample schedule for an egg donor and an egg recipient couple.

The start of a menstrual cycle is referred to as DAY ONE (1) of the cycle. In an average 28-day cycle, a woman will most likely ovulate around day 14. This means the egg retrieval will usually take place on day 14 and the transfer will take place on day 16 or 17.

According to the treating physicians instruction, the egg donor will undergo ovulation induction. It is a procedure that involves the administration of fertility drugs to produce multiple egg (follicle) development. Fertility drugs are administered by injection or sometimes taken orally. There are two drug protocols that physicians use.

[ FLARE UP ] This protocol begins on the third day of the donor's menstrual cycle, and continues for seven -to ten days. During this time hormone levels will be monitored by means of blood tests and follicle development will be followed by means of transvaginal ultrasounds.

[ DOWN REGULATION ] This protocol begins around the 20^th day of the previous cycle. The physician will temporary "turn off" the ovaries using Lupride to promote better egg development.

When the follicles containing the eggs reach the requisite size, an injection of HCG is administered to prepare them for aspiration. The egg retrieval/aspiration is performed in a hospital like facility under sedation. A vaginal ultrasound probe is utilized for aspiration of all ovarian follicles. This is a non-surgical procedure that takes about twenty to thirty minutes, depending on how many eggs are retrieved. However, the donor should plan to spend at least three hours at the clinic. After a brief period in the recovery room, the donor will go home that same day.

It is important that you do not blame yourselves or each other, if a pregnancy is not achieved in any given cycle, Fertility is not an "all or nothing" proposition - it's a matter of degree. Unfortunately, there are factors that are unknown and therefore, no one has any control over that which can affect conception.

Following is a sample synchronization and aspiration schedule for an egg donor and an egg recipient couple :