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CRH’s Oocyte
Donation Program gives you the power to create a miracle. With
respectful care, we make the experience special and confidential. We
have a proven procedure to screen the best potential candidates to
ensure the closest match for you. Protocols are in place to customize
the treatment of the donor and recipient to ensure the highest
possibility of success.
 Who will benefit from oocyte donation
Oocyte donation is offered to a woman who desires to carry and deliver
a child that she could not otherwise conceive due to one of the
following medical conditions:
1.
She has no ovaries, or
2.
She has
ovaries which do not produce oocytes (premature ovarian failure), or
2. She has ovaries which produce poor
quality oocytes, or
3. Her oocytes are genetically
abnormal, or
4. Her oocytes cannot be retrieved due
to ovarian inaccessibility.
Sources of Donor Oocytes
Women who are interested in oocyte
donation may choose to have a Known or
Anonymous donor.
Known Donor
The known donor recipient has to
identify a donor oocyte of 21 to 30 years of age, nonsmoker, with a
healthy medical and genetic history. The known donor screening testing
for infectious diseases is similar to all oocyte donors and is
performed according to the standard criteria of the CRH and following
the American Society for Reproductive Medicine (ASRM) guidelines.
Since the donor and recipient know each other, it is recommended to
contact an attorney to prepare a legal contract and have it signed by
all parties.
Anonymous
Donor
For the
anonymous donor, the identities of the donor and the recipient are
maintained in strict confidence. Although anonymous oocyte donation is
medically analogous to sperm donation, and in
the present state of technology, oocytes cannot be successfully
cryopreserved (frozen) as sperm.
In our program
anonymous donors are women of 21 to 30 years of age, nonsmoker, normal
body weight, with a healthy medical and genetic history, who must test
negative for all the infectious disease screening performed according
to the standard criteria of the CRH and following the ASRM guidelines.
These donors
are not patients of the CRH but come to the CRH to donate their
oocytes for the compassionate reason of helping an infertile woman to achieve a
pregnancy. Since they have to receive daily hormonal treatment,
several blood testing and vaginal ultrasound monitoring, and a
surgical procedure to remove the oocytes, our center strongly feels
that these donors should receive a financial consideration for their
time, effort and risks involved in the donation of oocytes. In
addition, the recipient couple is responsible for paying the entire
donor medical expenses related to the oocyte donation.
Screening Requirements for Recipient
Couple of Donor Oocytes
1. Initial
consultation of the couple with a staff physician of the program to
review previous medical records.
2. Physical
examination of the female partner to ensure general good health.
3. Female
laboratory testing Rubella Immunity, Blood type and RH, HIV antibody,
Hepatitis B and C surface antigen, RPR for Syphilis, Cytomegalovirus (CMV),
Cervical cultures for Gonorrhea, Chlamydia, Ureaplasma Urealyticum,
and Mycoplasma Hominis.
4.
Hysterosalpingogram within the past two years to ensure normal uterine
(womb) cavity.
5. Male
laboratory testing Blood type and RH HIV antibody Hepatitis B and C
surface antigen RPR for Syphilis CMV
6. Semen
analysis within the past 6 months
Screening Requirements for Donor
Oocytes
1. Complete
the Donor Profile questionnaire
2. Initial consultation and physical
examination by the physician
3. Laboratory testing, to include but not
limited to:
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Lupron
Challenge Test
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Blood type and RH
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HIV
Antibody
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Hepatitis
B and C Surface Antigen
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RPR for Syphilis
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T4, TSH & Prolactin
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4. Cervical
Cultures for Gonorrhea, Chlamydia, Ureaplasma, and Mycoplasma.
Matching Physical
Characteristics and Treatment
Protocols for Donor and Recipients
Physical characteristics of the egg
donor such as skin color, eye color, hair color and body build are
matched closely as possible to the characteristics of the intended
recipient couple. In addition, ethnic background, physical traits, and
blood group & Rh factor are matched as accurately as possible. CRH
has a large pool of donors and is usually able to meet most of the
recipient’s wishes.
Protocol for the Donor Oocyte Cycle
Recipient
Most
recipients undergoing a donor oocyte treatment cycle will receive
Lupron, a medication used in women who still have periods to prevent
the pituitary gland from releasing the hormones that usually stimulate
the ovaries. This is required to synchronize both the recipient and
the donor oocyte cycles.
After
approximately two weeks of Lupron, the recipient will begin the
two-week treatment with Estradiol Valerate to prepare the
uterine lining for implantation. In addition, close to the time of
embryo transfer the recipient will start the Progesterone
supplementation, another hormone required for implantation of the
developing embryos. The hormonal treatment is continued until the
pregnancy test is performed. If a pregnancy is established, the
hormonal treatment will continue through the first trimester.
During the
treatment cycle both partners should not smoke nor take more than one
alcoholic beverage per day, eat healthy food and vitamin
supplementation. They should not take any additional medication other
than the prescribed by the CRH.
Oocyte Donor
The oocyte donor will undergo ovarian stimulation, which requires the use of
fertility drugs such as Humegon7, Repronex 7, Metrodin 7, Fertinex 7
and other commercially available products. This treatment is known as
superovulation, and it is used in conjunction with Lupron. To assist
in evaluating the response to the superovulation treatment and
predicting the time of the expected ovulation, the oocyte donor will
be carefully monitored. This is accomplished by several blood testing
and vaginal ultrasound examinations.
When the most
ovarian follicles have reached adequate development the oocyte donor will receive human chorionic gonadotropin (hCG), an injection to
produce the simultaneous development of several oocytes and to control
the timing of ovulation, so the oocytes can be retrieved before they
are spontaneously released. The oocyte retrieval is usually scheduled
36 hours after HCG administration.
Oocyte Retrieval
The oocyte
retrieval is conducted by ultrasound-guided transvaginal follicle
aspiration, under mild conscious sedation. For the procedure, a
vaginal transducer is placed in the vagina, and then an aspiration
needle is inserted alongside the transducer and through the upper part
of the vagina directly into each large ovarian follicle. The fluid
contained in the follicles is withdrawn and collected into test tubes
and examined under the microscope in the IVF laboratory for the
presence of the oocytes.
Sperm Collection
The day of
oocyte retrieval, a sample donor from the recipient's partner or
designated semen donor will have to be available to the IVF laboratory
for processing.
In Vitro Fertilization
The mature
donor oocytes are combined with the sperm (insemination) about six
hours after the oocyte retrieval. If the recipient couple is diagnosed
with male factor infertility, then another procedure called
Intracytoplasmic Sperm Injection (ICSI) will be required to assist the
sperm to fertilize the oocyte. Each oocyte is observed the following
morning for fertilization.
The normally
fertilized oocytes are then returned to the incubator for an
additional 24 hours to allow cell division (cleavage) to occur, and
thereafter the fertilized oocyte is called embryo.
Embryo Transfer
If the embryos
have developed satisfactorily in the laboratory, up to four of them
are selected and placed in the woman's uterus three to five days after
the oocyte retrieval. The embryo transfer is a simple and painless
procedure performed without anesthesia. A speculum is placed into the
vagina to visualize the opening into the womb. The embryos are then
loaded into a narrow catheter, which it is gently introduced into the
uterine cavity, where the embryos will be released for implantation.
The patient is
required to stay at the CRH in the transfer room for about one hour,
and to limit all her activities for the following 96 hours. A
pregnancy test is done approximately ten days after embryo
replacement. If a pregnancy ensues, then the Progesterone
supplementation is continued for ten more weeks.
Embryo Cryopreservation
Any excess of
fertilized oocytes and/or normally developing embryos may be
cryopreserved and stored for the patient's future use at the patient's
request.
Outcome of Oocyte Donation
Excellent
pregnancy rates are reported with oocyte donation; these rates are
typically much higher than those for IVF-ET without donation. Possible
explanations include the fact that most donors are not infertile and
may have higher quality oocytes than infertile patients. Secondly, the
recipient endometrium is not hyperstimulated, and may be more
receptive to implantation. For these reasons, usually three donated embryos are replaced at any one time.
With high
quality embryos, delivered pregnancy rates above 40% have been
reported.
A Path Towards Success
We acknowledge
that participation in an In Vitro Fertilization Cycle with donor
oocyte is a complex procedure. It requires additional time than a
routine In Vitro Fertilization cycle because it requires matching of
the physical characteristics of the recipient with a donor,
preparation of both treatment cycles, financial counseling
for the recipient, and have the consent forms of both
parties explained and signed.
CRH is
committed to your success and will lead you through the process
towards a successful pregnancy.
To make an appointment, please call us
TODAY at 615-321-8899.
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