Donor Egg IVF Cycle Steps
Egg Recovery from the Donor
The egg retrieval is an outpatient surgical procedure that involves ultrasound-guided aspiration of the follicles. An anesthesiologist is present during this operation. All donors receive a full explanation of the procedure and instructions concerning the retrieval, and must have someone to drive home after the eggs are retrieved.
A preliminary report on the number of eggs obtained will be given to the recipient couple as soon as possible after the egg retrieval.
Not all follicles aspirated can be expected to yield an oocyte (egg). With ovarian stimulation using fertility medications, mature, immature, and/or post-mature oocytes are recovered. The number of oocytes obtained from our egg donors can range between four and 66, with the average being 18.
Sperm (Semen) Collection
Ideally, a sperm sample is provided to the laboratory the morning of the egg retrieval. In normally fertile males, the sample is provided through masturbation. Dallas Fertility Center provides a private collection room in the andrology department in a location that is separate from the Center’s IVF laboratory and procedure rooms. If sperm collection problems are anticipated, please advise our office. A “backup” sample may be obtained and frozen in case of ejaculatory failure on the day of the egg retrieval.
Oocyte Fertilization and Embryo Culture
Once the embryology laboratory receives the eggs, they will be placed in special fluid media for four to six hours. The sperm specimen will be prepared during this time, and either incubated with the egg(s) for 16 to 18 hours or injected into the egg(s) using ICSI.
The egg(s) will be evaluated at approximately 16, 40, and 64 hours (days 1, 2, and 3 after the egg retrieval) after the time of insemination, in order to determine the fertilization of oocytes and to monitor embryo development. Our laboratory personnel will contact you by telephone on a daily basis, and embryo transfer will be scheduled three to five days after the egg retrieval procedure.
Approximately 70 percent of the eggs retrieved will fertilize, and approximately 50 percent of the fertilized eggs will continue to grow to day five or six. If more than two or three high quality embryos develop to the blastocyst stage (day 5 or 6), cryopreservation may be employed to preserve the excess embryos for use in a future cycle(s). Approximately 30 percent of couples undergoing oocyte donation will have excess embryos to freeze for future use.
When normal development of the embryo(s) has occurred, the recipient will be scheduled for embryo transfer. The male partner is welcome to come with the recipient to the transfer procedure.
A very soft, flexible catheter will be placed through the cervix into the uterus, and the physician will then transfer the embryo(s) into the uterine cavity. This is a painless procedure and no anesthetic is required. Patients are asked to remain in a reclining position in the recovery room for 30 minutes post-embryo transfer. Patients are welcome to bring food, books, a small radio with headphones, and so on to remain occupied during the rest period. After leaving the clinic, activities should be minimal. Patients are asked to stay off their feet for the remaining of the day following embryo transfer. Afterwards, patients can resume activities that are not stressful or physically tiring.
Following Embryo Transfer
Progesterone supplementation begins the day after the donor receives her hCG shot to induce ovulation—usually four to six days before embryo transfer—and will continue through the first pregnancy test. The first pregnancy test occurs 14 days after egg retrieval. With a positive pregnancy test, the fertility nurse will provide instructions regarding follow-up appointments and prescription medications.
If the pregnancy test is negative, progesterone supplementation will be stopped and a follow-up appointment should be scheduled with the physician. This visit summarizes the treatment cycle, discusses future plans (future IVF cycles or other infertility options) and gives patients the opportunity to ask questions.
Approximately 50 percent of pregnancies induced through oocyte donation result in a multiple gestation, even when only two embryos are transferred. About 2 percent of the time, a triplet gestation will occur because of monozygotic (single embryo splitting or ‘identical’) twinning.
If a patient’s insurance covers IVF, our office will file claims for services provided; however, the recipient couple must pay for services provided to the egg donor. Our office will not file a claim for any test or procedure conducted on the egg donor, although we will provide documentation for services provided. Our office will also collect for the anesthesiologist who bills our office for anesthesia services provided to the egg donor. This policy was created to ensure the egg donor has proper confidentiality measures in place.