Egg Donor Program Screening Process
Both partners are strongly encouraged to complete a psychological evaluation with a mental health professional to discuss the psychological aspects of oocyte donation. Among other topics, the issue of disclosure (to the child) of the donor egg process will be discussed.
At the time of the initial consultation, the physician will outline the specific procedures that must be completed before and during the cycle. During one of these visits, a physical exam will be conducted. Both partners will have several blood tests, and the husband must give a semen sample for analysis.
Patients must sometimes undergo additional testing to evaluate their general physical condition, much like an insurance medical evaluation. Women older than 44 may be asked to undergo additional medical testing, such as an exercise stress test, a chest x-ray, and blood testing. They may also need additional in-depth consultation with one of our physicians before attempting fertility treatment.
It may be necessary to document that the uterus is normally developed and free of polyps and fibroids. This can be accomplished with a hysterosalpingogram (an x-ray of the uterus and tubes), a saline sonohysterogram (a special type of ultrasound) or an office hysteroscopy (an office procedure allowing direct visualization of the inside of the uterine cavity).
Sometimes patients are asked to undergo a test cycle with hormones to determine if the uterine lining (endometrium) responds normally by thickening and becoming more vascular.
Matching of Recipient and Donor
Donors are found through our Donor Screening Program, an outside agency, or individually if the patient has a known donor. Those choosing a donor through our office must schedule an appointment with our donor oocyte nurse coordinator.
Recipients have an opportunity to review our oocyte donor list and donor characteristics. Every attempt is made to match the donor and the recipient with regards to race, height, weight, hair, eye color, and personality traits. However, as the donor pool is highly selective, we will not always be able to match every characteristic for each donor and recipient. It is not necessary for the recipient and the donor to have the same blood type.
Once a match is made, the potential donor will be contacted to identify a target month during which it is convenient for her to undergo ovulation induction and egg retrieval. Waiting times vary depending on availability and eligibility of donors. The potential donor will then be referred for a psychological evaluation, if one has not already been completed. Alternately, a donor can be located through an outside agency. Once a donor is designated, the agency will contact our office and provide her information.
Both known and unknown donors must complete the same medical/genetic history form, physical exam, and testing. All potential donors will be screened for significant medical and genetic problems and donor blood tests check for blood type, Rh factor, HIV (AIDS), hepatitis, syphilis, chlamydia/gonorrhea, and illegal drugs.
Because some genetic disorders are significantly increased in certain ethnic groups, each potential donor is screened accordingly. For example, we screen Caucasians for cystic fibrosis and African-Americans for sickle cell anemia. Finally, the donor will be asked to visit a counselor who specializes in infertility issues. This psychological screening is conducted to evaluate the personality traits of the donor, as well as to ensure that the donor recognizes what is involved in the oocyte donation process. Donors must understand that they have no claim whatsoever to a baby born as a result of the donor egg program.
***All of the egg donors available in our in-house egg donor program go through an extensive screening process prior to being added to our database.
Synchronization of Menstrual Cycles
Once a target date has been identified, the donor will be given detailed information about medications, how to administer them, and when to start. At the same time ovarian stimulation is occurring in the donor, uterine stimulation is occurring in the recipient. We emphasize that timing is extremely important! The recipient’s uterus must be ready to receive the embryo and the donor’s oocytes must be mature at precisely the same time.
Financial Concerns and Insurance Coverage
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.
Discussion of Multiple Gestation Risks
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.