Egg Donation IVF can be a highly successful treatment for women whose ovaries do not produce high-quality eggs.
Probability of Success: Egg Donation and Frozen Egg Donation are the most effective fertility treatment available. The likelihood of a successful outcome depends primarily on the fertility potential of the egg donor, and you should expect over a 50% probability of a successful outcome with a highly fertile egg donor.
Treatment Efficacy: Donor Egg IVF has become a mainstream treatment for infertility.
Donor Egg IVF Offspring: Children conceived with the help of Donor Egg IVF are genetically linked to the male partner and the egg donor, but the female partner is the one who becomes pregnant, nourishes the baby throughout the pregnancy, and experiences childbirth.
The baby receives one set of genes from the dad and another from an egg donor, but you, the mom carrying the pregnancy, make that baby your very own. The new science of epigenetics describes how our environment modifies gene expressions and possibly the genes themselves.
The epigenetic marks transmitted from the mother are a fine-tuned mechanism to control gene activation during the complex process of early embryogenesis. And this maternal influence continues throughout the pregnancy. You will imprint yourself onto the baby! By the time your son or daughter is born, that baby will be biologically yours.
Selecting an Egg Donor: Your egg donor can be someone blood-related to you to preserve the genetic link, or you could choose a donor from one of the many egg donor agencies. Most (but not all) Donor Egg IVF treatments are anonymous.
Obstetrical Care: Once your Donor Egg IVF treatment is completed (approximately 6-8 weeks into your pregnancy), the pregnancy becomes indistinguishable from conception through intercourse, and your obstetrical care should be no different than if you conceived without any treatment.
Once you select your egg donor, she will become a patient at your fertility clinic and will be medically and genetically screened by us.
Donor Egg IVF is a two-stage treatment. The first phase consists of the development and cryopreservation of embryos:
- Ovarian Stimulation
- Egg Retrieval Procedure
- Fertilization of eggs
- Culture of embryos
- Cryopreservation of embryos
- Embryo storage
The second stage consists of the Frozen Embryo Transfer cycle.
Ovarian Stimulation: There are several different forms of ovarian stimulation protocols, each with many modifications. Your egg donor’s treatment is always individualized to maximize the probability of a successful outcome.
The selection of an optimal protocol is based on your donor’s reproductive history and her pre-treatment evaluation. Below is an example of an egg donation treatment protocol. Your donor’s individualized protocol may take less or more time to complete.
Follicle-stimulating hormone (FSH) or a combination of FSH/luteinizing hormone (LH) hormones will stimulate the production of multiple eggs in the donor’s ovaries. They are given once a day or once every other day subcutaneously with tiny needles for approximately ten days.
During this time, your donor’s progress is monitored by estradiol (estrogen, E2) and progesterone blood levels and ultrasound examinations.
Ovarian stimulation should result in the development of several eggs in each ovary. The ultrasound image below shows a stimulated ovary. Each of the several follicles (dark circles) contains a microscopic egg.
Egg Retrieval Procedure: The procedure only takes a few minutes.
Under ultrasound guidance, the tip of a thin needle is passed through the top of the vagina into the cul-de-sac (space behind the uterus). The ovaries are located near the bottom of the cul-de-sac, allowing the tip of the aspirating needle to enter the ovarian follicles and aspirate the follicular fluid from them. The fluid is examined under a microscope to identify the eggs.
The egg retrieval procedure is the last step in the donor’s participation. She will have her normal menstrual period within two weeks of the egg retrieval.
Fertilization of Eggs: On average, twelve to sixteen eggs are aspirated during the donor egg retrieval procedure. The eggs are identified under the microscope and placed in petri dishes filled with culture medium. The composition of the medium resembles the fluid secreted by the Fallopian tubes. This allows the eggs and embryos (fertilized eggs) to develop at the same rate as inside the Fallopian tubes.
The male partner collects a semen specimen by masturbation on the day of egg retrieval. The highest quality sperm are extracted from the semen and combined with the eggs three hours after the egg retrieval. This process of in vitro fertilization takes place over several hours during the evening after egg retrieval.
If the male partner has never caused pregnancy, or if your test results indicate a possibility of significant male infertility, Intracytoplasmic Sperm Injection (ICSI) is performed. In ICSI, a single sperm is inserted into an egg. This can significantly increase the probability of normal fertilization for selected patients.
Culture of Embryos: Evidence of fertilization can be seen the next day, 16 hours after insemination. The fertilized eggs are transferred into a growth medium and continue to be cultured.
A normally fertilized egg (zygote) will show two pronuclei representing the genetic material from the egg and sperm.
The following day, embryos should divide into 4 cells and, the day after, into 8 cells.
This picture shows a morphologically exquisite, day three, 8-cell embryo. At this stage, human embryos are still microscopic and invisible to the naked eye.
By the fifth to seventh day after insemination, embryos should reach the blastocyst stage (80 or more cells).
This picture shows an advanced stage of blastocyst development. Notice the central fluid-filled cavity. The cells within the blastocyst have already differentiated into the inner cell mass (at seven o’clock) that will give rise to the fetus and the trophectoderm cells that will form the future placenta.
Cryopreservation of Embryos: Embryos that develop normally are cryopreserved (vitrified). Preparation for the freezing process involves removing water from within the embryos and replacing it with a cryoprotective substance to prevent ice crystal formation during vitrification and subsequent thawing. The embryos are then flash-cooled to −196 °C (−321 °F). Such rapid freezing (vitrification) prevents damaging water crystal formation.
Embryo Storage: Following the cryopreservation process, the embryos are transferred to a liquid nitrogen storage chamber. Theoretically, there is no limit on the length of storage, but conceiving past the age of 40 may result in a high-risk pregnancy.
Once you decide to conceive with your cryopreserved embryos, you will have one or two embryos thawed and transferred into your uterus. A large majority of the embryos will survive the vitrification and thawing process. The implantation rate of the thawed embryos should be the same as the “fresh” embryo implantation rate.
If you are successful, your pregnancy becomes indistinguishable from conception through intercourse, and your obstetrical care should be no different than if you conceived without any treatment.
