Donor Egg / Embryo Recipient

Donor Egg or Embryo Recipient

For some patients, the path to parenthood requires help from an egg donor.

There are several indications for egg donation, including:

  • Severe diminished ovarian reserve or premature ovarian insufficiency
  • Prior chemotherapy or radiation
  • Advanced reproductive age
  • Absent ovaries (congenital absence or prior oophorectomy)
  • Multiple failed IVF cycles
  • History of poor or abnormal fertilization
  • Arrested embryo development
  • Female carrier of a genetic condition in couples not pursuing preimplantation genetic diagnosis
  • Single men, same-sex male couples and transgender individuals

There are many important decisions in the process of selecting an egg donor. The process requires a considerable investment of time, energy and money, it’s more than just screening and medical treatment but also involved could be the egg bank or agency fees and other expenses for the involved parties. Our medical team and third party coordination team have the experience necessary to assist you through this journey and to plan a personalized treatment plan specific to meet your family’s needs.

Egg Donor Recipient

There are several options available when looking for an egg donor:

  • Known donors identified by the patient
  • Anonymous donors identified and screened through the RMA of Southern California Egg Donor Program
  • Anonymous donors identified through an independent agency
  • Anonymous donors who have already donated and frozen eggs at an egg bank

Each of these options have their relative advantages and disadvantages, and the team at RMA will help guide you through the process of selecting the right one for your family. Some of the many factors to consider include the cost of treatment, time to successful match, availability of ethnically diverse or otherwise appropriate donors, desire to maintain kinship through a known donor arrangement, planned family size, and whether or not it is important that subsequent children be full siblings. The Physician, Nursing and Mental Health teams at RMA can help you explore these issues to determine the best path for you.

EMBRYO DONATION

When selecting a suitable donor, you might also need to consider including the cost of treatment, time to successful match, availability of ethnically diverse or otherwise appropriate donors, desire to maintain kinship through a known donor arrangement, planned family size, and whether or not it is important that subsequent children be full siblings. RMA of Southern California can help you explore these issues to determine the best path for you.

Every path is different—we are here to support your decisions and facilitate a successful outcome. Take the next step toward parenthood.

Speak to an RMA of Southern California patient liaison today at 424.293.8841.

DONOR EGG OR EMBRYO RECIPIENT PROCESS

Screening the Donor

Our in-house egg donors undergo an extensive medical, genetic and psychological screening process using standards established by the American Society for Reproductive Medicine and the U.S. Food & Drug Administration. Potential donors undergo rigorous infectious disease screening, genetic testing, physical exam and history, and personality assessment.

We also work with egg donors from trusted agencies across the United States. If a recipient decides to work with an outside agency, we will screen the donor to the same standards as one from our own program. Alternatively, patients can work with an egg bank to use frozen donor eggs. Using an egg bank may shorten the time spent in the donor matching process, as the donors have already been screened and completed their cycle, so the eggs are immediately available. This process allows you to choose your own egg donor from a data bank. While infectious disease screening is standardized for all egg banks, genetic testing can be variable.

Screening the Recipient and Partner

Donor egg recipients undergo routine infectious disease screening and uterine cavity evaluations with saline sonogram or hysteroscopy to confirm there are no intrauterine polyps, fibroids or scar tissue. For couples planning to undergo treatment using donor eggs must also be screened for infectious disease screening and genetic testing to assure an appropriate match with the donor. Couples/individuals will have an option to meet with a psychological counselor to discuss relationship and family dynamics, age-appropriate ways to disclose to their children how they were conceived, and issues related to anonymity and possible search for biologic siblings in the future. Couples will also meet with a Genetic Counselor to discuss the potential match and if any additional testing is warranted.

Prep Cycle

The intended female partner undergoing donor egg treatment will not necessarily require a formal prep cycle (aka mock cycle) unless there is a suspicious history.  It is important for this partner to have an uterine cavity evaluation before starting treatment to make sure they have an adequate uterine lining and thickness.  If they have previous records to show their uterine quality your physician will review the results to see if it is necessary to repeat the test.

In some cases, woman undergoing donor egg treatment suggested by their physician will need to complete a prep cycle.  The physician may want to see how the uterine responds to the hormone injections prior to the actual transfer. Estrogen supplementation is targets endometrial thickness and once the pattern is reached, oral progesterone is then used to end the prep cycle and bring on a period. Following the successful completion of this prep cycle, the recipient is then placed on the RMA of Southern California donor waiting list or can execute a contract with a donor egg bank for purchasing the shipment of frozen eggs, provided that other testing is complete.

Matching

Matching process can be easy but for some people, it takes time to find the donor they desire. Couples complete an intake form that reviews their matching priorities—anything from eye color or ethnicity, to educational background, family history or hobbies. Similarly, donors have completed a profile for recipients to review. Recipients who choose an anonymous donor through the RMA of Southern California egg donation program will have their name placed on a waiting list until a suitable match becomes available.

When a donor becomes available, the recipient will receive a full report on the candidate. The Recipient can choose to accept or decline the match for any reason without compromising her position on the wait list. Agency donors likewise are matched based on recipient priorities, but the process can vary considerably from agency to agency. For patients matching through an egg bank, online databases with detailed profiles are available to review in real-time; many of these banks have donors cycling from across the country, so the profiles can be added or deleted continuously as new donors become available and other recipients lock in a match.

Treatment Cycle: Donor Egg Retrieval/Thawing and Fertilization

Coordination of the egg donor stimulation cycle with the recipient transfer cycle is no longer routinely done, which allows the time necessary for the embryos to undergo Comprehensive Chromosome Screening (CCS) as known as preimplantation genetic screening (PGS) and cryopreservation for subsequent transfer. Not only does this improve pregnancy rates, but it also allows the embryos to be created independent of the time for transfer, which permits greater scheduling flexibility.  

Once the eggs are retrieved from the donor, or shipped from the egg bank to RMA of Southern California to be thawed, sperm is placed directly with each egg for fertilization. Embryos then grow for five to six days in culture and are frozen for future use. It is also possible to biopsy the embryos prior to embryo freezing, for subsequent CCS testing to determine whether an embryo has the correct number of chromosomes and is capable of developing into a healthy pregnancy.  

CCS may decrease miscarriage rates and also improve the live birth rate per transfer. Despite the donor’s young age, as many as 1 in 5 eggs may contain the wrong number of chromosomes. In addition to testing the health of the embryo by looking at 22 chromosomes, CCS also tests the sex chromosomes, making it possible to determine whether a particular embryo is male or female. Some patients prefer to know this information when selecting an embryo to transfer.

Treatment Cycle: Recipient

Once embryos are available, the recipient is ready to start her transfer cycle. In some cases the physician may recommend that the intended female partner undergo a prep cycle, with the exception that instead of taking an oral progesterone to bring on a period, daily intramuscular progesterone injections are given to prepare the uterine lining to accept an embryo and hopefully maintain the pregnancy.

From the first day of medication to the day of embryo transfer, it is approximately three to four weeks. Occasional monitoring visits for blood work and/or ultrasound are necessary to evaluate cycle progress and time the transfer appropriately.

Embryo Transfer, Pregnancy Monitoring, and Transition to Obstetric Care

Once the uterine lining is ready for implantation, the recipient is ready for the frozen embryo transfer, which is a brief procedure done under ultrasound guidance without anesthesia. Normal daily activity following the transfer is encouraged. Nine days after the transfer, the first pregnancy test is performed.

If pregnancy results, the first ultrasound is done seven to ten days later. Once the recipient reaches approximately eight weeks of pregnancy, care is then transitioned to a local obstetrician for the duration of pregnancy and delivery.

For more information on donor eggs in SoCal, please contact us today.