Process of In Vitro Fertilization (IVF) With Donor Egg

The following paragraphs provide more specific information about each step in the process:

1) Recipient screening

Evaluation of the recipient involves a number of tests, some of which may have been done in the past (and do not need to be repeated). Additional testing may be indicated in some couples. At this visit, the doctor will measure the depth of the uterus and do a complete pelvic exam. Standard testing includes:

  • Semen analysis
  • Recent pap/mammogram
  • Uterine depth measurement
  • Infectious disease testing
  • HSG or hysteroscopy or sonohysterogram
  • History and physical exam

2) Donor screening

All donors must be screened by a counselor trained in the issues related to Reproductive Medicine unless they are acquired through an outside donor program. This is to ensure that the donor is emotionally stable, recognizes the commitment and the expectations of the oocyte-donation process and that she understands that she has no "claim" whatsoever to a baby born as a result of the Donor Oocyte Program. Both known and anonymous donors are asked a list of questions mandated by the FDA to ensure that they have no risk factors for transmitting disease and are seen for a history and physical exam by our physician. They must also complete a medical/genetic history form. Blood tests drawn on donors include blood type and Rh factor, HIV1+2, HTLVI+2, HIV1/HCV NAT, HepB SAg, HepC, RPR, chlamydia and gonorrhea, cystic fibrosis, Complete blood count, and any other genetic testing recommended by the physician. The potential donor will then identify a "target" month to undergo the ovarian stimulation process.

3) Recipient preparation for the active cycle

Once the recipient (your) and donor baseline data is complete and a match has been made, you will be contacted by our program Coordinator to discuss schedules. If you are menstruating on her own, you will be asked to start taking oral contraceptives, and then start an agonist such as Leuprolide Acetate prior to the actual cycle. This medication works to suppress your reproductive cycle to ensure you don’t ovulate or menstruate during the time you receive the embryo(s). An ultrasound appointment and an appointment with the nurse is scheduled prior to start of these injections.

When your cycle is suppressed and when the donor is ready to begin the stimulation, you will be asked to come to the clinic for a baseline ultrasound.

  • You will begin the Estradiol patches/Estrace. You will also be scheduled for follow-up appointments to check the uterine lining.
  • If using fresh semen, the male partner should be available on the day of the donor’s egg retrieval (when the oocytes are recovered). He will need to donate sperm the morning of retrieval. We recommend that he abstain from ejaculation 3-5 days prior to the day of egg retrieval.

4) Donor's preparation during active cycle

Both the known and anonymous donor will identify a "target" month. Donors will be given detailed information about their medications and how to take them. The medications used for the donor generally are Lupron (Leuprolide acetate) to suppress ovulation, Gonal-F or Follistim and Menopur to stimulate multiple follicle development and HCG to trigger follicle maturation. They have been used for many years in fertility programs with few associated adverse side effects. If you have recruited a known donor who will be with you during the active cycle, she may want you or your partner to learn how to give her the daily shots. This will be taught by our nursing staff prior to beginning the cycle.

We would like to emphasize that timing is extremely important! The recipient's uterus must be ready to receive the embryo(s) and the donor’s oocytes(s) must be mature at the precise time of removal. Therefore, the donor will be monitored by ultrasound and occasional blood tests. In spite of these measures, there is an estimated 1-5% chance that ovulation will have occurred spontaneously. If this happens, egg retrieval will not be performed and another cycle may be attempted later if the donor is willing. There are a small number of donors that don't stimulate on the dose selected and the cycle may have to be canceled.

The donor is cautioned about avoiding intercourse from the beginning of hormone stimulation until her menstrual period after egg retrieval. This is to ensure that there is no chance of pregnancy occurring during the month she donates eggs.

5) Egg recovery from donor

Both known and anonymous donors will be required to sign consent for the procedure needed to recover the oocytes. The retrieval involves ultrasonic location of the follicles and retrieval by means of a special needle. Moderate sedation is used for this procedure. The donor will receive full explanation and instructions on the procedure. If the donor is a known donor, it will be the collective responsibility of the donor and the recipient to make the necessary transportation arrangements to and from our center.

6) Fertilization of oocytes and development of the embryo

This is broken down into several sequential steps as follows:

  • Sperm (semen) collection: The partner's sample must be collected in a sterile container and be in the lab within 45 minutes of collection, or the sample can be collected at our facility on the morning of the retrieval.
  • Oocytes culture and fertilization: Once the eggs are received by the IVF laboratory, the eggs will be placed in special fluid media and allowed to stabilize for a few hours. The sperm specimen will be washed, incubated and then placed in with the egg(s).
  • Results of operation: A preliminary report of the number of eggs obtained will be given to the recipient couple as soon as possible after the egg recovery. Not all the follicles aspirated can be expected to yield an oocyte (egg). All stages of oocytes can be recovered: mature, immature and post-mature. The following day, you will be contacted about the fertilization of any eggs recovered. This is not the final number of embryos but an early assessment of fertilization. The embryos will be evaluated on day 3 after retrieval and the decision of a day 3 or day 5 transfers will be discussed.

If more embryos develop than you want transferred, the embryos will be evaluated at the blastocyst stage to determine if appropriate for Cryopreservation. You will be provided more information on embryo Cryopreservation prior to your cycle and the appropriate consent form should be signed.

7) Transfer of embryos to recipient

The recipient (you) will return to the clinic 3-5 days after the donor's retrieval. It is recommended that the partner or a close friend come with you for the embryo transfer procedure. The procedure does not require anesthesia. A very fine catheter will be placed inside the uterus through the cervix and embryo(s) will be transferred into the uterine cavity. You will then rest for approximately 1/2 hour. After the transfer, your activities should be minimal. You should not do any strenuous activity for the first 48 hours following embryo transfer and after that you can gradually resume your normal activities.

For Patients

Call us to schedule a new patient appointment. If you are already an established patient, you will still need to call and schedule an appointment for a consultation with the doctor to discuss your donor egg cycle or gestational carrier cycle. 

PREPARE FOR YOUR APPOINTMENT

Bring or mail all prior medical records with you to your appointment.  You can request these records using the Medical Records Release Form.

Stanford IVF/Donor Program
900 Welch Road, Suite 350
Palo Alto, CA 94304

If you have infertility benefits under your plan, you may want to verify with your insurance if donors or gestational carriers are covered.

Call us to make an appointment

650-498-7911

For Health Care Professionals

PHYSICIAN HELPLINE

Phone: 1-866-742-4811
Fax: 650-320-9443
Monday – Friday, 8:30 a.m. – 5 p.m.

Stanford Health Care (formerly Stanford Hospital & Clinics) provides comprehensive services to refer and track patients, as well as provides the latest information and news for physicians and office staff. For help with all referral needs and questions visit Referring Physicians.

HOW TO REFER

Fax a referral form with supporting documentation to 650-320-9443.

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