Donor Egg IVF Process Step By Step
The process of IVF with donor eggs starts at the beginning of the egg donor’s menstrual period. If the egg recipient (the intended mother or surrogate) is going through a fresh embryo transfer, our physicians will synchronize her menstrual cycle with the egg donor’s cycle, using birth control pills. For donor egg IVF process with frozen embryo transfer, egg donors and recipients do not have to synchronize their cycles, allowing for greater scheduling flexibility and making the process a popular option. Fresh and frozen embryo transfers have comparable live birth success rates in the donor egg IVF process
The following steps are a general guideline for the egg donation process here at Santa Monica Fertility. Details may vary based on the needs of both the egg donor and the intended mother as well as desired fertility goals.
Egg Donor Selection and Retention
The first step of the donor egg IVF process is for you to select and retain a suitable egg donor. You will collaborate with our Egg Donation Coordinator, who will guide and support you throughout the entire egg donation process. You can browse the profiles of our egg donors at any time; our online egg donor database features a number of exceptional egg donors who are available for fresh and frozen cycles. To meet your individual needs, we work with ladies from a variety of ethnic backgrounds, including Caucasian, Black, Indian, mixed race and Asian egg donors. Most egg donors whom we work with are already medically and psychologically screened, and many have successfully donated eggs before.
Your Complimentary Phone Call with Dr Jain
We will organize a complimentary phone call between you and our Chief Fertility Specialist and Medical Director, Dr. John Jain. Dr. Jain will review and discuss your medical history, explain the donor egg IVF process in detail and answer all questions that you may have. Dr. Jain will consider your fertility goals and recommend the IVF with donor eggs package that may best meet your needs.
Egg Donor’s Preparation For Egg Retrieval
Throughout the process, the egg donor will take a number of egg donor medications to prepare for egg retrieval. The egg recipient will take medication that will prepare her for IVF.
Although the medication protocol will vary, the main milestones in the donor egg IVF process are usually as follows:
- Baseline test
On day two or three after the onset of menses, both the egg donor and the intended mother will visit our clinic for a baseline ultrasound examination and a blood test.
- Ovarian suppression
The two women’s cycles are synchronized using oral contraceptives and/or Lupron (fresh embryo transfer only). Oral contraceptives help start the ovarian suppression process and are taken for two to four weeks. In order to achieve ovarian suppression, Lupron is begun about two weeks before the start of ovarian stimulation and overlaps with the oral contraceptives. To ensure that ovarian suppression has been achieved, we’ll schedule another clinic visit for an ultrasound and blood test approximately two weeks after starting Lupron.
- Ovarian stimulation
Once both the egg donor and intended mother have achieved low estrogen levels, the donor begins a daily dosage of injectable fertility medications, while Lupron is continued at a lower dose. The medications are usually self-administered subcutaneously (under the skin) using a short needle and taken for eight to twelve days. The recipient begins oral estrogen therapy.
- Cycle monitoring
The donor will start regular clinic visits on day five of stimulation. These visits continue every one to two days until egg retrieval, and our clinical staff performs an ultrasound and blood test for estradiol at each visit. Based on the donor’s monitoring, the intended mother’s cycle is adjusted to the donor’s cycle to prepare for the donor egg IVF process and embryo transfer.
- Ovulation induction
When the follicles are large enough, usually between day eight and twelve, our clinical staff triggers the final egg maturation stage by injecting human chorionic gonadotropin (hCG). The timing of the hCG dose is very important, as our physician will perform the egg retrieval thirty-six hours later.
Egg Retrieval and Fertilization
Thirty-six hours following hCG injection, the donor eggs are retrieved and fertilized with the male partner’s (or sperm donor’s) sperm.
On the day of donor egg retrieval:
- The recipient will begin progesterone suppositories to prepare for pregnancy.
- We will obtain the sperm from the intended mother’s male partner. In order to optimize sperm quality, we recommend that the male partner abstain from ejaculation for two to seven days prior to the first sperm specimen. If we use frozen sperm from the intended mother’s male partner, or a sperm donor, we’ll need to have received the sperm specimen at least one day before the retrieval of donor eggs.
To achieve fertilization, sperm are placed with the eggs in an IVF dish or injected directly into the egg (ICSI). We will check the eggs the next day to determine which ones are fertilized. At that time, we can freeze all embryos (or just the excess) for a frozen embryo transfer at a later date.
Preimplantation Genetic Testing (PGT)
If indicated for your donor egg IVF process, we’ll perform Preimplantation Genetic Testing (PGT) when the embryo reaches the blastocyst stage (day five or six of development). PGT can not only reveal the gender of the embryo for sex selection but also certain genetic conditions. The results from PGT are available within 7-14 days after starting the diagnostic test.
Donor Egg Recipient Medication Protocol
There are several medication protocols that can be used to prepare for frozen embryo transfer from donor eggs. Medication protocols utilize birth control pills to schedule embryo transfers more easily. Lupron is an injectable medication used in combination with birth control pills to prevent ovulation and provide more flexibility in scheduling the embryo transfer. These medications are followed by estrogen to help thicken the uterine (endometrial) lining and progesterone to allow embryo implantation.
In general birth control pills are taken for 2 weeks commencing at the time of the menstrual period, followed by Lupron 1 week after starting birth control pills for an additional 2 weeks – in total approximately 3 weeks for these first 2 medications. Estrogen is then taken for 12-14 days followed by 6 days of progesterone before blastocyst embryo transfer – in total approximately 18 days.
For women who cannot take birth control, Lupron can be started after ovulation (luteal phase) with estrogen and progesterone commencing once the next period starts.
It is also possible to take just estrogen and progesterone without birth control pills or Lupron, but there is a chance of prematurely ovulating (20% of time) requiring cycle cancelation. Embryo transfer timing will be based on the menstrual period with little scheduling flexibility.
IVF with Donor Eggs Embryo Transfer
The embryo will develop in the IVF dish for five days. After the five day period, the embryo will be transferred into the egg recipient’s uterus. The embryo transfer is a simple procedure performed by placing a soft catheter containing the embryos through the cervix under ultrasound guidance. The procedure does not require anesthesia. However, we will administer Valium to help relax the pelvic muscles, so you will need to arrange a ride home rather than drive yourself. After approximately one week, you will need to complete a pregnancy test at our clinic to determine if the embryo transfer was successful.
After the embryo transfer, the intended mother will take supplemental hormones until our clinicians advise them to stop. Egg recipients usually require supplemental hormones for the first 12 weeks after the embryo transfer. After the supplemental hormone stage, the placenta will be able to provide the necessary hormones for normal fetal development.
Coordinating For Out-of-State and International Patients
If the patient uses frozen donor eggs or requests PGT for an embryo, the egg donation process described above will vary slightly. You don’t need to be local to California to undergo the donor egg IVF process here at Santa Monica Fertility. For patients living outside of the Los Angeles area, most of the steps for egg donation can be coordinated with your local IVF clinic. Dr. Jain can work with your physician to coordinate your initial screening, bloodwork, and medications. This means that in most cases, patients from outside of California will not need to come to our clinic until the time of the embryo transfer itself. For some international or out of state patients, the embryo transfer process usually requires about a one-week stay in the Los Angeles area.
Once we fertilize the donor eggs, we can also freeze and ship the untransferred embryos anywhere around the world. Your chosen IVF clinic can then thaw and transfer the embryos.
We invite you to further explore our site, where you can learn about the cost of donor eggs, the success rates of IVF using donor eggs, donor eggs epigenetics and more. Our FAQ section provides answers to many questions that you may have.
You can view profiles of our egg donors available for fresh and frozen cycles online at Santa Monica Donor Egg Bank.