This fact sheet has been written to help potential egg donors considering the option of donating their eggs at Life Fertility Clinic. It aims to take you step by step through the treatment cycle, explain why certain things are done and answer most of the questions that commonly arise during treatment. We suggest you read the leaflet carefully before embarking on egg donation and follow it during the treatment cycle. If you are unclear about any aspect of your treatment, the medical and nursing staff are always happy to answer your questions or concerns.
All donors and their partners are required to undergo screening blood tests, genetic testing and counselling which are mandatory prerequisites to our egg donor program. All aspects of treatment and the legal implications will be discussed, along with the donor’s feelings about becoming an egg donor and the consequences of success or failure, during a patient information session with the IVF Nurse Coordinator.
WHO NEEDS DONATED EGGS?
Egg donation now offers the chance of pregnancy to women who are unable to produce or use their own eggs due to, for example:
- Premature menopause.
- Ovarian failure due to chemotherapy and / or radiotherapy treatment.
- Absence of the ovaries.
- Carriers of a genetic disorder.
- Poor ovarian response to hormonal stimulation.
- Recurrent poor egg quality.
CRITERIA FOR DONORS
- To be aged between 21 and 35 years old (preferably completed their family). In the case of known donation the age of a donor may be older than 35, however the potential recipient needs to understand the implications and increased risks.
- Can be known to the recipient or clinic recruited.
- Adoptees will need to have a medical history available and be aware of their biological origins.
- To undergo counselling with a Life Fertility Clinic counsellor.
- To be screened for infectious diseases such as HIV, Hepatitis B and C, syphilis, HTLV, as well as chromosomes and blood group. Have repeat blood tests after six months.
- Give consent to treatment and complete a medical and lifestyle questionnaire in order to rule out the possibility of an inherited condition or transmissible infection being passed on.
- To provide Life Fertility Clinic with nonidentifying and identifying details to be recorded on our donor register.
- All potential donors are to produce formal identification such as Medicare card, driver’s license or passport.
- If married or in a de facto relationship, the partner must consent to the donation.
- Women undergoing egg retrieval for their own fertility treatment are not to donate eggs to a recipient.
- Although it is illegal in Australia to receive payment for egg donation, the matched recipient will meet out of pocket donor expenses.
It is crucial to remember that all consultations, blood tests, assessment of the medical and lifestyle questionnaire, education and counselling sessions, and consent forms must be completed by the egg donor and their partner at least two weeks prior to commencement of the treatment.
A minimum two week cooling off period is mandatory prior to commencement of treatment from 2nd counselling session.
HOW ARE DONORS AND RECIPIENTS MATCHED?
- Clinic recruited donors
The recipient will be given a profile of the potential donor consisting of non identifying details such as physical characteristics (hair and eye colour, height, weight, build, complexion, race), blood group, career and education, to assist in the decision making process as to whether they will accept the potential donor. It is very difficult to match physical characteristics due to the limited number of egg donors.
Life Fertility Clinic has a register in which names and details of every egg donor, recipient and offspring are recorded. Nonidentifying donor information is released in conjunction with the donor’s consent in a profile format to match potential recipients. However, when a child born as a result of treatment using donor eggs reaches the age of 18 years, they are entitled to obtain the donor’s identifying details by applying to Life Fertility Clinic.
The register also maintains and records the number of offspring generated by each donor. Once ten families have been attained, donation must cease. It is important that all potential egg donors inform Life Fertility Clinic if they have donated eggs to another clinic. Egg donors are entitled upon request to Life Fertility Clinic to obtain nonidentifying information about the recipient, including the number and gender of persons born.
There are many factors to consider when deciding to become an egg donor. An important factor is where you stand legally as an egg donor. Egg donors can withdraw or change their consent at any time prior to insemination or fertilisation of the eggs. Once fertilisation has taken place, the embryo belongs to the recipient. As an egg donor you have no legal rights or responsibilities to any child born as a result of egg donation.
Counselling is mandatory for every egg donor (and her partner) who is considering donating eggs and they must attend a minimum of two counselling sessions. This gives the donor and her partner the opportunity to talk through the implications of this with a counsellor, who is a part of the Life Fertility Clinic team. Counselling acts as an assessment of your suitability to become a donor. It also gives you time to talk through your feelings about donating your eggs and how this may affect your life, now, and in the future. Most women find it very helpful to have the opportunity to reflect upon what they are planning and appreciate being able to talk freely and in confidence about such an important and sensitive matter. The length of your commitment may be as few as six weeks and as long as three months. Treatment medication may include the oral contraceptive pill (minimum of three weeks), a nasal spray and injections (twelve to sixteen days) and at least one or more days off work. This is a significant commitment you are considering, but a rewarding one as well. There have been thousands of women who have donated eggs and in turn there have been thousands of women who have become pregnant with donated eggs – women who otherwise would never have become pregnant.
- Obtain a referral from your GP.
- Make an appointment for your consultation with a Life Fertility Clinic specialist.
- Attend a mandatory 1 1/2 hour education session with a Nurse Coordinator.
- Attend two counselling sessions with a Life Fertility Clinic counsellor to discuss the implications of donating eggs (partners must attend sessions).
- Attend blood screening tests, complete medical and lifestyle questionnaire, and consent forms (both donor and partner).
- Commence treatment when matched with recipient.
Once treatment commences you will be required to have approximately 4 visits to Life Fertility Clinic.
Your menstrual cycle will be synchronised with that of your recipient. You will commence the oral contraceptive pill when your period starts. You will continue on the pill for a minimum of three weeks. Your Nurse Coordinator will advise you when to cease the pill and await your next period.
Now that your menstrual cycle is being hormonally regulated, it’s time to stimulate the growth of the egg follicles. You may be required to begin taking a nasal spray (Synarel) to switch off your natural hormones before we start stimulating the ovarian follicles with a daily injection of follicle stimulating hormone (FSH) (Puregon or Gonal F). There are other methods to stimulate egg production, and your Doctor will choose the method that is most appropriate for you. These injections stimulate and grow the follicles. By stimulating the growth of egg follicles in this way, our specialists are able to collect several eggs at once rather than the one egg that women usually ovulate each month. There are other methods to stimulate egg production, and your doctor will choose the method that is most appropriate for you.
IVF specialist will perform an ultrasound scan. This involves the use of a vaginal probe, enabling us to measure the size and number of the developing follicles, which contain the eggs. (It is important to remember that not every follicle will contain an egg). This procedure does not require a full bladder, is painless and lasts for only a few minutes. At this appointment the IVF specialist may adjust the medication dose to minimise side effects and optimise the number of eggs available for collection. They will also advise you of your next scan appointment (Day 10-12). Please bring all your medications to Life Fertility Clinic for each appointment. You must continue administration of your nasal spray and FSH injections until advised to stop by your Doctor or Nurse Coordinator of the Life Fertility Clinic team (usually on the day of hCG trigger injection).
HUMAN CHORIONIC GONADOTROPHIN (hCG) (TRIGGER INJECTION)
Your Day 8-12 scan will determine if the follicles have reached a satisfactory size and number. If so, and when directed by your IVF Doctor, the Nurse Coordinator will make arrangements for the egg collection and explain how the hCG injection (trigger injection) is to be given. This injection helps with final maturation of the egg. The trigger injection is usually administered late in the evening, 36 hours prior to egg collection. The Nurse Coordinator will give you clear instructions on how to self administer the injection and also give you instructions detailing egg collection. It is extremely important that you read and understand this information and follow all instructions carefully. You will be requested not to eat or drink for six hours prior to your procedure.
DAY OF EGG COLLECTION
On the day of egg collection you will be asked to attend Life Fertility Clinic IVF theatre an hour prior to the time of your procedure. You will be cared for by the day theatre staff, who will admit and prepare you for the egg collection. Just prior to the collection you will meet the anaesthetist who will sedate you. You will be under anaesthetic for 30-40 minutes.
The eggs are recovered vaginally, using the ultrasound probe (as used during scanning) to guide a fine needle through the wall of the vagina into the follicles. The follicles are then aspirated and flushed until the eggs are obtained.
Upon waking from the anaesthetic the recovery nursing staff will care for you. The Life Fertility Clinic embryologist will inform you of the number of eggs collected. During the postoperative period you may experience some abdominal discomfort similar to period pain. Paracetamol (if you are not allergic to it) will usually control any discomfort, which generally subsides in two to three days.
We advise that you continue regular pain relief (if needed) every 4-6 hours following egg collection. Most people recover sufficiently to leave the clinic 1 -2 hours following the egg collection procedure. You will need someone to collect you from the hospital as you are unable to drive for 24 hours. You will be advised to rest for the remainder of the day. You may experience some vaginal bleeding (from the fine needle punctures at the top of the vagina). This should subside after a few hours. If, for any reason, you experience excessive abdominal pain, prolonged bleeding, or feel faint, please don’t hesitate to contact Life Fertility Clinic.
If you experience excessive abdominal pain or bloating, vomiting or shortness of breath (symptoms of ovarian hyperstimulation syndrome or OHSS) you must contact your IVF Doctor or the IVF Nurse Coordinators at Life Fertility Clinic (if after hours contact your Life Fertility Clinic Doctor).
IMPORTANT! RISK OF PREGNANCY!
There is a possibility that your body may naturally release eggs after the egg collection process. In this circumstance you are at a heightened risk of a pregnancy yourself. At Life Fertility Clinic we urge egg donors to abstain from sexual intercourse until your next period.
WHERE PROBLEMS OCCUR
Described below are a few of the more important problems and hurdles. They can be of more relevance to some people than others. Their relative significance for you will be discussed at your scanning appointments.
THE DONOR’S MONITORING PHASE
- Under Stimulation: If three or fewer follicles are developing your IVF Doctor may advise abandoning the cycle. We then review the stimulation regime to try to improve the situation in future cycles.
- Over Stimulation: If a very large number of follicles are developing, there is a risk of OHSS (see below) occurring. Again it may be advised that the cycle is cancelled and the stimulation regime revised. There is a new preparation (nasal spray) that can be used as a trigger, which can avoid hyperstimulation.
Ovarian hyperstimulation syndrome (OHSS) is a condition where there is an over abundance of eggs which cause ovarian enlargement and collection of fluid in the pelvis and even in the lungs. The syndrome may be classified as mild, moderate or severe by signs and symptoms. The symptoms usually begin 3-4 days after the egg collection. The majority of women have a mild or moderate form of the syndrome that invariably resolves within a few days, but which may delay recovery. Patients may complain of pain, a bloated feeling and mild abdominal swelling. In a small proportion of women, the degree of discomfort can be quite pronounced.
Very rarely the ovarian hyperstimulation is severe and the ovaries are very swollen. The woman will feel ill with nausea and vomiting, and abdominal pain. Fluid accumulates in the abdominal cavity and chest, causing abdominal swelling and shortness of breath. There is a reduction in the amount of urine produced. These complications require urgent hospital admission to restore the fluid and electrolyte balance and to monitor progress and pain relief. Rarely admission to the intensive care unit is necessary.
As mentioned previously, there is a now a new method (nasal spray) to prepare for egg collection, which means we can avoid hyperstimulation occurring.
Not all follicles necessarily contain eggs and not all eggs obtained are necessarily mature (which makes them unusable). In normal circumstances approximately 75-80% of eggs recovered are mature. Rarely, no eggs are recovered (empty follicle syndrome) or all eggs are abnormal. If less than three follicles develop the cycle may be cancelled. All eggs are donated immediately after egg collection. It is important to realise that not all eggs may be suitable for treatment and not all eggs will fertilise to create an embryo.
The Donor Conception Support Group of Australia Inc.
PO Box 554
Seven Hills NSW 1730
Phone: (02) 96245110
The Donor Conception Support Group of Australia Inc. is a self-funding organisation run by volunteers and has been in existence since 1993. The membership is made up of people considering or using donor sperm, egg or embryos, those who already have children conceived on donor programs, adult donor offspring and donors.
The Donor Conception Support Group provides support, help and research assistance with:
- A bi-monthly newsletter.
- Information nights for donors (past and potential), donor recipient families, donor conceived offspring and other interested parties.
- A library with a collection of books and articles on infertility and donor issues available to members, as well as audio and video tapes. These can be borrowed at meetings and social days, or arrangements can be made to send the books to you in the mail.
- Personal stories – read how others have coped and dealt with donor related issues.
- Telephone contacts for personal support.
- Consumer advocacy on issues relating to donor recipients and offspring.
- Social days and activities for everyone.
PO Box 6769
Silverwater NSW 2128
Phone: 1800 888 896
Fax: (02) 97390245
Access is a consumer based, independent, non profit organisation committed to being a national voice in promoting the wellbeing and welfare of infertile people of all ages.
Special services provided: provision of a range of fact sheets about infertility, a quarterly newsletter, a register of Australian regional infertility self help groups and a list of accredited infertility clinics. Access serves 5,000 members around Australia and internationally.
CONTACT LIFE FERTILITY CLINIC
The friendly and professional team at Life Fertility Clinic are eager to assist and answer any questions regarding our donor egg program.
For more information or queries regarding any of the services offered at Life Fertility Clinic, please contact us.