The ways in which families are created are as varied as potential parents. Many of our patients decide to or need to create their family using donated eggs. This fact sheet explains the options, considerations and treatment processes involved.
Getting started
If you are considering having treatment using donated eggs, this is an outline of some of the preliminary steps that will be involved:
- You will need a referral from your GP if you are not already a patient of Life Fertility Clinic.
- You must make an appointment for a consultation with a Life Fertility Clinic specialist who will review your history and recommend treatment that is best suited to your circumstances.
- You must attend an education session with our Nurse Coordinator who will outline your donor options, arrange any blood tests and go through the consent forms with you.
- You must attend a minimum of two counselling sessions (mandatory) to discuss the implications of being a recipient of donor eggs.
- There is a minimum two week cooling off period once everything is in place, before treatment can begin.
Donor options
If you know someone who is willing to donate eggs to you, we can arrange everything for both you and your donor. Your donor will also need to have a consultation with one of our fertility specialists and to attend a nurse education session. These can be joint appointments with you or separate appointments. There are some preliminary requirements that will need to be met and they (and their partner if they have one) will also need to have two counselling sessions. You will all also need to attend an additional joint counselling session.
Separate fact sheets are available outlining the requirements, considerations and processes involved in being an egg donor
Life Fertility Clinic is occasionally contacted by women who are willing to be anonymous egg donors. Once all the necessary preliminary steps have been completed, profiles for these donors are offered to patients on our egg donor waiting list.
Please advise our Nurse Coordinator if you wish to be put on our egg donor waiting list.
How long does the process take?
If you are using donated eggs, there is likely to be a few months of preparation while you and your donor have testing, attend counselling sessions and sign consent forms. When everything is in place, at a time convenient for you and the donor, your IVF treatment can begin.
If you are using an anonymous donor, you won’t meet her but she will also be going through all the preparatory steps and, if necessary, her treatment will be carefully timed to match yours.
It is possible that an donor’s egg retrieval cycle may not result in the expected number of eggs or embryos which may mean you both need to start again a month or two later. Your Life Fertility Clinic IVF Nurse Coordinator will keep you informed and make all the arrangements for you both.
Counselling
You (and your partner, if you have one) must attend a minimum of two confidential counselling sessions with a Life Fertility Clinic associated counsellor. These sessions give you a chance to explore whether being a recipient of donated eggs is for you. They also give us a chance to get to know you and make sure you fully understand your rights and the situations that could arise in future as a result of your treatment.
Most recipients appreciate the opportunity to talk through their decisions and how this may affect their life and that of their family now and in the future.
If your egg donor is known to you, you will also be required to have a joint counselling session with them as well.
You can decide not to go ahead as a result of these sessions or, if we have any concerns, we may suggest you defer or do not go ahead with treatment.
Legal issues
An egg donor can change or withdraw her consent to be a donor at any time up to the time of insemination of the eggs in the laboratory. Insemination happens a few hours after the eggs have been collected. Once this point in treatment has been reached, all rights and responsibilities for any embryos created, any pregnancies, or any legal responsibilities for any child born lie with you (and your partner).
At the time of donation though, an egg donor will be
asked whether she is happy for you to donate your embryos (created using her eggs) to someone else should they remain in storage when you have completed your treatment. This is because donation of these embryos could result in further families being created from her eggs. You will be informed of her consent about this and can decide not to accept the donation if needs be.
As a recipient of donated eggs, regardless of whether the donor is known to you or not, you (and your partner with whom you undertook treatment) are the legal parent(s) of any child born as a result of the treatment. You (and your partner) are named on the child’s birth certificate.
All egg donors must consent to their identifying information being held with Life Fertility Clinic. When a child conceived using donor eggs reaches 18 years old, they are entitled to ask Life Fertility Clinic for the donors identifying details.
The donor may also ask for non-identifying details about who has received their eggs and the number and gender of any children born.
It is a licensing requirement for us that the number of families created from any egg donor is appropriately limited. For both known and anonymous egg donors, it is Life Fertility Clinic policy that all egg donors are limited wherever possible to creating no more than five families (in Queensland) including their own.
Do I need to pay my egg donor?
No. It is illegal in Australia to receive payment for egg donation but, as the recipient of the donated eggs, you will usually be expected to cover the costs of your donor’s treatment cycle. You may also choose to refund their reasonable out-of-pocket expenses associated with the donation.
Treatment options – fresh or frozen embryo transfer?
Treatment using donated eggs involves an IVF cycle.
In outline, the donor’s ovaries are stimulated to produce eggs. On the day that the donor’s eggs are retrieved, the sperm is prepared and used to inseminate the eggs by standard IVF or ICSI. The recipients are responsible for all decisions about all aspects of the IVF treatment process, which are the same as when a woman uses her own eggs. This includes embryo culture, embryo transfer and cryopreservation.
Separate fact sheets are available about IVF step-by-step, ICSI and freezing.
In some cases the recipient’s own cycle will be controlled and synchronised with the donor’s cycle so that a fresh embryo transfer can take place in the same cycle, five days after the egg collection.
In other cases, all of the suitable embryos created in the egg donation cycle will be frozen (a ‘freeze all’ cycle) and the recipient will be scheduled for a frozen embryo transfer at another time.
Your fertility specialist will advise you as to which treatment approach is best suited to you.
Separate fact sheets are available about frozen embryo transfers.
Synchronising cycles – fresh embryo transfer
If you are planning on having a fresh embryo transfer following your donor’s egg retrieval, the first step of the treatment process will be to match the timing of your menstrual cycle with that of your egg donor. You will most likely be instructed to start taking the oral contraceptive pill when your period starts and will continue on the pill for three weeks or longer until the two cycles are matched. Your Nurse Coordinator will advise you when to stop taking the pill and wait for your next period.
Stimulation phase
When your menstrual cycles and your donor’s cycle are synchronised, you will start a hormone regime (Progynova tablets) to thicken the lining of your uterus. At the same time the egg donor will start medications to stimulate and grow her egg follicles.
Monitoring treatment
When you have been on the hormone tablets for 10 to 12 days, your IVF specialist will do an ultrasound scan to measure the thickness of your uterine lining. This scan uses a vaginal probe which is painless, lasts for only a few minutes and does not need a full bladder.
We aim to give your uterus a lining of the right thickness to create the best environment for an embryo to implant. If the scan shows that the developing lining needs further adjustment, the IVF specialist will change your hormone medication. You must continue this medication until advised to stop and you may need to book another scan.
Your egg donor will also be monitored using vaginal scans during the stimulation process. Once her follicles have reached a satisfactory size and number, we will make arrangements for the egg collection.
Egg collection and beyond – all cycles
Egg collection
Your egg donor will have her eggs collected under sedation in the hospital operating theatre. The eggs are retrieved via the vagina using an ultrasound probe (as used during scanning) to guide a fine needle into the follicles.
When the eggs have been collected, the Life Fertility Clinic scientist will let you know if the process has been successful and the number of eggs that have been collected.
Sperm sample
At about the same time as the egg collection, your partner will provide his semen sample using a private room at the Life Fertility Clinic (unless arrangements have been made in advance to freeze his semen sample or to use donor sperm). If you are using ejaculate, he should not have ejaculated for between 2 and 7 days before this appointment.
If your partner is having sperm extracted by TESA or PESA (a surgical procedure), this will be arranged by the Nurse Coordinator and he should not eat or drink for six hours before the procedure.
Insemination and embryo culture
Immediately after the eggs have been collected, the Life Fertility Clinic scientist prepares the donor eggs and the sperm for standard IVF insemination or ICSI (direct injection of the sperm into the egg). The method of insemination will be decided by you and your fertility specialist.
The day after insemination, the scientist will call you to let you know how many eggs have fertilised. The embryos are then cultured in the lab for 5 to 6 days, at which time the best embryo will be selected for embryo transfer (if appropriate) and/or all good quality embryos will be frozen.
A scientist will talk to you about everything that has happened in the lab during your treatment, including details of the embryo(s) for transfer and what has been frozen.
Fresh embryo transfer
If you are having a fresh embryo transfer, during the time your embryos are in the lab, you will be instructed to start taking progesterone medication in addition to the previous hormone medication to maintain and support the uterine lining into which the embryo(s) will implant.
The embryo transfer is done via the vagina. Your specialist will place a speculum into your vagina (as for a pap smear), insert a small catheter through your cervix into your uterus and transfer the embryo through the catheter. This process does not need sedation.
Your Life Fertility Clinic nurse coordinator will give you instructions to continue the hormone and progesterone medication and will tell you when to have a pregnancy (quantitative hCG) blood test.
Frozen embryo transfer
Frozen embryo transfers using embryos created using donated eggs are exactly the same as cycles involving a woman’s own eggs.
If you are having a frozen embryo transfer immediately after a freeze-all cycle using donor eggs, or because a previous fresh transfer was unsuccessful, or because you may want to create a sibling later for any child born your IVF Nurse Coordinator will advise you how to go about arranging this.
Separate fact sheets are available about frozen embryo transfers.
Things that can go wrong during the IVF cycle
Although you are in the best hands at Life Fertility Clinic, it is wise to be prepared for some of the things that can upset the smooth progress of IVF treatment using donor eggs. The process can be a little more complex than using your own eggs, particularly if both women’s cycles have to be coordinated.
These are a few of the things that can cause complications for the donor, and delays or disappointment for you:
Not enough follicles develop
If three or fewer of the donor’s egg follicles are developing with stimulation, the IVF specialist may advise the donor to stop the cycle. We will then review the stimulation medication to try to improve the situation for future cycles if she is willing to try again.
Too many eggs develop
This may sound like a good problem but if a very large number of egg follicles are developing and the donor has very high oestrogen levels, there is a risk she will develop ovarian hyperstimulation syndrome (OHSS). This can be a serious condition that requires hospitalisation. If the specialist thinks there is a risk of OHSS, he will advise her to stop the cycle to protect her health. Again, we can review the stimulation medication to try to improve the situation for future cycles if she is willing to try again.
No eggs or only unsuitable eggs collected
Not all egg follicles contain eggs and the eggs collected may not all be mature and suitable to use. Usually 75% of follicles contain an egg and approximately 85% of the eggs are mature. On rare occasions, we cannot collect any eggs (empty follicle syndrome) or all the eggs are abnormal or immature.
No embryos suitable for transfer or freezing are produced
Even if an egg donor is young and/or has previously had children, sometimes the embryology that we see in the laboratory can be unexpected or disappointing. On rare occasions the eggs may not fertilise, the embryos may not progress beyond early stages or may not be of suitable quality for embryo transfer or freezing.
Support groups
Australian Donor Conception Network
Email: donorconceptionnetwork@gmail.com
Website: www.australiandonorconceptionnetwork.org
The Australian Donor Conception Network 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.
Access
Email: info@access.org.au
Website: www.access.org.au
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.
Contact Life Fertility Clinic
The friendly and professional team at Life Fertility Clinic are eager to help and answer any questions about our donor program.