In our second video series, to give representation to the many questions our Intended Parents and Egg Donors have about Egg Donation and the IVF process, Dr. David Tourgeman explains what happens in a fresh cycle from the viewpoint of an egg donor.
Listen and watch along with us as Dr. David Tourgeman, Reproductive Endocrinologist at HRC Fertility, gives a quick overview on how the process of egg donation works from a mechanical perspective as well as the procedural aspects.
Hello my name is Dr. David Tourgeman from HRC Fertility.
I’ve been asked by Egg Donation, Inc. to help explain the mechanics and process of a fresh egg donation cycle so that you can better understand how it all works.
The first thing we do to initiate the process, is to receive what is called a “match letter” from the egg donor agency. This match letter triggers a few things to happen.
The first, is that the egg donor will need to come in for a detailed history evaluation and a physical examination. During this time we will be asking multiple medical questions, inclusive of medical issues, that occur within the donor or her family.
We will also obtain information about, perhaps, travel to areas that may be endemic for the Zika virus, a history of sexually transmitted diseases, when the last tattoo or piercing the donor may have had, and also general questions regarding the consumption of alcohol, tobacco, or recreational drugs.
During this time, we will do a physical examination. The physical examination is a trans-vaginal ultrasound to evaluate the number of follicles within the ovaries of the egg donor. We typically expect somewhere, upwards of fifteen to twenty follicles in total. That will give us a guide that the ovarian reserve looks relatively good.
We will combine the ultrasound with some blood tests. For example, a blood test called the anti-mullerian hormone level or AMH level, is collected. This test is a guide to give us information about the ovarian reserve.
The best way to think about this is that all follicles, all eggs, produce a little bit of anti-mullerian hormone and so, the higher that hormone level is, the more anticipated eggs we should expect when the ovaries are stimulated to grow.
During the time of the initial consultation we will also do an infectious disease screening, as well as, bloodwork to evaluate any genetic predispositions. For example, Cystic Fibrosis. That’s a specific gene that the donor may not have, but she may carry a trait, and so, testing for Cystic Fibrosis is an important thing to evaluate at that point.
Once the results of all the testings have come back and are presumably all normal, we will then have the intended parents and the egg donor start legal documents. This is generally a process, by which there is, especially in an anonymous situation, intervening Council who will draw up what the legal binding agreement is between both parties.
Once legal is completed, we would have the egg donor return for further evaluation via ultrasound and blood work to make sure that we are able to start treatment.
When all of that is completed, we will begin the process of the stimulation of the ovaries, and at that same time, we will do bloodwork that allows us to proceed with the egg donation process.
This blood work is really dictated, and is a regulation, of the FDA or the Food and Drug Administration. Once we have completed the blood work, or during the process of its completion, we will start the stimulation of the ovaries. This is a medication that we have to give daily, for somewhere between nine and twelve days. During this process the egg donor will need to come in, not only for blood work, but ultrasounds to evaluate the appropriate growth of the follicles, and making sure there are no changes that are needed within the ovarian stimulation protocol.
Once the follicles have reached maturity by ultrasound, we are then ready to prepare the ovaries for the harvesting of the eggs. Typically one or two trigger shots, as we call them, are given and approximately 35 hours after those medications are given, we are ready to extract out the eggs.
This is a very simple procedure that is done under an IV anesthetic so the donor will feel no pain. During this process the donor essentially feels asleep, and during this time, we place an ultrasound, with a very small needle, that is guided into each one of the follicles, within the ovary.
This is done through the vagina and so no scars or anything like that are encountered. The fluid from within the follicles, along with its eggs, are retrieved. The eggs are then identified by the embryologic staff to make sure that the eggs have been captured, and at that time, they are further evaluated for maturity.
The recovery of the anesthesia is actually quite quick. We expect that most egg donors will be able to get up and leave within 30 minutes to 60 minutes from the egg retrieval. It’s not uncommon to have some cramping after the procedure and that is simply because the ovaries are much more enlarged than they typically are normally.
After the retrieval, we will follow-up with the egg donor to make sure that she is doing well postoperatively and that she’s not in any need for medications to control pain or nausea or the such.
So, that’s just a quick overview on how the process of egg donation works from a mechanical perspective as well as the procedural aspects.
I hope you found this helpful. Have a great day
Making the Right Choice
Egg Donation, Inc’s Southern California agency in Los Angeles is host to one of the most successful donor egg programs in the United States and the world. We are at the forefront of advances in egg donation. If you would like more information about which one might be the right one for you, be sure to contact our team for more information.