Donor egg program includes oocyte retrieval from healthy young donors after controlled ovarian hyper stimulation followed by IVF and embryo transfer in recipient’s uterus.
What is Donar Egg Program?
Who are the Reciepients?
Who are the Donars?
How to Select the Right Donar?
DETAILED CASE HISTORY OF DONOR
Menstrual&Obstetric history (how many pregnancies she has had, when was the last pregnancy, any history of recurrent abortions etc. to determine fertility potential)
Family history (history of any genetic / congenital abnormalities in any family member)
Personal history(habits like using tobacco, smoking, drinking, what is the contraceptive being used)
PRESELECTION ULTRASOUND ASSESSMENT To look for donor’s ovarian reserve and presumption of ovum retrieval after hormonal ovarian stimulation
Investigations done before choosing Donar
At Ankoor Clinic , once donor’s profile is found to be appropriate after meeting our criteria, blood tests are carried out to screen for any hormonal abnormality in the donor, any major blood disorder and infections that can be transmitted to the baby. We also do blood tests of donor’s husband to screen for any infectious diseases that may be transmitted to the baby if not screened early. Tests for genetic disorders may be done in certain circumstances on recipient couple’s request.
Thus, at Ankoor clinic, utmost care is taken in screening the donors, and only health , fertile and disease free donors are chosen. When we have a patient in need of a donor egg/ oocyte, we chose a suitable one from our Donor bank after matching the profile of the lady in need of the donor eggs with the donor.
If there are special requirements of a couple, about the donor, then we try to meet these specific requirements also.
For example: A Brahmin couple may want only an educated, graduate Brahmin donor
Steps involved in Donar Egg Program
Matching with donor
Synchronization of menses of donor and recipient
Controlled ovarian hyperstimulation of donor
Recipient’s treatment to prepare endometrium for implantation Oocyte retrieval from donor
In vitro Fertilization of retrieved oocytes with recipient’s husband’s sperm /Donor sperm obtained from Sperm bank
Culture of embryos
Embryo transfer in recipient’s uterus and luteal phase support
Serum beta HCG level on day 14
Once the investigations are done and are normal and inclusion criteria are met with, the menstrual cycle of the donor and recipient are matched using oral contraceptive pills so that synchronization of cycles happens We start with tab estrogen after stopping the oral contraceptive pills to maintain the supression and to start preparing the endometrium for implantation.
A dummy embryo transfer is done for the recipient at this stage to rule out cervical stenosis. If there is cervical stenosis, cervical dilatation is done on day 2 of periods in the next cycle. This helps the actual embryo transfer to be easy and atraumatic. (Atraumatic transfer increases the success rate of pregnancy in IVF cycle.) The donor is simultaneously started on injection lupride in the late luteal phase to shut down her natural hormones.
Once the donor gets her periods she is started on injections for ovulation induction. The estrogen dose in the recipient is progressively increased so that the endometrial thickness is in the range of 9-11 mm.
Once the donor’s eggs are ready hCG injection is given for maturation of the eggs and ovum pick-up is done between 34-36 hours after hCG injection. On the day of hCG injection for the donor, a progesterone preparation is started for the recipient
The donor’s eggs are fertilized with the recipient’s husband’s sperms. The resultant embryo is transferred in the adequately prepared uterus (estrogen & progesterone primed uterus) of the recipient between the 15th & 20th day of periods i.e. between the 6th & 9th day of starting progestrone. Specific tablets / injections / vaginal preparations are given to the recipient in the luteal phase of the cycle to support the pregnancy.
A blood test (serum beta hCG) to confirm the outcome of the cycle is done on the 14th day after embryo transfer. If the blood test results are positive, the luteal phase support is continued and further instructions are given.
For couples not staying in Mumbai, the trip to Mumbai can be planned around the time of onset of periods for egg donation in Mumbai. Thus they will need to spend around 3 weeks in Mumbai. The total number of hospital visits will be around 8-10.
What are the outcomes of oocyte donation IVF cycle?
Success rates with conventional IVF decline steadily as the age increases, mostly beyond 35 years of age.
In contrast, live birth rate in oocyte donation cycle varies little across all age groups.
There are no unique problems associated with pregnancy after oocyte donation.
Multiple pregnancies are common with well known associated high risks.
Therefore, at our clinic, only two embryos are transferred in a cycle to prevent multiple pregnancy and complications associated with it.