For many of our patients and couples, not being able to conceive is a challenging obstacle. At Elite IVF Solutions, we offer “third-party reproduction” solutions for those individuals and couples who may benefit from donor and/or surrogate assistance.
“Third-Party Reproduction,” according to the American Society for Reproductive Medicine, refers to the use of eggs, sperm, or embryos that have been donated by a third person (donor) to enable an infertile individual or couple to become parents. The use of donor eggs, sperm, or embryos can then be used in ART (assisted reproductive technology) procedures such as IUI and IVF. “Third-party Reproduction” also includes surrogacy with a gestational carrier.
Frequently Asked Questions
Egg Donation
Why do I need an egg donor?
Some women are unable to conceive because they cannot produce healthy eggs. Our oocyte (egg) donor program can help women who otherwise would not be able to conceive, by providing this missing link - healthy eggs. Egg donation was started in the 1980s and over the past 40 years has grown exponentially in popularity because of excellent success rates.
There are several indications for using an egg donor, including:
Our team has been involved with egg donation since 1991 and has previously established some of the largest programs in the country. We have helped many women conceive with eggs donated by both identified (known) and anonymous donors.
Who are egg donors?
Known egg donation uses eggs donated by a specific person: a sister, relative, or friend.
Anonymous egg donation uses eggs donated anonymously from women recruited specifically for egg donation or from women undergoing an IVF cycle who are willing to donate excess eggs. Donors donate because they want to give this very special gift, but are also compensated for each completed cycle.
Before donors are accepted into the program, they undergo a series of medical and psychological evaluations. All egg donors are screened according to guidelines recommended by the American Society for Reproductive Medicine (ASRM). Potential donors must be between the ages of 19 and 32 and non-smokers. Candidates fill out a medical questionnaire reviewing their medical history, family history, and social habits, all of which are reviewed by our team to determine the donor's acceptability and ascertain potential risk for significant medical or genetic disorders.
The potential donor and her partner (if applicable) are then invited to meet with us to learn about why women need an egg donor, the process, and the emotional, psychosocial, ethical, and legal issues that pertain to egg donation. It is important to evaluate the donor's well-being and level of comfort to cope with the stress of being a donor.
If the egg donor feels comfortable with the process, she will undergo various tests to ensure good medical health. These tests include:
How can we find the right egg donor?
Elite IVF Solutions has several close relationships with very successful egg donor agencies around the country. We also have a number of local donors who know of our philosophy at EIS and wish to donate. In all, we have access to a large number of donors and an increasing number of frozen donor eggs. We all take a comprehensive approach to the screening process, and historically, around 40% of ovum donors who are screened and tested become available for you to choose.
A screening process includes a meeting with Dr. Lindheim, who reviews with all candidates:
Legal and Ethical issues are also discussed in great detail. Concerning legal issues, all donors are made aware that they have no rights, commitments, or obligations attached to the donation process. Ethical issues pertaining to oocyte and embryo disposition are also discussed.
Fresh eggs or frozen?
Until 2005, the process of egg donation required that the recipient’s menstrual cycle be synchronized with the donor’s cycle. This requirement was critical for success because the recipient’s uterine lining needed to be in synchrony with the fresh developing embryos in the laboratory. Otherwise, implantation would not occur. This “fresh” embryo transfer is still extremely successful, but there is another option. We now have the scientific knowledge to freeze eggs. Eggs are more difficult to freeze and thaw than sperm because they contain a great deal of water, which can crystallize and fracture the egg. A technique called vitrification is now used in our laboratory to freeze and thaw eggs with great success. The success rate using frozen eggs is comparable to the use of fresh eggs, but it has advantages. The advantages include not having to wait for the right donor to be found, potentially proven success already with a cohort of eggs, and potential cost savings. While this decision may seem daunting, our staff will discuss the pros and cons in detail. Either way, it is a choice between two excellent options.
How successful is Egg Donation?
Very successful. Elite programs like ours will have delivery rates above 65%. That is, for every fresh egg donation cycle you start, you would have a greater than 60% chance of delivering a baby in our program. The national average delivery rate for egg donation is approximately 50%, as published by the Society of Assisted Reproductive Technologies.
How do you choose a donor?
Elite IVF Solutions offers patients and couples the option of known or anonymous egg donation. Known egg donation is reserved for those individuals or couples who select a family member or friend to be their egg donor. Anonymous egg donation is when the donor is initially unknown to the patient or intended couple. Most times, egg donation starts as anonymous, but the recipient couple and the donor may choose to meet before final selection. Our donor selection is diverse, and all egg donors have been thoroughly screened and educated on the process of egg donation. We follow the guidelines set forth by the American Society of Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART), as well as FDA regulations for egg donation and egg donor compensation. Most young women who make an application to become an egg donor are not selected. Donor applicants are between the ages of 19-32 and must be very healthy. We select only those women as donors who truly want to help others have a child and have passed appropriate physical, genetic, and psychological screening.
We work with qualified and regulated egg donor agencies where egg donors are selected by the recipient patient (or couple). In most cases, eggs are already cryopreserved, and a set number can be purchased.
How do most people feel about Egg Donation?
Egg donation is now widely accepted. Thousands of egg donation cycles are performed each year in the US, and more than ten thousand worldwide. In certain areas in the US, each kindergarten class has at least one child born through egg donation. Couples have repeatedly told us that they love their child born through egg donation as much as imaginable. It is not unusual for families to have had their first child without infertility therapy and their second child through egg donation.
How do you get started?
The first step is to meet with Dr. Lindheim to discuss your individual situation. He will answer your questions and perform an ultrasound to do an initial evaluation of your uterus. You will then be scheduled for a water ultrasound or an X-ray procedure called a hysterosalpingogram (HSG) to further evaluate your uterus. Once your uterus is assessed to be capable of carrying a pregnancy, and your medical examination and blood tests are normal, you are all set to look for your donor. We will guide you each step of the way. Many patients/couples start the process of donor research and selection as they are undergoing their screening tests. From the time you select a donor, it is usually about two months before your embryo transfer.
How does the Egg Donation cycle work?
With known donor cycles, Dr. Lindheim will put you and your donor on birth control pills (OCP’s). These OCP’s will synchronize your menstrual cycle with the donor’s cycle. This is critical because each of you must be in the same phase of your menstrual cycle. Once on the OCP’s you will start a medication called Lupron, which will shut off your cycle in preparation for the upcoming embryo transfer. At this point, the donor will start the fertility hormones, and you will start Estrogen. After 12 days or so, the donor will have her egg retrieval and you will start Progesterone. The eggs will be fertilized in the embryology laboratory with your sperm choice. The donor is now recovering, and her cycle is complete. She will have a period in 2 weeks and, over time, resume her normal daily activities. The donor is specifically counseled not to have intercourse until after her menses in order not to become pregnant.
Once the eggs are fertilized, they will begin to grow and develop in the embryology laboratory. The embryo transfer will occur approximately 5 days after the egg retrieval, depending on your specific situation. You may have additional embryos that can be cryopreserved. You will know whether or not you are pregnant within 12 days after the embryo transfer.
When frozen donor eggs are used, the process is much simpler because your treatment protocol does not have to be synchronized with the donor. Your medications will be tailored to your reproductive health status, and may include OCPs, Lupron, Estrogen and Progesterone. The timing of the embryo transfer is based on the results of monitoring procedures (ultrasound and blood tests) that you will undergo while on the medications. You will know whether or not you are pregnant within 12 days after the embryo transfer.
Costs
The costs of an egg donation cycle are somewhat higher than for a regular IVF cycle because there are three patients involved (recipient, male partner, and donor). The “fresh” donor receives compensation for her time; frozen egg donors are financially compensated for their donation by the agency. An important part of any third-party treatment cycle is a thorough discussion with the EIS financial counselor.
Philosophy
We believe that egg donation is an incredible therapy to allow a couple to have a family even when the female partner has no viable oocytes. Egg donation has revolutionized the treatment of infertility in the last twenty years. We would be honored to help you decide if egg donation is best for you.
Sperm Donation
Sperm donation is when a male voluntarily gives his sperm in the hopes of helping a woman or couple to become pregnant by way of IUI or IVF. Just as in egg donation, sperm donation can be done anonymously or as a directed (known) donor.
Anonymous Sperm Donation
Elite IVF Solutions assists couples with selecting anonymous donor sperm from sperm banks that are accredited by the American Association of Tissue Banks (AATB). Such accreditation assures us that these banks meet specific minimal standards for disease screening and semen quality.
Known Sperm Donation
Known or directed sperm donation is reserved for those individuals or couples selecting a family member or friend to be their sperm donor. We follow the guidelines of the American Society of Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) as well as FDA regulations for directed sperm donation. We select only those men as donors who have passed appropriate physical, genetic and psychological screening.
Embryo Donation
Embryo donation involves using another individual’s or couple’s embryo(s) that were produced from previous IVF cycle(s) in order to conceive. For many patients and couples undergoing IVF, more embryo(s) are created and cryopreserved (frozen) than are used to successfully complete their family. These remaining embryos are often donated, providing a unique opportunity to help other individuals or couples experience pregnancy and childbirth.
We follow the guidelines of the American Society of Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) as well as FDA regulations for embryo donation. We work with established and regulated embryo donation agencies, whose donors have passed appropriate physical, genetic and psychological screening.
Surrogacy
A surrogate is a woman who agrees to carry a pregnancy for another woman or couple.
One of the most generous gifts a woman can give to another is to carry a baby for 9 months. With the onset of new advances in reproductive medicine, this is now possible. For a woman without a healthy uterus, she can now have her own genetic child.
When is Surrogacy needed?
The most common reason is that a woman does not have a healthy uterus. There can be many reasons for this, including infection, small size, scar tissue, poor endometrial development, or previous hysterectomy. Additionally, certain women are born with ovaries but no uterus.
How successful is Surrogacy?
The success of surrogacy depends on many factors. However, by far and away the most important factor is the age of the egg provider. For women or donors below age 32, the success rate is above 60% per cycle.
Who becomes a Surrogate?
There are many educated women who very much enjoy being pregnant. In addition, they enjoy helping another woman have a child. There are a number of requirements before a woman can become a surrogate, including having a child of her own and being at least 21 years old.
How are Surrogates chosen?
The surrogate agencies provide a great deal of information on prospective surrogates, including pictures and personal information. The surrogate/egg provider relationship is often non-anonymous, but that is decided by each case.
When a surrogate is selected, medical and psychological screening tests are done to ensure the surrogate is satisfactory from the general health, hormonal, and psychological perspectives. The medical tests include a careful medical history, a pelvic examination (including a pelvic ultrasound), blood tests to look for infectious diseases (HIV, hepatitis B, hepatitis C, syphilis and HTLV-1), and cervical cultures for gonorrhea and chlamydia. The psychological screening includes an interview with a therapist experienced in this area.
How is Surrogacy accomplished?
Surrogacy is an IVF cycle split between two women. Both women take birth control pills for a few weeks and then start the medication, Lupron. This serves to synchronize the menstrual cycles of the women and get both of them to the “starting gate” at the same time.
The surrogate then begins an estrogen medication to prepare her uterus to receive an embryo. Meanwhile, the egg provider receives daily injections of fertility drugs (such as Gonal-F, Follistim, and Menopur) which help mature a group of eggs in her ovaries. Usually, 8-12 days of fertility hormones are required before the eggs mature and ready to be retrieved. At this point, the surrogate begins progesterone, the other hormone necessary to maintain pregnancy. This can be in the form of a vaginal gel or a daily injection. It has long been our custom to teach a spouse, relative, friend, or neighbor to give injections so frequent trips to our office are not needed.
The eggs are retrieved and then inseminated a few hours later with sperm from the recipient’s husband (or sperm donor). This is done by our embryologists. They will culture the fertilized eggs (now called embryos) until the time of transfer to the recipient’s uterus. The embryo transfer is usually done approximately 5 days after the egg retrieval.
What are the risks of being a Surrogate?
The primary risk is that of being pregnant. Pregnancy itself is a risk. While it is beyond the scope of this information to discuss the risks of a singleton pregnancy, we strive to limit the number of multiple pregnancies. Multiple pregnancies increase the risk of complications to the surrogate and the unborn babies. This includes premature delivery and the respiratory, infectious, and other complications that often follow. We therefore limit the number of embryos we transfer while still maximizing success rates.
Can Surrogacy reduce the future fertility of the Surrogate?
It is not thought that surrogacy reduces the future fertility of the surrogate. This is unless there is a complication with the pregnancy or the delivery.
Gestational Surrogacy (also known as a Gestational Carrier) is the most common type of surrogacy and refers to a woman who agrees to have another individual’s or couple’s embryo transferred into her uterus, as discussed in the above process. The surrogate has no genetic link to the pregnancy she carries.
Traditional Surrogacy refers to a woman who is artificially inseminated with sperm (typically from the male partner of a couple seeking a surrogate) for the purpose of conceiving. The surrogate’s eggs are fertilized with the sperm during this process, and therefore, the surrogate has both a genetic and biological link to the pregnancy she carries. At this time, traditional surrogacy is not offered at Elite IVF Solutions.