For The Oocyte Recipient
Procedure for the Oocyte Recipient in our Egg Donation Program:
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A mid cycle ultrasound, and hysteroscopy to evaluate the uterine cavity is required. Hysterosonography is also performed within one week of cessation of menstruation and is usually performed in our clinic. Based on the findings of the aquascan, you may be asked to obtain a hysteroscopy. Hysteroscopy is usually performed within one week of cessation of menstruation and may be performed by your doctor or our surgeon.
The male partner of the couple must provide evidence of sperm function with a semen analysis. We may also make available donor sperm from our pool of donors.
The male partneror donor, will have blood drawn for Infectious disease screening (HIVI, HIV II, VDRL/RPR, Hepatitis B Surface Antigen and Hepatitis C Antibody). The female partner will require blood to be drawn for Prolactin, TSH, Rubella, Varicella, ABO/Rh typing and Infectious disease screening. Genetic screening is also recommended. Routinely we require a cystic fibrosis test from the male partner and Factor V Leiden genetic test from the recipient. The result of the Factor V Leiden may take several weeks from some countries . However at our clinic, you can obtain the results in one week.
Egg Donor Selection
Egg donation in Greece is completely anonymous. The privacy of both the donor and the recipient is completely protected by law. Our clinic have available in our donor pool, wonderful, beautiful, proven young donors. We usually find a match for you within a month or less, unless you have a rare requirement.
Donor Screening
Our donors undergo extensive and rigorous screening before they are accepted into our egg donation program.
The donor will have bloodwork performed, including a blood draw for HIV I, HIV II, VDRL/RPR, Hepatitis B Surface Antigen, Hepatitis C Antibody, Prolactin, TSH, HTVL-1, ABO/Rh typing and CMV IgG and IgM antibodies, Chlamydia and Gonorrhea.
Genetic testing based on ethnic background is also performed.
Synchronization of the Donor and Recipient
After all parties have completed the required tests, the Donor and Recipient will usually be started on low dose oral contraceptive pills (OCP's) iin order to synchronize their cycles. After a minimum period of at least 14 – 21 days of the pill, a hormone called "Lupron" or "Synarel" will be prescribed for both parties. They work to down regulate the pituitary gland and, in essence, shut down the ovaries. Lupron is taken as a subcutaneous injection. Synarel is administered as a nasal spray. Once it is determined that both the Donor's and Recipient's pituitary glands are adequately suppressed, stimulation of the ovaries and endometrium may be initiated respectively.
Ovarian and Endometrial Stimulation
Both Donor and Recipient continue with Lupron injections or Synarel sprays. The recipient will begin estradiol injections in order to prepare her endometrium or uterine lining for the embryo implantation. The Donor will begin injections of fertility medications in order to stimulate the growth of numerous follicles on her ovaries. This process is known as controlled ovarian hyperstimulation. We treat our donors with the same loving care and attention as we treat our patients. Therefore, we never over stimulate our donors. We administer gentle doses in order to acquire good quality eggs.
Monitoring
While the Donor is administering the fertility medications, she is required to be monitored by routine estradiol levels and transvaginal pelvic ultrasounds. This follows the rate of follicular growth and rise in estradiol levels. When the physician determines the time is optimal for the egg retrieval, the Donor will receive a final injection called hCG, which will mature the eggs for retrieval. At the same time, the Recipient is monitored by periodic estradiol levels and ultrasound evaluations for endometrial thickness.
Egg Retrieval
The egg retrieval is a transvaginal ultrasound directed needle aspiration. This is a minor surgical procedure and is performed under general anesthesia. A vaginal probe (transducer) is placed in the vagina and a needle is inserted through a needle guide attached to the probe. The ultrasound image allows the physician to accurately guide the needle through the vagina directly into the follicles for aspiration under direct visualization. The process takes about 30 minutes. Following the retrieval, the donor recuperates for 1 – 2 hours and is then discharged to resume light daily activities.
Fertilization and Embryo Transfer
Fertilization, the union of the sperm and egg, is a very complex process that occurs in the laboratory hence the term "in-vitro" which translates to "in glass". The eggs retrieved are examined by the embryologist and then placed in a specialized culture medium in preparation for insemination with sperm. A masturbated sperm sample is enhanced by a highly specialized process prior to being placed with the eggs. Either 3 or 5 days following egg retrieval, selected embryo(s) are transferred to the Recipient's uterus. If there are embryos of sufficient quality remaining, they may be frozen for subsequent transfers.
The embryo transfer procedure requires no anesthesia. A catheter is inserted through the cervix into the uterus, and the embryos are gently and carefully placed into the uterine cavity. The Recipient is maintained in a recumbent position for approximately fifteen minutes and then discharged.
Post Embryo Transfer Management and Follow-up
The Recipient will need to take daily hormone injections in order to sustain an optimal environment for the embryo implantation. Approximately two weeks after the embryo transfer, two pregnancy tests are performed. If the Beta-hCG titer is rising, this indicates that implantation has taken place. Hormone injections will then be continued until 10 weeks of gestation at which time the placenta will supply all the hormones necessary to sustain the pregnancy. In the interim, ultrasound examination(s) will be performed to definitively diagnose pregnancy between 5 to 6 weeks after the embryo transfer. If the pregnancy test is negative, all hormonal treatments are discontinued and menstruation will usually ensue within two weeks.