Donor Egg IVF
Bay IVF - Advanced Reproductive Care                                Palo Alto  650-322-0500

 

Donor Egg In Vitro Fertilization

Donor Egg IVF is a highly successful treatment widely used for patients who no longer have high-quality eggs within their ovaries.

Probability of Success
Donor Egg IVF is the most effective fertility treatment available. The likelihood of a successful outcome depends primarily on the fertility potential of the egg donor, and you should expect over 50% probability of a successful outcome with a highly fertile egg donor.

Treatment Efficacy
We performed our first Donor Egg IVF treatment in 1988. Since that time, Donor Egg IVF has become a mainstream treatment for infertility. Over the years, we have streamlined and simplified the process of Donor Egg IVF to minimize interference with your lifestyle. A cycle of Donor Egg IVF treatment can take as little as two to three months and only requires 3 to 4 brief visits to the Clinic for the recipient mother.

Donor Egg IVF Offspring
Children conceived with the help of Donor Egg IVF are genetically linked to the male partner and the egg donor, but the female partner is the one who becomes pregnant, nourishes the baby throughout the pregnancy, and experiences the childbirth.

The baby would get one set of genes from the dad and another from an egg donor, but you, mom carrying the pregnancy, would make that baby your very own. There is a whole new science of epigenetics that describes how our environment modifies the gene expressions and possibly the genes themselves.

The epigenetic marks transmitted from the mother are a fine-tuned mechanism to control gene activation during the complex process of early embryogenesis. And this maternal influence continues throughout the pregnancy. You will imprint yourself onto the baby! By the time your son or daughter is born, that baby will be biologically yours.

Selecting an Egg Donor
Your egg donor can be someone blood related to you (female partner) to preserve the genetic link, or you could choose a donor from one of the many egg donor agencies. Most (but not all) donor agency Donor Egg IVF treatments are anonymous.

Obstetrical Care
Once your Donor Egg IVF treatment at Bay IVF is completed (approximately 6-8 weeks into your pregnancy), the pregnancy becomes indistinguishable from conception through intercourse, and your obstetrical care should be no different than if you conceived without any treatment.

Once you select your egg donor, she will become a patient at our Center and will be medically and genetically screened by us.

 

Donor Egg IVF Procedure

 

Donor Egg IVF Procedure

 

Donor Egg IVF is a two-stage treatment. The first phase consists of development and freezing (cryopreservation) of embryos.

  1. Ovarian Stimulation
  2. Egg Retrieval Procedure
  3. Fertilization of eggs
  4. Culture of embryos
  5. Cryopreservation (vitrification) of embryos
  6. Embryo storage

 

The second stage consists of thawing and a uterine transfer of embryos.

  1. Preparation of recipient’s uterus
  2. Thawing and culture of cryopreserved embryos
  3. Assisted embryo hatching
  4. Embryo transfer
  5. Implantation

 

Stage One: Development and Storage of Embryos

 

  1. Ovarian Stimulation

    There are several different forms of ovarian stimulation protocols, each with many modifications. Your egg donor's treatment is always individualized to maximize the probability of a successful outcome. The selection of an optimal protocol is based on your donor's reproductive history and her pre-treatment evaluation. Below are three examples of egg donation treatment protocols used at Bay IVF Clinic. Your donor's individualized protocol may take less or more time to complete.

Ovarian Stimulation Example #1

 

Ovarian Stimulation Example #1

 

Ovarian Stimulation Example #2

 

Ovarian Stimulation Example #2

 

Ovarian Stimulation Example #3

 

Ovarian Stimulation Example #3

 

Follicle stimulating hormone (FSH) or a combination of FSH/luteinizing hormone (LH) hormones will stimulate the production of multiple eggs in the donor's ovaries. They are given once a day or once every other day subcutaneously with tiny needles for approximately ten days.

During this time, your donor's progress is monitored by estradiol (estrogen, E2) and progesterone blood levels and ultrasound examinations.

Ovarian stimulation should result in the development of several eggs in each ovary. The ultrasound image below shows a stimulated ovary. Each of the several follicles (dark circles) contains a microscopic egg.

 

Ovarian Follicles

 

  1. Egg Retrieval Procedure

    The egg retrieval procedure is performed at our Center. The procedure only takes a few minutes, and we use very comfortable conscious sedation for analgesia.

    Since 1985, we have done many thousands of egg retrievals and are very experienced in retrieving eggs from the ovaries.

    Under ultrasound guidance, the tip of a thin needle is passed through the top of the vagina into the cul-de-sac (space behind the uterus). The ovaries are located near the bottom of the cul-de-sac allowing the tip of the aspirating needle to enter the ovarian follicles and aspirate the follicular fluid from them. The fluid is examined under a microscope to identify the eggs.

    The egg retrieval procedure is the last step in the donor’s participation. She will have her normal menstrual period within two weeks of the egg retrieval.

  2. Fertilization of Eggs

    On average, twelve to sixteen eggs are aspirated during the donor egg retrieval procedure. The eggs are identified under the microscope and placed in petri dishes filled with culture medium. The composition of the medium resembles the fluid secreted by the Fallopian tubes. This allows the eggs and embryos (fertilized eggs) to develop in our laboratory environment at the same rate as inside the Fallopian tubes.

    The male partner collects a semen specimen by masturbation on the day of egg retrieval. The highest quality sperm are extracted from the semen and combined with the eggs six hours after the egg retrieval. This process of in vitro fertilization takes place over several hours during the evening after the egg retrieval.

    If the male partner has never caused pregnancy, or if your test results indicate a possibility of significant male infertility, Intracytoplasmic Sperm Injection (ICSI) is performed. In ICSI, a single sperm is inserted into an egg. This can significantly increase the probability of normal fertilization for selected patients.

  3. Culture of Embryos

    Evidence of fertilization can be seen the next day, 16 hours after insemination. The fertilized eggs are transferred into a growth medium and continue to be cultured in our laboratory.

    A normally fertilized egg (zygote) will show two pronuclei representing the genetic material from the egg and sperm.

    The following day, embryos should divide into 4 cells, the day after into 8 cells.

    This picture shows a morphologically exquisite, day three, 8-cell embryo. At this stage, human embryos are still microscopic and invisible to the naked eye.

 

Eight Cell Embryo

 

By the fifth to seventh day after the insemination, embryos should reach the blastocyst stage (80 or more cells).

This picture shows an advanced stage of blastocyst development. Notice the central fluid-filled cavity. The cells within the blastocyst have already differentiated into the inner cell mass (at seven o’clock) that will give rise to the fetus and the trophectoderm cells that will form the future placenta.

 

Blastocyst

 

  1. Cryopreservation of Embryos

    Embryos that develop normally are cryopreserved (vitrified). Preparation for the freezing process involves removing water from within the embryos and replacing it with cryoprotective substance to prevent ice crystal formation during vitrification and subsequent thawing. The embryos are then flash cooled to −196 °C (−321 °F). Such rapid freezing (vitrification) prevents damaging water crystal formation.

  2. Embryo Storage

    Following the vitrification process, the embryos are transferred to a liquid nitrogen storage chamber in our Center. Theoretically, there is no limit on the length of storage, but conceiving past the age of 40 may result in a high-risk pregnancy.

 

Stage Two: Thawing and Uterine Transfer of Embryos

 

  1. Preparation of Recipient Mother's Endometrial Lining

    There are several different forms of endometrial lining stimulation protocols, each with many modifications. Your treatment is always individualized.

    Below are three examples of endometrial stimulation protocols used at Bay IVF Clinic. Your individualized protocol may take less or more time to complete.

Endometrial Stimulation Example #1

 

Endometrial Stimulation Example #1

 

Endometrial Stimulation Example #2

 

Endometrial Stimulation Example #2

 

Endometrial Stimulation Example #3

 

Endometrial Stimulation Example #3

 

The treatment begins by taking oral contraceptives. They are started within the first four days of the beginning of a menstrual cycle. A few days after the last pill, you will have a menstrual period, and the endometrial stimulation will begin at that time.

Oral and subcutaneous injection medications are used to prepare your endometrial lining for the transfer of the frozen-thawed embryos. The endometrial lining preparation is straightforward, and you should not expect any side-effects.

  1. Thawing and Culture of Cryopreserved Embryos

    You will need to decide and communicate to us how many vitrified/thawed embryos you would like to transfer. Please let us know if you need help with this decision.

    Most patients should select one or two embryos for the thaw and transfer to eliminate the risk of a high order multiple pregnancy (triplets or more). With this approach, most pregnancies from cryopreserved embryos are single baby pregnancies.

  2. Assisted Hatching

    Assisted hatching is a laboratory procedure used to create a "weak spot" in the eggshell of an embryo. Since embryo freezing commonly hardens the embryo eggshell, assisted embryo hatching is always a part of the Frozen Embryo Transfer treatment.

    This picture shows an embryo after assisted embryo hatching with an opening breaching the eggshell at 12 o’clock position.

 

Assisted Hatching

 

  1. Embryo Transfer

    Transfer of cryopreserved embryos into the uterus is identical to "fresh" embryo transfer: Just prior to the embryo transfer, the embryos are placed into the tip of a thin embryo transfer catheter. The catheter is then passed through the cervical canal to within 15 mm of the top of the uterine cavity, and the embryos are gently released.

    Having done thousands of embryo transfer procedures, Dr. Polansky will precisely place your embryo(s) within the endometrial cavity. The embryo transfer usually takes only a few seconds to complete, and no resting is required afterward.

  2. Implantation

    After the embryo transfer, the endometrial lining gently holds the embryos within the top of the uterus. There is no restriction on your physical activity.

 

Hatching Blastocyst

 

This picture shows a healthy blastocyst in the process of "squeezing out" of its eggshell. Once fully hatched, it will stay in the uterus unattached for one to two days and then implant.

A blood pregnancy test is done ten days after the embryo transfer. If the pregnancy test is positive, an ultrasound examination is scheduled two weeks later to visualize the implantation site and to look for a heartbeat within the embryo. Once a heartbeat is seen, there is a 95% probability that the pregnancy will continue to a baby.

There is no increased risk of birth defects in pregnancies from cryopreserved embryos compared with conceptions conceived through intercourse or using "fresh" embryos.

 

Pregnancy Ultrasound

 

This ultrasound picture shows a six-week pregnancy. The pregnancy sac is 25 mm in diameter. The baby inside the sac is only 13 mm long, and yet it is already possible to distinguish the head and the "tail" portion of the baby’s body and to see the cardiac activity.

 

 

Supplementation of estrogen and progesterone must continue until the placenta produces enough of its own estrogen and progesterone to sustain the pregnancy. You will be closely monitored for 6 to 8 weeks as this transition takes place. Once all medications are discontinued, you will be referred to your OB doctor for the remainder of your obstetrical care.

At this point, your pregnancy becomes indistinguishable from conception through intercourse, and your obstetrical care should be no different than if you conceived without any treatment.

 

Please use the following links for financial information about Donor Egg IVF and to schedule a consultation.

 

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with Dr. Polansky

 

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