More Information on Donor Egg
Before the donor egg cycle begins, a new donor egg patient (often referred to as "the recipient") meets with her physician to discuss the treatment and undergoes a preparatory cycle with hormones that mimic the normal menstrual cycle.
Patients who wish to match with an anonymous CRM donor complete a questionnaire about their preferences in a donor and are placed on the anonymous donor matching list.
Patients may also receive eggs from "known" (most commonly sister) donors and donors from an egg donation agency on a limited basis. Patients with known or agency donors must also complete a donor egg consultation and preparatory cycle.
Donor Egg Consultation
During the donor egg consultation, the physician explains CRM's donor/recipient matching process and the medical procedures required to have a child using donated eggs. Pretreatment testing of the donor egg patient is usually completed before the donor egg consultation; note that the male partner's semen analysis (if applicable) may be scheduled for the same day as the initial appointment.
The doctor and patient also review records of previous fertility treatments at other centers, if any, at this initial consultation, including:
- Blood test results
- Previous IVF cycle reports
- Surgical reports
- Semen analysis results
- Uterine evaluations
Recipients (and their partners, if applicable) meet for a psycho-educational session with a staff psychologist to discuss the egg donation process. CRM’s staff psychologists specialize in the emotional and psychosocial aspects of infertility, and are available for ongoing individual and couples therapy beyond the initial donor egg consultation.
Psychological services at CRM are an integral part of the infertility treatment team, and our psychologists, who understand the highly stressful nature of infertility treatment, make every effort to be available to patients at any point during the process. Contact the Donor Egg and Psychological Services Program Coordinator at (646) 962-3447 for more information, or to make an appointment.
Donor Egg Orientation Class
CRM offers a donor egg orientation class. Taught by a nurse, the class includes:
- Staff introduction
- Treatment timeline
- Explanation of recipient/donor matching process
- Medication protocols
- How to mix and administer medications
- Injection technique
- Post-treatment follow-up
- Support services
- Billing and insurance questions
After the class, patients have the opportunity to meet one-on-one with a nurse to review the specific medication protocol.
Undertaken prior to donor matching, the preparatory cycle ("prep cycle") is used by the physician to confirm an appropriate response of the uterine lining.
Patients may complete the prep cycle in their home cities or countries and do not necessarily have to come to CRM for this part of the treatment.
Matching with an Anonymous CRM Donor
CRM's egg donation program physician and staff recruit and screen oocyte donors for the Center's donor egg patients. Recipients and donors are mutually anonymous. CRM can also work with patients with known or oocyte agency donors.
The Center's donor screening process includes both medical and psychological screening. Over the last 25 years, we have successfully matched thousands of women with oocyte donors.
Patients who choose to match with a CRM donor are placed on the donor match list when they complete the preparatory cycle. Recipients submit a profile that includes their physical characteristics and a photograph, as well as traits they value in a potential donor.
When the donor egg team, which includes the program administrator, medical director, donor egg nurses and the patient's physician, has identified a potential donor/recipient match, the patient receives a detailed profile of her prospective donor, including:
- Physical and psychological evaluation
- Medical and social history
- Genetic testing report
CRM makes every effort to find a donor who closely matches the patient’s preferences. Every donor egg patient has complete autonomy in choosing their donor, and can ask for another donor after reviewing the donor profile. Further, a patient's place on the recipient/donor match list is unaffected by a request for another donor.
Frozen Egg Donation
CRM maintains a bank of frozen donated oocytes obtained from CRM-recruited donors. Patients open to using frozen oocytes may match more quickly with a donor.
Single vs. Shared Cycles
Patients using a CRM donor have the option of a single or shared egg donation cycle. A patient who elects a single cycle is matched to one donor, and all eggs retrieved from this donor are available to that patient. In a shared cycle, eggs from one donor are available to two patients.
While shared and single cycles have comparable pregnancy outcomes, each option has its pros and cons. Shared-cycle recipients may match with a donor more quickly since a donor is matched to two recipients. Shared cycles also generally cost less. On the other hand, a single-cycle recipient, in general, will have more eggs available for fertilization and an increased chance of viable embryos available in the future, should she choose to have another child via frozen embryo transfer. The physician, donor egg program administrator and patient coordinator discuss these options in detail with each donor egg patient.
After the recipient has approved the donor match, the recipient and donor begin the donor egg treatment cycle.
Donor Egg Cycle: Step by Step
The table below summarizes the treatments the recipient and donor undergo in a donor egg cycle using "fresh" (non-frozen) oocytes.
The donor egg treatment includes menstrual cycle synchronization, ovarian stimulation of the oocyte donor (unless frozen oocytes are being used), donor ovarian stimulation and egg retrieval, egg fertilization and embryo transfer.
During menstrual cycle synchronization, the recipient takes estrogen and progesterone (usually with Lupron to suppress ovulation). The goal is the creation of simultaneous cycles in both donor and recipient so that the recipient's uterus is ready to support a pregnancy with the embryo(s) resulting from the fertilization of the donor's eggs. Cycle synchronization usually requires around six to eight weeks.
Donor Ovarian Stimulation and Egg Retrieval
During the cycle synchronization period, the donor undergoes ovarian stimulation and egg retrieval. If the egg recipient has a male partner, he produces a fresh semen specimen on the day of the retrieval. Frozen donor or partner specimens from New York State-accredited sperm banks may also be used.
Fertilization and Embryo Development
The recipient is informed of the fertilization results on the day following the procedure and the embryos' development is monitored closely by CRM embryologists. Embryos that are not transferred and deemed viable at the end of the donor egg cycle can potentially be frozen for use in future IVF cycles.
Embryo Transfer: Day 3 or Day 5 After Retrieval
Based on the development of the incubating embryos, the embryo transfer is scheduled for either the third or fifth day after retrieval. Five-day-old embryos are called "blastocysts." The number of embryo(s) transferred is decided by the physician and patient prior to the procedure based on the patient's specific clinical history and the age of the donor.
Embryo transfer is an outpatient procedure performed at NewYork-Presbyterian Hospital. The physician uses a catheter inserted through the cervix to deposit the embryo(s) in the uterus. Patients are advised to rest briefly following the procedure, but in general experience very few side effects; mild uterine cramping can occasionally occur.
After Embryo Transfer
Pregnant patients continue under the care of their CRM physician during their first trimester, including an ultrasound at seven weeks of pregnancy, blood testing and hormone supplementation, before transitioning to the care of an obstetrician for the duration of the pregnancy.