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The Whole Person Fertility

Oocyte Donation

EGG DONATION (YOU CAN GET PREGNANT EVEN AFTER MENOPAUSE)

    Egg donation has the advantage that the couple can share a pregnancy, whose half of the genetic make-up comes from the father. Oocyte Donation or OD cannot protect the expectant mother from the complications of pregnancy and childbirth.  Women who have children by OD have exactly the same risk of an abnormality in their children as those who conceive naturally, based on the same age of the donor. Since the donor is on the average in her early 20s, this risk is low.  There is no decrease or increase in the risk of congenital abnormality due to the technique.   

      As with the natural process of bearing a child with one's own eggs, the loving bond between the mother and the child is formed, regardless of the genetic origin of the donated egg. This is not greatly different from the donor sperm situation, except that donor eggs are even more favorable for bonding, because the mother identifies with the baby (regardless of genetic origin) by carrying it. The emotional bonding with the child, including the child’s personality, intelligence, value system, and even athletic ability come from—genes or environment  Donor sperm is only occasionally used these days because of ICSI, and donor sperm requires much deeper psychological preparation than donor eggs. The fact that the child has been carried for nine months in the uterus results in solid bonding between mother and baby, regardless of the genetic origin of the egg.

     The medical world was initially shocked to hear about the first pregnancy using an embryo from a donor egg, which was achieved in a menopausal woman at Monash University in Melbourne, Australia, in 1983. Dr. Peter Lutjen, Dr. Alan Trounson and their colleagues were the innovators of this idea. These brilliant reproductive scientists from Australia established what then seemed to be the impossible system of hormonal replacement for the menopausal woman that allowed her uterus to behave just like that of a woman in her twenties, permitting implantation of an embryo despite the fact that she had no ovaries to make the hormones which are normally necessary to sustain a pregnancy in the first three months.

IT IS THE AGE OF THE DONOR AND NOT THE AGE OF THE RECIPIENT THAT MATTERS

     Much older women (late forties and fifties) have no difficulty getting pregnant (greater than a 50 percent pregnancy rate per cycle) so long as the donor eggs come from young women. The age of the uterus is not what is significant in the high pregnancy rate of these patients, but rather the fact that: 1) the eggs came from healthy younger women, and 2) the recipient’s only infertility problem was that she had run out of fertile eggs. With these two operative factors, pregnancy rate using IVF and donor eggs in menopausal women is over 50 percent, no different than what one would expect in younger women. The main determinant of pregnancy rate is the age of the woman from whom the eggs originate.

     In our Clinic, the maximum age to become a recipient for donor eggs is 50 years old.  We have women from all corners of the world traveling to Buenos Aires to take part in our "all person care" program, from the moment you arrive until long after you depart, our staff will be by your side to provide the best care and follow-up guidance.

     Still, many of these older women getting pregnant with egg donation have multiple and often large fibroids in the uterus. These fibroids completely distort the uterine shape, and in prior decades they were thought to be a cause of infertility. On the basis of the ease with which these women become pregnant with donor eggs and deliver healthy babies, it is now apparent that the vast majority of uterine fibroids, no matter how large, have no effect on a woman’s fertility, and should not be overzealously operated upon. In fact, the only fibroids that should be removed for fertility are those that are occasionally found upon hysterosalpingography to be inside the cavity of the uterus. We have had many older patients with large uterine fibroids become pregnant with donor eggs and deliver healthy babies.

     Many women in their late 30’s and early 40’s who have run out of fertile eggs initially resist adamantly the suggestion of using donor eggs. They may insist on going through one unsuccessful IVF cycle after another, unwilling to even consider donor eggs. Eventually, years later, most of these women request donor eggs. Despite years of negative feelings about the idea, all of them are overjoyed when they finally have a baby via donor eggs. 

RECRUITMENT OF AN EGG DONOR

      There are two forms of donation; one is to recruit known donors (such as a sister, other relative, or friend) and anonymous donors.  Anonymous oocyte donation has gained popularity by providing a larger pool of oocyte donors to meet the growing demand of infertile women.  In certain circumstances, women who are undergoing IVF themselves, who do not intend to use all of their oocytes may donate them.  CEGYR offers both alternatives: the couple can bring their own known donor or we can provide an unknown donor who matches the recipient’s physical features.  CEGYR only works on a basis of ANONYMOUS DONATION   Our voluntary and anonymous egg donation program includes healthy women of 21 to 33 years old, with proven fertility.    

     Many people are interested in finding out why women become donors.  Studies indicate the most common characteristic donors possess is a desire to help others.  Oocyte Donors are often blood donors and many report having friends and/or family members who have had a fertility problem.  

     The next approach is similar to that of running a sperm bank. The egg donor is paid a fee. The donor’s cycle is synchronized to that of the recipient just like with gestational surrogacy.

EGG DONOR SCREENING

     Our donors are screened according to American Society of Reproductive Medicine guidelines in order to maximize the success rates of oocyte donation and minimize the rates of fetal abnormalities.  All donors undergo a psychological evaluation.  If a donor is determined to be a good candidate, she is counseled regarding the details of the medical procedure that she will undergo, with a complete explanation of the risks and potential complications of taking fertility medications and undergoing the surgical procedure to harvest oocytes. 

     The donor meets our mental health professional who evaluates the psychological tests and performs a detailed assessment of the donor’s psychological well-being. Once it is determined that the donor can proceed, she is then counseled to determine whether she understands the medical information and is able to give an informed consent. Donors are extensively screened for medical diseases, hereditary diseases, psychiatric disease, substance abuse and other high-risk behaviors.

Family and Personal Clinical Records Include:

-Education

-Work Experience

-Medical History

-Reproductive History

-Family Medical History

-Sexual Practices

-Infection Risk

-Psychological History

-Social Habits (tobacco, alcohol, drugs)

-Physical characteristics

-Previous Egg Donor Experience

Psychological Assessment: personal evaluation and MMPI2 personality test when is considered by Psychologist

Infectious Diseases: HIV, Hepatitis B and C, Syphilis Serology. Gonorrhea, and Chlamydia

Genetic Evaluation: Karyotipe and Cystic Fibrosis ∆F508 gen mutation (to all our Caucasian donors), Sickle Cell (African, Hispanic), Thallasemias (Mediterranean, African, and Asian), and Tay-Sachs disease (Jewish)

Gynecological Evaluation:  Ovarian Reserve tests, Hormonal Profile, Pap smear, Transvaginal Ultrasound and Breast examination.

Clinical evaluation: Blood type, Cardiological assessment with ECK, and laboratory tests CBC, Coagulation tests, Glycemia, Liver function, Kidney function.  

HOW IS IT DONE?

      The technical aspect includes 1) synchronizing the cycles of the donor and the recipient, and 2) giving the proper hormone replacement to recipients so that their uterus is prepared for implantation of the embryo and also to maintain the pregnancy until such time as the placenta starts making its own hormones by eight to twelve weeks of pregnancy. 

     The only other difference in the protocol is that if the recipient is truly menopausal, she does not need to be placed on birth control pills, and she does not need to be placed on Lupron, because she is simply not making hormones at all. She would begin Estrace, however, on the same day that you see on the cycle chart in this chapter. It is all timed out with the same goal in mind, that the recipient first receives proper estrogen priming of her uterus, and then one day after the donor receives her HCG injection the recipient begins taking progesterone injections in addition to the estrogen. This assures that the IVF transfer will be performed at that time in the cycle where the window of receptivity for egg implantation is open. Between day four and day six of progesterone replacement is when the day 3 embryo must be placed into the uterus.

     Even after it is clear that you are pregnant you will have to stay on estrogen and progesterone supplements for up to twelve weeks longer, until the normal time in pregnancy when the placenta takes over the function of the ovary and produces all of its own self-sustaining estrogen and progesterone. This may require considerably less than twelve weeks, and the latest data indicate that by six weeks (contrary to our previous thinking) the placenta may be making enough estrogen and progesterone to sustain the pregnancy. The way to determine that is to get blood tests every week for estrogen and progesterone levels, and when the progesterone level begins to rise dramatically over what we know you’re getting from replacement, then we know the placenta has taken over and you no longer need to take hormone replacements.  

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Affordable Fertility's Goals:

Our concept is that every person, whether married, single and /or suffering through numerous failed attempts will be considered and every attempt will be made to help you fulfill your dreams.  We are a leading global fertility center in Buenos Aires, Argentina.  Direct flights from Atlanta, Houston, Miami, and many more US International airports are within 10 hours and airline prices begin at $750 round-trip.  Also, with the devaluation of the Peso in 2001, the US Dollar is pegged at 4-to-1 ratio. Thus, with our fees beginning at only $5,000 versus $18,000 and upwards in the USA and Europe, along with our close and personal patient care, our center is an optimal location for you to obtain your dreams.

  Contact us now and we can clarify any concerns or questions that you may have.

It is within your Reach -

You can Conceive!

It is yours for the Asking

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