In vitro fertilization (IVF) with donor egg and gestational surrogate

Egg Donor Categories
Egg donors are healthy women, ideally between the ages of 21 to 32. The following are categories of potential egg donors:

Known Donors: Sisters, other family members, or friends close to the recipient may donate eggs.

Anonymous Donors: If an appropriate known donor is unavailable, an anonymous egg donor may be used. Intended parents normally utilize Egg Donor Agencies to recruit an anonymous egg donor. These women donate eggs to intended parents whose identity may remain anonymous. Anonymous donors are remunerated for their time, effort, inconvenience, and time lost from work. They are not being paid for "selling" their eggs. RSC New England abides by guidelines established by the American Society for Reproductive Medicine to assure that the monetary compensation is not coercive or construed as "purchasing" eggs.

All donors complete a questionnaire about known familial genetic diseases which will be traced, as extensively as possible, for at least two generations. There is, of course, a risk that potential donors may fail to reveal an aspect of their genetic history. The potential egg donor (and her partner, if any) will be screened for sexually transmitted diseases such as HIV, hepatitis, syphilis, gonorrhea and Chlamydia, according to FDA regulations.

All egg donors undergo a process of controlled ovarian stimulation in which hormonal medications are used to stimulate the ovary to induce maturation of multiple eggs. The only technical difference between standard in vitro fertilization (IVF) and IVF with donor eggs is the involvement of two women. The medical procedures are nearly identical.

Preparation for Gestational Surrogates
The uterine lining (endometrium) must be synchronized with the stage of embryo development in order for pregnancy to be possible. When the use of fresh embryos is planned, both the surrogate's cycle and donor's cycle must be synchronized. The donor's cycle may be manipulated with birth control pills and/or Lupron, and then controlled ovarian hyperstimulation will begin, followed by transvaginal oocyte retrieval. The surrogate's menstrual cycle can also be synchronized with birth control pills, other hormones or Lupron, and then the surrogate is administered estrogen and progesterone to prepare the uterine lining for transfer of the embryos. In rare cases, the synchronization will not be possible and any embryos resulting from the union of the donor's oocyte and the sperm will be cryopreserved to be transferred in a subsequent cycle, using an estrogen/progesterone preparation cycle.

Choosing a Gestational Surrogate : If a relative or friend is not participating as a donor and/or gestational surrogate, male couples will need to engage an agency and/or attorney that screens and facilitates finding gestational surrogates. Consulting an attorney before making a decision is advised.

The assisted reproductive therapy used is in vitro fertilization (IVF). Eggs are retrieved from the donor, are fertilized in the laboratory using the father's sperm, and a healthy embryo is transferred to the surrogate's uterus. (Unused embryos can be frozen for later use to attempt additional pregnancies).

Choosing an Egg Donor and Gestational Surrogate
Agencies facilitate arrangements with gestational carriers and egg donors. Legal contracts need to be drafted between intended parents, and gestational carriers. Some agencies offer in-house legal counsel, or an independent attorney specializing in reproductive law and contracts can be selected.

Psycho-social Counseling
Meeting with one of the Reproductive Science Center's professional counselors is scheduled for all couples using egg donors and/or gestational surrogates. This is an opportunity to clarify and discuss the emotional aspects of pregnancy, birth and parenting associated with assisted reproductive therapies.