Process for Using Donated Eggs and a Gestational Carrier/Surrogate
- Egg Donation
- Gestational Surrogacy
Intended Parents Using Egg Donors
Intended parents should meet with the nurse egg donor program coordinator who will thoroughly explain the egg donation process and how we work with egg donor agencies to find a donor. She also will review how egg donors are screened.
Who are Ideal Egg Donor Candidates?
Ideal egg donors are women between the ages of 21 and 30 who have a body mass index under 25. During the medical screening process, we will rule out genetic, congenital or medical problems. Donors must be willing to take hormonal medication during their treatment cycle.
Known Versus Anonymous Donation
Most anonymous donations occur through agencies, though some agencies advocate an open donation arrangement. Intended parents also can find their own known donors, provided the donors meet medical and psychological requirements.
The Donor Psychological and Medical Workup
Once a donor is found, our donor coordinator organizes psychological testing and an initial consult and workup with one of our physicians. Psychological testing consists of the MMPI (Minnesota Multiphasic Personality Inventory) and a consultation with a mental health professional to discuss any emotional issues and to screen for problems.
The initial consultation will include a complete medical history, a physical exam, pelvic and breast exams and a pap smear, unless the donor’s primary care physician performed any of these evaluations recently.
The donor will have blood hormone tests to evaluate her estrogen (E2), follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), and prolactin levels. Additional blood tests include blood typing, a complete blood count (CBC) and screening for +Rh (Rhesus factor), cystic fibrosis, HIV, hepatitis, and syphilis. Donors also must take urine cultures to screen for gonorrhea and Chlamydia and a urine drug test. If applicable, donors will be tested for genetic conditions like Tay Sachs, sickle cell or thalassemia.
All the STD blood tests are repeated one month before the egg retrieval by an FDA-certified lab.
Learning About the Egg Donor Process
The egg donor meets with the CRMI egg donor nurse who will explain the egg donor process and what the donor is required to do with injections, medications, blood draws, ultrasounds and consent forms. The nurse will also explain hyperstimulation risks.
FDA Testing Requirements
If the recipient is the intended parent who is using donor eggs, then the egg donor needs to be tested for FDA-required bloods not more than 30 days before the embryo transfer. If the prospective parents are using a gestational carrier, either the egg donor or intended parent who is providing the eggs need to be tested not more than 30 days before the transfer. Also the person(s) providing the sperm need to be tested not more than seven days before the transfer.
Intended Parent Screening
The intended parents must meet with a psychotherapist and have a physician consultation. The mother must synchronize her cycle with the donor’s.
Who are Ideal Gestational Carrier Candidates?
Gestational carriers should be between 25 and 38 years of age and have had previous uneventful pregnancies and deliveries. They should have no medical issues like diabetes or high blood pressure and refrain from smoking, alcohol or recreational drugs. Also they should not have an infectious disease or be on any medications.
Carriers should have a normal uterus without fibroids or a congenital uterine abnormality. They also should not have a history of uterine surgery or recurrent miscarriages and live in a supportive environment.
Gestational Carrier Screening
The gestational carrier and her husband/partner must meet with a psychotherapist and have a physician consultation. The carrier will synchronize her cycle with the egg donor or intended mother. Both professionals will discuss the surrogacy process in detail.
Gestational Carrier Workup
The gestational carrier workup includes the following tests:
- Blood Type and Rh
- Prolactin and TSH hormone levels
- HIV 1 and 2
- Hepatitis: C, B Core Ab, B sAg
- Urine drug test (if applicable)
- Syphilis screening
- Urine cultures for gonorrhea and chlamydia
- Pap smear
- Evaluation of the uterus via a hysteroscopy, sonoHSG, endometrial biopsy
The carrier’s husband/partner will also need blood tests and a drug screen within six months.
Male intended Parent Workup
- Blood type and Rh
- Hepatitis: C, B Core Ab, BsAg
- HIV 1 and 2, syphilis
- Semen analysis
The male providing the sperm needs blood drawn to screen for FDA-required tests (above testing plus CMV, HTLV and urine culture for gonorrhea and chlamydia) not more than seven days before the transfer of embryos to the gestational carrier. FDA testing for sperm and eggs must take place in a FDA-certified laboratory.
We will stop the natural cycles of the egg donor/biological mother and the gestational carrier by using oral contraceptive pills and +/-Lupron/Antagonist. The cycles of the carrier and the biological mother/donor must be synchronized so the egg retrieval and embryo transfer are correctly coordinated.