Our donor egg recipient program matches you with an anonymous egg donor to help you become pregnant.
If you elect to participate in the anonymous oocyte recipient program, your participation will be held in confidence.
Health care providers who assist in your care may know that you are an oocyte recipient but they have been instructed to keep this information confidential. At the completion of your cycle, your donor will not be informed of the outcome of the cycle.
It is up to you and your partner to decide with whom to share this information should you conceive. We recommend that you consider who you will inform and the potential consequences of this decision prior to beginning a cycle of receiving anonymous oocytes.
The oocyte donor’s identity is also protected and you will not be given any information about her. We will discuss our screening and matching procedures with you and make an attempt to incorporate any special requests that you may have in the selection of your donor. If you should use a known donor, she must meet the same screening criteria as our anonymous donors.
Charges for the cycle with either anonymous or known donors is the same with the possible exception of donor compensation. It is your decision to choose whether or not you want to compensate a known donor.
Cost of Procedure
See cost estimates for an estimate of charges that are incurred during an average cycle.
Additional charges for medications, laboratory screening, or other services may be incurred. These charges are also subject to change without prior notice.
A deposit is required prior to beginning a cycle and no medications will be started until the deposit is received. This policy is designed to help us minimize the cost of oocyte donation for our patients.
Questions regarding financial matters should be addressed to our financial representative at 919-572-HOPE (4673).
Genetic History
You and your partner will need to complete a genetic history form. This information will need to be returned to us before we can begin the matching process. In this form you will provide physical characteristics (height, weight, hair and eye color, and blood type) and genetic or medical history of both partners.
Donors are matched with these characteristics as closely as possible. We also require that both partners have screening lab work obtained prior to beginning a cycle. The lab work required is:
- Female Partner Lab Work: HIV, Hepatitis B antigen, Hepatitis C core antibody, VDRL (STS), Rubella, and Blood Type
- Male Partner Lab Work: HIV, Hepatitis B antigen, Hepatitis C core antibody, VDRL and Blood Type
This lab work may be performed at Duke or by your local physician. The results must be current within one year and must be received by us prior to beginning a cycle.
We also recommend that the male partner perform a specialized semen evaluation called a semen profile. This will generally be scheduled for the same day as your initial recipient evaluation with Dr. Walmer.
This is an expensive test but provides us with important information regarding the ability of the sperm to fertilize oocytes and assists us in deciding whether or not to recommend intracytoplasmic sperm injection to assist with the fertilization of the oocytes.
Trial Cycle
Before the actual oocyte recipient cycle, you may be required to do a trial cycle to make sure that you respond optimally to the hormone replacement therapy.
Oral, transdermal, sublingual, subcutaneous, or intramuscular medications are administered in a programmed regimen to allow us to mimic an optimal menstrual cycle that can be synchronized with your donor.
This programmed cycle will be evaluated by serum (blood) hormone testing and possibly an endometrial biopsy to evaluate the lining of the uterus. Your doctor will discuss this with you if you are required to do a trial cycle.
Getting Prepared
A cycle begins when we have matched you with an oocyte donor. This process may take anywhere from three to 12 months.
We will notify you by phone that we have found a match and schedule a date to begin medications.
If you have any ovarian function we will need to suppress this by having you start a medication called Lupron. Lupron is a daily subcutaneous injection given in the morning that will generally be started four to seven days before your next expected menses.
Before beginning Lupron you will need to have a blood pregnancy test and an ultrasound to evaluate your uterus and ovaries. This may be performed at your local physician’s office if you live far away from Duke.
At this time we will also be starting the donor on Lupron to suppress her ovaries. We will ask both of you to call us when you start your menses after beginning Lupron. If you do not start a menses after 14 days, please call our office to schedule a serum estrogen level.
Once you have both had menses, we can begin to coordinate your cycles. You will start estrace pills 2 mg twice a day (every 12 hours) and the donor will begin the stimulation of her ovaries with gonadotropins.
When the follicles on her ovaries have reached a mature size (generally 10 to 15 days) we will notify you by phone that we are ready for the next step. At the time of this call we will give you instructions to begin your intramuscular progesterone injections (25 mg or 0.5 ml every 12 hours). On this day you will stop the Lupron injections.
We will also schedule sperm collection for the day of egg retrieval. This will generally be two days after the phone call described above and will be in the morning. You may choose to collect at home if you live within 30 minutes of the clinic. Please arrange to pick up a container from us ahead of time.
We have a private room outside the clinic area with visual aids for those wishing to collect at the clinic. Very rarely we will need to collect a second specimen so please leave a number for us to contact you should this be necessary.
Embryo Transfer
The day after egg retrieval and sperm collection, we will call you with the results of the retrieval (how many eggs retrieved) and the results of fertilization (how many embryos resulted).
At this time we will decide when to transfer embryos into your uterus. Embryo transfer will occur two or three days after retrieval.
On the day of embryo transfer, we will discuss with you the number of embryos that will be transferred. We usually advise couples not to transfer more than three embryos.
The transfer is performed in a room near our laboratory area and requires no special preparation. The discomfort is similar to a Pap smear.
Following the transfer you may rest for one hour in our recovery area and may choose to extend this rest period at home.
Pregnancy Test
Two weeks after the embryo transfer we will perform a serum (blood) pregnancy test.
The progesterone injections usually prevent a period even if you are not pregnant. If the pregnancy test is negative you will discontinue all medications and will probably begin a period within the next week.
If the pregnancy test is positive we will recheck the estrogen and progesterone levels. You will continue the supplemental estrace and progesterone for another six weeks (until 10 weeks gestation when the placenta will be supporting the pregnancy).
Cancellation
There are several reasons why a cycle of anonymous oocyte donation may be cancelled.
The most common reasons are poor stimulation of the donor’s ovaries, excessive stimulation of the donors ovaries, the presence of ovarian cysts prior to beginning a cycle, or a change of heart for either the donor or recipient (this is a rare occurrence).
There is no guarantee as to the number of oocytes that will be retrieved, the number that may fertilize, the quality of the recovered oocytes, or that a pregnancy will result. There is also no guarantee that a positive pregnancy test will lead to a live birth.
Success Rates
Our "take home baby" rates utilizing donor oocytes are about 50 percent per cycle start. At your initial visit with Dr. Walmer we will quote you the most recent program statistics.
Individual statistics will be discussed with each couple prior to beginning an IVF cycle. Institutional statistics are not directly applied to individuals. An institution gathers their information over a period of time from all of their patients and compiles this information. The statistics gathered in such a manner are for populations of people and not individuals specifically.
When choosing a program that is right for you be sure to consider the entire program and not just numbers. Other important factors include the personnel, location, experience, and services provided.
Both the Centers for Disease Control and the Society for Assisted Reproductive Technology issue statements advising patients and physicians not to use statistics as a means of comparing programs. There are several reasons why this is true. SART data, for example, do not take in to account factors such as practice patterns, numbers of embryos transferred, number of attempts per individual, and cancellation criteria.
See additional statistics information.
