Egg Donor Recipient

Barbados Fertility Clinic Egg Recipient

Thank you for your interest in our Egg Donor Recipient programme. We follow the guidelines set up by the Human Fertilisation and Embryology Authority (HFEA) of the UK, the guidelines within the Data Protection Act, and those of the Barbados Fertility Center.

Women who do not produce eggs or for those, in whom the quality of eggs is very poor, may be advised to seek treatment with donated eggs. Our standard policy is to offer anonymous donation to women up to the age of 49, we will not transfer embryos once you turn 50.

In vitro fertilisation (IVF) involves fertilisation in the laboratory of a woman’s eggs with her husband’s/partner’s sperm. The resulting embryos are placed in the womb 3-5 days later, and if they implant may develop into pregnancy. Unfortunately, some women are unable to provide eggs for IVF, the possible reasons being:

1. The ovaries have never developed properly e.g. Turner’s Syndrome.
2. Early menopause/premature ovarian failure.
3. Chemotherapy or previous surgical removal of the ovaries.
4. Where the woman is a carrier of a genetic disease, such as muscular dystrophy or hemophilia.
5. Poor quality of eggs due to age.

Women who fall into one of these categories can now have an opportunity to become pregnant by IVF using eggs obtained from another women.

Potential egg donors come forward voluntarily, purely because of a desire to help others. There is no incentive, either financial or otherwise. They must be fit and healthy and between the ages of 18 and 34 years, unless there are exceptional circumstances. The donors are screened for hereditary and transmissible infectious diseases and have consented to their eggs being donated.

All treatment is confidential. The couple who receive the eggs will not have access to the identity of the donor. It is, however, a statutory requirement that the names of donors and recipients are recorded and held by the Barbados Fertility Center. The names are not available to either party. The donor has no claims on, or obligations towards any resulting children.

Many women will have relatives or friends who would gladly donate eggs if this is the case we are happy to assist you.

After the initial consultation you will be required to have your screening tests done along with a womb assessment.

You will provide the Coordinator with a physical characteristics form which we will give you to complete so she can find a suitable donor for you.

You will be put on the egg donor recipient waiting list and contacted when a donor becomes available.

The clinic staff are well aware of the stress and strains of waiting and is available to answer any queries you may have. You are welcome to contact the Center at any time to check how you are progressing on the waiting list. We cannot anticipate the length of time it will take for a donor to become available, once you are Afro Caribbean ethnicity the wait time is 3-6 months. If you are of another ethnicity we would recommend you use an agency, which we can provide to you on request.

When a donor has been found we will send you the donor’s characteristics before allocating the donor to you, once you agree to this donor we will then proceed with your cycle.

The egg donor will attend for a consultation where a full medical and family history will be taken. Screening for infectious diseases will be carried out and counseling sessions arranged.

Egg Recipients Stages

Preparation

To prepare for your cycle we recommend you make certain adjustments to your lifestyle. You should avoid smoking, reduce alcohol consumption and increase your intake of folic acid. Also during this time a sample of the husband or partner’s semen is examined to make sure it is suitable for IVF.

When you have been matched with a donor, you will be given the treatment schedule and a prescription for the necessary medication. An appointment will be arranged with the Nurse Coordinator to discuss the treatment plan, to ensure a clear understanding.

The preparation for ovum donation treatment involves the synchronization of the ovarian cycles of both the donor and the recipient. This ensures that the embryos are placed in the recipient’s womb at the optimal time for their implantation. The preparation of the recipient’s womb is achieved by the use of subcutaneous injections which make the ovaries inactive. This is known as “down regulation”. Many women requiring donor eggs do not menstruate and therefore will not need to use this medication.

Once down regulation has been achieved, hormone tablets, Estrofem or Estradial Valerate are given daily for two weeks before eggs are to be obtained. This hormone prepares the lining of the recipient’s womb to receive the embryos.

An ultrasound scan will be carried out on Day 8 and 11 following commencement of these tablets. This will allow the Doctor to assess the womb lining to ensure that it is the appropriate thickness for embryo transfer.

If the womb lining is satisfactory, an additional hormone, PROGESTERONE in oil, Intramuscular injection is commenced once daily, when directed. This hormone ensures that the lining of the womb is in the best possible condition for implantation of the embryos.

Obtaining oocytes

On the day that eggs are due to be obtained from the donor the recipient’s husband/partner must be available that morning to leave a sperm sample at Barbados Fertility Center. He should have abstained from ejaculation for at least 2 days beforehand, but not for longer than 5 days.

It is possible that the donor may not respond to her treatment and therefore no eggs become available. This happens less than 5% of the time, but couples must be prepared for a last minute disappointment. If no eggs are available, the hormones are stopped and another donor is found as soon as possible.

Fertilisation

Fertilisation of the eggs is attempted by the manner which offers the highest chance of success. This will have been discussed and agreed earlier with your consultant. The process of fertilisation takes 12 to 18 hours and is recognized by characteristic changes which occur in the egg and can be seen under a microscope. The recipient couple will be contacted by the Barbados Fertility Center on the day after the donor egg collection to inform them of how many eggs have fertilised. If fertilisation has occurred you will be advised of arrangements for embryo transfer. If fertilisation does not take place, you will be given an appointment to see your consultant to review your treatment.

Embryo transfer

The fertilised eggs (embryos) develop in the laboratory for 3-5 days until ready for transfer into the womb. They are replaced through the neck of the womb using a small plastic catheter. This is a painless procedure rather like having a cervical smear test and takes 5-10 minutes to perform.

Only embryos that have been carefully checked and appear to be developing normally are replaced.

Although there is no evidence that resting for a prolonged period increases the chances of pregnancy, strenuous exercise is not advisable in the days following the embryo transfer. Smoking, alcohol and non-prescribed drugs should be avoided.

Hormonal supplements

Following embryo transfer the Estrofem tablets and Progesterone Injections should be continued daily as indicated in the treatment schedule you will also start Cyclogest Pessaries after the transfer. These hormones reflect the changes which normally occur in a woman’s body at this time.

While the hormone supplements are being given, a period will not occur, but this does not necessarily mean pregnancy has started to develop. Two weeks after the embryo transfer a urine pregnancy test is carried out. If this is positive, a scan is performed two weeks later to ensure that the pregnancy is inside the womb and that the fetal heartbeat can be seen. The hormone tablets and injections are continued until approximately 10 weeks of pregnancy.

If the pregnancy test is negative the hormones are stopped and a period starts approximately 2 to 3 days later. However if you have spare embryos in storage a frozen embryo transfer can usually be arranged within the next few months. A review appointment with your consultant will be arranged following unsuccessful treatment.