Recipient Information
Introduction
About The Donors
Finding A Donor
Initial Consultation
Stages Involved in IVF Using Donated Eggs
Counselling
Thank you for inquiring about our egg donor programmes with regard to being a recipient. 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 donation to women up to the age of 45.
We at Sims started providing satellite facilities in 1999 for couples who where attending egg donation and in 2002 started our own Egg Donation Programme utilizing Irish donors. However, the supply of donors was far smaller than the supply of recipients resulting in long waiting lists. In order to address this, in 2005 we launched the European Donor Egg Programme to provide a comprehensive service to meet the need of many couples who have been affected by this shortfall in service over the years.
The success rates of the European Donor Egg Programme in 2006 were 67% live Birth Rate per completed cycle (50% Live Birth Rate per transfer). Given that just over half of our patients have embryos frozen there are also additional chances in achieving a pregnancy.
We provide a full range of options for couples seeking egg donation with a range of anonymous donors available. It should be noted that when you choose a selected donor, that donor donates exclusive to you which is not the case in other programmes. Essentially, we offer one-to-one donation.
We adhere to the guidelines of the Human Fertilisation and Embryology Authority (HFEA) of the UK, as well as provisions of the Data Protection Act (1988), those of the (Irish) Medical Council and of the Sims Clinic. We have obtained detailed scientific, legal, medical and lay advice in order to best protect the interests of all concerned. These stringent safeguards include medical and infectious screening as well as mandatory psychological counselling.
For full details of the European Donor Egg Programme. please refer to our new Web site www.eggdonation.ie.
Introduction
In vitro fertilisation (IVF) involves fertilisation in the laboratory of a woman’s eggs with her husband/partner’s sperm. The resulting embryos are placed in the womb 2-3 days later, and if they implant may develop into pregnancy. Unfortunately, some women are unable to provide eggs for IVF, the possible reasons being:
- The ovaries have never developed properly e.g. Turner’s Syndrome
- Early menopause
- Chemotherapy or previous surgical removal of the ovaries.
- Where the woman is a carrier of a genetic disease, such as muscular dystrophy or hemophilia
Women who fall into one of these categories can now have an opportunity to become pregnant by IVF using eggs obtained from another woman.
Situations, which do not concur with our policy, may be brought before our ethics committee for consideration.
All donors and recipients are required to attend for an initial consultation and make an appointment to see an independent counsellor.
About The Donors
Potential egg donors come forward voluntarily because of a desire to help others. They must be fit and healthy and between the ages of 18 and 35 years (unless there are exceptional circumstances such as known donation). The donors are asked about hereditary and transmissible infectious diseases and have consented to their eggs being donated.
All treatment is confidential. The couple who receive the eggs from an anonymous donor 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 Sims Clinic. The donor has no claims on, or obligations towards, any resulting children.
Many women will have relatives or friends who gladly donate eggs. In addition, if a friend or relative wishes to help by donating eggs anonymously we can provide treatment for you with an alternative (reciprocal) donor.
Finding A Donor
In Ireland, the first step for many couples is to go on our egg recipient waiting list and wait to be contacted when a donor becomes available. Unfortunately we cannot anticipate the length of time it will take for a donor to become available and this usually takes several years. You are welcome to contact the clinic at any time to check how you are progressing on the waiting list.
Many women will have relatives or friends who would gladly donate eggs. If you have a friend or relative who wishes to help by donating eggs, then they can donate either as a known or anonymous donor. In the latter case, this is called reciprocal donation whereby they donate not to you, but on your behalf. In this situation we will supply a donor to you and your reciprocal donor donates to one of our other recipients. In either of the above situations, there is no waiting list and the only time it takes is that involved in scheduling the cycle, usually 2-3 months.
Another alternative is to advertise in the media. If you do so, and your message is seen or heard by Irish women, you probably will get a donor (in our experience). One of the things we can do is give you proforma ads which you can place in local or national papers. These do not have your name on them but we give you a reference number which is on the ad. The donor then phones us and she donates (anonymously) to you if she is suitable and you wish to proceed.
Of course when a donor has been found we will discuss the donor’s characteristics with you before allocating the donor to you.
Who generally donates their eggs and why?
Any action taken to raise awareness will motivate other Irish women to want to help infertile couples. Most are young married women with small children of their own. They know the joy that being a parent brings and wish to help another couple make the family that is their dream. Indeed they often will have a close friend or family member who has had infertility in the past. Thus they have often been made aware of the huge needs of infertile couples and wish to help.
Another option is the European Donor Egg Programme. Please refer to the egg donation web site or contact us directly for further information on this.
Initial Consultation
Physical characteristics and blood groups of both partners are recorded and discussed.
Relevant investigations which may be performed include:
• A screening blood test for rubella immunity, hormone levels, HIV, VDRL and Hepatitis B + C.
• An ultrasound scan
• A semen analysis/ semen freeze
You will be put in contact with our Egg Donor Coordinator who will go though the full process of the donor programme including time frames and investigations that will need to be carried out.
Donor selection is carried out once all investigations have been completed and results reviewed. Selection is from a pool of donors that are currently available.
The clinic staff are well aware of the stress and strains of waiting and are available to answer any queries you may have. You are welcome to contact the clinic at any time to check how you are progressing.
Outline Of The Stages Involved In IVF Using Donated Eggs
- Preparation
- Obtaining eggs
- Fertilisation
- Embryo transfer
- Hormonal supplements
1. Preparation
During the waiting time it may be appropriate to 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.
All patients will be contacted when a donor becomes available; 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. This is achieved by the use of a nasal spray which makes the ovaries inactive. This is known as “down regulation”. Many women requiring donor eggs do not menstruate and therefore may not need to use the spray.
Once down regulation has been achieved, hormone tablets (Estrofem) are given daily which prepares the lining of the recipient’s womb to receive the embryos.
Ultrasound scans will be carried out following commencement of these tablets to 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 (Cyclogest Vaginal Pessary) is commenced twice daily as directed. This ensures that the lining of the womb is in the best possible condition for implantation of the embryos.
2. Obtaining Eggs
On the day that eggs are due to be obtained from the donor the recipient’s husband/partner sperm is normally used.
It is possible that the donor may not respond to her treatment and therefore no eggs become available. This will happen approximately 10% of the time, so 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, although this may take some time.
3. Fertilisation
Fertilisation of the eggs may be carried out by micromanipulation i.e. ICSI in order to maximise the chances of success. The process of fertilisation is recognized by characteristic changes which occur in the egg and can be seen under a microscope. The recipient couple will be informed after fertilisation 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.
4. Embryo transfer
The fertilised eggs (embryos) develop in the laboratory for 5-6 days until ready for transfer into the womb. They are replaced through the neck of the womb using a small plastic tube. This is a painless procedure rather like having a cervical smear test and take 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 and sexual intercourse are not advisable in the days following the embryo transfer. Smoking, alcohol and non-prescribed drugs should be avoided.
5. Hormonal supplements
Following embryo transfer the Estrofem tablets and Cyclogest pessaries should be continued daily as indicated in the treatment schedule. 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 three weeks later to ensure that the pregnancy is inside the womb and that the fetal heartbeat can be seen. The hormone tablets and pessaries are continued until 12 weeks of pregnancy.
If the pregnancy test is negative the hormones are stopped and a period starts in 2 to 3 days later. Another attempt at treatment is possible but other couples who have not yet had treatment will be given priority, so a further wait can be expected. 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.
Counselling
What is counselling?
Counselling is a confidential and sensitive relationship in which the counsellor attached to the Centre meets with individuals and couples to discuss the personal, psychological or social effects of their fertility treatment. This counsellor is completely impartial.
What is counselling in the context of treatment?
Fertility treatment can cause a great deal of stress and anxiety to both partners and can affect domestic, social and working life. Therefore it is usually best for couples to attend together at all visits. Sometimes very difficult decisions have to be made and difficult questions have to be resolved, such as:
- Should we discuss it with our family?
- How do we really feel about assisted conception?
- Could we cope with the stress of treatment?
- How will we cope if it fails?
- How can we come to terms with stopping treatment?
- How do we feel about using a donor egg or donor sperm?
- Will it feel like our child?
- Would we tell the child?
- How do we tell our child if we wanted to?
These are some of the questions asked by the couples approaching and going through treatment.
People often feel a range of confusing or unusual emotions, for example: depression, anxiety, anger or hostility, guilt, feeling of grief and loss, problems with sleeping or eating and difficulties in coping in social and work situations which would usually be a problem.
The role of the counsellor in this context is to offer emotional and psychological support at a time when it is needed.
To comply with our Guidelines it is mandatory to have a counsellor appointment before proceeding with our egg donation program.