What to Expect when Donating Eggs?
Initially, Appointments will be made with both the recipient and the donor to address any issues individually. The donor will be asked to provide the clinic with some basic information on medical and family history, health and appointments will be made with the counsellor if everything is suitable to proceed.
Many clinics will try to schedule all initial appointments on the same day where possible. Throughout the cycle blood tests and scans will need to be done by both the donor and recipient to monitor the progress of blood levels, follicle development and endometrium lining. Often clinics will open very early so it may be possible to complete these before the average work day begins.
Generally before cycling both the donor and recipient will be in sync (coming off the pill at a similar time), the donor will be set in time with the recipient after a natural period and a holding pattern set in place for the recipient so that they are synchronised at the same time. Once you are given the go ahead, the idea is to carefully synchronise the donor cycle and the recipient’s cycle so that when the eggs are ready for pick-up, the recipients body is ready to accept them. These protocols vary greatly depending on Doctor and clinic procedures.
For the down regulation part of the cycle, most donors have to sniff a nasal spray (Synarel) twice a day. This drug tells your brain to shut down activity in your ovary and prevents your body from ovulating. After about a week on Synarel, a blood test is taken to ensure that your body is not ovulating. Then you begin the stimulation phase, using a drug called Puergeon or Gonal F, where your ovaries are over stimulated to produce more than one egg. This drug is injected into your tummy and you are taught how to do this at the clinic…once you know how to do it, it becomes very easy to do and hardly even stings.
The actual cycle can take from two to around four weeks depending on what type of cycle (long or antagonist). Different people can respond differently to drugs so the cycle is adjusted accordingly.
The clinic will create a plan for both the donor and the recipient which is a schedule of time lines- drugs and dosages to follow during the cycle. Most donors will go through a cycle called ‘down regulation’ cycle, where your ovaries are suppressed from producing eggs before being over stimulated. The donor often starts with the pill then goes through a phase of ‘down-regulation’ which lasts around two weeks/ This is when the donors is prevented from ovulating, followed by a period of ‘stimulation’ (around 10 to 12 days) where the ovaries are over-stimulated to produce more the usual one egg.
After about 5-6 days of stimulation with FSH (follicle stimulation hormone) an ultrasound will be performed to assess the donors follicle development (how many follicles and their sizes) and will give an indication of a potential pick up date. If the follicles are too small and need more stimulation, treatment (FSH unit dosage) can be adjusted as can the estimated EPU date. Around day 8-10 of stimulation another ultrasound date will be set and everything monitored before trigger date is set. Sometimes the follicles are ready to go, and EPU is moved forward. Some cycles may also be cancelled at this stage if there is no follicle development. After the “trigger” injection- EPU under a general or local anesthetic occurs about 36 hours later.
This trigger injection of HCG (Human Chorionic Gonadotrophin)is a drug that mimics preparation of the uterus lining for embryo implantation, thus tells the brain to release any eggs formed. It is given either in the tummy (subcutaneously) or in the thigh (intramuscular).
As admission at a day surgery facility is scheduled for Egg Pick Up- it is required that the donor fast from both food and drink after midnight the night before. The donor will be checked by the nurse and will be scheduled to talk to an anesthesiologist before the procedure. You will be given a light anesthetic and be asleep for about an hour while the doctor picks up your eggs. This is done using a needle and needle guide through a vaginal transducer. (basically a tube inserted to collect the eggs from the follicles). The fluid in the follicles is drained, and the eggs are then taken for fertilisation.
When you wake up from the procedure, you may feel quite drowsy at first. This will usually wear off fairly quickly. It is recommended that the donor organises someone to take her home after the procedure. This may be the recipient, a friend or partner. It is illegal to drive after a general anesthetic for 24 hours. It is advised that the donor rest after pick up and drink plenty of water. It is also advised that the donor up her intake of protein or supplement (Sustagen) and taking something to help with constipation is a good idea (pear juice, prune juice or Metamucil) You may have some spotting and your ovaries may be quite tender. Clinics advise the donor take some Panadol or Panadol Forte for pain relief and suggest a heat pack for the abdomen.
Information sourced with approval from Egg Donation Australia website.