Egg, Sperm, and Embryo Donation: The Procedures
If you and your partner are considering egg, sperm, or embryo donation, you are probably very interested in finding out how donations are retrieved and what steps need to be taken in order to use them in fertility procedures. This article will provide you with the basic information that you need when choosing to undergo egg, sperm, or embryo donation.
Egg donation is now being used more and more frequently in fertility treatments. In fact, more than 11% of all fertility procedures in the United States involved donated eggs. In order to use donated eggs in your IVF treatments, the eggs must first be retrieved from the donor. The eggs are then prepared for fertilization and are implanted into your uterus.
Retrieving Donor Eggs
The egg retrieval process takes a lot of time, commitment, and painstaking work by both the egg donor and your reproductive endocrinologist.
The aim of the egg retrieval procedure is to remove a number of healthy and mature eggs from the donor's ovaries. In order for this to happen, the donor must first undergo hormone therapy. Hormone therapy helps to encourage the development and release of multiple follicles, which can later be transferred into the recipient. Special hormones designed to stimulate the ovaries are administered to the recipient beginning three weeks before egg retrieval is to take place. Egg development is then monitored using ultrasound images. When the donor's eggs have matured to an appropriate point, the egg donor is given an hCG injection. This injection helps to trigger ovulation.
36 hours after the hCG injection has been given, the donor's eggs are removed through a procedure known as transvaginal ultrasound aspiration. This involves inserting a syringe into the ovaries with the help of an ultrasound guide. This syringe is then used to aspirate the mature egg follicles. Once these eggs are removed, they are immediately prepared for freezing or for use in fertility procedures.
Using Donor Eggs
Once the donated eggs have been retrieved, they can be prepared for use in fertility treatments. Eggs are taken to a laboratory and placed inside of a petrie dish. Next, donated sperm or sperm provided by your partner is washed and placed inside of the dish. The eggs are then monitored for fertilization. Once fertilization has taken place, the embryos are cultured for three days, until they can be implanted.
Embryos created from the donor egg are transferred once your endometrial lining has been built up. You will receive estradiol therapy while the donor is undergoing hormone therapy. This will help thicken your uterine lining, so that implantation can take place. You will also receive progesterone. After fertilization takes place, your uterine lining should be ready for implantation through IVF.
Sperm donation is also becoming increasingly popular, especially with recent increases in male infertility rates. Donated sperm can be collected from known or unknown donors for use in IVF and IUI treatments.
Retrieving Donated Sperm
Donated sperm is usually collected from known or unknown sperm donors. It is up to you and your partner which type of sperm donor you would like to use. The majority of sperm donors are anonymous and have had donated their sperm, through masturbation, to a sperm bank. Known donors also donate their sperm through masturbation. This sperm is typically handed over to your fertility clinic right after it is produced.
Preparing the Donated Sperm
Before donated sperm can be used in your IUI treatments, it first must be rigorously tested and examined. All sperm donations are tested for infectious diseases, including STDs, before they can be used in IUI or IVF treatments. Sperm screenings can be performed by your fertility clinic or they will be performed by the sperm bank. Donated sperm is also washed, in order to ensure that only the most motile sperm are used during the fertility procedure.
Freezing the Donated Sperm
The majority of donated sperm, particularly anonymous sperm donations, are frozen and quarantined for a period of six months prior to use. This helps to limit any possible chances of infecting you or your child. Sperm is frozen in plastic or glass tubes that look much like straws. Known as cryopreservation, frozen sperm can generally stay fertile for a period of at least two years. Sperm are mixed with a special protective solution prior to freezing to keep them from developing frost bite.
Using the Donated Sperm
After the donated sperm has been quarantined for the appropriate amount of time, you can begin to get ready for the IUI treatments. There are different types of artificial insemination treatments, including intrauterine, intravaginal, intracervical, and intratubal insemination. Whichever treatment you and your partner choose to pursue, the treatment will need to be timed according to your menstrual cycle. IUI typically takes place within six hours of ovulation. Your reproductive endocrinologist will monitor you for ovulation by performing ultrasound scans and LH tests.
As you near ovulation, the donated sperm will be thawed so that it can be used in the IUI procedure. Sperm is thawed slowly, and at room temperature. Once you are within six hours of ovulation, the donated sperm will be transferred into syringes, so that it can be transplanted easily into your uterus.
Many couples choose to pursue embryo donation in order to increase their chances of having a child. Embryos are often donated by anonymous couples who have extra embryos remaining from previous IVF treatment cycles. Donated embryos can also be created by using donated eggs and sperm. Most donated embryos are used in a process called frozen embryo transfer.
Retrieving Donated Embryos
Donated embryos are generally retrieved from frozen storage. Donated embryos must be frozen and quarantined before they can be implanted into your uterus. This is to ensure that the embryos are not diseased and will not infect you or cause problems with your baby. Embryos are placed inside of small glass vials and then frozen in liquid nitrogen. This process is very similar to the sperm freezing process. When they are ready to be transfered, embryos are thawed slowly and brought to room temperature. The embryos are washed in various solutions to help remove the cryoprotectant used to preserve the embryos during the freezing process.
Getting Ready for Frozen Embryo Transfer
Before your embryos can be transferred into your uterus, your body must be ready to accept the embryos. This means that you will have to take a number of different fertility drugs in order to prepare your body for possible pregnancy. This process typically takes about two months.
You will begin by taking a birth control pill to help regulate your cycle. You will also take a GnRH agonist (typically leuprolide) to help suppress your pituitary gland and encourage the buildup of you endometrial lining. After about a month, you will stop the birth control pill and have a normal period. You will also begin to drop the dosage of your GnRH agonist.
About a month before the transfer, you will receive injections of estradiol to encourage the growth of your uterine lining. As your uterine lining gets thicker, you will receive progesterone injections in order to support your luteal phase and potential pregnancy. It is likely that your uterine lining will be analyzed for thickness through ultrasound.
Preparing the Thawed Embryos
When your uterine lining is almost ready to receive the embryos, the frozen embryos will be retrieved from storage and thawed. Embryos are brought up to room temperature and then to body temperature (approximately 39 degrees Celsius). They are then analyzed for proper formation and health. Because not all embryos will survive the freezing process, your reproductive endocrinologist will analyze all of the embryos carefully. Depending upon the health of the embryos, your reproductive endocrinologist will decide how many embryos should be implanted into your uterus. Typically, a maximum of four embryos are implanted during each procedure.
Using the Thawed Embryos
In order to transfer the embryos into your uterus, the embryos are carefully inserted into a syringe. This syringe is then used to place the embryos into a catheter, which has been inserted into your uterus, depositing the embryos in your womb.