How egg donation works – Part 2 – Synchronization in Donor Egg Cycles

In order for egg donation to work, the egg donor and recipient must be synchronized so that the eggs are being developed in the egg donor at the same time as the uterus is being prepared in the recipient.

There are a number of ways this can be done. The most common involves placing both the egg donor and the recipient on a medication called Lupron. Lupron suppresses the pituitary gland and prevents stimulation of the ovaries. In effect, this turns the ovaries “off” temporarily. This puts the egg donor and the recipient at the same starting point in preparation for further medication.

Stimulation of the egg donor with fertility medications and preparation of the recipient uterus

Stimulation of the egg donor’s ovaries occurs in the same way as in women who are going through IVF – in vitro fertilization with their own eggs. In short, they take fertility medications over a period of around 9 to 10 days while being monitored with blood tests and ultrasounds.

The recipient’s uterus is prepared in much the same way as would be done for use of frozen embryos. There are only two hormones that are necessary to prepare the uterus: estrogen and progesterone.

Estrogen can be given in various ways. I like to use oral estrogen tablets but others may use estrogen patches, estrogen vaginal rings or even estrogen injections. The published medical data does NOT suggest that one method works better than another.

Progesterone can also be given in a number of different ways for egg donation. There has been much debate in the medical literature over what is considered to be the best way to give progesterone. Most programs will use either vaginal progesterone such as suppositories or ointments, or use progesterone intramuscular injections. The medical data is divided on this issue. Some studies suggest that injections yield the highest pregnancy rates. Others state that vaginal progesterone gives the highest pregnancy rates. Still other studies indicate that it probably does not make a difference which one is used.

For the last few years, our protocol has been to use both vaginal and intramuscular progesterone.

The recipient is monitored primarily by transvaginal ultrasound to determine the thickness of the uterine lining. Estrogen levels obtained by blood test are also used.

Retrieval of the Donor’s Eggs

Egg retrieval for the egg donor is done exactly the same way as it is done for women doing IVF – in vitro fertilization with their own eggs. Once the donor has undergone an egg retrieval her part in the treatment cycle is completed.

On the day of the egg retrieval the recipient’s partner collects the semen specimen.

Prior to the egg retrieval, the recipient is started on progesterone to finalize the preparation of her uterus for the eventual embryo transfer.

Fertilization and culture of the donor’s eggs

Fertilization and culture of the donor eggs is done in the same way as in standard IVF – in vitro fertilization.

Transfer of the Embryos into the Recipient’s Uterus

Transfer of the embryos derived from the donor eggs is done in the same way as in standard IVF – in vitro fertilization.

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