Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
The Process for Egg Donors
At Fletcher Allen, anonymous egg donors provide eggs to infertile women who cannot use their own eggs to conceive. You must complete our screening requirements to be accepted into the program as an egg donor.
The screening process includes:
- Completion of a detailed questionnaire, which explores your medical, familial, psychological, social, and sexual history.
- Appointment with the nurse coordinator to discuss details of the process of becoming an egg donor.
- Psychological screening, testing, consultation and an interview with a qualified mental health professional.
A physical exam, which includes a pap smear, pelvic exam, and cervical cultures for chlamydia and gonorrhea.
Screening blood work includes:
- Screening for the presence of sexually transmitted diseases.
- Screening for inheritable diseases according to your history and ethnic background.
- Screening to test your ovarian function and reserve.
The results of the above screening tests will be reviewed by the In Vitro Fertilization (IVF) team members involved in the donor egg program. You will be informed of the results of your blood tests. A positive value for any infectious disease other than cytomegalovirus (CMV) is a cause for being excluded as a donor. Positive carrier status for a genetic condition will be considered on an individual basis.
Hormonal Preparation and Cycle Monitoring
Oral contraceptives given
In order to adequately synchronize your cycle and the recipient's cycles, you will be initially placed on oral contraceptives for a short period.
Stopping menstrual cycle
After you have taken oral contraceptives for at least two weeks, you will receive Lupron (Leuprolide Acetate), a medication that stops the ovaries from functioning and halts the normal menstrual cycle. It is an injection just under the skin.
Baseline tests done
After you have taken Lupron for 10 days, a baseline ultrasound and a blood draw will be scheduled to measure your endometrial lining and estrogen level. This will assess whether or not your ovaries are suppressed and clear of follicles or cysts. If your ovary function is suppressed, you can then begin the next step: ovarian stimulation.
Ovulation stimulation begins
You will be contacted by the nurse coordinator who will tell you when to administer the stimulation medications. Most donors take these medications for an average 10 - 12 days, depending on how their ovaries respond.
Measuring development of follicles
You will be monitored three or four times at our office with transvaginal ultrasounds and blood tests. Transvaginal ultrasounds are performed at each visit to measure the growth and development of the ovarian follicles -- fluid-filled sacs that contain the eggs. Follicular size is an indicator of egg maturity. Blood levels of estradiol rise as the follicles grow and will be measured at each visit as well.
Final development of egg
When the stimulation is complete, you will be given specific instructions as to when to take human chorionic gonadotropin (hCG) – a natural hormone that triggers final development of the egg. The eggs are obtained 36 hours after the hCG injection.
Side Effects of Medications
- Lupron (Leuprolide Acetate): Lupron is a synthetic hormone that blocks the release of the gonadotropins LH and FSH from the pituitary gland and suppresses the normal menstrual cycle. Suppression of your hormone activity gives better control of ovarian stimulation during the donor IVF cycle. The side effects are similar to symptoms of menopause. Minor hot flashes, vaginal dryness, and headaches are not uncommon while taking Lupron and will resolve quickly once you discontinue the medication.
- Gonadotropins: Gonadotropins are synthetic or naturally derived hormones. Once your hormone system has been adequately suppressed with lupron, these injections will stimulate your ovaries to produce eggs. In a regular menstrual cycle, only one egg will develop and ovulate. However, careful use of gonadotropins in a stimulated cycle can cause many eggs to grow and mature. They will then be available for retrieval and fertilization in the lab. Controlled ovarian hyperstimulation can cause the ovaries to enlarge and become tender. As your ovaries increase in size, it is recommended that you decrease your activity level. Common side effects include mood swings, abdominal bloating and tenderness.
- hCG: This is a synthetic or natural product that plays a crucial role in egg maturation before ovulation. The injection is given at a very specific time at night. Approximately 35 hours after the injection, the eggs will be surgically removed. Timing of hCG and the retrieval itself is critical to prevent spontaneous ovulation and egg loss.
Process of Retrieval
This outpatient surgical procedure takes place at the Gynecology Outpatient Clinic on Fletcher Allen's Medical Center Campus.
You will receive antibiotics and anesthesia through an IV.
Eggs Removed from Ovary
The eggs are removed by guiding a needle via an ultrasound probe into the ovary. This procedure is not painful, as anesthesia will be provided. After the retrieval, you will stay in the recovery area for one to two hours.
May Cause Drowsiness
There may be some (minimal) vaginal bleeding, and you may feel drowsy from the sedation. You should not drive a motor vehicle the rest of the day, and will need to arrange transportation from the hospital.
Important to Take it Easy
After the retrieval it is advised that you take it easy for a few days. Side effects may include light vaginal bleeding, abdominal tenderness and bloating. The donor will be asked to return to the clinic for a follow-up visit after the retrieval.
The risks of egg retrieval are similar to those of other minor surgical procedures. These can include infection and injury to the bowel, blood vessels, or other structures, as well as bleeding during or after egg retrieval.
In addition, ovulation induction drugs cause the ovaries to become temporarily enlarged, which may cause some abdominal discomfort.
Other risks can include:
• Ovarian hyper-stimulation syndrome (OHSS) -- a rare condition when the ovaries become hyper-stimulated. This syndrome can usually be treated at home with bed rest and careful monitoring of symptoms.
• Allergic reaction -- there is a risk of allergic reaction to the medications as well as swelling, redness, and slight discomfort at the injection sites. Donors may also experience fatigue, mood swings and nausea, which may be attributed to higher levels of estrogen.