ConceiveAbiliies Announces Seminar on Egg Donation in Chicago

ConceiveAbilities Announces Seminar on Egg Donation in Chicago

Terminology

Dear Reporters, Journalists, and members of the media:

When a recipient mother receives an embryo during an embryo transfer that embryo is
transferred into the uterus where it then hopefully implants.

I can't tell you how many articles I have read that state that mother has an embryo implanted into her uterus.

This isn't like a heart, lung, kidney, or liver transplant.

Please get the terminology correct.

How to Select An Egg Donor

(Okay, I have been told I need an egg donor. Now what?)


Your doctor tells you that you need an egg donor. First of all, take a deep breath. This is bound to be one of the biggest decisions you are going to make in your life, and it can feel very overwhelming.

Because this news can be so mind boggling, give yourself time to wrap your mind around egg donation, what it means, and the steps it will take to complete an egg donor cycle from start to finish.

To begin with, it’s important for us as women and mothers-to-be to know that it is normal to be sad about losing our genetic link to our future child. For some women, it can be a lengthy grieving process. We encourage you to give yourself time to grieve this loss. Sometimes seeing a counselor a therapist can help sort through complicated feelings.

Remember that no matter which egg donor you select, a DE (donor egg) child will be one you and your partner (if you should have one) create and give life to. The child will be exclusive and special to your own family, and he or she wouldn’t be coming into this world if not for the love that you have to give. It is also important to focus on the fact that you are going to love, honor, and cherish this child regardless of eye color, hair color, height, or other physical characteristics.

Where do we start? And what’s important?

First, you need to decide if you want to select an anonymous donor or a known donor. For some parents it’s important to make a personal connection with their egg donor. They may want to select a donor who will be willing to meet their child one day in the future. Others choose the anonymous donor route, not wanting to know anything other than what a profile states about their donor.

When selecting a donor, pay close attention to the egg donor’s profile. Read carefully, taking into account how the donor portrays herself. Look for a donor that you can relate to, that you could call your friend, or that you imagine could fit in with your own family.

Some recipient/intended parent(s) place value on the GPAs, SAT scores, and college education of their donor. Some recipient/intended parent(s) place value in egg donors who have excelled in athletics, music, science, or other areas. Some recipient/intended parent(s) require their donor to be the same faith as themselves. The majority of recipient/intended parent(s) we talk to also tell us they would prefer an egg donor to have a physical resemblance with the recipient mother, so that the baby “looks like Mom and Dad.”

In addition, it is not uncommon for us to hear: “I want an egg donor who’s drop-dead gorgeous and incredibly bright!” This is not an unreasonable request – let's face it, who doesn't want their child to be beautiful and brilliant? Therefore, the demand for attractive, exceptional college girls who are willing to donate eggs is high. However, not all attractive, intelligent, college-age girls are going to make good donors. That's why medical and psychological testing is required and paying close attention to the results of those tests is important.

As a recipient/intended parent, the characteristics you desire in a donor are unique to you and based on your personal priorities and choices. There is no right or wrong way to go about this! Just keep in mind that as a recipient/intended parent, you are investing a good deal of money in this process. Being a pro-active, smart consumer armed with information is imperative when selecting an egg donor.

I’m just starting this process and I feel like I’m reading another language!

Here is some terminology for those who are just starting out:

An anonymous egg donor is an egg donor you do not meet, selected with the help of a clinic or an agency. You do not know her name or anything else about her that is not stated on her profile. You may or may not see a photo of the donor. The donor would know nothing about the recipient/intended parent(s) or the cycle other than how many eggs were retrieved, and in some instances, whether or not a pregnancy resulted.

A semi-known egg donor is an egg donor who knows the recipient/intended parent(s’) first name(s) and the state in which they live. The donor and recipient/intended parent(s) might exchange emails and photos; however, no specific personal information is provided about the donor or the recipient/intended parent(s).

A known egg donor can be a friend, family member, or someone selected by the recipient/intended parent(s) with the intention of meeting face-to-face. The donor may know the recipient/intended parent(s’) first and last names and/or where they live, and in addition the two parties may be willing to exchange email, telephone calls, and personal information as well as to continue to keep in contact with one another. The donor and the recipient/intended parent(s) may agree upon the child meeting the donor at a future point in time. The recipient/intended parent(s) may or may not send photos of their child with updates to the egg donor as well. The arrangement regarding exchange of information is agreed upon and put into place between the egg donor and recipient/intended parent(s) at the time of the cycle. In many instances, information is shared for medical purposes.

All egg donors should complete an in-depth egg donor profile compiled of several pages of questions covering their medical history, personal history, social history, and reproductive history. You do not want to do business with an egg donor agency, broker, or clinic that does not require their egg donors to complete at least a medical profile. All egg donors should meet with a psychologist to be administered an MMPI* and a psychological evaluation.

*The Minnesota Multiphasic Personality Inventory, or MMPI, is the most frequently used clinical personality test. It is an easy test to administer and provides an objective measure of personality. It provides clear, valid descriptions of the test subject’s characteristics in broadly accepted clinical language. It also provides information about any potential psychological problems or symptoms that may deem a potential donor inappropriate to proceed with the egg donation process. It always needs to be scored, evaluated, and interpreted by a licensed clinical psychologist at the PhD level.

What should I look for in an egg donor?

The following is a list of important qualities to look for in a potential egg donor. Ideally, egg donors should:

Be between the ages of 21 and 30** and exhibit maturity, responsibility, and dependability
Be in good physical health as documented by history and testing
Be in good psychological health as documented by history and testing
Be of proportionate height and weight [being overweight may affect egg quality, as well as necessitate higher doses of stimulation drugs to create follicles, which translates to additional costs for the recipient/intended parent(s)]
Be drug free
Be a non-smoker of tobacco and marijuana
Have regular menstrual periods and is not using Depo-Provera
Have an FSH (Follicle Stimulating Hormone) level on cycle day three (3) of no more than eight (8), preferably under six (6)
Have an E2 (Estradiol) level on cycle day three (3) of less than fifty (50)
Have an Antral follicle count*** of at least fifteen (15) combined count.

** Donors younger than 21 may not be emotionally mature; donors older than 30 are not at peak fertility. Always follow your reproductive endocrinologist's advice regarding age.

***Antral follicles are small follicles (about 2-8 mm in diameter) that a reproductive endocrinologist can see, measure, and count with ultrasound. Antral follicles are also referred to as resting follicles. Vaginal ultrasound is the best way to accurately assess and count these small structures. The antral follicle counts (in conjunction with female age) are by far the best tool that we currently have for estimating ovarian reserve and/or chances for pregnancy with donor eggs through IVF.

Specific questions to ask an egg donor (or to ask the clinic/agency about an anonymous donor):

1. Do you have or does anyone in your family have a tendency towards any particular illnesses, i.e., allergies, intestinal problem, cancer, heart disease or psychological problems? Who had one or more of these illnesses, and at what age did the onset occur? (These questions should be answered completely within the donor profile.)

2. Are your blood relatives living, i.e., parents, siblings, grandparents, aunts, and uncles? If not, how old were they when they died, and what did they die of? (These questions should be answered completely within the donor profile.)

3. Have you or any member of your immediate family ever smoked, drank alcohol to excess, or used illegal substances? To what extent are any of these, or have any of these ever been, a problem? Note: Some agencies don’t like to ask this question. However, it is a reasonable and important question, as studies have shown that some forms of addiction have hereditary components. (These questions should be answered completely within the donor profile.)

4. Have you ever been pregnant? What was the outcome? (These questions should be answered completely within the donor profile.)

5. Have you ever donated eggs before? If you have, how many follicles developed? How many eggs were retrieved? How many successfully fertilized? Was there a resulting pregnancy or multiple pregnancy, and a live birth(s)? Note: The donor may or may not have this information.

6. What can you tell us about your family of origin? Who are they and what are their ages? What are their vocations and vocational interests, hobbies, talents and dispositions? What are their physical characteristics, such as coloring, size, weight and height? (These questions should be answered completely within the donor profile.)

7. Do you have any children? If yes, how old are they now? When did they learn to sit up, walk and talk? Were there and are there any significant health issues we should know about? What are their sleeping and eating habits? What are their special abilities and interests? What was their birth weight and length? (These questions should be answered completely within the donor profile.)

8. What is your family’s genealogical heritage or history? What country(s) did your ancestors come from, where did they settle here, and when? (These questions should be answered completely within the donor profile.)

9. Why do you want to help us have a baby using your egg(s)? What do you think you will get out of it? If you have already donated, what did you get out of it? If you do not already have children, have you considered the unlikely circumstance that at a later date you might be unable to conceive? (This should be discussed with a psychologist before the donor donates.)

10. If we get pregnant, will you tell your family members including your children? If so, how will you tell them, and when? Would you want your children to know that our child would share half of their genetic heritage? How will you handle their questions?

11. May we see or have pictures of your family, siblings, and children? If we desire [in an known donor agreement], may we meet with your immediate family, including your children?

12. Have you thought about how you'd feel if, after all this interaction and sharing, we don't get pregnant?

13. Have you thought about whether you would like any ongoing contact such as pictures, phone calls or meeting the child?

14. Is your job or school situation flexible enough to do this procedure? Do you have childcare available, if you have children?

A few last words about choosing a donor

Do your homework, research, ask questions, and if something doesn’t sit well, listen to your gut. Don’t be led to believe that if you pay a top price for an egg donor, you will get a premium donor. That’s not the way it works. Also, while we are talking about it, don’t believe that paying a higher fee to an agency or a donor is going to create or produce a top quality (or even a better quality) egg – or, for that matter, increase your chances at becoming a parent. Again, that’s not the way it works.

At the end of the day, we believe that the child you have via this process is the child you are meant to have, and will be the most amazing, beautiful, perfect child you have ever laid on eyes on.

How To Select A Clinic or Egg Donor Program

Marna: This is part of our "How To Series"

Selecting a Treatment Clinic that’s Right for You

At PVED, we understand how overwhelming beginning the process of creating or adding to your family through egg donation can be. There are many decisions to think about, and one of the most important is where to go for treatment. With that in mind, we’ve put together an informational “How To” to help guide you as you start the process.

Differences Do Matter

First, keep in mind that no two treatment programs are alike; each clinic has its own set of statistics (success rates), protocols, and procedures. As consumers, we want to get the most value for our money (after all, no matter how much we might come to love our reproductive endocrinologists, clinics are running a business). Because IVF using donor eggs is expensive and not always covered by insurance, it’s important to be educated about the process and to have a list of questions prepared to ask your physician, business office, and insurance specialist so you can make an informed decision.

Success Rates and Statistics

You will often hear around PVED: “Make sure you ask about their success rates!” So what the heck are these success rates, anyway?

Clinics performing fertility treatments are required by law to send statistical information each year to SART (Society for Assisted Reproductive Technology) and the CDC (Center for Disease Control), who then compile that information into reports that are released to the general public. The reports contain percentage-based success (pregnancy) rates regarding in vitro fertilization (IVF) cycles and IVF with donor egg cycles at every clinic. Also included are the number of cycles performed, which makes it easier to put success rates into perspective.

SART releases a report each year, whereas the CDC releases their report every other year in order to record a live birth rate (as opposed to a clinical pregnancy rate). So it is important to know that, for example, CDC figures published in 2008 reflect 2006 success rates.

Becoming familiar with SART and CDC statistics is instrumental to choosing a treatment program. They are a good place to start, and can help you narrow down your choice of potential clinics. As you’re doing your research, keep in mind that statistics fluctuate from year to year for many reasons. That’s why it is important to look for success rate trends: Is a clinic generally improving its success rates each year? Are they growing the number of donor egg (DE) cycles they complete each year? Do the statistics illustrate an overall consistency of success?


Just Ask! (Questions to Ask Potential Clinics)

After you’ve familiarized yourself with the statistics and narrowed down your choice of potential clinics, the next step is to pick up the telephone! Don’t be afraid to call to ask questions of every fertility clinic you're considering. This can help rule out some clinics at the outset—if you call a clinic and are told they're too busy to answer your questions, run the other way! If a clinic’s staff is too busy NOW to answer your questions, they probably aren’t going to have the time to answer your questions once you are a patient.

Since you’ll already know something of your potential clinic’s success rates, don’t hesitate to ask about them and what they mean. Different clinics have different criteria for what they consider to be fertility treatment “success.” Some clinics define success as achieving a pregnancy, while other clinics define it as achieving a live birth delivery. Make sure to ask how the clinic compiles its figures and, in particular, how it treats different age groups in its statistics.

Ask your future clinic about their technology – do they perform many blastocyst transfers, or are their transfers mainly day-three transfers? What kind of lab do they have? Is it a clean lab? Does the clinic regularly perform ICSI, assisted hatching, or PGD? Does the clinic perform egg vitrification? Make sure that the clinic you select has a wide repertoire of infertility procedures and remedies and that they are comfortable and familiar with the latest technology.

Because every clinic is run by human beings, mistakes can occur. This leads to horror stories of misplaced embryos, lost sperm, embryos transferred to the wrong uterus, or ugly legal battles over a patient’s frozen eggs or embryos. To make sure this doesn’t happen to you, ask your future clinic about quality control and their ethics policy.

Ask your future clinic about the tenure of their medical director. What is their staff turnover like? How long have their other doctors and the technicians been there? High staff turnover can be a big red flag for many reasons. It can mean faulty management from a practice perspective, which can contribute to mistakes that can make or break your cycle.

Ask your future clinic about age limits for treatment. Some people feel that if a clinic does not institute age limits on IVF procedures, they must not be concerned about ethics. This is a controversial issue; ask for an explanation of the clinic’s age guidelines or their decision not to restrict treatment. Ideally, each clinic should treat its patients on a case-by-case basis instead of approaching patients in a cookie cutter, one-size-fits all manner.

Ask your future clinic if the doctor you see for a consultation will be the doctor you will see on an ongoing basis. Many clinics have a team approach, meaning you may see a different doctor each time you have an appointment. Assess your own level of comfort with this type of process.

Ask your future clinic about their determinations on transferring of embryos back into the uterus. How many are embryos are transferred? Who decides how many embryos are transferred? Is this something the doctor and patient decide together, or does the clinic have its own guidelines? PVED does not recommend seeking treatment from a clinic where the doctor has complete control – ethically, the choice about how many embryos to implant should be made in collaboration with the patient.

Ask your future clinic how many donor egg cycles they perform annually. If the clinic in question performs many cycles each year, ask how they prevent patients from feeling like a number on a production line. If they perform few cycles each year, ask about the reason and the clinicians’ comfort level with the procedure.

Ask your future clinic if they perform shared cycles.

Ask your future clinic if they participate in embryo donation.

Ask your future clinic about the cost of treatment. Do they offer a money-back guarantee? Are they part of shared risk program? It’s important that you know the costs ahead of time so there are no surprises along the way. Ask the clinic for a printed cost sheet that has every single procedure outlined, from donor egg retrieval through the transfer of embryos into the patient’s uterus. Don’t forget to ask about ultrasound costs, lab costs, extra office visits, and the cost of after-hours calls if needed.

Ask your future clinic how they communicate with their patients. Is it primarily by telephone or e-mail? Will you have access to your doctor’s e-mail address? How does the doctors’ on-call rotation work?

Don’t be afraid to ask your doctor:

Where did you receive your medical training? When?
Are you a board-certified reproductive endocrinologist?
How long have you been treating infertility?
Do you or your nurse have a call-in time so that I can ask questions?
Who can I call if I have a problem after office hours?
Can procedures be done on weekends? Is the clinic open every day including weekends and bank holidays?
Are you affiliated with a hospital?

Ask your future clinic about other resources they may provide, including counseling or support groups, acupuncture, and other non-medical support.

Ask your future clinic how they communicate with their patients. Is it primarily by telephone or e-mail? Will you have access to your doctor’s e-mail address? How does the doctors’ on-call rotation work?

Finally, ask your future clinic if they have an in-house donor pool. If your future clinic has an in-house door pool, it’s important that when selecting your donor you don't feel rushed. Another important point to remember is that no matter how intelligent, gifted, beautiful, talented, athletic, or artistic the donor you select may be, there is absolutely no guarantee that the child you have will have those traits.

In addition, if an agency or a clinic with an in-house donor pool charges up-front fees in order for you to view their donors, walk away. And whatever you do, don’t fall victim to the idea that “If I pay a lot of money, I will get a first-class donor.” Paying in excess of ten thousand dollars ($10,000 US) isn’t going to produce or create a better ovum (egg) or enhance your chances of becoming a parent any more than an egg donor whose compensation rate is five thousand ($5,000 US). Your clinic, their treatment protocol, their statistics, and your uterus are what are going to determine your success in becoming a parent, not the cost of the egg donor.


Go With Your Gut

Even armed with the list of questions above and a working knowledge of clinic statistics and success rates, we can’t encourage you enough to search for a practice that you feel comfortable with. You can go to the best clinic in the world from a success-rates standpoint, but if you don’t feel good about where you are and how you are being treated, it can make for a stressful and negative experience. We cannot overstate the importance of feeling confident and positive about wherever you choose to seek treatment.

Look for a physician who is going to be kind, caring, compassionate, and above all, willing to partner with you during your treatment. We can’t tell you how many times we have heard patients say, “My RE doesn’t listen, he’s so rushed, he acts as though I have no idea what I am talking about, I feel stupid each and every time I leave his office…” The rapport and relationship you develop with your physician is critical. You want a clinic where you feel honored, respected, and cared for—and with that comes a physician or team of physicians who have your best interest in mind.

While this may all seem time consuming, overwhelming, detail oriented, and daunting, just remember that you are in the driver’s seat. The clinic is a service provider designed to meet your needs. You, the patient, have the very last say in your treatment – this is your body!

And remember – above all, keep your eye on the prize – which is a baby!