If you’re considering becoming a parent through egg donation from a third party, we’re here to help. PAMF Fertility has provided egg donation treatment since 1990, working with anonymous and known donors (usually relatives or friends of the recipient parents), and donors from our own donor registry.
One of the most significant advances in reproductive medicine has been the introduction of egg donation. Egg donation can be part of in vitro fertilization that allows a woman to bear children, even if she is experiencing infertility due to a low number or low quality of eggs. Egg donation was originally developed for women who had experienced menopause (complete depletion of eggs) or for women who were born without functioning ovaries. Today, egg donation is most commonly used by women who are experiencing age-related infertility. In the best interest of the health and safety of the mother and baby, it is strongly recommended that the recipient be no older than 50 years of age at the time of embryo transfer. There should also be no medical or other contraindications to pregnancy.
To better understand why egg donation is a successful treatment for age-related infertility, it is helpful to review the natural process of reproductive aging. Here’s a brief summary. A woman is born with all the eggs she will ever have. Each month, nearly 1,000 eggs die for every one that ovulates. Ultimately the egg supply reaches zero and menopause occurs. As women get older, they will often continue to ovulate regularly, but the quality of the egg that is released will, on average, not be as good as the quality of the egg that is released by a younger woman. An egg released by an older woman will be more likely to contain the wrong number of chromosomes. If such an egg is fertilized, it will often become an embryo that does not develop or that miscarries. This is why women may experience significantly reduced fertility even 10 to 15 years before menopause, despite regular ovulation. Since this is not a well-known fact, many couples have planned their lives and careers based on the mistaken belief that their fertility will remain high well into their 40s.
Although age-related infertility or menopause are the most common reasons for considering egg donation, the treatment may be considered in other circumstances. For example, some women carry a genetic disease that they want to avoid passing on to their offspring. Other people consider using egg donation because of a lack of success with other forms of infertility treatment. The success rates for egg donation is much higher than those of traditional IVF. Over the past three years at PAMF Fertility, more than 65% of our egg donor recipients welcomed home a healthy baby after one egg donation cycle.
The chance of success with egg donation is much greater if multiple eggs are retrieved. Therefore, the egg donor undergoes treatment with fertility drug injections (gonadotropins). During this time, the development of the follicles is monitored by ultrasound and blood tests for estradiol. If the donor lives outside of this geographic area, it is often possible to have some of this monitoring done by an experienced physician close to the donor’s home. When the follicles are mature, the donor receives an injection of human chorionic gonadotropin (hCG) and the eggs are retrieved 35 hours later. Most commonly, the eggs are fertilized using the sperm of the recipient’s partner. Donor sperm may be used if the recipient does not have a male partner or if her partner does not produce sperm.
It is extremely important to coordinate the development of the eggs and embryos with the development of the recipient’s uterine lining. The embryos will only implant if transferred during a window of time after appropriate exposure to estrogen and then progesterone. Therefore, the hormones estrogen and progesterone are prescribed in a timeframe that is synchronized with the development of the eggs. While the donor is taking fertility medications, the recipient will take estrogen tablets to prepare her uterine lining for receiving the embryos. Shortly before the embryo transfer, the recipient will begin taking progesterone along with the estrogen in a way that mimics what happens in a natural menstrual cycle.
It is usually recommended that one or two embryos be transferred. You will discuss this number carefully with your physician because the biggest risk of assisted reproductive technologies is the risk of multiple pregnancy. You may choose to transfer one embryo to reduce the risk of having a multiple pregnancy. If additional viable embryos are created during the cycle, these can be frozen for possible transfer at a later time. If a pregnancy develops, it is necessary to take hormone supplementation during the first trimester of the pregnancy. After this time, the pregnancy itself makes sufficient hormones, and no additional hormone supplementation is needed.
Although a child conceived through egg donation will not be genetically related to the mother who delivers the child, most women who have become mothers through egg donation feel they developed a strong maternal bond to the child during the pregnancy. They also appreciate the fact that they have control over the pregnancy. Unlike adoption, egg donation allows the birth mother and her partner to be recognized as the legal parents from the beginning.
Recipients who do not live in the San Francisco Bay Area will be required to travel to PAMF Fertility at two different times in order to complete an IVF cycle with eggs donated by an egg donor:
There are some evaluations that must be performed by PAMF Fertility during your first visit:
Please contact our Egg Donor Coordinator to schedule your initial consultation and discuss the logistics of your fertility treatment at PAMF Fertility. The donor team will ensure that all necessary evaluations are scheduled consecutively on the same day, to minimize the time you are required to stay in San Jose, CA. Call (800) 597-2234 for info.
In the best interest of patient convenience, we will allow recipient patients (female and/or male partner), who do not live near our offices to have some preliminary testing performed by their own local physician in their home city, state or country, prior to their initial consultation at PAMF Fertility. A list of these evaluations may be provided to you or to your physician upon request. It is important that PAMF Fertility receives your medical records and any results of testing performed by your local physician one week prior to your initial consultation. At the initial appointment, PAMF Fertility will perform or repeat any tests or evaluations. (Results are not available for review at that time.) All test results must be current within one year of the embryo transfer. If any test results expire prior to embryo transfer, they will need to be repeated by PAMF Fertility.
PAMF Fertility works with pharmacies that will ship your cycle medications directly to you, even if you live outside of the country. Alternatively, you may wish to have your local physician transcribe the prescriptions written by PAMF Fertility so that you may purchase your medications through your preferred pharmacist. You will be given prescriptions for cycle medications at your initial visit.
If it is anticipated that the male recipient partner may be unable to make a second prolonged trip to PAMF Fertility for IVF and Embryo Transfer, a semen sample may be frozen at PAMF Fertility during the initial visit. However, the results of the semen evaluations must be acceptable for IVF in order for the frozen specimen to be used, so this option cannot be guaranteed until the results become available and are determined favorable after the initial visit. PAMF Fertility cannot accept frozen semen samples from outside of the United States.
One of the most important factors to consider in choosing an egg donor is her age. Success rates will be much higher if a donor is young because the eggs will be of better quality. In general, it is recommended that the donor be age 34 or younger. Most clinics and agencies recruit donors who are between 21 and 30 years of age. It is reassuring if a donor has had a prior pregnancy, however many potential good donors have never tried to become pregnant, so “proven fertility” should not be a requirement. A good outcome from a prior donor cycle can also be reassuring, but it is important to consider that the donor’s prior cycle involved different sperm, a different uterus and often times a different fertility practice, gamete laboratory and/or stimulation protocol.
The donor should have no history of infertility herself and must have a favorable ovarian reserve. This will be evaluated with an ultrasound performed by a physician at the donor’s screening appointment. Most couples attempt to match some basic physical characteristics (e.g. race) of the donor with the physical appearance of the woman who will be the mother of the child. Even though an egg donor may have certain favorable physical characteristics, it is important to understand that her eggs will contain genetic material from all of her ancestors. That means the baby may not necessarily inherit the donor’s traits, but instead resemble someone in her family history, or the father, sperm donor, his ancestors or a combination of everyone in the unique pedigree.
It is not recommended that a woman donate her eggs if she has current marital instability, chaotic lifestyle, a desperate financial situation, current high stress, high-risk sexual practices, or if she has a history of substance abuse or legal difficulties. It is also important to review the family history of the donor because this information may be very valuable to the future health of your child. Many recipients decide to have a mutually anonymous relationship with their donor. Medical and social history obtained by the agency or PAMF Fertility will be made available to potential recipient parents about the donor. The donor will not know any identifying information about the recipient parents. Other recipients decide that they wish to have some greater degree of contact with their donor, and they can choose an agency that will accommodate this desire.
If you choose to use an outside agency, here are some questions to ask that may make your search for an anonymous donor more effective.
Egg Donation Consultation
During the consultation, you and your physician decide if egg donation is the right treatment for you. This is typically the first step in the process. Multiple issues relevant to your cycle of egg donation are also reviewed, such as success rates, number of embryos to transfer, legal protection, psychological counseling and other issues that are unique to your particular medical history.
Financial Consultation
Before you start your search for a donor, you will be required to meet with a PAMF Fertility financial counselor, at no charge to you or to your insurance, to discuss the costs associated with an egg donor cycle. The financial counselor will review insurance coverage, pricing and payment options and make sure all of your financial questions are addressed. This important meeting will be extremely beneficial to you as you consider your options in finding your donor. Upon completing your Financial Consultation and Egg Donation Consultation, you will be able to reserve a PAMF Fertility donor for an upcoming cycle or move forward with selecting a donor from an outside agency.
Psychologist Consultation
A consultation with a licensed counselor who specializes in third party reproduction is critically important before beginning your egg donation cycle. You will have an opportunity to address the psychological and emotional issues related to the egg donation process. These concerns include: disclosure to child and family/friends; donor selection; loss of genetic ties to the child; readiness of all parties to use an egg donor; and important legal necessities. The counselor will issue a report indicating your readiness to move forward. This is required before treatment can begin, so it is necessary to schedule the consult after you have chosen your treatment option and before commencing treatment. Ideally, use this consult as an opportunity to gain support, information and guidance. Many patients benefit from an additional session in advance of the required consult session for help in making a decision that is best for them. Your egg donor will also be required to complete a psychological evaluation prior to starting the cycle. PAMF Fertility works with several counselors in the Bay Area who have extensive experience working with intended parents and donors who are considering egg donation. You will be provided with a referral at your Egg Donation Consultation or Cycle Review.
Choosing a Donor
You will choose a donor as outlined above, or select a donor from PAMF Fertility’s registry. You can generally expect the egg retrieval to happen about 4 to 6 months from the time you select your donor. The process can sometimes take longer if it is necessary to work around recipient or donor schedules, or if there are any unanticipated issues such as recipient or donor illness, abnormal screening tests, ovarian cysts, uterine polyps, legal disagreements or if the recipient or donor have not completed the required tests and evaluations in a timely manner.
Financial Arrangements
Before your donor can be scheduled for screening in our office, a down payment for the cycle, as discussed at your financial consultation, must be received. If you will be working with ARC (Advanced Reproductive Care, www.arcfertility.com), your donor will be scheduled for her screening appointments after PAMF Fertility has received confirmation from ARC that your arrangements have been finalized and PAMF Fertility has collected payment for any cycle services that are not included in your ARC package. If the cycle is cancelled for any reason, you will receive refund of the money left over after the charges for any services that were rendered, such as screening tests, have been processed.
Cycle Review
Once you have selected a donor, you will need to have a Cycle Review meeting with a PAMF Fertility Egg Donor Program Coordinator, who will discuss the tests that are needed, provide orders for testing, and review the logistics of your cycle including potential treatment dates. All testing and evaluations for the recipient and intended father must be current and up to date at the start of the egg donation cycle. The recipient testing requirements for egg donation IVF cycles are different than what is done prior to standard IVF treatment, so it may be necessary to repeat and/or update some testing.
History and Physical Examination
You will undergo a complete physical exam to identify any important health concerns within six months of initiating the egg donation cycle and becoming pregnant.
Blood Tests and Cultures
All blood tests and cultures must be current within one year of the anticipated embryo transfer for your egg donation cycle. Necessary updates to these evaluations will be ordered by your Egg Donor Coordinator at your Cycle Review.
Uterine Evaluation
If no uterine screening has been done within six months of donor selection, your doctor may order a sonohysterography (SHG). An SHG is an ultrasound procedure performed by a PAMF Fertility physician in our office to determine if the shape of the uterine cavity is normal. It takes about 30 minutes to perform, and the results are interpreted upon completion of the examination.
Semen Analysis
Semen is always assessed by the PAMF Fertility andrology laboratory prior to starting a treatment cycle and within 6 months of the initiation of any new treatment cycle. A semen sample can be collected in a private collection room at the lab or at home if it can be delivered within 30 minutes of collection. The laboratory assesses sperm count, sperm motility and sperm morphology to determine the best way to fertilize the eggs.
During an instruction class, we discuss medications and possible side effects with you and your partner. You learn how to mix and administer the various medications. The class is taught by appointment.
Legal Agreement
A legal agreement will need to be signed by you and your donor. It is recommended that you and your donor have separate attorneys to advise you during this process. Egg donor agencies may either provide you with a legal agreement or refer you to an attorney who can develop one for you. If you are using a donor from PAMF Fertility, a legal contract will be provided for you and your donor.
Embryology laboratory and medical costs for an egg donation cycle will vary depending on what specifically is needed in your particular case and are usually in the range of $10,000 to $15,000, depending on the fertility program at which the cycle is completed and any insurance benefits you may have. Additional costs that also vary greatly between different clinical programs and agencies, as well as with personal insurance benefits and the source of your egg donor may include but are not limited to: cycle medications, hospital/surgery facility fees, anesthesia, compensation to the donor, agency fees, screening tests/evaluations, legal fees and donor travel costs if the donor does not live in San Jose. The total cost of an egg donation cycle can therefore range from $25,000 to $50,000.
All recipients meet with a financial counselor at PAMF Fertility before beginning treatment. A summary of the medical and embryology laboratory charges relevant to your particular case is reviewed. Estimates are provided for medical expenses incurred outside of PAMF Fertility (such as medications). The counselor will help you to determine which parts of your care might be covered by insurance. Your donor agency will help you estimate other costs of the cycle (such as legal fees, agency charges and compensation to the donor).
Some people wonder if they will be able to afford egg donation. Certainly, the costs are not inconsequential. PAMF Fertility is pleased to be a member of Advanced Reproductive Care (ARC), a national network of reproductive medical specialists. Through this membership, PAMF Fertility is pleased to offer our patients financial services including package pricing for donor cycles, refund guarantee programs and access to financing to help our patients more easily manage the financial aspects of fertility treatment. To learn more about ARC offerings, contact ARC toll free at (888) 990-2727 or via email at info@ARCfertility.com. Your PAMF Fertility financial counselor can also provide you basic information about ARC services.
At PAMF Fertility Physicians of Northern California it is our mission to help people become parents, and we take great pride in our experience providing advanced reproductive healthcare services to people from all over the world. Our total focus is on helping you realize your dream of having a healthy child.
We have helped thousands of people become parents and would be honored to help you make your dream of having a healthy baby come true. Please count on us to help you through every step of the process and know that our goal is to make your fertility treatment as comfortable, safe and successful as possible.
PAMF Fertility offers the full range of medical solutions patients need to start a family, from simple drug therapy to advanced procedures such as in vitro fertilization and pre-implantation genetic screening. Our physicians are all specialists in reproductive endocrinology and infertility, treating reproductive and fertility disorders including problems related to ovulation, conception, repetitive pregnancy loss (miscarriage), sperm production and function, tubal occlusion and hormone disorders.
We understand how complex the process of egg donation can seem. In order to help you, we have a dedicated team of medical professionals to assist you through donor selection, legal and medical requirements and the treatment process. We have been providing egg donation treatment since 1990, working with anonymous and known donors. We have an in-house registry of egg donors who are carefully screened and local to the San Francisco Bay Area. Federal laws and medical guidelines are carefully followed at PAMF Fertility to ensure the privacy and well-being of everyone involved.
Recipients who do not live in the San Francisco Bay Area will be required to travel to PAMF Fertility at two different times in order to complete an IVF cycle with eggs donated by an egg donor:
There are some evaluations that must be performed by PAMF Fertility during your first visit:
Please contact our Egg Donor Coordinator to schedule your initial consultation and discuss the logistics of your fertility treatment at PAMF Fertility. The donor team will ensure that all necessary evaluations are scheduled consecutively on the same day, to minimize the time you are required to stay in San Jose, CA. Call (800) 597-2234 for info.
In the best interest of patient convenience, we will allow recipient patients (female and/or male partner), who do not live near our offices to have some preliminary testing performed by their own local physician in their home city, state or country, prior to their initial consultation at PAMF Fertility. A list of these evaluations may be provided to you or to your physician upon request. It is important that PAMF Fertility receives your medical records and any results of testing performed by your local physician one week prior to your initial consultation. At the initial appointment, PAMF Fertility will perform or repeat any tests or evaluations. (Results are not available for review at that time.) All test results must be current within one year of the embryo transfer. If any test results expire prior to embryo transfer, they will need to be repeated by PAMF Fertility.
PAMF Fertility works with pharmacies that will ship your cycle medications directly to you, even if you live outside of the country. Alternatively, you may wish to have your local physician transcribe the prescriptions written by PAMF Fertility so that you may purchase your medications through your preferred pharmacist. You will be given prescriptions for cycle medications at your initial visit.
If it is anticipated that the male recipient partner may be unable to make a second prolonged trip to PAMF Fertility for IVF and Embryo Transfer, a semen sample may be frozen at PAMF Fertility during the initial visit. However, the results of the semen evaluations must be acceptable for IVF in order for the frozen specimen to be used, so this option cannot be guaranteed until the results become available and are determined favorable after the initial visit. PAMF Fertility cannot accept frozen semen samples from outside of the United States.
The PAMF Fertility Donor Registry was developed for our patients to help reduce the cost and complexity of finding an egg donor. IVF patients at PAMF now have exclusive access to local egg donors who have been recruited and pre-screened by the same experienced team of specialists who provide excellent fertility care at PAMF Fertility. Our registry is increasingly growing as we advertise throughout Silicon Valley and the greater San Francisco Bay Area. If you would like to become a PAMF Fertility patient and participate in our egg donor program, please schedule a New Patient Appointment as your first step. If you have any questions, our dedicated program coordinators are happy to answer them — contact our Donor Program Coordinator at (800) 597-2234.
Our online database displays the basic physical characteristics for each one of our donors and is publicly available to all potential recipients. A login and password for online access to the donors' complete written profiles is available upon request. Donor photographs are available for review by appointment at our San Jose office.
Please see our Donor Registry glossary for a detailed description of donor screening levels and categories of availability. Reservation requests are processed in the order they are received and only established PAMF Fertility patients may select a PAMF Fertility donor for an upcoming egg donation IVF cycle. PAMF Fertility Donors are not available for cycles at other IVF programs.
If none of our available donors match your preferences, a list of outside agencies with egg donors will be provided upon request. The agencies on our list are in good standing with our program and have signed an agreement to follow federal and industry guidelines. PAMF Fertility must complete the evaluation and screening of any egg donor from an outside agency prior to her starting an egg donation cycle at PAMF Fertility.