10 Things I Didn’t Know About IVF Before Donating My Eggs
Earlier this year, I donated my eggs to a close and dear friend of mine.
Researching the process — and befriending the ladies at We are Egg Donors — got me thinking that there’s a lot of room for progress in the egg donation industry.
While researching this article, I discovered many fascinating factoids. For example:
Did you know that each year, a few Japanese visitors flock to Alaska to make love under the Northern Lights, because it is believed that babies conceived under the Northern Lights will be more intelligent?
Random, right?!
Just like artificial insemination has been around for a long time, IVF is a technology for family building — like finding the right sexual position, time of day, or geographical location for conception. Egg donation is among one of many ways to create a family.
Here’s what I learned from my egg donation experience.
xoxo
Ashley
1. When you tell people you’re donating your eggs, expect to hear a variety of sentiments.
Over drinks, I told a few anthropologist friends that I was considering donating eggs to a close friend of mine. As a social scientist, I thought it would be a great way to elicit feedback that could help me make an informed decision about the range of emotional, psychological, and social aspects of egg donation.
“That’s a very selfless act you’re doing.”
“That’s cool.”
“That’s very anti-nazi of you.”
“That’s an amazing thing you did for your friend.”
“You’re trying to control fate.”
“Will this affect your fertility?”
Interestingly, no one asked how it would affect my immediate relationships with family, friends and significant other. Very few friends asked how does it work, one family member asked but seemed bored or simply didn’t understand what egg donation and IVF meant for me, for my friend (AKA “the recipients” if it were an anonymous donation), and for humanity.
Mostly, it seemed, that most people didn’t know what to say. How could they? Egg donation is relatively new.
2. How you’re monitored after your egg retrieval surgery depends on the IVF clinic.
Some clinics will monitor egg donors one week after retrieval and beyond, while others will send you home after retrieval and tell you to call if something bad happens.
As a donor, know your rights. You’re a human, not an egg factory.
Egg donor insurance is available but may not cover you after 90 days. Check your policy and check yourself to rule out the impact of the synthetic hormones that are not FDA approved for IVF.
3. The ideal number of eggs to be retrieved per cycle is 15.
Without hormone stimulation, women typically produce 5-10 follicles per ovary, with 1-2 eggs maturing for the month. What’s the “magic number” for a stimulation cycle? According to one study, 15 oocytes retrieved is optimal for the clinical outcome of live birth for the oocyte recipients.
My doctor prescribed enough medication that would stimulate oocytes, but not so many that it would increase the risk of Ovarian Hyperstimulation Syndrome (OHSS).
4. Eggs and embryos are rated according to their quality.
Once the reproductive material is harvested, each egg and embryo are given a report card, so to speak.
A number of factors may be used to determine embryo quality, according to the University of Southern California Fertility and Shady Grove Fertility clinic. USC Fertility identifies “egg quality” as the probability of embryo plantation, which is “strongly related to the age of the woman who provides the egg and to her ovarian reserve.”
Shady Grove Fertility breaks down embryo quality determination: cell division over time, by day, and morphological appearance. Embryo gene expression also helps determine embryo quality.
5. Today, embryologists typically implant an embryo after 5 or 6 days.
In the beginning of IVF, the embryologist placed an embryo, or blastocyst (name of embryo on day 5) in a woman’s uterus on day 3 because no one knew if the embryo would live to day 4 or 5. Today, embryos live until day 5 or 6, allowing the embryologist to select a blastocyst with the higher probability for implantation.
Researchers at Stanford identified three parameters associated with successful blastocyst formation: (1) the duration of first cytokinesis (the last step of a period in the cell cycle called mitosis in which the cell physically divides), (2) the time between first and second mitoses, and (3) the synchronicity of the second and third mitoses.
6. Federal restrictions limit research on embryos in the United States.
Since 1996, research on embryos cannot be supported by the Federal Government because of the Dicky-Wicker Amendment that “prohibits the use of federal funds for research in which a human embryo is destroyed–evens ones that would otherwise be discarded.”
Examples of embryo sources are private donors, anonymous donors, the March of Dimes and the Stanford Institute for Stem Cell Biology and Regenerative Medicine. Research on embryos would be useful in determining which embryo has the greatest chance of implantation. In my view, it should not be confused with Darwinism, since the strongest embryo would be the one to implant anyway.
7. There are key questions egg donors should ask before starting the stimulation process.
Before you sign your contract and begin the egg stimulation process, researching the decision to donate your eggs is very important.
A donor should always ask herself: “How will this affect my body in the short and long run?”
She should also ask about the synthetic hormones she will administer to her body and for how long. Then she should research these synthetic hormones and understand how they work on the body in general with an understanding each woman’s body is different.
Next, she should speak with other donors about how their cycles affected their lives (for example, my colleagues at We Are Egg Donors were very helpful to me).
In the two to three weeks you’ll be stimulating yourself, your life could change dramatically! It’s important to prepare yourself.
Before entering into the contract, find out what questions you need to be asking but are not asking and then make sure all of your questions are answered.
Also, be sure the contract is made early on (such as by when the doctor performs the first tests on you). Most contracts create an initial payment for preparations (DNA tests, blood work, physical, etc.), but if the contract is made later, the effort you’ve already made could impact how you dialogue about the contract. It is important to remember that egg donors are compensated for their time away from work and other incurred expenses related to the egg donation process, and pain and suffering – not their eggs! It is illegal to do that in the United States.
As a donor, remember, you are helping someone increase their chance to have a baby, but shouldn’t involved a sacrifice of your fertility. As such, it is important to remember you have human rights, too.
8. More research on egg donor health is needed.
Limited information is available on donor outcomes and bioethics of egg donation. Research is necessary on both topics to improve counseling and clinical decision making.
Why is this important? Because egg donors are in an age group that is considered “vulnerable.”
Egg donors are typically between 20-29 years of age, however some can donate as early as 18 and as late as 36 years of age. Although, Monash IVF in Australia allows to age 36. Women between 18-30 years of age are a vulnerable audience, whether they’re just finishing high school and starting college, have completed college and working to pay off education loans, or starting a family of their own.
In a situation where the synthetic hormones are not FDA approved for IVF, it is curious that further steps from doctors, psychological evaluations and follow-up evaluations aren’t taken more seriously and in greater depth.
There is limited information regarding maternal and infant outcomes, according to one study from Dr. Kawwass and colleagues, “Trends and Outcomes for Donor Oocyte Cycles in the United States, 2000-2010.” They discuss oocyte donation is more common but limited information is available regarding maternal and infant outcomes.
9. There are important differences in the treatment of known donors versus anonymous donors — and this could be improved.
In the eyes of the IVF clinic, recipients can be seen as “customers” rather than “people trying very hard to create a pregnancy.”
When an anonymous egg donor enters the picture, there’s no personal connection between her and the people trying to get pregnant.
In the case of anonymous donations, contact is limited but often non-existent. The only information known is about the egg donor, rarely the recipient. While attempts to keep recipients and donors anonymous, they sometimes fail. Also, in an anonymous donation, they wouldn’t have gone to the appointments with me or demonstrated care or concern about me. Often, donors aren’t allowed to know the outcome of their egg in the recipient mother. This seems unfair to me since the egg is the donor’s genetic material. What if the donor wants to conceive but she doesn’t know the health of the recipient parents’ baby is poor. It seems to me a bilateral informational arrangement would be fair and could be executed through a mediator. Both recipients and donors should have information on each other’s health and health of IVF baby.
Being a known donor, I felt a personal connection with my “recipients” — they are my friends. We cared about what happened to each other and were able to stay updated on each other’s progress throughout the cycle. We always checked on each other. In my eyes, they were potential parents who wanted a little one to love and care for, and they knew how much I cared about their pregnancy outcome.
When donors and recipients are known, there’s an opportunity to see each other as humans. We connect.
10. Be careful what you Google about egg donation – recruiters present most of the information found online.
When you Google “egg donation,” the majority of information out there is presented by clinics and agencies who are trying to recruit new egg donors. We Are Egg Donors was particularly helpful for me partly because it is not a business that facilitates egg donations – it is the only group out there that is focused 100% on egg donor health initiatives.
By taking the commercial agenda away from the conversation, egg donors are able to have candid and insightful conversations about their egg donation experiences.
The ladies at We are Egg Donors were incredibly supportive and informative throughout my egg donation experience. We Facebooked, texted, talked on the phone for hours. We talked about how the industry can be changed to the betterment of egg donor experiences.
Part of the mission at We Are Egg Donors is to build a robust evidence-based resource for egg donors and women considering egg donation. You can check out some more egg donor Q&As, or shoot us a message and let us know how we can help you!