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The UCSF Ovum Donor Program began in 1991 and was one of the first donor ovum programs in the Bay Area. Ovum donation is a method that allows couples to become parents when the woman is unable to successfully conceive using her own eggs. The UCSF Ovum Donor Program helps over one hundred couples achieve their goal of becoming parents each year.
Initiating the process of having a baby through ovum donation may seem complicated at first, but take comfort in knowing that our experienced physicians, nurses, and counselors will guide you step-by-step through the entire process.
Why use donor eggs?
An increasing number of women are choosing ovum donation when other traditional infertility therapies have been unsuccessful or when hormonal tests indicate very poor reproductive potential. Using an ovum donor may also be appropriate for a woman whose ovaries were absent at birth or were removed or damaged by surgery, chemotherapy and/or radiation. Finally, it can be an option for patients who would like to eliminate the risk of passing on a known genetic condition carried by the female partner.
Because the chance of achieving a live birth is strongly related to the age of the egg, using donor eggs can often substantially increase the likelihood of having a baby from IVF. At UCSF, the chance of achieving a live birth from a single ovum donation cycle is greater than 60%. Furthermore, because many cycles using donated eggs result in surplus embryos to freeze, the cumulative pregnancy rate including subsequent frozen embryo cycles is approximately 80% at our center.
Having a baby using a donor egg provides couples with the opportunity to experience pregnancy, childbirth, and breastfeeding, and to have a child who is genetically connected to the father. You and your partner will have control over many aspects of the process, including when to try to become pregnant, the choice of the donor, and, once pregnant, the uterine environment provided for the child. Choosing a donor
An important step in the ovum donation process is choosing a donor. At UCSF, we respect that the process of determining the right donor is a uniquely personal decision. We have several resources, including a psychologist with expertise in fertility and family building, to assist in the decision-making process.
There are two basic types of ovum donors
Known donors:
These are most commonly sisters, but also can be cousins, nieces, friends, and sometimes acquaintances. Known donors must pass minimum screening criteria. They may be compensated or non-compensated.
Recruited donors:
These are usually young women with excellent reproductive potential who are compensated for their time and efforts in assisting other patients in becoming pregnant. Recruited donors may be found through egg donor agencies or through the UCSF Center for Reproductive Health in-house donor pool.
Using a donor from the UCSF Center for Reproductive Health donor pool
The team at UCSF recruits and screens a pool of in-house donors who are available for selection by your patients. The cornerstone of our program is our highly selective comprehensive screening process. In recruiting and screening donors, we adhere to the guidelines from the American Society for Reproductive Medicine, the United States Food and Drug administration, and to our own institutional ethics board. Our donors are recruited and screened by our Ovum Donor Screening Team, including Dr. Huddleston, reproductive endocrinologist, Dr. Pasch, clinical psychologist, Gina Davis, certified genetic counselor, and our donor ovum coordinators. In most cases, donors become available only after their screening has been fully completed and candidates have been designated as eligible according to all our guidelines. This includes full review of medical history, physical examination, genetic and mental health screening, and testing for infectious disease.
There are several benefits of choosing a donor from our pool. We have a highly selective comprehensive screening process. Our multidisciplinary team of physician, psychologist and genetic counselor work together in order to ensure that donors in our pool are fully eligible. This means that you are unlikely to experience the disappointment of carefully choosing a donor from an agency only to find out they are ineligible once they are medically screened. Additionally, you will have the ease and simplicity of working closely with one center for all of your needs during the ovum donation cycle. Finally, using a donor from our pool is often more economical than working with an agency because there are no extra agency fees to pay.
 Choosing a donor from an outside agency
We also work collaboratively with many outside ovum donor agencies. Outside agencies recruit and partially screen donors. The agency then assists couples in identifying possible donor matches from within their pool. We are happy to assist you in coordinating a donor ovum cycle with a donor from an outside agency. One benefit of using an outside agency is the overall larger pool available to you. Because there are many agencies in the Bay Area, couples may find donors meeting their own specific criteria more efficiently by working with an agency.
If you are interested in using a donor from an outside donor agency, we will provide you with a list of donor agencies in the area. We recommend that you ask the agency about their policies and procedures for recruitment and screening directly. Donors from outside agencies must have a mental health screening arranged through the agency and must meet specific criteria for eligibility, such as recent infectious disease screening, in order to proceed with a cycle within our center. Once selected, the donor will undergo an exam performed by physicians in our office prior to cycle planning.
Consultation
A first step for prospective patients is to consult with one of our reproductive endocrinologists who will perform an evaluation and then discuss the various treatment strategies available to you. Our physicians strive to help guide you in understanding all aspects of the options available. If you decide to proceed with a donor oocyte cycle, your physician will discuss what is required to prepare for your cycle. Your physician will perform a medical evaluation and physical examination to ensure that your health would not be jeopardized by pregnancy.
Cycle Preparation
In order to optimize the success of a donor egg cycle, your physician will order several tests that seek to identify and correct any abnormalities that could interfere with fertilization and/or implantation. These tests include a detailed semen analysis, a saline sonogram (a test which evaluates the uterine cavity) and basic blood work evaluating blood count, blood type and thyroid function. In consideration of your overall health, we also require that you are up to date on recommended health screening, such as the pap smear and mammogram (if over 40).
Though women achieve high success rates with ovum donation throughout their 40s, the risks during pregnancy increase as age approaches 50. If you are 45 or greater, additional testing is required to ensure that you enter your pregnancy in optimal physical condition. This testing includes a screen for diabetes, an EKG and clearance by a perinatologist (high risk obstetrician).
As part of preparation for the cycle, you will also meet with our psychologist to discuss your plans for ovum donation and to review the various decisions you will face now as you go through the process and in the future once you have a child born from ovum donation.
Selection of donor
UCSF donors
If you are working with the UCSF in-house pool, our ovum donor coordinator will arrange a time for you to view profiles of our donor candidates. You will have access to information about the donor’s background, medical history, educational level, and family history. You will also have the option of viewing photographs of prospective donors. We will discuss with you any relevant findings from the screening process itself, including genetic screening and testing, mental health screening, infectious disease results, and physical findings.
Once you have chosen a donor, the donor coordinator will confirm with the donor candidate that she is free for donation during the time period requested.
Once the donor selection process is complete, information about your donor will be given to your physician and nurse coordinator, and your cycle will be arranged.
Agency donors
If you select a donor from an outside agency, the agency will send information about the donor to our office for cycle coordination.
Synchronization
It is important for the donor and recipient to be synchronized such that the recipient’s uterine lining will be ready for implantation at the time that the donor’s eggs are retrieved and fertilized. This is usually accomplished by administration of birth control pills to synchronize the ovum donor and recipient’s cycles. When the cycles are synchronized, the donor is instructed to take the medications to stimulate the growth and maturation of a cohort of eggs, and is monitored by ultrasound and blood tests over the course of 10-14 days, until the eggs are ready for egg retrieval. Meanwhile, the recipient will be taking different medication to prepare the uterine lining for implantation of the embryos.
Egg retrieval and Embryo Transfer
Once the donor’s eggs reach the point of maturity, an egg retrieval is scheduled. The recipient’s partner or sperm donor will need to provide a sperm sample on the day of the egg retrieval for insemination of the eggs. When the embryos reach the proper stage for transfer, usually day 3, the recipient will return to the clinic for transfer to the uterus. We typically recommend the transfer of one or two embryos from donor cycles. The decision regarding how many embryos to transfer will be discussed in detail with you by your physician. The transfer of a single embryo will reduce the risk of a twin gestation. Additional high quality embryos that are available from the cycle can be frozen and preserved for their use at another time.
What qualities should I look for?
To maximize the likelihood of success, we recommend you chose a donor who is under 35. Most ovum donors are between the ages 21-30. Other factors related to likelihood of success are having previously carried a pregnancy to term, or having previously completed an ovum donor cycle with good results. Other factors that many patients consider are physical characteristics, ethnic background, family medical history, educational background, and personality characteristics. Our whole team can help you with any questions you have about the selection process.
How are donors screened?
Our in-house donors undergo an extensive screening process. Prospective donors complete a detailed questionnaire that is reviewed by our team. Donors meeting specific criteria will be invited to complete the additional screening. Additional screening involves meetings with our coordinator, a reproductive endocrinologist, a psychologists and a genetic counselor. The reproductive endocrinologist screens the donor from a medical perspective, while our psychologist screens the donor from the psychological perspective. Our board-certified genetic counselor screens for family history of birth defects or hereditary diseases via a comprehensive family history intake. A report of the findings and the family tree is available upon request. The prospective donor also must undergo a physical exam, cultures and blood test to rule out the presence of infectious diseases, such as HIV, Hepatitis B, Hepatitis C, Gonorrhea, Chlamydia. In addition, our donors are tested for their blood type and are screened for cystic fibrosis and hemoglobinopathies. American Society of Reproductive Medicine (ASRM) and FDA guidelines are followed for all screening procedures.
Can we meet the donor if we want to?
Yes. Donors recruited from the community are often willing to meet the recipients if the recipients want to meet them. Usually this meeting is completed without exchange of any identifying information like last names, addresses, or telephone numbers, so that anonymity of the arrangement is maintained. If desired, the meeting can be facilitated in our offices with the assistance of our psychologist, Dr. Lauri Pasch. If you use a donor from an agency, the agency can also assist in arranging a meeting.
What if I have a known donor I’d like to work with?
The first step is to discuss your known donor with your reproductive endocrinologist. He or she will help determine if your known donor is a good candidate. Known donors are usually younger than 35 years old, in good health, and have a healthy family background.
What are the legal implications?
Your donor will sign a consent form in which she relinquishes all rights and responsibilities regarding her donated eggs. In California, the woman who delivers the baby is the legal mother except in pre-arranged gestational carrier arrangements. Thus, for women using ovum donation to in order to conceive, there is no need to file any legal documents to establish the parentage of the child.
Laws regarding the use of donor ovum vary in different states and countries. We can provide resources in the community for legal assistance if desired.
How do we decide if ovum donation is right for us?
Donor ovum can be a wonderful way for couples who are unable to conceive on their own to become parents. Nevertheless, arriving at the decision to pursue ovum donation can be a difficult process. Patients often come to this decision over time, after thinking hard about what becoming parents really means to them. Couples may consider other options at this time as well, including adoption or not having children. Our psychologist is available to help you think through your thoughts and feelings about the varied family building options available to you.
If you are a new patient and interested in more information about the UCSF Ovum Donor Program, contact us at . We will discuss the program with you and can set up an initial consultation with a member of our medical team. During this first appointment, the procedure will be discussed in detail. After taking your history, the physician can then best advise you whether egg donation is a viable option for you. If you are an established patient and interested in more information about ovum donation, including the UCSF Ovum Donor Program, speak to your doctor or nurse about next steps.
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Ovum Donor Program: For Recipients
