less about her physical appearance and more about about educational accomplishments or heritage. Once the prospective parents have made their final decision to you as their donor we will contact you. If you agree to proceed, you are considered matched.
Legal You will sign a contract with AAG known as the agency-donor contract. In addition you will sign a contract with your intended parents known as the direct contract which establishes an agreed upon compensation amount and outlines duties, relationships and rights between the egg donor and the intended parents. This contract will be drafted by your intended parent's attorney. You will schedule an appointment with your lawyer (which will be assigned to you by the agency) to go over the direct contract in depth and he or she will answer any questions you may have. You may also request changes. After you feel comfortable with your contract you will sign it and your attorney will send the signed contract with any requested changes back to the drafting attorney. You will not be given clearance by your physician to begin any medications until this contract has been signed by all parties.
Medical Screening After matching has taken place you will visit a clinic local to you or the intended parents cycling clinic (which may require you to travel if you reside in a state other than that of your intended parent's clinic). This first appointment will take place on day 2, 3, or 4 of your menstrual cycle so it is essential that you contact AAG on the first day of your menses so we can schedule your initial screening. You will have to be off of any hormone based birth control for at least one month prior to your preliminary screening so that your hormone levels can be tested. The purpose of this screening is to ensure you are an eligible candidate for egg donation. This screening will take three to four hours so it is important you set aside half your day for this appointment.
During this initial screening you can expect a urine analysis to test for substance abuse, blood draws to test for blood type, hormone levels, and FDA required screening for infectious diseases, as well as a complete physical and a baseline vaginal ultrasound to check the overall health and condition of your ovaries as well as the number of Antral, or resting follicles.
You are also expected to undergo a mental evaluation as a part of this initial screening which will be administered at the clinic or by an independent psychologist appointed by this agency. During this mental evaluation you will be administered an MMPI (Minnesota Multiphasic personality Inventory) and will then meet with the psychologist to discuss your feelings about egg donation and possible resultant offspring.
Cycle Start Provided the results from your initial screening negate infectious disease and confirm your positive candidacy for egg donation, you will be given the green light to begin a series of medications which will cause your body to mature more eggs than what it normally would. You will be placed on a monophasic birth control regimen to regulate your cycle with that of the recipients. In most cases you will take oral contraceptives for a minimum of three weeks.
Cycle Commencement Depending on your day 3 FSH levels and Antral Follicle Count the cycling clinic will draw up a prospective calendar outlining your medication protocol and a projected retrieval date. This earmarks a period of approximately 10 - 20 days where you will undergo several monitoring appointments and will give yourself daily subcutaneous injections in the privacy of your own home. You will receive a portion of your compensation once you start your injectible medications. There are three stages in your cycle:
- Ovulation Suppression Ovulation Suppression is done to allow the doctor to control ovulation and is eventually used in conjunction with follicle stimulating drugs. There are two classes of drugs. The most commonly prescribed ovulation suppression medications are Lupron, Zoladex, or Synarel and are known as GnRH Agonists. Another class of ovulation suppression medications are Ganirelix or Cetrotide and are known as GnRH Antagonists. Both work in different ways to suppress LH surges. Ovulation Suppression medication will be given by self administered injections, subcutaneously, meaning into the fatty tissue of your belly.
- Follicle Stimulation During Follicle Stimulation (also known as controlled ovarian hyperstimulation) more follicles are caused to mature than the one or two that normally would during a girl’s menstrual cycle. The most commonly prescribed Follicle Stimulating Hormone products are Follistem, Menopure, Bravelle, or Gonal-F. FSH products will overlap with Lupron. Your dose of Lupron or similar agent may be reduced at this time. The monitoring clinic will continue to monitor your hormone levels and follicular growth and will adjust your dosage as necessary. During this time you can expect to have monitoring visits at the IVF clinic bi-daily during the first part of your follicle stimulation phase, and daily during the last few days of this stage. It is imperative that you do not take Ibuprofen or other anti-inflammatory drugs and that you abstain from sexual intercourse for the remainder of your cycle. Similar to your ovulation suppression medication, your follicle stimulation medication will be self administered subcutaneous injections.
- Final Egg Maturation When your estrogen levels and follicle measurements look best for a positive IVF outcome the cycling clinic will instruct you to take an HCG (Human Chronic Gonadotropin) shot. This is a one time injection, commonly referred to as the "trigger shot" which will give your eggs their final maturation. This injection may be administered subcutaneously but is more commonly administered intramuscular, meaning in the muscle (into your thigh or buttocks). Your doctor will advise you if your trigger shot will be administered subcutaneously or intramuscular, it is not a preference. Your retrieval procedure will be scheduled exactly 34-36 hours later so it is very important that you take your shot at the exact hour and minute that your doctor instructs you to. The day following your trigger shot is usually an injection free day. The night before the retrieval Your doctor will instruct you not to eat or drink anything for a minimum of twelve hours before your procedure. It is important to stay hydrated during the day in preparation for the procedure, being careful not to drink anything more after the time your doctor advises.
Retrieval You will arrive at the clinic at the time your doctor instructs you to. It is very important that you are on time. In most cases, your doctor will ask that you arrive about an hour before your scheduled procedure. Ideally, you should wear loose fitting clothing such as sweat pants and a T-shirt. In addition, you will need to have someone take you to the clinic and remain there so they can drive you home after the procedure. You will not be admitted to, or released from the clinic without a designated driver.
You will be placed under anesthesia by I.V. and will be comfortably sleeping during the procedure, but will be breathing on your own. The doctor will then use an ultrasound guided needle to aspirate your eggs. To do this s/he will puncture each follicle and aspirate all of the fluid which will contain a single egg (per follicle). Once all of the follicles have been emptied the procedure is complete. Most procedures last around 15-25 minutes.
After you wake up the doctor will monitor you for a little while to see how you are feeling. In many cases the donor is released as soon as an hour after her procedure.
Recovery The day of, and after the procedure you should stay off your feet as much as possible. It is important that you stay well hydrated with electrolytes or water and eat plenty of proteins. You will feel bloated and will experience pains comparable to period cramps. You can take Tylenol to relieve your pain, or in some cases your doctor may have prescribed you pain medication to take as needed. In addition, you may be placed on an antibiotic regimen to avoid infection from the procedure.
On the second and third day after retrieval you will be advised to continue to take it easy, but can return to most of your normal activities. You can return to work as soon as you feel comfortable, which can be as early as two to three days after the retrieval procedure.
Call your doctor if you experience any of the following:
- Severe abdominal pain
- Severe, persistent nausea
- Dizziness or fainting
- Difficulty urinating, or painful urination
- Heavy vaginal bleeding soaking more than a pad per hour (spotting or light bleeding is normal)
You can expect to receive your period 2 to 4 weeks after the retrieval procedure. You must abstain from sexual intercourse until you have had your period! In addition, you are advised to avoid swimming in swimming pools, natural bodies of water, or taking a bath (especially with bubble bath) to avoid infection.
As is with all medical procedures there are medical risks involved which should be discussed in detail with your physician.
Compensation Congratulations! The hard part is over! Your selfless gift, dedication, and effort will forever affect the lives of a family. For most parents they may never feel like ‘thank you’ is enough, however, a small token of their appreciation is to offer you compensation for your time and discomfort exuded to provide them with this priceless gift. After your retrieval An Angel's Gift will mail the remainder of your compensation check to your address on file with this agency within 72 hours.