Breaking Down the Egg Donation Process: Ovarian Stimulation
If you’re thinking about becoming an egg donor, you may be wondering about the details of the process. Egg donation consists of several steps that lead from applying to become a donor to the egg retrieval itself.
Once you have been matched and medically cleared, you will be scheduled for a stimulation cycle. Before eggs can be retrieved, your ovaries must be stimulated to mature a number of eggs all at once, unlike a normal ovarian cycle. Normally, your body brings one or sometimes two eggs to maturity each month to be released at ovulation.
To increase the chances of creating a viable embryo through in vitro fertilization, we want to be able to retrieve as many eggs as possible. To prepare for that, we perform ovarian stimulation to mature multiple eggs simultaneously.
What Is Ovulation?
Within a woman’s ovaries are many thousands of fluid-filled sacs called follicles holding oocytes (oh-uh-sites), which are immature egg cells. Each month several follicles begin to enlarge just about the time of your period. Over the next few weeks, only one or two dominant follicles develop to maturity (18 to 24 mm in diameter, about the size of a dime), rupturing the follicle to be released into the Fallopian tubes in a process called ovulation.
Any other follicles that had begun to enlarge stop their progress and degenerate. If pregnancy does not occur, you have a period, and the cycle repeats itself again. Only a tiny fraction of the follicles you have available ever mature into eggs, making it possible to donate a few with no impact to your own future fertility.
Ovarian Stimulation for Egg Retrieval
Since the goal is to have multiple eggs for a single in vitro treatment, we need to create a condition in which several follicles mature in a single cycle. Using a variety of medications, many of which are hormones typically found in your body, we lay the groundwork for egg retrieval over the course of several weeks.
The medications are self-administered, so the only visits you will make to the clinic are the times we monitor the number and maturation of the eggs themselves. Then, of course, the retrieval procedure occurs at the end.
Each ovarian stimulation is personalized to the woman undergoing the procedure, meaning not every medication mentioned below is used for every ovarian stimulation process. Every woman is different, and no two women have identical cycles or hormone levels.
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- Oral contraceptives, oral estrogens, and possibly testosterone are given to improve ovarian response or create more symmetrical follicle growth and maturity.
- Synthetic follicle stimulating hormone (FSH) and luteinizing hormone (LH) are injected over eight to fourteen days using very thin needles under the skin. The amounts prescribed are much higher than your body typically releases so more than one egg will develop.
- Along with the synthetic hormones, a GnRH (gonadotropin-releasing hormone) antagonist is introduced to keep ovulation from occurring too early in the cycle. You don’t want the eggs to release before they can be retrieved.
- A “trigger” medication is given 36 to 44 hours before we want ovulation to occur, typically a shot of hCG (human chorionic gonadotropin) or a drug called Lupron. Egg retrieval is scheduled about 35 hours after the trigger is administered.
What Is Happening?
In the weeks before ovarian stimulation, you take oral estrogen or an estrogen-progesterone mix like that found in birth control pills. Providing known amounts of these hormones prepares the ovaries for stimulation and assists with follicle size and maturity.
At a specific time in your next cycle, you begin to inject FSH and LH to make multiple eggs start to develop. Remember, normally your body only prepares one, maybe two eggs each cycle. Higher levels of FSH and LH stimulate many more follicles to enlarge at once.
Throughout the stimulation treatment, you have blood drawn to measure the levels of various hormones in your blood. At the same time, we monitor the number and size of the follicles developing in your ovaries using transvaginal ultrasound. This type of ultrasound does not require you to drink large amounts of water, so it is a very easy procedure. You may even get to see your follicles on the screen as the technician measures them.
While your ovaries are being stimulated, you also take medication to keep from ovulating before it’s time for the egg retrieval. This medication works to deplete the FSH and LH your body normally makes so it can be controlled. The blood levels of LH must be very low during the last few days of follicle growth.
When the follicles have reached the desired size, the trigger medication, such as hCG, is given to get ready for ovulation.
Throughout the entire process, the clinic maintains close communication with you, so you know the progress of your treatment, receive instructions on any changes, and have ample time to ask questions or raise any concerns you may have. There is never a time when you are out of touch with us.
Ovarian stimulation is the step in the egg donation process just before the egg retrieval procedure. The entire process can take two or three months, but you spend very little of that time at the clinic; you are free to go about your life with few restrictions.
Most of your appointments occur during the time when you are taking FSH and LH when you have brief appointments when we draw blood and check your ovaries with ultrasound. The process may be somewhat stressful, and you may experience mood swings while you are on the hormone treatment, but it’s only for a short time. Most women tolerate it very well.
Egg donation is an amazing way to help someone else start a family that has not been able to on their own. For your participation in this event, you can receive up to $10,000 a cycle, just for two or three months of your time, some hormone therapy, and a brief outpatient procedure.
Ovarian stimulation has been around for over 40 years. It has been refined, so you receive the precise amount of hormones required. You have hundreds of thousands of follicles within your ovaries, only a tiny fraction of which ever mature into eggs. There is no impact on your future fertility, and you provide the chance for someone else to realize the dream of parenthood.
For more information about becoming an egg donor, read our ebook!
If you think you’re ready to get started, you can apply right here!