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Indian Egg Donors & Surrogates
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Frequently Asked Questions:

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The following are the baseline protocols that we follow in our egg donation and surrogacy practice. These are in full complianace with the protocols that Having Babies (MHB), considers as the most critical standard for an ethical surrogacy journey:

Informed consent: The personal commitment and medical risks associated with egg donation and surrogacy, including possible complications and invasive procedures, should be fully explained by the clinic to all parties involved before any contracts are signed or medical procedures commence. Surrogates and donors should be informed about their right to receive such advice before, during and after the medical treatments from an independent medical professional that is not directly compensated by the IPs.

Medical screening: Clinics should medically screen prospective donors and surrogates to ensure they are healthy and likely to complete the process with minimal risk to themselves or the child. The screening professional should be financially independent from the agency or any entity that receives a fee for finding medically suitable candidates, to avoid a conflict of interest.

Social and psychological screening: Agencies should conduct screening and take steps to insure that surrogates and donors are aware of the potential stressors associated with the surrogacy journey, that they demonstrate sufficient social-emotional wellness to participate in the surrogacy journey, and have the required supportive environment. In particular, steps should be taken to ensure that the surrogacy journey will not adversely and irreparably affect the surrogate’s close social relationships, and that her safety and long term well-being will not be jeopardized due to social stigma or disapproval.

Medical terms: The agency should facilitate an agreement among the parties prior to contract signing regarding planned and contingent medical treatments. These should include the following: limitations to the number of embryos to be transferred, the number of transfer attempts, invasive diagnostic procedures (such as amniocentesis), selective reduction, termination, and the method of delivery.

Contracts: Providers shall not commence with any medical treatments before contracts are signed between the parties that detail all obligations, restrictions, compensations and planned medical procedures. These contracts should remain accessible to all parties throughout the journey.

Legal representation: Agencies and attorneys shall make sure that surrogates and donors have effective and independent legal representation in contract negotiations and finalization procedures. Exceptions may only be made in uncontested parentage proceedings in which no conflict of interest exists or is likely to arise among the parties, or where good faith efforts have been made to ensure such representation without success.

Financial mediators: Agreed compensation, expense reimbursement and other financial arrangements affecting the surrogate and donor should be fully disclosed to them and paid to them or accounts owned by them, directly or through an escrow account. Should mediators or other individuals claim to represent the surrogate or donor financially, to the extent permitted by law, such arrangements or commissions have to be fully disclosed to and consented by all parties in advance, and payments to mediators should not exceed those terms at any point throughout the journey.

Language: Agencies and clinics should make sure that medical risks and contracts are explained to the surrogate and donor in a language they fully understand, and that the contract they sign is available in the language of their choice. Support and coordination functions should also be offered in the donor’s and surrogate’s language, and arrangements made to facilitate direct communication between the surrogate and IPs in the mutually agreed form and scope.

Insurance: The agency should make sure that the donor and surrogate have suitable medical insurance and life insurance in effect before medical treatments commence, and last until they have fully recuperated from the donation or delivery respectively. Applicable medical insurance should be in place for the surrogate even if IPs plan to pay for all pregnancy and labor charges privately, to cover her in cases of complications or other medical problems during the journey.

Accommodations: In cases where a surrogate agrees or desires to relocate to the vicinity of the clinic for any length of time during the journey, steps should be taken to ensure that she has ongoing access to her family and other sources of support, and that she is able to leave the facility at will.

Meeting the child: Regardless of the nature of the relationship between the parties, agencies need to ensure that at the very least, the surrogate has the right to see and hold the child she carried after the delivery.

If a couple cannot be helped through procedures such as in vitro fertilization, they may want to consider using donor eggs. Donor eggs -- and sometimes donor embryos -- allow an infertile woman to carry a child and give birth. You might be a candidate for donor eggs if you have any of these conditions:

  • Premature ovarian failure, a condition in which menopause has started much earlier than usual, typically before age 40
  • Diminished ovarian reserve, meaning that the eggs that you have are of low quality; this can often be caused by age, since fertility drops off steeply after 40
  • Genetically transmitted diseases that could be passed on to your child
  • A previous history of failure with IVF, especially when your doctor thinks that the quality of your eggs may be the problem

The use of donor eggs is becoming increasingly common, especially among women over 40. In 2000, about 10% of all assisted reproduction techniques used donor eggs. And the technique enjoys the highest success rate of all fertility procedures. In fact, women using fresh embryos (not frozen), have a 43.4% chance of getting pregnant in each cycle.

Most egg donation in America and India is anonymous, but some couples prefer to know their egg donor and take legal steps to contract for the donation of the eggs. If the donor knows the couple, the donor may wish to receive updates once the child is born or may even request visits. An egg donor contract that explicitly spells out the terms of any future relationship should always be used even when the donor is a close friend or relative.

If you decide to use donor eggs, ask your fertility clinic if they have available donors that they have already screened. Since some clinics have long waiting lists, you may prefer to find a donor through one of many egg donor agencies and registries. Some people place ads for donors in college newspapers or other publications that young women read.

Finding a donor yourself can be faster than going through a busy clinic, but there is a serious disadvantage: You will have to interview the donor yourself rather than having a professional screen and evaluate her. It's crucial that donors be tested for any genetic disorders or diseases such as HIV. This is also true for women using donor sperm.

Egg donor programs vary in their requirements, but most conduct extensive screening and provide you with detailed information about the medical history, background, and education of the donor. Some programs have strict age limits; they won't accept donors older than their mid-20s. The American Society for Reproductive Medicine recommends that egg donors be less than 34 years old.

The procedure for egg donation and implantation is similar to standard IVF treatment. After a thorough exam, the woman receiving the donor egg will need a course of hormone treatments to prepare her for the egg. If she still has functioning ovaries, she'll need estrogen and progesterone treatments in order to make her cycle coincide precisely with the donor's.

Meanwhile, the donor will also be treated with hormones to induce super ovulation. Once she is ready, the eggs will then be retrieved and fertilized. A few days later, the embryo or embryos are implanted in the recipient's uterus. She will continue to take hormones for about 10 weeks afterward.

Donor eggs can be frozen for later use. But the chances of success are lower with frozen eggs.
A newly available option is shared embryo implantation. In this technique, you use a previously frozen embryo that was left over from another couple's IVF treatments. That couple may have gotten pregnant, or decided against IVF. Whatever the reason, they've granted the clinic the right to give their leftover embryos to other couples. But keep in mind this one drawback: Donated embryos often come from older couples who were probably coping with infertility problems themselves. Success is less likely than with the eggs of a young and healthy egg donor.

There are many potential legal issues that arise when egg donors are used by infertile couples. The egg donor contract should explicitly state that the donor waives all parental rights forever. It should state that any children born from the donated eggs are the legitimate children of the prospective parents.

Couples using donor eggs must usually bear all costs. Still, investigate your insurance company's coverage of these procedures and ask for a written statement of your benefits. Typically, you'll be paying for your own procedure, as well as for the donor's medical expenses, including any additional expenses due to complications that may arise from the egg retrieval process. These complications can include bleeding, infection, and injury to the bladder or abdominal organs.

The donor usually also receives a fixed fee for her participation. This amount should be carefully spelled out in the contract that the couple and the donor sign. How the payment is made (i.e. partial payments before and after egg retrieval) depends on the specifics of the contract. The contract also spells out what will happen in the event the donor withdraws before her eggs are retrieved.

Since you may not get pregnant with the first treatment, you may want to ask the donor if she will donate eggs a second time and include that requirement in the contract. Networking with other couples who've gone through infertility procedures is also a good idea. They may be able to share helpful tips and hints you won't find elsewhere.

One of the main benefits of this new reproductive technology is its high rate of success. The principle seems to be that the age of the egg, not the uterus, is the critical factor. Success rates for donor egg IVF can be three to ten times higher than with regular IVF. Much of this success is due to the use of young, normally fertile donors.

Donor egg IVF offers some possible advantages over adoption. One is that couples have complete control of the pregnancy. The woman can be sure of getting excellent prenatal care and be sure to avoid alcohol, tobacco, illegal drugs, or unnecessary medications.

Whether one turns to egg donation or not depends on the medical diagnosis. In consultation with your physician, the decision should be made whether you are psychologically prepared to be a candidate. This means being ready to make a commitment to parenting a child that is genetically related to only one of you. It also involves asking yourself and your partner some hard questions, which deserve some very honest answers. These questions will be extremely difficult ones. Who to tell or not to tell; when to tell; the non-genetic relationship disclosure issues, and what to tell the child, are all important questions that need to be discussed.

If you have any questions concerning the Egg Donation Program, please feel free to call our office for more information. We look forward to working with those patients who find egg donation to be their option and making their experience a rewarding one.

Donor egg IVF was initially developed to treat women with premature ovarian failure, women who didn't have any eggs and couldn't become pregnant. New technologies have greatly expanded this capability. Donor egg IVF is now used for women who are carriers of genetic diseases, women who have had multiple failed cycles of IVF, women with impaired ovarian function, or for older healthy women. This treatment also heightens the chance of pregnancy for women whose attempts at IVF have revealed a poor response to fertility medications, or eggs that did not fertilize well or form viable embryos.

Perhaps a preface to this guide should be a reminder that fertility and achieving a pregnancy is not an exact science. There are so many unknown factors influencing fertility, that even with all the advances in reproductive technology, conception remains as much an art as a science.

Each doctor has his own protocol, and the couple or donor's reaction to the drugs may result in a change in protocol. Following is a sample schedule for an egg donor and an egg recipient couple. The start of a menstrual cycle is referred to as DAY ONE (1) of the cycle. In an average 28-day cycle, a woman will most likely ovulate around day 14. This means the egg retrieval will usually take place on day 14 and the transfer will take place on day 16 or 17.

According to the treating physician's instruction, the egg donor will undergo ovulation induction. It is a procedure that involves the administration of fertility drugs to produce multiple egg (follicle) development. Fertility drugs are administered by injection or sometimes taken orally. There are two drug protocols that physicians use:

This protocol begins on the third day of the donor's menstrual cycle, and continues for seven -to ten days. During this time hormone levels will be monitored by means of blood tests and follicle development will be followed by means of transvaginal ultrasounds.
This protocol begins around the 20th day of the previous cycle. The physician will temporary "turn off" the ovaries using Luprolide to promote better egg development.

When the follicles containing the eggs reach the requisite size, an injection of HCG is administered to prepare them for aspiration. The egg retrieval/aspiration is performed in a hospital like facility under sedation. A vaginal ultrasound probe is utilized for aspiration of all ovarian follicles. This is a non-surgical procedure that takes about twenty to thirty minutes, depending on how many eggs are retrieved. However, the donor should plan to spend at least three hours at the clinic. After a brief period in the recovery room, the donor will go home that same day. It is important that you do not blame yourselves or each other, if a pregnancy is not achieved in any given cycle, Fertility is not an "all or nothing" proposition - it's a matter of degree. Unfortunately, there are factors that are unknown and therefore, no one has any control over that which can affect conception. Following is a sample synchronization and aspiration schedule for an egg donor and an egg recipient couple. Kindly note that this protocol may be very different for a specific couple, depending upon their medical history and is being provided for illustration purposes only:

DAY 1: Donor undergoes an ultrasound before the drug is administered to examine her ovaries and blood tests recipient to enable doctors to check her hormone levels. She is provided with medication to down regulate her system. (start of cycle) The drug is administered to the Recipient to synchronize her menstrual cycle with the donor's cycle.

Day 2
Day 3
Day 4
Day 5: Recipient begins taking Estradiol pills to develop the lining of her uterus, known as the endometrium.

Day 6
Day 7
Day 8
Day 9
Day 10: Donor undergoes another ultrasound and blood tests. She continues taking medication and receives a nine day supply of an ovulation stimulant that will cause her to produce a large quantity of eggs.

Day 11: At home, the donor receives her first injection of medication.
Day 12
Day 13
Day 14
Day 15
Day 16
Day 17
Day 18 Donor: More blood testing and an ultrasound to measure the size of her eggs

Day 19
Day 20: After undergoing another ultrasound to check on the development of her eggs, the donor receives an injection of HCG, a pregnancy hormone that helps prepare her eggs for retrieval.

Day 21 : Recipient receives Progesterone, a drug that further prepares the lining of her uterus for implantation of the embryo(s).

Day 22 Donor undergoes an outpatient procedure in which eggs are removed from her ovaries. A long needle removes maturing eggs from her ovaries. The microscopic eggs are sucked through the long needle into a test tube. That evening the eggs are placed in a test tube and inseminated with sperm from the recipient's husband in preparation for implantation.

Day 23:
Day 24: Approximately four of the best-fertilized eggs, or embryos, are implanted into the recipient's uterus. The other embryos had been frozen and stored in liquid nitrogen the day before.

Day 25 Rest day for recipient
Day 26: Rest day for recipient
Day 27: Ok to resume normal activities for recipient including travel

NOTE: Under our complete program, where the entire cycle is done in New Delhi the recipient can arrive in New Delhi on Day 1 and stay through Day 27. If you have IVF support from your local IVF Specialist, the recipient can undergo most of the pre-pregnancy treatments under the combined guidance of our New York Office and your local IVF Specialist; and arrive in New Delhi around Day 20 of the cycle and leave around Day 27. This would reduce the stay time in India to about one week.

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License info

*New York state residents may work with IED as intended parents, but state law currently restricts New York residents from serving as surrogates (carriers).

Licensed by the NYS DOH

Compliant with the Guidelines Established by the Society for Assisted Reproductive Technology (SART)