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Our egg donation program has been one of the most progressive and successful programs in the southeastern United States. From our first cycle in 1998, we have had among the highest of success rates while maintaining a very low risk of high order pregnancies. This has been achieved through the application of prolonged pre-embryo culture and blastocyst transfers. Unfortunately, our program has seen rates of twin pregnancies that have ranged from 30-40%. While many patients believe that a twin pregnancy is a desired goal, we consider a twin pregnancy to be a complication of assisted reproductive techniques. This is due to the very high incidence of premature labor and delivery that is seen in twin pregnancies. Most twin pregnancies deliver between 34-35 weeks. A pregnancy is considered "term" when it passes the 37th week. The great majority of twins have difficulty with breathing and feeding. The smallest babies even have difficulty regulating their body temperature. The newborn ICU can be a dangerous place. For that reason, we counsel all our egg donation recipients to consider accepting the implantation of a single blastocyst whenever the blastocysts have an outstanding appearance and when there are additional blastocysts available for cryopreservation. In addition, some patients in our egg donation program choose to also have us perform pre-embryo biopsies (PGD) in order to assess the sex of the pre-embryos and to determine the degree of chromosomal aneuploidy of each pre-embryo. Studies have shown that PGD information can enhance the per embryo chance of implantation. PGD information can be of great help in deciding which blastocyst or blastocysts to select for implantation.
Who is a candidate to be a patient treated with the help of an anonymous egg donor? Egg quality decreases rapidly with age. This is evidenced by the declining pregnancy rates with age. With IVF, there is remarkable drop in pregnancy rates in patients after the age of 38. After 40, expected pregnancy rates are less than or equal to 25%; at 41, the expected pregnancy rate is 15-20%; after 42, pregnancies occur in less than 15% of patients. Patients in their late thirties and forties also experience spontaneous miscarriages more often. This is most commonly due to genetic abnormalities that are associated with the aging process of humans.
Pregnancies after the age of 43 are extremely rare with IVF. Some patients may have tried to conceive with standard IVF and may have failed due to poor ovarian response or poor egg quality. Some patients may have failed IVF for "unknown" reasons. More and more scientific evidence continues to show that the "unknown" reason has to do with embryonic genetic abnormalities. Some patients may have been diagnosed with pre-mature ovarian failure. There are other patients who simply choose egg donation as the primary treatment without ever trying with their own eggs. These are couples in which the female partner carries a genetic disease that they wish to avoid or who are of advanced age and choose to have the highest chance possible. We understand that as a woman it is quite difficult to come to the realization that egg donation is the only or the best option to start a family.
Why not just adopt? Adoption of a child is a wonderful thing to do. It is, however, not without risk. An adoption can fail just like IVF can fail. The children who are adopted out are by definition "not wanted" by the genetic mother who is carrying the pregnancy. This is of concern to many intended parents we meet. With anonymous egg donation, the patient chooses the donor who best matches her physical and personal characteristics. In addition, the pregnancy is very much wanted and cared for by the parents during the entire pregnancy. The pregnancy experience is complete. Egg donation can be as confidential as the parents wish to make it.
Who are the anonymous egg donors? Our egg donors are young ladies who have contacted our office and have been thoroughly screened by our medical staff. They are healthy, altruistic volunteers who understand the difference that they can make in a family's life. The donors are mothers, students, nurses, medical assistants, realtors, law students, nursing students, waitresses, models, graduate students, real estate appraisers, teachers, etc. In summary, they are regular people who have normal lives. They are healthy, monogamous, low-risk individuals. They register to be egg donors both to help and also to be compensated for their time.
How are anonymous egg donors screened?
What are the risks? Infectious disease screening is as per the current guidelines followed by members of the Society for Assisted Reproductive Technology and the American Society for Reproductive Medicine. These tests are HIV 1 & 2, Hepatitis B, Hepatitis C, RPR, Human Tumor Lymphocyte virus 1 & 2, Cytomegalovirus IgM, gonorrhea, chlamydia, ureaplasma, and mycoplasma. Caucasian donors are tested for cystic fibrosis carrier screen (if the intended father has not been tested). Since CF is a recessive condition, we only need to test one genetic parent. Note that we can test your donor if you wish to make sure that you are not introducing a common CF gene mutation into your family through the anonymous egg donor. Other genetic tests can be ordered as needed. More commonly we are testing for the most common genetic cause of mental retardation, Fragile X. This test is expensive as it is not yet standard care. If you have questions about further genetic testing of your egg donor, please arrange for a genetic counselor consultation through our office. Egg Donors in our program have been assessed for ovarian reserve by the medical team. This is prior to allowing them into our program. This is done through an early FSH level or through a vaginal ultrasound measurement of the ovaries and the "resting follicle count." This is a way of trying to predict if a donor will make a reasonable number of eggs when stimulated. Additional screening like psychological profiles and IQ tests can be obtained at the intended parents' request and expense.
What are the initial steps? The initial step is to complete the intended parent form. It may take our team more than two weeks to arrange your initial egg donor selection meeting. During that time donors are being contacted for availability and the matching process is going on. In the near future intended parents will be able to view a secure database to review profiles on their own. This database is currently under development. For now, local patients come to our offices for a meeting. Out-of-town patients can do this over e-mail and phone. Please be patient. We are much faster at this than any of our competitors. There are some intended parents who can never stop "shopping." They are presented several healthy donors but continue to request more and more profiles. When this happens they may be referred elsewhere. We
Once a donor is identified and matched with the intended parents, the infectious disease screens are obtained. The donor is educated about the injectable medications. Both donor and intended parent are usually placed on a birth control pill in order to synchronize their menstrual cycles. Ovarian suppression is started at the same time so that both donor and intended parent have their menstrual cycle at the same time. They are both seen for ultrasound. Note that all visits are carefully scheduled in order to avoid the meeting of an anonymous egg donor and an intended parent. Then the donor is stimulated to make multiple eggs while the intended mother is stimulated to build a uterine lining with estrogen. Progesterone is usually started prior to conception. The intended father presents to the office at a specific time on the day of conception. The insemination of the eggs is carried out later that day. The embryo culture in egg donation is usually for 5 days. On the 5th day we are able to choose the best one or two blastocysts for intrauterine transfer. A pregnancy test is performed 9-10 days later.
What is the cost of egg donation? The costs are listed on the Prices page on this web site. Please note that there will be costs for donor screening and medications and any additional tests that you require. Please check with our front desk by phone if you have any further questions.
The Intended Parents Form If you wish to download the Intended Parent Form, you may do so in our forms section. Please note that you must be a registered patient of the clinic in order to begin the matching process.
For Further Reference You can read an article about Egg Donation in the Herald Tribune which features an interview with Dr. Pabon. Contact us for additional information on Egg Donation
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The screening process begins with a lengthy questionnaire that is reviewed by our medical staff. Donors are then invited for an office interview where they are interviewed by our medical staff. Their old medical records are reviewed. Points of interest in their application are clarified. At that time the donors are educated further about the screening process, the medications that they will be taking, and the potential risks. If any concerns are discovered, the donor is either not allowed into the program or further testing and counseling is ordered. Acceptable donors are generally those with a negative health history, an unremarkable family history, and those with above-average intelligence. A donor's medical history is confirmed by reviewing her old medical records. Recent grades and transcripts are reviewed in order to further document her abilities. 
understand that we cannot meet everyone's expectations. Certain specific ethnic donors may be difficult to find. The medical team may have to advertise to locate your particular donor. Such advertisements are anonymous, but the cost of the search is passed on to the patient. 
