Donor Egg Recipient FAQ
Why Needs Donated Eggs?
Women who are unable to produce or use their own eggs require donated eggs. The following are some of the reasons why:
- Premature menopause
- Genetic abnormality
- Carriers of a genetic disorder
- Poor ovarian response to hormonal stimulation
- Absence of the ovaries
- Ovarian failure due to chemotherapy and/or radiation treatment
What Kind of People Donate Eggs?
Donors are anonymous unless the recipient chooses a family member or friend to be the egg donor. In both cases the donors undergo rigorous screening.
Potential egg donors come forward voluntarily for different reasons. The donors must undergo extensive screening to evaluate whether or not they will be suitable for egg donation. Donors must be between the ages of 21 and 31. They are asked to complete a detailed questionnaire, which is reviewed by our staff. If the questionnaire is favorable then they are interviewed. A potential donor’s medical history, both present and past as well as family history, is taken into careful consideration. Donors undergo a rigorous physical examination and an assessment by both a clinical psychologist and geneticist. The psychological evaluation ensures that the donor will be well adjusted without any underlying psychological problems. Potential donors are asked to complete a standardized psychological test. A careful genetic history is taken by a trained geneticist in order to ensure there are no hereditable disorders in the family. If there is any suspicion due to particular backgrounds, they are appropriately genetically screened. All egg donors are evaluated for cystic fibrosis, which is the most common hereditary disease in the United States.
All donors are carefully screened for sexually transmittable diseases and any other potential infectious diseases.
Also performed are a drug screen, cervical cultures for sexually transmittable diseases, hepatitis, HIV and syphilis. Ovarian reserve is assessed hormonally.
The donors are anonymous and the potential recipient is not disclosed to the donor, nor are the results of their cycle. Even though the program is anonymous, the recipient has available to review the donor’s profile, psychological evaluation and genetic evaluation. This allows the potential recipient to have, available at their fingertips, sufficient information to make an informed decision regarding their potential donor.
How Are Donors and Recipients Matched?
Recipients complete a profile form listing specific attributes they want from the donor. In addition to the specific attributes requested, physical characteristics are also used in matching. Our physicians play a vital role in assisting the coordinator in making appropriate matches with the donor. All matches are confidential.
Synchronization of Cycles
The cornerstone of egg donation is the synchronization of the ovarian cycles of both the egg donor and the recipient. This ensures that the embryos are placed in the recipient’s womb at the optimal time for implantation. Synchronization is achieved by the use of birth control pills and Lupron.
When both the donor and the recipient are regulated, the donor starts the fertility medication (gonadotropin injections) to stimulate her ovaries to produce eggs. The recipient will start her estrogen replacement prior to the donor starting her medications. While the donor is receiving the fertility medication to mature follicles to provide eggs, the estrogen the recipient is taking will prepare the lining of her uterus so it will be able to receive the embryos. The day the donor has the retrieval the recipient will start her progesterone protocol to help create the best possible condition for implantation of the embryos. The eggs are fertilized in the manner that offers the best chance of success. The method of fertilization (conventional versus ICSI) is agreed upon by the couple prior to insemination taking place.
Three or five days after the retrieval, the embryos are placed in the recipient’s uterus. Typically two embryos are transferred at the blastocyst stage of development. After the embryo transfer the recipient will continue taking the hormones and a pregnancy test will be performed in less than two weeks. If there is a surplus of embryos and they can be frozen, the couple is offered additional chances of conception. Since the woman does not need to undergo gonadotropin stimulation again, the cost is greatly reduced.
What Guarantees are There with the Donor?
Donors come forward voluntarily. They can be either anonymous or are known. They are well-motivated and usually complete the treatment for egg donation. It is, however, completely within their rights to withdraw from treatment at any given time until egg retrieval
There may be a rare occasion when the donor does not produce enough follicles or stimulates too quickly. In either of these instances, the treatment cycle may be cancelled due to poor donor response or due to high risk of ovarian hyperstimulation syndrome.
Who is a good candidate for IVF?
When IVF was first used its main purpose was to help patients with tubal disease who could not conceive naturally. Since that time many others have benefited from IVF, namely people with ovulatory dysfunction, endometriosis, male factor infertility, uterine factors, immunological disorders and idiopathic reasons.
Is there an age limit?
Due to diminished ovarian reserves that result in compromised egg quality and embryo development, pregnancy rates are low in women greater than 42 years of age.
Are there screening criteria for IVF?
There are several diagnostic studies that can be done to help predict ovarian stimulation outcome. Most commonly utilized are the basal FSH, LH, and estradiol levels on cycle day 3. One of the best measures to help understand how many eggs you will make in your IVF cycle is the new patient ultrasound to measure ovarian volume and resting follicle count. We also utilize AMH (anti-mullerian hormone) levels for guidance.
Does IVF increase the risks of birth defects?
Studies over the last 30 years show that IVF does not appear to increase that risk of birth defects in children above a couples baseline risk. There is an approximately 2% risk of birth defects in naturally conceived children and in children conceived by IVF.
What are the chances of multiple pregnancies with IVF?
Approximately 30% of patients will have more than a single gestation if more than one embryo is transferred. Efforts to reduce this number have been instituted at our center by selectively replacing just 1 embryo at the blastocyst stage and through the newer use of preimplantation genetic screening.
What is involved in Cryopreserved Embryo Transfer?
Estrogen replacement therapy is initiated at the beginning of the cycle to prepare the endometrium for implantation. A select number of embryos are thawed and transferred into the uterine cavity during the appropriate window of receptivity. Progesterone therapy is given to maintain luteal support for a pregnancy. With the newer embryo freezing techniques called vitrification pregnancy rates in frozen cycles now rival fresh cycles.
How will I pay for treatment?
The good news is that many couples have infertility benefits that cover the initial consultation and diagnostic testing and may also have coverage for fertility treatment. The news is especially good for South Carolina state employees who typically have coverage for all forms of infertility evaluation and treatment.
We recognize that understanding insurance benefits can be challenging, which is why at Coastal Fertility Specialists we have invested substantial resources in making the financial/insurance process as seamless as possible for you.
You will be introduced to your financial counselor during your new patient visit to be sure you have one point of contact for all of your insurance questions or financial concerns. We will investigate your benefits so that you know what is covered before any testing or treatment is initiated. The counselor will help you navigate your insurance benefits and provide you with alternate financial options should you need them.
Financial Options at Coastal Fertility Specialists
For patients without insurance benefits for treatment, we offer a variety of options. Our finance department is always available to answer insurance questions and provide financing options.
We accept several different insurance companies and recommend that you call one of our new patient coordinators to see if we accept your insurance. Since infertility may or may not be covered by your insurance company we also recommend that you contact your insurance company so you can fully understand your benefits and can make informed decisions regarding your treatment plan. We have put together some benefit verification guidelines that will help you through the process of working with your insurance company.
When insurance benefits aren’t available we offer programs to lessen the financial anxiety. One of those programs is the Coastal Fertility Shared Risk Program that offers a 100% guaranteed refund if treatment is unsuccessful for IVF and a 100% guaranteed refund if treatment is unsuccessful for Donor Egg.
We are also proud to provide access to financing through Ally Lending and Lending Club, who offers convenient, low-interest and flexible financing programs for all types of treatment, including the Shared Risk IVF Program. Coastal Fertility Specialists patients are eligible for an exclusive Lending Club financing package with interest rates as low as 3.99% APR.
Medications can be one of the most expensive parts of infertility treatment and we want to help you with your medication purchase. We have several options to assist you in getting your medications without compromising care. DirectRx, Mandell’s Pharmacy and Freedom Fertility Pharmacy all offer many advantages to purchasing medications. Some have mail order pharmacy programs and also provide excellent customer service with “online” pricing.
The second option is both Merck and EMD Serono which have compassionate care medication programs for those patients undergoing IVF and Donor Egg treatment. Their programs are based upon your income and degree of insurance coverage. Those patients with lower household incomes without insurance have a good chance of receiving donated medications. Please download their applications and apply if you are interested. We recommend you apply to both to maximize your chances. There is no charge to apply.
Coastal Fertility Shared Risk Program FAQ
What Else do the Programs Include?
The Coastal Fertility Shared Risk programs typically cover IVF and FET in-cycle services, (meaning when stim medications are started), monitoring office visits for in-cycle blood tests, ultrasounds, egg retrieval, fertilization and embryo transfers.
The programs do not cover IVF pre-screening tests and medications. Storage of excess embryos, assisted hatching and anesthesia are not typically covered, as well.
Why Doesn’t Everyone Offer This Program?
To offer such a program, a fertility center must maintain higher than average IVF delivery rates. In fact, Coastal Fertility Specialists has such high pregnancy rates that we are one of the few centers that can offer a 100% refund in the IVF program.
The unique, non-traditional nature of the Coastal Fertility Shared Risk IVF Program represents a dramatic change from the typical fee for service payment. The concept of a “shared risk for IVF” was carefully reviewed and analyzed by the American Society for Reproductive Medicine (ASRM). They stated that with appropriate checks and balances this type of program can be ethically pursued and provide great benefit to patients. The feedback we have received from patients over the last ten years reinforces our strong belief in the ethical nature of this program. We offer the Coastal Fertility IVF Program as an alternative financial option but do not try to persuade couples to participate. We advise everyone considering this option to weigh the benefits of this program vs. the traditional fee for service.
Worried about how you can pay for your fertility treatments? Coastal Fertility Specialists is pleased to provide access to financing through both Ally Lending and Lending Club Patient Solutions, who offer convenient, low-interest and flexible financing programs for all types of treatment, including our Shared Risk IVF Programs. Coastal Fertility Specialists patients are eligible for exclusive Ally Lending and Lending Club financing packages with interest rates as low as 4.99% APR.
Through Ally Lending and Lending Club, your Coastal Fertility Shared Risk IVF Program and other infertility treatment expenses can be paid for over a period of 18 to 84 months, at low fixed rates.
A Patient’s Point of View
“The Coastal Fertility Shared Risk IVF Program gave us peace of mind while we were going through IVF because the costs were fixed-no surprises. Once pregnant, we were comforted knowing that if anything happened to the pregnancy, we could try IVF again or adopt.”
Questions & Considerations
Our goal in offering the Coastal Fertility Shared Risk IVF Program is to help infertile couples create or expand their family, with less financial anxiety, when insurance benefits aren’t available to help defray the costs.
Does the Program Guarantee a Successful Outcome?
This program does not guarantee a successful outcome. As is clearly stated in our written and verbal communication, we don’t expect nor do we guarantee every couple will take home a baby. However, the Shared Risk IVF Program does guarantee that the cost of an IVF cycle will be limited if the treatment is unsuccessful.
Why Does the Program Have Age and Other Limitations?
The delivery rate in the Shared Risk IVF Program must be maintained at or above 40% per cycle for this program to be financially feasible for us to “share the risk.” Therefore Refund Program participants must be able to complete three IVF cycles by their 38th birthday. However, patients using donor eggs are eligible for the program even if older than 39. The age limit was not set to “skew” the outcomes in our favor but rather works to maintain the delivery rate that allows us to offer the Shared Risk IVF Program to eligible couples who have no insurance benefits for IVF. For IVF patients who don’t qualify for the Refund Program, they have the Multi-Cycle Program option, which provides about a 30% savings.
What Percent of Patients “Take Home a Baby” in the Refund Program?
92% of patients who complete the 3 cycle IVF Refund Program take home a baby. The chance of taking home a baby if you complete the 2 cycle IVF Refund Program is 80%. Persistence matters.
How Many Patients Actually Qualify for the Refund Program?
Over the last 10 years approximately 80% of couples who applied have met the eligibility criteria for the Shared Risk IVF Refund Program.
Are Different Therapies Used for Attain IVF Enrollees?
The therapies used for patients are the same whether you are in the Shared Risk IVF Program or not. Typically, the Shared Risk IVF Program is only discussed after IVF or donor egg treatment is chosen as the medically appropriate therapy.
Questions? Call us Today at 843-883-5800.
More information about the Coastal Fertility Shared Risk Program.