The egg donation process is a medical regimen that averages between 6-8 weeks from start to finish. Both donors and recipients benefit from a clear understanding of each stage of the complex process and are better equipped to adjust to the physical and emotional demands of the transplant.
Initial Medical Workup and Baseline Testing
The first step in the cycle is to assess the health of both partners with blood work, ultrasound, or a physical test. The patient's hormone profile is evaluated in order to start with the best conditions, and a pelvic ultrasound is used to identify normal ovarian morphology and the absence of any cyst that may affect the stimulation.
Infectious disease testing is carried out or updated to verify donor health and recipient safety. Psychological assessment may also help to verify emotional preparedness for donation.
Birth Control Pills and Cycle Synchronization
Many donors start oral birth control tablets 2-4 weeks before stimulation to control their menstrual cycle and timing as much as possible. This stage enables teams to carefully time cycles and synchronize with recipient preparation.
Birth control shuts down the production of natural hormones to give us that blank slate to work with when we start COH in the next stage. Bicycle length of the bicycle varied depending on the clinic and individual cycle characteristics.
Ovarian Stimulation Phase
This phase is 10-14 days, during which a woman receives one or more injections a day of medication that stimulates the development of many follicles. The key drugs are gonadotropins (FSH and LH), which cause the ovaries to ovulate more than one mature egg, unlike the one mature egg a month typical in a natural cycle.
Donors are well trained in the mode of injection, storage, source of medications, and timing of injection. The most common method is a subcutaneous injection, using small, insulin-type syringes that, for most women, are fairly painless.
Monitoring and Dosing Phase
Donors receive many monitoring visits (2-3 days apart) comprising routine blood work and transvaginal ultrasound exams during the cycle. Hormone levels, including estradiol, LH, and occasionally FSH, are checked via blood work to monitor response to medications.
Healthcare providers monitor the number and size of developing follicles using ultrasound methods. Drugs are titrated according to a woman's response to achieve egg yields while reducing the potential complications.
At this stage, it's important to recognize regional expertise, such as that found in egg donation Boston programs, which often offer advanced monitoring protocols and tailored donor support.
Trigger Shot
A donor is instructed to take a "trigger shot" of HCG or similar medication when her follicles have reached the ideal size for egg maturation (usually 18-20mm). This shot needs to be timed closely, typically given at 36 hours on the nose before you pull your eggs.
How close together should the trigger shot and the egg retrieval be scheduled? Timing is attached directly to successful retrieval, as the eggs will need to be harvested before natural ovulation sets in. Donors are sent explicit timing instructions and may even be called in by staff to ensure they get the administration right.
Egg Collection Procedure
This procedure is an outpatient surgery that is conducted under conscious sedation or light general anesthesia. A reproductive endocrinologist uses transvaginal ultrasound to guide the insertion of a slender needle through the vaginal wall to reach each ovary.
The captured follicles are punctured, and the contents are aspirated under mild suction. The process is relatively short, lasting between 20-30 minutes, depending on the number of follicles. The view of the newly recovered fluid is instantly examined under the microscope by embryologists to find and count mature eggs.
Post-Retrieval Recovery
After the procedure, donors' recovery is monitored for 1-2 hours to ensure stable vitals and lack of complications. Many women notice mild cramping or bloating (similar to a menstrual cramp), which will go away after one or two days.
Typically, normal daily activities can be returned to in 1-2 days, but heavy lifting or strenuous activity should be avoided for approximately 1 week. Routine checkups can track progress and for any further needs.
Adverse Effects and Complications
Common side effects during stimulation are bloating, mood changes, fatigue, and mild discomfort at the site of injections. Rare, more severe side effects that may require urgent medical attention include ovarian hyperstimulation syndrome (OHSS).
Symptoms of OHSS: Severe stomach pain (abdomen), increase in weight or swelling of the stomach, Shortness of breath, or a decrease in urination. Detailed information regarding warning symptoms and how to contact first responders is provided by medical teams.
Cycle Results and Follow-up
In general, donors are informed about the number and quality of eggs retrieved, but information related to the outcomes of fertilized eggs and pregnancies may not be disclosed directly due to clinic policy and legal agreements.
The menstrual cycle typically resumes within 4-6 weeks after retrieval. Most donors can cycle again (if they would like to donate again) after 2-3 regular menstrual cycles. Understanding this process in its entirety definitely can help to promote informed consent and positive results for all people associated with egg donation cycles.
