After a donor is chosen by the IP/recipient from the agency profile or clinical database, she then undergoes an intensive process of medical, psychological and genetic testing. These examinations are expensive and time sensitive, therefore the agencies must first confirm that a match is guaranteed before investing in this process.
In countries where donors are required to remain anonymous, the donor is chosen by the recipient’s physician in consultation with the IP/recipient. Once the match is confirmed, your donor will be referred first and foremost to a psychologist who, through a series of meetings, will evaluate if she is mentally prepared to undertake and complete the donation process safely and successfully.
Next, the donor is required to undergo a comprehensive medical examination, which starts with a blood draw in order to check her hormone levels, to rule out infectious diseases or inappropriate drug or medication usage, and to confirm her Rh factor and blood type. A pelvic examination is done via ultrasound in order to confirm the health status of the donor’s ovaries, uterus, cervix and other reproductive organs.
In cases of surrogacy, the same intensive medical and psychological testing that is carried out on the donor is conducted in parallel on the surrogate in order to ensure optimal conception, pregnancy and delivery outcomes. A complete family history is then conducted that ideally includes three generations.
In some cases, genetic testing is also undertaken in order to ensure that donors do not carry mutations (for example, cystic fibrosis). Not all clinics automatically perform such testing, so if this is something that concerns you, please clarify with the appropriate clinic whether such testing will be done.
After the screening is complete and a legal contract is signed, the donor begins the donation cycle, which can take anywhere between three to six weeks. Birth control pills are administered during the first few weeks of the egg retrieval process in order to synchronize the donor’s menstrual cycle with the recipient’s/surrogate’s cycle. This is followed by a series of injections that halt the normal functioning of the donor’s ovaries. Follicle-Stimulating Hormone (FSH) injections are then given to the donor in order to stimulate egg production and increase the number of follicles produced by the ovaries. Typically, each follicle contains one mature egg at the end of this process, but it can also contain fluid only or alternatively, two to three eggs. Only under special microscope in laboratory conditions can the eggs be counted, but an approximate number can be estimated beforehand via the number of follicles seen on ultrasound.
Throughout the entire cycle, the donor’s hormones, follicle growth and overall well-being are carefully monitored by a physician using blood tests and ultrasound examinations. When the follicles reach a specific stage of maturity, the physician will determine a date and time for egg retrieval.
The last injection of Human Chorionic Gonadotropin hormone (better known as HCG) is then administered to the donor exactly 36 hours before the egg retrieval procedure in order to ensure that her eggs are ready to be harvested. This procedure is a minimally invasive surgery typically done under general anesthesia or IV sedation that lasts approximately 20-30 minutes. A special ultrasound-guided needle is inserted through the uterus to aspirate the follicles in both ovaries into special clinical test tubes that are then carefully passed to the lab, where the eggs are then counted.
The recovery time for this procedure is approximately one to two hours. After the donor rests, eats, and is checked by the medical team, she is then discharged home and able to resume regular activities by the next day.