The Donor Egg Process

For intended parents using surrogacy, building your family with a donor egg is a precise, medically-supervised journey. This course, designed by the medical team at Surrogacy4All, provides a clear, step-by-step breakdown of the clinical process. We will demystify the medical protocols, from donor selection to embryo creation, giving you the confidence that comes with understanding the science behind your family’s creation.

Course Modules:

Indications & Initial Considerations – Is Donor Egg Right for You?

Understand the primary medical reasons for using a donor egg and the initial steps in the process.

• Clinical Indications for Donor Egg:
  • Diminished Ovarian Reserve (DOR): When the quantity or quality of a patient’s eggs is reduced, often related to age.
  • Premature Ovarian Insufficiency (POI): Early loss of ovarian function before age 40.
  • Genetic Disorders: To avoid passing on a known genetic condition carried by the intended mother.
  • Recurrent IVF Failure: Particularly when poor egg quality is suspected as the cause.
  • Absence of Ovaries: Due to surgery or a congenital condition.
• The First Step: Medical & Psychological Screening
  • Both Intended Parents and the Gestational Carrier undergo comprehensive medical and psychological evaluations to ensure readiness for the process.
  • Legal counsel is engaged simultaneously to draft contracts defining parental rights and responsibilities.

The Donor Selection & Screening Protocol

Learn the rigorous, multi-stage process we use to select and qualify an egg donor.

• Donor Databases & Agency Partnerships:
  1. We work with reputable egg donor agencies and maintain our own rigorously screened database.
  2. Initial selection is based on Intended Parents’ preferences, including phenotype, education, medical history, and personal characteristics.
• The Three Pillars of Donor Screening:
  1. Genetic Screening: A full genetic carrier screening panel is performed to identify risks for hundreds of conditions. Karyotyping is also conducted.
  2. Psychological Evaluation: A licensed psychologist assesses the donor’s mental health, motivations, and understanding of the process.
  3. Comprehensive Medical & Fertility Workup: This includes infectious disease testing, a physical exam, and a transvaginal ultrasound with an Antral Follicle Count (AFC) to assess ovarian reserve. Hormone testing (AMH, FSH, Estradiol) is also crucial to predict her response to stimulation medications.

Synchronizing Cycles & Medical Preparation

Understand how we coordinate the biological cycles of the donor and the gestational carrier to prepare for embryo transfer.

• Cycle Synchronization:
  • Using birth control pills or other medications, we temporarily synchronize the menstrual cycles of the egg donor and the gestational carrier.
  • This ensures the carrier’s uterus is perfectly receptive when the embryos created from the donor’s eggs are ready.
• Preparing the Gestational Carrier’s Uterus:
  • The carrier undergoes a mock cycle to ensure her uterine lining develops optimally.
  • She will receive estrogen (to build the lining) and progesterone (to make it receptive for implantation) in a carefully timed sequence.

The Donor’s Stimulation & Egg Retrieval

Get a detailed look at the controlled ovarian stimulation process and the minor surgical procedure for egg retrieval.

• Ovarian Stimulation Protocol:
  • The selected donor will self-adminject daily hormonal injections (FSH/LH) for approximately 8-12 days to stimulate the development of multiple follicles.
  • She is monitored every 2-3 days via ultrasound and bloodwork to track follicle growth and adjust medication dosages for optimal results and safety.
• The Egg Retrieval Procedure:
  • This is a minor, outpatient procedure performed under light sedation, taking about 20-30 minutes.
  • Using an ultrasound-guided needle, the physician aspirates the fluid from each follicle, which is then immediately handed to the embryology lab to identify the retrieved eggs.

Fertilization, Embryo Development & PGT-A

Follow the journey in the embryology lab from fertilization to embryo biopsy and freezing.

• Fertilization (ICSI is Standard):
  • In donor egg cycles, Intracytoplasmic Sperm Injection (ICSI) is the gold standard. A single sperm is injected directly into each mature egg to maximize fertilization rates.
• Embryo Culture & Selection:
  • Fertilized eggs (now embryos) are cultured in a state-of-the-art incubator for 5-6 days until they reach the Blastocyst stage.
  • The embryologists grade the blastocysts based on their morphology (appearance and expansion).
• Preimplantation Genetic Testing for Aneuploidy (PGT-A):
  • Highly Recommended: A few cells are biopsied from the trophectoderm (the part that becomes the placenta) of each blastocyst.
  • These cells are sent for genetic analysis to identify chromosomally normal (euploid) embryos. This significantly increases the chance of a successful pregnancy and reduces the risk of miscarriage.

The Embryo Transfer & Beyond

Learn about the final step of transferring the embryo and the subsequent pregnancy test.

• The Frozen Embryo Transfer (FET):
  • Once the gestational carrier’s uterine lining is perfect and PGT-A results are back, a single, genetically normal embryo is selected for transfer.
  • The transfer is a simple, painless procedure that requires no sedation. Using a thin catheter, the embryo is gently placed into the uterus under ultrasound guidance.
• The Two-Week Wait & Beta-hCG Test:
  • The carrier continues progesterone support.
  • Approximately 9-12 days after transfer, a blood test (Beta-hCG) is performed to confirm pregnancy.