Frequently Asked Questions

1. Are there any restrictions on who may use frozen eggs?
   
   Generally speaking, all patients with diminished ovarian reserve or egg quality can use frozen eggs. There are a few exceptions, however. Couples that require sperm retrieval by TESE or TESA, couples where the total motile fraction is less than 1 million sperm, or patients who want PGD (pre-implantation genetic diagnosis) performed on their embryos cannot use the egg bank. These patients will need to use a fresh egg donor. The reasons for this are two-fold: 1) Egg thaws do not provide enough eggs to guarantee 2 high quality embryos if the couple has severe male factor infertility or desires PGD. 2) The cost associated with purchase of additional eggs for patients with severe male factor or genetic testing brings the cost of a frozen cycle up to that of a fresh one, so we do not recommend using the egg bank in these situations. For severe male factor and genetic diagnoses, fresh cycles prove to be far more cost efficient even if the initial expense is higher that that for frozen eggs.

1. What are your requirements for donors, and how are they screened?
   
   Women ages 21-30 answer our advertising and apply to the egg donor program here at RBA. The donor team reviews the donor applications and profiles and selects the profiles of young women likely to pass screening. Donors must be taller than 5’0” with a normal body mass index (BMI). Educated donors are strongly preferred.
   Donors are subjected to genetic, medical, endocrinologic, psychologic, and ultrasound testing to determine if they are eligible. Included in the psychological consult is a Minnesota Multiphasic Personality Inventory (MMPI). Eligible donors are also screened and interviewed by one of the RBA physicians. All donors who pass screening meet FDA standards.

1. What is the difference between fresh and frozen donor cycles?
   
   Fresh cycles involve stimulation of the donor, retrieval and insemination of her eggs, with transfer to the recipient, all within a few weeks time.
   With a frozen egg cycle, donors have been treated in advance, with the eggs collected and frozen for future use. Recipients using frozen eggs will select their donor as the eggs are needed.

1. Is there an age cut-off to be a recipient?
   
   We accept women up to age 50 for our recipient program. The embryo transfer must be completed prior to the 51st birthday.

1. How much does a treatment cycle cost?
   
   For a fresh donor cycle, the cost is approximately $25,000. A frozen donor egg cycle costs $16,500. Our business office representatives will work closely with you to determine your insurance benefits and payment options.

1. Are the medications included in the cycle cost?
   
   The cost of the medications for the donor ARE included in the cycle cost. Medications used to prepare the recipients uterus for embryo transfer are not included, but are much less costly.

1. Will the donor know if a pregnancy occurred?
   
   We do not inform donors of the success or failure of the donation, however, we do invite some donors to make additional donations. These donors may conclude (correctly) they are being invited back because they initiated a pregnancy.

1. What are the advantages/disadvantages to using frozen donated eggs?
   
   Some of the advantages to using frozen eggs include lower cost, more convenience for the recipient, and a decrease in the potential ethical and financial burdens of maintaining unused embryos.
   Recipients choosing eggs from the frozen egg bank will probably have no frozen embryos remaining for future use. Patients seeking more than one child from egg donation may prefer a fresh egg donation cycle to increase the chances of having embryos remaining for another attempt.
   

1. What are the requirements to become a recipient?
   
   A physician consult, screening bloodwork and cultures, pap smear, mammogram (>40 yrs), flexible sigmoidoscopy (>50 yrs), medical clearance letter (>45 yrs), uterine evaluation, sounding (trial embryo transfer), psychological consult. The male partner will also need screening bloodwork and a semen analysis.

1. What is the time frame involved for a cycle?
   
   Once a match has been made, a fresh cycle takes approximately six weeks, from first injection to the pregnancy test. Frozen cycles may take as few as four weeks to complete.

1. Can my OB/GYN do some of my initial testing so insurance will cover?
   
   Yes, an order can be written for your OB/GYN to perform some of the screening.

1. What is the percentage of success with each treatment cycle?
   
   Registered data with the Centers for Disease Control (CDC) and the Society for Assisted Reproductive Technology (SART) since 2002 show a typical delivery rate per embryo transfer >60%. The one exception to this was in 2005, where the delivery rate was 50%. At RBA, current data from 2007 shows a 67% delivery rate in fresh cycles. Egg freezing is so new that the CDC and SART do not have separate accounts for these pregnancies. Since the opening of our frozen egg program, over 60 cycles have been completed with an ongoing/delivered pregnancy rate of approximately 66%.

1. Can I use a donor from outside your bank/clinic?
   
   We encourage the use of our egg donors, as we are aware of the screening they have done and have personally approved them for our program. However, if you do choose an agency donor, we can coordinate with the donor agency for the cycle. Agency donors must pass our screening requirements. Use of an agency donor generally adds $8,000-15,000 in additional expense as a result of the agency’s fees. Our costs, however, remain the same.

1. Can I see a photo of the donor?
   
   Our donors are unwilling to show adult photos. Our promise to keep their identity protected allows us to recruit a large number of highly qualified donors. If available, you may be shown a baby photograph of your donor.

1. What information is given to me about the donor?
   
   You will receive a copy of the donor’s profile, family medical history, and genetics report.

1. How do you find your donors/how do you recruit/advertise?
   
   We advertise for egg donors at reputable colleges and universities, local publications, and on the radio. A large number of donors are referred by their friends who have previously donated here at RBA.

1. Are all your donors college-educated?
   
   No, however, we have a strong preference for educated donors. Donors who have not graduated from college generally have some other highly desirable trait(s) to make them candidates for our program. We review each donor’s personal situation/history thoroughly before accepting them into our program, as we want to be able to offer the best donors to our recipients.

1. How does the matching process work?
   
   With fresh cycles, the donor coordinators and physicians try to find and offer the closest possible match to what the recipient desires in her donor.
   With the launch of our new egg bank website containing the frozen donor eggs, recipients will have the opportunity to review the donors that are available, and forward their choices to the donor coordinators.

1. Can I exercise while going through treatment?
   
   Exercise is not contraindicated during your recipient cycle; however, once the embryo transfer is performed, you will want to only perform low-impact exercise until your pregnancy test.

1. What are the side effects of the medications I will be taking?
   
   Some of the possible side effects of the cycle medications include headaches, hot flashes, minimal weight gain, water retention, and mood swings.

1. Can I travel during treatment?
   
   Once your recipient cycle begins, it is important to be available for any needed appointments. Your nurse, prior to your cycle, can assist you in planning for these appointments.

1. Can I see my physician at one of your satellite offices?
   
   The satellite offices are staffed by certain physicians, and not all of our physicians rotate to each of these offices.

1. Who do I call with questions?
   
   During the matching process, you may contact the egg donor program administrative assistant with any questions. She will pull your chart and one of the egg donor coordinators will call you back. Once you have begun your cycle, you may contact your primary physician’s administrative assistant, and one of your nurses will return your call.

1. When can we have intercourse after ET and if I am pregnant?
   
   After your transfer, we ask that you refrain from intercourse until your pregnancy test, approximately 10-12 days later. If you are pregnant, as long as you are not experiencing bleeding or discomfort, intercourse is not contraindicated.

1. Can I fly on a plane after my ET?
   
   Air travel should be fine following the embryo transfer. It is extremely important to have your blood pregnancy test drawn at the appropriate time following the transfer.

1. If I am pregnant, is it normal to lightly spot or have some abdominal cramping?
   
   Spotting (dark red or brown) can be quite normal early in pregnancy. However, if you experience bright red bleeding, that soaks a pad an hour, immediately get off your feet and call our office.
   Intermittent mild cramping and slight twinges on either side may also be normal. If cramping is moderate to severe, and not relieved by Tylenol, this may not be normal and should notify our office.

1. When will I be able to tell if I am pregnant?
   
   Pregnancy testing is scheduled 10-12 days after the embryo transfer, depending on the stage of the embryos at transfer.

1. How long will I stay with the practice once I am pregnant?
   
   Typically you will not be discharged to your OB/GYN until 8-10 weeks of pregnancy. You will have several blood tests and ultrasounds to determine appropriate growth of the pregnancy before you are released.

1. Do I need to divulge to anyone that I used donated eggs?
   
   Pursuing donor eggs as a treatment option is a very personal decision. It is patient preference to share this information with others. We do recommend sharing this information with your OB/GYN, as he/she will be continuing your care once you are discharged from our practice.
   Current data from psychological journals on this subject suggest disclosing this information to the child at the appropriate time in the future.

1. Can I be a recipient if I have had my fallopian tubes removed or am menopausal?
   
   Yes.

1. Is it necessary when being matched with a donor to have a blood type match?
   
   No, unless you are planning on not disclosing the information to your child.

1. Can I go to my pharmacy to purchase my cycle medications?
   
   Yes, you may use your regular pharmacy to purchase your medications for your recipient cycle. However, some of the medications may need to be pre-ordered, as some pharmacies may not keep some of the medications in stock.