Egg Donation
“Best Egg donor IVF Florida services provided by clinic with its own egg donor bank.
Patients from all over the world come to us for the privacy and confidentiality that is provided through our boutique practice in Florida’s West Coast.”
Our clinic has provided Egg donor IVF services since 1997. Dr. Pabon has always made an effort to recruit and maintain an active egg donation “bank” in Florida in order to try to make this type of treatment more affordable. Egg donor “agencies” come and go and unfortunately some of them charge very large fees for “matching” donors and surrogates. Most of these “agencies” hold no professional licenses and are not governed by professional codes of ethics or standards. It is a consumer beware kind of transaction. Most of our patients can match with a suitable egg donor from our bank. Dr. Pabon will refer patients to outside agencies if they so desire or if the match is difficult due to uncommon ethnic backgrounds or special needs. Our patients will also have the opportunity to compare traditional egg donation arrangements where a single egg donor donates eggs to a single designated patient versus using frozen egg donor eggs from donors that have been screened, stimulated, and have previously donated their eggs.
What is Egg Donation?
Egg Donation is a wonderful gift. Egg donation IVF involves stimulating the egg donor with fertility medications in order to harvest several eggs for fertilization in the IVF lab for subsequent implantation into the mother or gestational carrier. An egg donor may be an anonymous egg donor from our bank or from an agency. Some patients have a “known” donor who has agreed to donate to the couple or person. A legal waiver of parental rights is executed in both cases so that the intended parents can be confident that there will be no legal doubts regarding parenting.
Recently, another source of egg donor eggs has emerged as a result of improved technologies in the freezing of eggs. Patients will also be able to consider purchasing frozen eggs from or affiliated frozen donor egg provider. Patients will be able to compare and contrast the pros and cons of either approach. The cost of using previously frozen egg donor eggs may be higher than using fresh egg donor eggs if the patient chooses a donor from our bank as the egg donor matching fees are very reasonable. Unfortunately, due to the poor survival of frozen vitrified eggs, the costs of this type of frozen egg approach may be higher than using fresh eggs from a donor. The costs may be more comparable if a patient has to consider using an agency to find a particular type of egg donor since agencies typically add ten to fifteen thousand dollars to the process.
What are the reasons to consider egg donor IVF?
Patients needing treatment with the help of an anonymous egg donor come to us for a variety of reasons including premature menopause, decreased ovarian reserve, advanced maternal age or a family history of X linked recessive genetic diseases. We also treat same sex couples that require both an egg donor and a gestational carrier.
Why are egg donors usually less than 30 years old?
Egg quality decreases rapidly with age. “Egg quality” is a lay term that really relates to whether the egg is genetically normal or not. In humans, the eggs are made in embryonic development. A woman’s total number of eggs are already made when she is born. It is estimated that women are born with about 200,000 eggs. The chromosomes in the nucleus of these eggs are in a state of arrested cell division. The longer an egg is “stored” in the ovary before it is activated to complete the reduction of its number of chromosomes, the more errors that can occur. That is why the chance of producing a normal egg decreases after the age of thirty and most sharply after the age of 37. These changes are the reason why pregnancy rates decrease with the age of the egg. Additional evidence of this is found when one notes the increasing risk of miscarriage with age as well as the increased number of genetically abnormal embryos when older women undergo IVF with Pre-implantation Genetic Screening or Pre-implantation Genetic Diagnosis. Most interesting is recent data showing that older and younger patients have the same high pregnancy rate when a single genetically normal embryo is transferred. See the PGD/PGS section.
As in nature, with IVF, there is remarkable drop in pregnancy rates in patients after the age of 40. After 40, expected pregnancy rates are less than or equal to 25%; at 41, the expected pregnancy rate is 15-20%; after 42, pregnancies occur in less than 15% of patients. Patients in their late thirties and forties also experience spontaneous miscarriages more often, most commonly due to genetic abnormalities associated with the aging process of humans. As mentioned above, recent data indicates that there is no difference in the chance of pregnancy between the very young and the older patients when a screened genetically normal embryo is implanted.
Who is a candidate for egg donation?
Candidates for egg donation vary by individual situation. Some patients have been diagnosed with premature ovarian failure while others simply chose egg donation as the primary treatment without ever trying with their own eggs. Typically, these couples have a situation in which the female partner carries a genetic disease they wish to avoid without PGD/PGS or they are of advanced age and chose to have the highest chance possible.
What are my chances of having twins or multiples if I use Egg Donation?
Our egg donation program has been one of the most progressive and successful programs in the southeastern United States. From our first cycle in 1998, we have had among the highest of success rates while maintaining a very low risk of high order multiple pregnancies. This has been achieved through the application of prolonged pre-embryo culture and blastocyst transfers. Unfortunately, in the past, our program had rates of twin pregnancies that ranged from 30-40%. While many patients believe that a twin pregnancy is a desired goal, we consider a twin pregnancy to be a complication of assisted reproductive techniques. This is due to the high incidence of premature labor and delivery seen in twin pregnancies.
Multiple pregnancies are very high risk. Twins or higher order pregnancy babies have an increased risk of cerebral palsy (6 times higher) and congenital anomalies (6 times higher) that can be quite severe. Recent technology with laser assisted trophectoderm blastocyst biopsies have allowed us to confidently implant single embryos and expect a pregnancy in over 75% of cases. The ability to conclude an IVF treatment with a single embryo transfer and expect very high success makes pre-implantation genetic screening of egg donor embryos a reasonable approach. In fact, since 2014 our clinic performs embryo biopsies for chromosome testing on almost all IVF cycles including donor and non-donor cases. Since we have become a “single euploid embryo transfer IVF program,” more than 95% of our embryo transfers are single embryos. We therefore have an extremely low risk of multiple pregnancy. Testing the genetics of the embryos improves the efficiency of treatment and also gives the patients very important information about stored frozen embryos.
Why not just adopt?
Adoption of a child is a wonderful thing to do. It is however, not without its own risks. Patients considering adoption should contact an attorney specializing in this area of law. There are many fine attorneys to choose from in Florida and our office fully supports your decision to explore this option. With egg donor IVF, patients may choose the general appearance of the egg donor and also have a lot of information about that donor’s education, health and genetic history. In addition, most commonly, the intended father is also the genetic father.
Who are the anonymous egg donors?
Egg donors are healthy, altruistic volunteers who understand the difference that they can make in a family’s life. The donors are mothers, students, nurses, medical assistants, realtors, law students, nursing students, waitresses, models, graduate students, real estate appraisers, teachers, etc. In summary, they are regular people who have normal lives. These monogamous, low-risk individuals have registered as donors because they have the desire to help others have a family. Egg donors are also financially compensated for their efforts.
Our center is unique because we have a secure web based donor bank containing 50 to 70 active donors at all times. These donors have been screened by Dr. Pabon and are for our patients. There is a fee of $250 for access to the data bank. When a patient selects a donor from the bank, the $250 fee is applied toward the $1,500 matching fee. These fees are used to maintain the data base. The matching fee of $1,500 is about ten times less than what some egg donor agencies charge. We have set up our own donor data bank in an effort to make treatments more affordable. In most cases, there is no need for an outside agency. Some patients may not find a suitable donor in our data bank. In that case, an outside agency or frozen banked eggs may be used.
How are anonymous egg donors screened?
The screening process begins with a lengthy questionnaire reviewed by our medical staff. Those passing this first step are then invited to the office for a full interview. Their old medical records are reviewed and points of interest in their application are clarified. Once this step is completed, donors are educated further about the screening process, the medications that they will be taking, and the potential risks. If concerns are discovered, the donor is either not allowed into the program or further testing and counseling is ordered.
Acceptable donors are generally those with a negative health history, an unremarkable family history, and a low-risk lifestyle. In some situations, recent grades and transcripts are reviewed in order to further document her abilities.
How are the donors screened?
Infectious disease screening is as per the current guidelines followed by members of the American Society for Reproductive Medicine. Our clinic is registered with the Federal Drug Administration (FDA). We follow all FDA rules regarding the screening of egg donors. These tests are HIV 1 & 2, Hepatitis B, Hepatitis C, RPR, gonorrhea, and chlamydia. All our donors are screened for the most common recessive diseases like Cystic Fibrosis and Spinal Muscular Atrophy (SMA). We are currently screening egg donors with a 101 recessive disease panel from a company called Counsyl Genetics. Donors are also screened for Fragile X. Donors undergo random drug screens. Recently the FDA has asked us to start testing for West Nile Virus and to do thorough screening for Zika exposure risks.
Egg Donors in our program have been assessed for ovarian reserve by the medical team through an AntiMullerian hormone test or FSH level as well as a vaginal ultrasound measurement of the ovaries and the “resting follicle count”. This is a way of trying to predict if a donor will make a reasonable number of eggs when stimulated.
Additional screening like psychological profiles and IQ tests may be obtained at the intended parents’ request and expense.
What are the initial steps?
The initial step is to become an established patient of our clinic. Intended parents are then given secure access to the online database to review potential donors. Once the initial selections are made, intended parents inform our medical team of their top-three choices. Our office then contacts the donors to confirm availability and fees. We understand that we cannot meet everyone’s expectations and certain specific ethnic donors may be difficult to find. The medical team may have to advertise to locate your particular donor. Such advertisements are anonymous, and potential donors respond directly to the clinic to begin the application process. Alternatively, patients may be referred to an egg donor agency or our affiliated frozen egg bank.
The New Logistics (AFTER 2013) of an Egg Donor IVF cycle:
As has been mentioned above, our clinic is very active with Pre-implantation Genetic Screening of embryos for the purpose of achieving very high pregnancy rates with single embryo transfers. For that reason, the great majority of our egg donor IVF treatments are segmented as they are for all our patients. This means that the egg supplier is stimulated with fertility drugs, the eggs are harvested and fertilized. The embryos are grown and tested with embryo biopsies (usually on embryo culture day 5 and 6). All embryos that are biopsied are frozen and kept in our clinic while the patient is in treatment. The results of the genetic tests come from Genesis Genetics about 7 – 10 days later. At that time Dr. Pabon will contact patients and inform them of the results of the chromosome tests on each embryo tested. He will also disclose the gender of the embryos if the patients wish to know.
Once we have the genetic information, the recipient patient is prepped for a frozen / thawed embryo transfer cycle that will require ultrasound tests, uterine measurements, and an endometrial biopsy (endometrial scratching) to enhance implantation and rule out other possible problems prior to the embryo transfer. The embryo transfer cycle usually begins with a low dose birth control pill, followed by subcutaneous (small needle) lupron to avoid ovulation after the birth control pill is discontinued. The patient then receives estrogen supplements for at least 16 days and then an additional 6 days of progesterone prior to the embryo transfer. The goal will be a single embryo transfer, but patients usually consent to the “thawing of as many embryos as needed to obtain one healthy for transfer.” Patients receive only one embryo in more than 95% such transfers. Frozen embryo recovery is more that 95%. These plans rarely require the thawing of more than one or two embryos.
Traditional logistics of and egg donor IVF cycle:
Traditional IVF with egg donor and recipient concurrent treatment requires that both the egg producer and the recipient be synchronized and fully screened and prepped to receive the embryos 5-6 days after the egg harvest and fertilization. This method allows for an abreviated genetic test (approx. 3% of genome only) of embryos so that we can get results within one day. Note that only embryos that reach the blastocyst stage on day 5 will be able to be tested and considered for “fresh” transfer. Most patients choosing this approach are those that choose not to test the embryos genetically at all or those from remote international locations.
Once a donor is identified and matched with the intended parents, the infectious disease screens are obtained and the donor is educated about the injectable medications. Both donor and intended parent are usually placed on a birth control pill in order to synchronize their menstrual cycles. Ovarian suppression is started at the same time so that both donor and intended parent have their menstrual cycle at the same time and both are seen for ultrasound. Then the donor is stimulated to make multiple eggs while the intended mother is stimulated to build a uterine lining with estrogen. Progesterone is usually started the night before the egg harvest or the night after the harvest depending on whether the intended parent has requested PGS testing or not since “fresh” PGS requires the a delay of one day for the transfer.
The intended father presents to the clinic at a specific time on the day of conception. The insemination of the eggs is carried out that day. The embryo culture in egg donation is usually for 5 or 6 days. On the 5th day we are able to choose the best one or two blastocysts for intrauterine transfer and a pregnancy test is performed 9-10 days later. Patients choosing to have trophectoderm blastocyst biopsies for PGS will receive the screened embryo on the sixth day of culture. Please note that only those embryos reaching the blastocyst stage on the 5th day of culture will be available for a fresh transfer. Those reaching the blastocyst biopsy stage on the 6th day will not be available for fresh transfer and will be frozen for future use.
Very Important Note: All visits are carefully scheduled in order to avoid the meeting of an anonymous egg donor and an intended parent.
What is the cost of egg donation?
The costs are listed on the fees page on this web site. Please note that there will be costs for donor screening and medications as well as any additional tests that you require. Please check with our business office if you have any further questions. Call 941-787-2287 or email via the contact page of this web site.
What are the laws governing Egg Donations in Florida?
In Florida, gametes (the eggs) are considered property. Once the eggs are obtained, they are property of the intended parent. All donors are required to sign a legal waiver of parental rights for each donation. If patients prefer, a reproductive law attorney can execute the waiver and maintain the documents for you. We can provide you a referral to a reproductive law attorney.
In Florida, intended parents are able to learn a lot about their egg donors. Intended parents may view photos and extended profiles. This is quite different from the egg donor process in other states or countries. The anonymous program is anonymous in that neither the egg donor nor the intended parent know each other. Intended parents do receive the information they need in order to make a decision
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