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The Cycle of Life

Explaining the fertility business, from a woman's interest in donating her eggs, to the agencies who match egg and parent, and finally to a baby being born.

The Egg Hunt The Egg Hunt

Twenty-five years ago, the fertility business was embryonic. Today, it's a big and healthy industry that's providing hope to families and financial rewards to entrepreneurs. Read More

My Egg, My Choice, My Money My Egg, My Choice, My Money

One young woman who has donated her eggs five times (and collected more money with each donation) talks about her experience. Read More
Fertility

For reproductively challenged couples nationwide, egg donors can be the key to making their dream of having a baby of their own come true. For the donor, it can be an intense physical and emotional experience that lasts about six months. Here's how the journey takes place:

A Desire for Donation

A woman, for whatever reason—maybe she is drawn by the monetary gain, maybe she has an altruistic desire to help a woman conceive who otherwise might not have been able to—enters a fertility clinic or egg-donation agency seeking information on becoming an egg donor. The donor must first meet the basic criteria: She must be healthy, in the desired age range (generally between the ages of 21 and 30), and her body mass index, or BMI, must be lower than 30.

The Screening Process

Donors are screened using requirements from the American Society of Reproductive Medicine. The prospective donor will undergo a medical examination to determine her ovarian function, get tested for communicable diseases, undergo genetic screening, and provide a detailed medical history of her and her close blood relatives. Prospective donors also meet with a psychologist or social worker who will evaluate their desire to donate and make sure they have thought through the emotional, ethical, and social issues that come with the process. A legal agreement is made between the donor and the recipients, which typically states that the donor has no rights to resulting eggs, embryos, or children.

Waiting for a Match

Once the donor is approved, her photo, along with some basic physical and personality data, is put into the agency or clinic’s database. Intended parents search through the database in the hope of finding a desired candidate. Once a couple selects a donor, the egg-retrieval process can begin.

Waiting and Watching

The donor is given oral contraceptives to help synchronize her cycle with that of the recipient. Around the time of the donor's period, ovary stimulation begins. The donor must come into the doctor's office every one to three days to be monitored. The doctor will perform ultrasounds and blood tests to monitor the development of the eggs. When the doctor determines that the optimum level of follicle development has been reached, the donor is given another hormone that stimulates the final maturation of the egg. Also during this time the recipient is given estrogens and progesterone to make her uterus receptive to the embryo.

Retrieval

The donor is typically given an intravenous anesthetic to minimize any discomfort that may occur during the retrieval process. A needle is inserted through the wall of the vagina to extract the eggs. Once the retrieval is complete, patients generally recover for one to two hours before they are released to go home. Over the next few weeks they may experience side affects and are told to watch for warning signs of rare complications such as ovarian hyperstimulation. Donors are not paid for their eggs, just their time and the risks they take on. On average, a donor will receive between $5,000 and $10,000.

Fertilizing the Egg

The eggs are microscopically examined to determine their viability: If the egg if too immature or too old it will not be selected to be fertilized. The eggs must be fertilized between 12 and 24 hours after extraction. They are inseminated using sperm collected from the intended father, preferably the same day as the retrieval. Insemination is either performed by placing approximately 100,000 sperm around each egg or by injecting a single sperm into each egg. After 12 to 20 hours, the laboratory staff will look for signs of fertilization. About 70 percent of mature eggs generally reach fertilization.

Transferring the Embryos

The embryos are transferred to the intended mother three to five days after retrieval. The eggs are inserted with a flexible catheter into the uterus, and the patient is generally discharged after a few hours of bed rest. One or two embryos are transferred, and any remaining viable embryos can be frozen for later use.

Waiting for Baby

The mother is given a pregnancy test nine to 12 days after the embryo transfer. If the test is negative, the couple will typically meet with their physician to discuss possible causes of the unsuccessful cycle and consider future transfer of a number of any embryos which were frozen. If the pregnancy test is positive, the recipient remains on estrogen and progesterone into the first trimester of their pregnancy, followed by blood tests and ultrasound exams. If everything checks out, the pregnancy proceeds as normal. The cost for the couple varies from state to state and also by how much (if any) medical insurance covers, but generally ranges from between $10,000 and $50,000 per IVF cycle. The majority pay somewhere around $20,000.


Kayla Webley is a freelance writer living in New York City.

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