Egg Donation

Permission was granted to the Regional Fertility Program by the Foothills Hospital and the University of Calgary to start an egg donation program in 1992. This program was delayed until January 1994 in order to take into consideration and respond to the recommendations made by the Royal Commission on assisted reproductive technologies. Due to the recommendation that this program should be altruistic only most couples getting egg donation in Calgary will need to provide their own egg donor, who is not being paid to come through an IVF cycle.

The reasons why a couple may need to use an egg donor are many and varied and are increasing as women attempt to push the limits of their reproductive potential. Some women have been born without ovaries or without normal functioning ovaries and never go through puberty. Some women may undergo early menopause as early as age 25 or 30. As women push their childbearing years from their early 20's into their mid to late 30's and early 40's they have more opportunity to have diseases that involve their ovaries. They may have had their ovaries removed or damaged as a result of medical treatment involving the ovaries or as a result of medical treatments such as radiation and chemotherapy. They may also have had a poor response to an IVF cycle, poor egg and embryo quality at the time of their IVF cycle or they may have a genetic disease which they do not wish to pass on to their children. When a referral is received at the Regional Fertility Program requesting egg donation it will be reviewed to ensure this is an appropriate indication. The couple is given a choice to come in to discuss egg donation in general terms at a general infertility clinic or to be set-up to come through an egg donor information session.

Every attempt will be made to have egg donors and their commissioning couple comes through an egg donor/surrogacy information session. This is a mandatory information evening that must be attended by the egg donor and her partner as well as the commissioning couple. The reason these sessions are held separate from general IVF information sessions as the emphasis is placed more on the IVF process particularly with respect to short and long term risks to the egg donor and surrogate. The following day both females will have a pelvic ultrasound and will meet in the clinic with a clinic physician as well as the nurse coordinator for this program. It has always been clinic policy that an egg donor, her partner, and the commissioning couple attend a psychological assessment and it has now become mandatory under law that the psychological assessment occur.

Prior to attending the donor egg information session, the egg donor will need to have a pelvic ultrasound as well as two day 3 follicle stimulating hormone (FSH) blood level checks. These tests are necessary to determine whether she will be a good candidate for egg donation. This will help to determine the dose of the medications required to stimulate her ovaries. She and her partner will be required to undergo screening for diseases that potentially can be passed through body fluids such as HIV and Hepatitis and this screening must be done within three months of her coming through an IVF cycle and again in six months after the cycle has been completed. She and her partner will also be required to sign consents that they understand the process of IVF, potential risks, and complications of IVF and agree to donate their eggs to the commissioning couple without reserve.

The commissioning couple must undergo screening for viral illnesses such as HIV and Hepatitis within three months of their egg donor's IVF cycle as well as six months following that completed cycle if a pregnancy occurs. If a pregnancy has not occurred and frozen embryos are going to be transferred these tests are repeated three months later. In order for the commissioning female to have an idealized environment to transfer embryos a mock cycle is undertaken to determine the dose of estrogen and progesterone that is required to get an idealized uterine environment. This may require more than one cycle if an adequate cycle has not been achieved with the first stimulation. She will require an assessment of her uterine cavity either by a hysterosalpingogram or a hysteroscopy to determine that there is nothing to decrease her odds of implantation.

When all the tests have been completed by all parties the commissioning couple will be offered an opportunity to start an IVF cycle.

The implantation rate, pregnancy rate, miscarriage rate and birth defect rate will more closely match that of the egg donor than the commissioning female. The recommendations of the clinic with respect to genetic testing during pregnancy will be made based on the age of the egg donor. The cutoff for the egg donor program is 50 for the commissioning female.