The egg donor may be a relative or friend of the patient, but most often the woman who provides the egg is an anonymous donor found through an agency, or, sometimes through the IVF clinic. The egg donor undergoes ovarian stimulation for IVF, and the eggs are retrieved just as they would be if she were trying to get pregnant. The husband of the patient provides the sperm to fertilize the eggs, or a specimen can be obtained from a sperm bank.

While the ovaries of the donor are being stimulated, it is necessary to prepare the endometrium (uterine lining) of the recipient. It is the same protocol as for a frozen embryo transfer or gestational carrier (gestational host). If the woman is still having menstrual periods, it is necessary to prevent her pituitary gland from stimulating her ovaries, and therefore, her endometrium. We use Lupron to accomplish this suppression. We, then administer, first estrogen alone, followed by estrogen and progesterone to prepare the endometrium for the embryos. On the day of embryo transfer, a small catheter is placed in the uterus to deliver the embryos. Estrogen and progesterone administrations are continued for the first 8 weeks of pregnancy, or discontinued after 2 weeks if no pregnancy is established.

For gestational carrier, the process is the same scenario as for the recipient of donor egg. If a woman is unable, for medical reasons, to carry a pregnancy, or if she does not have a uterus, her ovaries are stimulated for IVF. After her eggs are retrieved, they are fertilized with her husband’s sperm, and her embryos are transferred to the already prepared uterus of her gestational carrier.

Today, we have technologies, which permit us to provide pregnancies for people who were previously unable to have children. There are, however, circumstances when the stress caused by our technology might be harmful. For that reason, we believe it is important for the patient-couple seeking donor egg or gestational carrier to have a psychological assessment. The introduction of a third party into a couple’s reproductive relationship could be disturbing. Similarly, the egg donor or gestational carrier, as well as her spouse should be evaluated. We wish to avoid upsetting their relationship, and assure the recipient couple of the stability of the donor or carrier they may choose to use.

Occasionally, couples find their own egg donors or gestational carriers. More often, they rely on an agency to locate the donor or carrier. In our opinion, the agency should provide the psychological assessments described above, and anonymity for both the egg donor and recipient. The patient couple should have all other personal information about the donor. In the case of gestational carrier, she is known by the patient-couple. The agency should also provide legal assistance for the patient couple, which includes contracts, to protect them as well as their donor or carrier. It is wise for any couple seeking such an agency, to investigate them. Ask questions. You need to educate yourself about all the processes, which will involve you.