Transcript Physician Flip Chart - Ottawa Fertility Centre

PHYSICIAN FLIP CHART
The Egg Donation Process
Ottawa Fertility Centre
TOPICS TO BE DISCUSSED
•Should I consider treatment with egg donation?
•Who are the egg donors?
•What are logistics between my cycle and my donor?
•What is recipient screening?
•What are the pregnancy rates?
•What are my financial options?
OPTIONS AVAILABLE
Ideal choice would be using your own egg and partner sperm
If the ideal option is not feasible the remaining options are:
•
Adoption
•
Donor Egg
•
Choosing Not to have Children
WHEN IS EGG DONATION NEEDED?
Decreased
Ovarian
Function
Premature
Ovarian
Failure
Genetic
Abnormalities
Failure of
Other
Treatments
GENETICS OF AGING OOCYTE
Reproductive Medicine Associates: Genetics 2003-2004
Maternal Age
Chromosomal
Abnormality
Newborns
30
1/385
35
1/192
40
1/66
41
1/53
42
1/42
43
1/33
44
1/26
45
1/21
ACOG publications
EFFECTS OF AGE ON PREGNANCY RATES
OOCYTE NUMBER
DONOR SCREENING REQUIREMENTS
• Women between the ages of 21 – 32 years
• Height & Weight Proportionate (BMI <28)
• Non-smokers
• Healthy Medical and Family History
• Normal Hormone & Ovarian Evaluation
• Consultation with physician or nurse practitioner
• Negative drug screening
• Negative for Communicable Diseases, in accordance to FDA protocol
• Genetic Screening (Cystic Fibrosis, SMA, Fragile X and ethnically indicated
genetic disorders)
• Psychological Evaluation
DONOR APPLICATION
Full profile includes :
• Physical characteristics
• Health and obstetrical history
• Family health history
• Likes & Interests
• Personal Essay Questions, including motivation for donation
• Childhood and adult photographs
REASONS FOR DONOR EXCLUSION
• Poor baseline hormone values and/or antral follicle count
• Psychological exclusion
• Problematic medical or family history
• Smoker
• Positive drug screen
• Positive genetic screen
• Donor changes mind, relocation, schedule conflict
FDONOR EGG BANK USA
Advantages
• Recipients receive 5-7 mature eggs
• No need for synchronization with donor
• Widens donor selection
• No wait to select
• More control of cycle timing
• Less expensive
Disadvantages
• Limited number of eggs
• Lower chance of embryo cryopreservation
SELECTING A DONOR
Decide on a donor
program: fresh or frozen
View Donor Profiles
Select Donor
Make payment and start
your cycle
TIPS FOR SELECTING A DONOR
• Take your time, you may not see someone you like immediately
• Expect to match the most important issues
• Expect to make compromises on some less important issues
• Look for intellectual potential (essay and skills section), not just education level
• Everyone has imperfections
• Matching blood types is not medically necessary and does not impact success rates
INFANT COMPLICATIONS FROM MULTIPLE PREGNANCY
Singleton
Twin
Triplet
9 mths
8 mths
7 mths
% Very Premature
(<7 mths)
1.7%
14%
41%
Average Birth Weight
7.4lbs
5.2lbs
3.8lbs
% Severe Handicap
1.9%
3.4%
5.7%
% Infant Mortality
0.6%
2.8%
19%
Average Month at Birth
DONOR EGG BANK USA THROUGH DECEMBER 31, 2013
Egg
Thaws
626
Embryos
Transfers
582
Average # of
Eggs
per Cycle
Average # of
Embryos
Transferred
Clinical
Pregnancies
(% ET)
Miscarriages
(% ET)
Ongoing
Pregnancies (%
ET)
6.2
1.8
(day 3)
1.6
(day 5)
291
(50%)
36
(6%)
255
(44%)