Thinking about becoming an donor?

4/14/2020 ° Why become an egg donor Overview of ° Application and screening Donor process ° process Orientation ° Potential medical risks ° Donor recipients ° Psychosocial issues Why become an egg donor?

° You’ll have the satisfaction of knowing your gift made a profound difference in the lives of people struggling to become parents.

° You’ll receive compensation for your time and effort.

3 What to expect when donating at UCSF

° We are a nationally recognized academic medical center

° Our ovum donor program has helped patients become parents since 1991

° All of our providers have extensive experience with ovum donation

° UCSF adheres to guidelines established by the American Society for Reproductive Medicine (ASRM)

4 Application and Screening Process

5 To qualify as an egg donor, you must:

° Be a woman between the ages of 21-33 ° Be in excellent mental and physical health ° Have a healthy family history ° Have a schedule flexible enough to allow for medical appointments ° Be mature, responsible, and dependable

6 What are my responsibilities if I agree to become a donor?

° Be truthful in all portions of the donor screening

° Follow all medical instructions

° Inform us of any changes in your health, medications, or personal situation

° Agree to provide updated contact and medical information

° Agree to being contacted by us in the future regarding your donation Ovum Donor Application

° Submit initial questionnaire

° Submit donor profile application

° Medical records

° Screening consents

° Photos

° School records and confirmation of test scores

8 Orientation and application review

9 Presentation Title Genetic Screening

° Personal and family history intake

° Three generation pedigree generated

° Family history summary letter written

10 Psychology screening appointment

° One hour zoom meeting with one of our psychologists

11 Ovum Donor Screening Exam

° Screening tool

° Photos will be taken for your donor profile

° General history & physical exam

° Blood work: genetic tests and infectious disease testing

° Medical risk consenting

° Follicle count via vaginal ultrasound

12 Final Steps

° If your application is approved , you will be notified by the egg donor team.

- If you then agree to become a UCSF donor, a profile will be created for our database for recipients to view.

° If your application is declined , you will be notified by the egg donor team.

- It’s likely you will not know specific reason for the decline.

13 Matching for an upcoming cycle

° Once you are selected by a recipient you will be contacted

° Before agreeing to match for an upcoming cycle you should consider the following issues:

- Current availability and flexibility of schedule

- Recent and scheduled travel

° If you decide to move forward, you will complete the preliminary paperwork

° Donors can donate up to 6 times in their lifetime

14 Egg Donation Process

15 Female reproductive cycle

Pituitary Gland

FSH E2 Uterus Fallopian Tube

Ovary Endometrium Cervix

16 The Ovaries: Natural Cycle vs. a Stimulated Cycle

VS.

Natural Cycle Stimulated Cycle

17 Will ovum donation impact my ability to have children or deplete my ?

° There is no evidence that the procedure itself impacts your future ability to have children.

° Females are born with approx. two million eggs.

° medications “rescue” a portion of these excess eggs that the body would have ordinarily discarded.

18 Monitoring appointments

° Regular monitoring appointments throughout the process - 7:30-9:30 am daily - Each visit is ~15 minutes - ~6 visits over 10-12 days Egg retrieval (36hrs later) Trigger Injection

Birth Control Pills FSH/LH Injections

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Ultrasound and Blood Monitoring

19 Ultrasound Monitoring

20 Egg Retrieval

21 Fertilization: Conventional vs. ICSI

22 Restrictions and Possible Medical Risks

23 What restrictions will I have during the donation process?

° Once matched:

- Take precautions to prevent risk of sexually transmitted infections (practice safe sex)

- If you engage in sexual activity that puts you at risk for , use condoms

- From last day of oral contraceptive pills until the next period: Abstain from intercourse (one month)

- From start of injections until 2 weeks after the egg retrieval: Refrain from activities that involve high impact

24 Medications

° Follicle Stimulation Medications - Follistim - Gonal-f

° Menopur - Human menopausal

25 What are the possible medical side effects to the medications?

° Allergic reactions

° Hot flashes

° Headaches

° Abdominal bloating or discomfort

° Nausea

26 What are the possible medical risks?

° Ovarian hyper-stimulation syndrome (OHSS)

° Ovarian torsion

° Injury to bowel or bladder

° Infection

° Bleeding that requires surgery or transfusion

° Ovarian cancer (no known risk)

27 Insurance and Taxes

28 Recipients of Egg Donation

29 Who are the recipients?

° Recipients are people who can’t conceive with their own eggs due to various factors like: - Older age (40s and early 50s) - Diminished ovarian reserve - Cancer treatment - Poor egg quality - Born with non-functional ovaries - Same-sex male couples - Single men

° Often recipients have had extensive fertility treatments with their own eggs without success, or they’ve experienced multiple miscarriages.

° While most recipients are married heterosexual couples, your recipient may be married or single. They may be in a same-sex couple. They may need the help of a gestational carrier. They be of any race, religion, or ethnic background.

30 What will the recipients know about me?

° Recipients will be able to see your profile from a secured donor website

° Your profile will contain: - The questionnaire you completed about yourself - Genetic and medical test results - GPA and educational standardized test results - Blood type - Height and weight - Any photographs you provide plus those taken at UCSF

31 What information is kept private?

° Recipients will NOT receive: - Your last name, address, phone numbers, or email address to protect your anonymity

° Some recipients are interested in meeting their donor - In general, no identifying information will be exchanged at the meeting

32 Psychosocial Implications

Presentation33 Title Legal and Social Implications

° Legally speaking, when you agree to donate your eggs, you are giving up all rights and responsibilities to the eggs, embryos, and any child born as a result of them

° Genetically, any offspring born as a result of your egg donation will be half genetic siblings to your own children

34 What limitations are there in terms protecting my identity?

- Photo recognition software

- Donor Sibling Registry

- Direct to consumer genetic testing (example: Ancestry.com)

35 Presentation Title What about the future?

° We are committed to respecting the needs and desires of our recipients, donors, and their respective families.

° You may be told the outcome of the cycle, but we can’t guarantee that information.

° You may be contacted in the future by us regarding your donation if a recipient or child requests contact. You will have a choice about how this contact will be made.

36 What else should I think about?

° Will I be able to manage the interruption of my daily life during the cycle?

° How will this decision affect my current or future partner, family, and friends?

° How might I feel about this decision in the future?

37 Thank You

° Being an ovum donor is a very generous decision ° Thank you for considering donating at UCSF ° We welcome your questions

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