Thinking about becoming an egg donor? 4/14/2020 ° Why become an egg donor Overview of ° Application and screening Donor process ° Egg donation 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 eggs? ° There is no evidence that the procedure itself impacts your future ability to have children. ° Females are born with approx. two million eggs. ° Fertility 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 pregnancy, 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 gonadotropin 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 38.