The Hugh Wynter Fertility Management Unit, The University Of the West Indies, Mona, Kingston 7 The decision to share The Hugh Wynter Fertility Management Unit, The University of the West Indies, Mona 1 egg sharer info june 2016 Denise Everett Keene June 2016 The Hugh Wynter Fertility Management Unit, The University Of the West Indies, Mona, Kingston 7 Table of Contents Who needs egg donation? ....................................................................4 What is egg sharing? ............................................................................4 Who can become an egg sharer? .......................................................... 5 What will the recipient know about me? ............................................. 5 What will I know about the recipient? ................................................. 5 What are the screening tests? ..............................................................6 What about consents? .......................................................................... 7 How much counselling will we have? .................................................. 7 What drugs will I be given? ..................................................................8 What are the possible side effects of these drugs? ...............................9 Does the egg recovery procedure hurt?................................................9 What are the risks of the procedure? ...................................................9 Can this affect my fertility? ................................................................ 10 Can I be cancelled once I have started the injections?....................... 10 The egg sharing procedure ..................................................................11 Can I have sexual intercourse? .......................................................... 12 Will I, (the donor) have any responsibility to any child born? .......... 13 Can I change my mind? ..................................................................... 13 How many times can I donate? .......................................................... 13 What costs will I incur? ...................................................................... 14 How often will I need to attend? ........................................................ 15 Before you start the programme .................................................................................... 15 Commencing the treatment cycle .................................................................................. 15 The egg recovery .......................................................................................................... 16 After the donation ......................................................................................................... 16 The first step to donating ................................................................... 17 What to expect after you return the form .......................................... 18 Meeting the team .................................................................................................19 • The psychiatric evaluation ......................................................................19 • Counselling as a couple ...........................................................................19 • The implications .....................................................................................19 • The medical consultation ........................................................................19 • The screening tests .................................................................................20 Acceptance as an egg donor .............................................................. 20 The Hugh Wynter Fertility Management Unit, The University of the West Indies, Mona 2 egg sharer info june 2016 Denise Everett Keene June 2016 The Hugh Wynter Fertility Management Unit, The University Of the West Indies, Mona, Kingston 7 Many couples want to have children and find it difficult or impossible to conceive. Some couples may be able to conceive using special techniques using their own eggs and sperm. Others will not achieve their dream of child unless gametes (eggs or sperm) are donated. You are reading this because you are considering becoming an egg sharer donor. We hope that this booklet will answer all your initial questions that will help you decide whether or not to become a donor. The desire to have a child is not determined by • Whether or not you are financially wealthy • Whether or not you are employed • Whether you are young or old • Your ethnic, social or racial origin • Your educational level There are THREE forms of egg donation 1. Anonymous 2. Known 3. Shared This booklet is designed for shared egg donation here at The Hugh Wynter Fertility Management Unit, The University of the West Indies, Mona. The Hugh Wynter Fertility Management Unit, The University of the West Indies, Mona 3 egg sharer info june 2016 Denise Everett Keene June 2016 The Hugh Wynter Fertility Management Unit, The University Of the West Indies, Mona, Kingston 7 Who needs egg donation? There are several factors that may make a couple seek egg donation There are certain medical conditions that a woman may have no eggs of her own (such as Turners syndrome). A woman may have to remove her ovaries. The ovaries may stop working as a result of cancer treatments (radiotherapy/ chemotherapy). Advanced female age can give rise to poor egg quality and at best less than a 5% chance of a successful pregnancy. Those couples that have been through the ART processes may be told that they have poor egg/ embryo quality. Some women may have or carry a genetic defect that they do not want to pass on to their offspring. What is egg sharing? This is a unique form of donation in that two groups of women who need IVF treatment benefit. One woman chooses to share the eggs collected with another woman. The other woman may be unable to produce or use her own eggs. Thus, the woman sharing her eggs helps a couple waiting for eggs whilst receiving a more affordable treatment cycle. The Hugh Wynter Fertility Management Unit, The University of the West Indies, Mona 4 egg sharer info june 2016 Denise Everett Keene June 2016 The Hugh Wynter Fertility Management Unit, The University Of the West Indies, Mona, Kingston 7 Who can become an egg sharer? Unfortunately, not all couples will be eligible for sharing. The following conditions are a guideline for the ideal egg sharer ✓ Be Fit and healthy ✓ Be Aged between 18 and 35 ✓ Have Normal periods ✓ Have Normal hormone levels ✓ Have an Acceptable body mass index (BMI) , determined by weight and height ✓ Be in a stable relationship ✓ Have a knowledge of you and your family’s medical history ✓ Be free of any transmissible diseases ✓ Dedicated to see this through to the end ✓ Attend at least one counselling session ✓ Be matched with a suitable recipient couple What will the recipient know about me? All the information the recipient receives is non-identifying. We hope to match the donors and recipients both physically and ethnically as much as possible. What will I know about the recipient? You will know nothing at all. As we keep the donation anonymous we will not be telling you about the outcome of the donation. The Hugh Wynter Fertility Management Unit, The University of the West Indies, Mona 5 egg sharer info june 2016 Denise Everett Keene June 2016 The Hugh Wynter Fertility Management Unit, The University Of the West Indies, Mona, Kingston 7 What are the screening tests? As the sharer you will be required to do Blood Tests ▪ Blood grouping ▪ Chromosome studies e.g. Karotyping ▪ Sickle cell (and possibly Haemoglobin electrophoresis) ▪ Hormone profile AMH, hTSH PRL and Day 3 E2, FSH, LH) ▪ Glycosylated Haemoglobin ▪ Hepatitis B and C ▪ HIV ▪ Rubella ▪ VDRL Uterine Investigations ▪ Saline Infusion Sonogram ▪ Hysteroscopy The male partner must have at least ▪ A recent Semen analysis (preferably performed at HWFMU) ▪ HIV ▪ VDRL ▪ Hepatitis B and C ▪ Blood group and sickle cell The Hugh Wynter Fertility Management Unit, The University of the West Indies, Mona 6 egg sharer info june 2016 Denise Everett Keene June 2016 The Hugh Wynter Fertility Management Unit, The University Of the West Indies, Mona, Kingston 7 What about consents? After the counselling and screening there will be the egg share agreement that has to be completed. You may voluntarily withdraw from the programme up to the time of the egg collection and this will be honored. Please note that if you choose to withdraw you will no longer qualify for the reduction of cost for your treatment. How much counselling will we have? At present we do not have a fulltime dedicated counsellor to see all sharers and recipients. You will be asked to undergo psychiatric evaluation and attend an appointment with our clinical psychologist. After which two counselling sessions with our counselling team. We hope that you will feel free to explore and express your concerns with us in strictest confidence. If possible and required we will try to offer as much counselling as possible. The Hugh Wynter Fertility Management Unit, The University of the West Indies, Mona 7 egg sharer info june 2016 Denise Everett Keene June 2016 The Hugh Wynter Fertility Management Unit, The University Of the West Indies, Mona, Kingston 7 What drugs will I be given? We may also ask you to take the contraceptive pill to help the timing of the donation. There are essentially three forms of medication. LHRH agonists (e.g. Buserelin) – given as a single daily injection to suppress