An egg-donation cycle may seem fairly straightforward, but even when the donor is a healthy, fertile woman, problems can crop up and cause the cycle to fail. Knowing the reasons why can help both the donor and recipient cope and make the necessary changes for a successful egg harvest.
Synchronizing cycles for egg donation
In order to achieve a productive egg-donation cycle (using fresh, non-frozen eggs), the donor's and recipient’s menstrual cycles must be synchronized. To that end, the donor self-administers several medications.
- First, she takes hormonal medication, usually a type of estrogen, to get her cycle in sync with the recipient's.
- Next, in most cases, she takes daily doses of gonadotropin-releasing hormone agonist (GnRH-a) to prevent her eggs from being released early.
- Throughout, the donor undergoes blood tests and vaginal sonograms to assess her progress.
About four weeks in, if all goes according to plan:
- The donor gets her period on the same day as the intended recipient.
- At that point, her egg follicles have been stimulated to produce eggs.
- When the follicles are fully developed, the donor usually gets a "trigger shot" of human chorionic gonadotropin (hCG) — often self-administered — in order to prepare the eggs for separation and retrieval.
The process is complex, and the timing of the injection of the hCG trigger shot is paramount to the success of the retrieval.
Avoiding a failed egg donation cycle
The egg donation cycle can fail at any point along the way, and for a number of reasons. Here are the top three reasons that might happen on the donor side:
The egg-donation cycle is time consuming and intense. There are daily injections and frequent visits to the doctor for ultrasounds, blood tests and examinations. If the donor misses just one injection or one trip to the doctor, it can derail the entire egg-donation cycle. Donors should be aware of the time commitment and decide in advance if they're going to be able to take time off from work or away from their own family in order to accommodate the requirements. Still, even after agreeing to these terms, sometimes they back out anyway.
2. Side effects of medication
The donor has to inject herself with a variety of hormones designed to prepare the eggs and uterus for a successful retrieval. These medications can cause side-effects that range from uncomfortable to serious enough to stop the whole process. Possible side effects include hot flashes, fatigue, sleep problems, and body aches, among many others. The trigger shot can cause ovarian hyperstimulation syndrome (OHSS), which can lead to serious — even life-threatening — medical complications such as blood clots and kidney failure. So donors need to be monitored carefully.
If a donor engages in unprotected sex or experiences a condom failure during the egg-donation cycle, she could become pregnant herself. Some eggs might be released before retrieval, or the doctor may not retrieve all of the eggs. Donors need to take all possible precautions to avoid getting pregnant during the egg-donation process.
The egg-donation cycle is complicated and fragile. Strict adherence to the procedures and requirements by both the donor and recipient is imperative for successful retrieval of the eggs. It's also a reason why the use of frozen (cryopreserved) donated eggs — which involves less time, expense, and complication — is becoming more and more popular.
Updated August 2014