This week as I finish birth control, wait for my period, and then get started on the delestrogen (booty) shots, I thought I’d provide a nice little overview of what the Donor Egg IVF process is like, as it’s a bit different than standard IVF. For my specific details and timeline, click HERE.
0) Decide to do Donor Egg IVF. It’s not an easy decision and should be carefully considered, so you go into it with eyes wide open, and understand not only the process, but your own emotions. For me, learning about epigenetics with my husband was very helpful, and talking about my story even more, as there are WAY more women out there who have used donor eggs than we often think. Just by opening up to people about what we were considering, we had several friends say that they had a friend who’d used donor eggs. Plus there are is an entire section on FertileThoughts dedicated to couples doing DEIVF so we can discuss what we’re going through. Both of these were huge in helping us feel less than abnormal and move forward.
1) Select the Egg Donor! My RE has his own donors registered so I didn’t need to go through an agency. I liked this because I know that my RE is the one who vetted and screened the donors. The list was much smaller (around 10 donors), but we found a donor on the list who’d been successful 5X and matched my basic physical characteristics. The average fee at my clinic is $3-5K, with that variation depending on if the donor was out of town or local. Mine lives about 3-4 hours away so we paid $5K.
2) Sign the contract with the fertility clinic. There are lots of things to think about and a good contract will explain the risks, protections, and options related to DEIVF. This includes things like what to do with the remaining frozen embryos (they can be donated or destroyed), protection of the donor’s anonymity, etc.
3) Figure Out How to Pay. For us, since my husband’s insurance covers none of it, we were fortunate to be able to charge it to our credit card, as I was able to get our line increased. But fertility clinics also have resources to provide patients, as there are a number of low-interest loans out there specifically for fertility treatment. We could have done this as well, but decided to take advantage of getting airline miles so that, no matter what, we could go fly somewhere (and for us, that was our trip to Paris in October). The total cost was around $17-18K which included the donor fee, procedure, and all meds. Yes, it’s more than standard IVF, *but* with a good egg donor, good sperm, and successful fertilization, you should be able to freeze a good number of embryos and never have to do a fresh cycle again. So, those who have regular IVF and try multiple times can easily spend $20-30-40K or more because they have to retrieve eggs from their own body multiple times. For us it was just the one retrieval, and the extra embryos were frozen, with a cost of ~$2,000 per FET.
4) The Fresh Cycle DEIVF Process Begins. Okay so this chart can be quite confusing to look at, but basically what’s happening is that the fertility clinic is getting both the egg donor and the recipient’s bodies aligned. We both get on the pill which allows the clinic to create a blank slate out of our reproductive systems, then Lupron which shuts down all potential natural egg production. Then they give the donor stimulants to produce a boatload of eggs, instead of one like our bodies normally do, and while she’s doing that, I as the recipient start on Estrogen (I chose Delestrogen intramuscular shots which are the most direct way to get it into the bloodstream with the least side effects) which gets my uterine lining thickened to support an embryo (something your body normally does on its own if you get pregnant). Then she goes through the egg retrieval process under partial sedation, and I add Progesterone to my own mix which is necessary for both implantation and provides support during the first 12 weeks of pregnancy. (image source)
5) My Husband Contributes, and the Lab Gets Busy. On the day of the donor egg retrieval, my husband will go in and they collect his sperm. The lab then puts them together and watches the sperm fertilize the eggs (or they can get more hands-on via ICSI, which we didn’t have to do), and they watch carefully to see how many embryos develop. These days, transfers are primarily done at the 5-day blastocyst stage, which is the “survival of the fittest” way of looking at it. (If they make it that far, they’ve got the best chance of implanting and if all works out, eventually growing into an actual baby) For us, our donor gave 21 eggs, which became 17 embryos, of which 13 survived to the blastocyst stage. No way in hell my body ever could have done that! (image source)
6) Weekly Acupuncture Treatments (optional). During this whole process, I have been happily taking advantage of the one thing that my insurance DOES cover – acupuncture, and getting weekly treatments at my ND’s office. Studies have shown acupuncture’s benefits during IVF, but whether you believe them or not, it’s incredibly relaxing, and in this stressful time, I’ll take relaxation wherever I can get it! Along with that, I also get a fertility massage a few days before the transfer that focuses on abdominal, lower back and craniosacral elements which for me really gets me deeply engaged both mentally and spiritually into what is going on in and with my body.
7) Fresh Embryo Transfer. The whole embryo transfer process takes maybe 10 minutes. I have acupuncture scheduled immediately before and immediately after to keep the mellow vibe and support increased blood flow to the uterus. On the day of the transfer, my husband and I focus on staying really low key. We have a nice breakfast, we go for a walk, and then the drinking of the water begins. You have to load up your bladder so that they can better see the ultrasound, you see, so it’s a tricky game knowing when and how much to drink so you don’t torture yourself too much in advance! I have it set on my calendar when my “final pee” is, as it’s important to remember that chugging a bottle of water 10 minutes before is meaningless as it doesn’t reach your bladder as fast as we all think it does. Anyhow, then a couple hours beforehand I pop 200 mg of ibuprofen to alleviate cramping, and an hour before the procedure I pop a valium and a vicodin – the first one for the mental and the second for any potential physical. (Doing this, during the first two tries I felt nothing but mellow.) The actual transfer is the embryologist handing the doctor the catheter loaded with our embryo, my doc’s assistant gently pushing my abdomen down with the ultrasound so he can guide the catheter in easily, and then releasing the embryo. We can watch it all transpire on the screen which is pretty cool. And That’s It. I lay there for a while, the embryologist comes into the room with a photo for me of the embryo that’s now inside of me. She’s nice. We are hopeful. We get our post-transfer acupuncture and the wait begins.
8) Wait. For this process, it’s an 8 or 9 day wait, rather than the traditional two week wait, because you’ve transferred a 5 day old embryo. So there’s a blood test that morning, and by afternoon you know if it worked. You are still on estrogen and progesterone until this day, and if it works you stay on for 12 weeks. If it doesn’t, you throw everything in the bag and cry. A lot.
9) Frozen Embryo Transfer. If the fresh cycle didn’t work, then you have frozen embryos most likely to fall back on. For us we had a dozen. The FET cycle is much more efficient. You wait to get your period, then oh yeah, you start on birth control again for a month to let your body settle down after being in hormone land. Your doctor sends you the cycle schedule of when to do what, and since there’s no donor to worry about, there’s no Lupron. You finish the pill, wait for your period, and then get on the estrogen shots. If you’re over 35 like me, there are studies starting to come out showing that FET cycles are showing slightly higher success rates than frozen. You are simply trying to stay realistic. You have no idea what’s going to happen and so the word hope doesn’t always exist in your vocabulary. You have to live your life and focus on the present, as looking back and looking forward can just start up the grief and anxiety.
You try to remember to breathe. It’s all you can do in this life.