Procedure
• Egg donor screening
• Recipient screening
• Endometrial stimulation & synchronization
Egg donor screening – It is preferable that oocyte donors be under 30 years of age as youngers donors appear to have higher pregnancy rates.The recruited suitable egg donor is required to undergo a through medical examination including a pelvic examination.
• Complete medical history
• Screening for infections diseases (HIV, H B.s Ag, VDRL, Chlamydia). Hormone levels
• Trans vaginal ultra sound of pelvic to examine uterus ovaries & other pelvic organs.
Oocyte donors need to be provided full & comprehensive informed consent including the risks involved & legal aspects.
Recipient Screening
• Age
Complete medical history & physical examination
• Complete blood count
• Blood Rh type
• Liver & Kidney function tests
• S.TSH Rubella & hepatitis Screen
• HIV, HBs Ag, VDRL
• Pap smear
• Transvaginal ultra sound
• ECG, X-Ray, chest mammogram, GTT, lipid profile as per medical history
uterine cavity evaluation
Procedure synchronization
Step 1
Birth control pills are administered during the first few weeks of the egg donation process to synchronize the donors cycle with the recipients
Downregulaiton of donor ovaries by GnRH analogues for a period of one to three weeks followed by ovulation indication from D2/3 of periods by Hmg/FSH injections for a total of 9-11 days. Donor cycle is monitored by repeated ultrasound examination. Once the follicles are mature hcG is Given & egg retrieval done after 34-36 hours. It is done under TV ultrasound a minimally invasive procedure guidance under light general anesthesia. After an hour or divot, the donor is released & can resume regular activities. The eggs are fertilized in vitro with recipients husbands semen.
The recipient receives GnRH agonist for down regulation similar to donor, followed by oral oestrogen from D2 or 3 of their cycle. She is maintained on estrogen an tile the day of donors oocytes retrieval (approximally 12-14 days) when progesterone is added.
Embryo transfer is done 2-4 days after progesterone one initiation. Oestrogen & progestions are continued for further 15 days after embryo transfer when if pregnancy is confirmed the same are continued till 12-14 weeks of pregnancy.
