Maybe you have already found the perfect donor with Cofertility, or maybe you have just started exploring the platform. Either way, it is time to have a candid discussion with your reproductive endocrinologist (REI) so you can be crystal clear on next steps, their involvement with the donation process, and what this could mean for your family-building journey.
Do not worry if at first you are confused and overwhelmed about what questions to ask. Many times I hear, “I don’t know what to ask because I don’t even know how any of this works!” This process can definitely be overwhelming and confusing. First of all, you are not alone and you are not expected to be an expert on all things IVF. But by the end of it all, you might as well have your medical degree because you will learn more than you ever thought you wanted to know about the reproductive system!
You eat an elephant one bite and a time, so grab a notebook or create a folder in your phone. Keep a working document with all your questions and answers in one place so when you get home you can review what was said (trust me, you will forget) and have time to process and call back to ask more questions.
Take a deep breath. Your laces are tied and you have started the race and we are here to help you up that hill. Below are some questions and discussion points to have with your REI regarding egg donation.
First, ask the clinic about their egg donor screening protocol
Protocols and screenings can potentially differ if you are using a donor who is experienced vs. someone doing this for the first time. So you need to ask questions regarding their donor screening and approval process.
- I am working with an agency to find my donor. What information do you need to move forward and work with my chosen donor? Will you accept testing/screening that was done outside your clinic?
- What is involved with the egg donor screening in terms of medical, genetic and psychological screening? What should I be looking out for? What happens if the donor fails one or all the screenings?
- How long can we expect the process to take? What is your appointment availability – one week or one month out? How long does it take to get results?
- How many in-person visits are required? This can be important if your donor lives far from the clinic, as you may be expected to pay for donor travel costs.
- Does the donor’s partner need to be involved in the screening process? If yes, what screenings and costs are involved?
- What can delay the screening and approval process?
- My donor doesn’t live close to this clinic, can she be monitored close to home? If so, do you have a list of clinics you recommend?
Ask for more information about egg retrievals
If you have never done an egg retrieval, you may want to learn more about the process, the medications and side effects.
- What does the donor need to do to prepare for retrieval?
- What are the side effects of the medications and the retrieval process?
- Is there anything she can do to make this retrieval successful?
- Can I have a copy of her calendar with medication instructions and anticipated lab or ultrasound visits?
- Who will teach her how to do the injections?
Ask about clinic success rates
You may have already discussed success rates with your clinic but if not, you want to ask specific questions. Sart.org is a great place to research and understand clinic success rates. You can use this online calculator from SART to get an idea of your success rates.
- Given my history, will donor eggs increase my chances of success?
- What is the success rate for my particular case using this particular egg and sperm?
- How is success measured? Is it defined as embryo creation, pregnancy or a live birth?
- What percentage of women get pregnant and deliver a baby after the first embryo transfer?
Ask about the role sperm plays
Sperm is 50% of the equation so you also need to ask some questions about sperm, regardless if you are using a donor, a partner, or your own.
- When will sperm need to be deposited? Day of retrieval or can it be deposited earlier and frozen?
- Is there a difference in outcomes if fresh vs frozen sperm is used to create embryos?
- What tests will be required of the sperm?
- What test results can make the sperm unusable?
- How many appointments will be needed?
- What if I already have frozen sperm? How do I get it to your clinic?
Ask about donor compensation or egg sharing
If you are participating in our split program and sharing the retrieved eggs with your donor instead of cash compensation, you should have a solid understanding about how it works.
- When will I find out how many eggs were retrieved?
- How will the clinic split the batch of retrieved eggs?
- How will they decide who gets which eggs?
- What happens to the eggs I keep vs the eggs the donor keeps after retrieval?
It is Cofertility’s policy that if an odd number of mature eggs are retrieved, the parents get one more egg than the donor. And if there are any immature eggs retrieved, the donor gets to keep those.
As about the clinic’s minimums and guarantees
Some clinics recommend or maybe even require a minimum number of eggs to be retrieved in order to create one embryo. So, finding out your clinic’s minimum is important.
- What is the minimum number of eggs you recommend / require to create one embryo?
- What happens if I do not have enough eggs?
- Do you do genetic testing on the eggs or do we wait until the embryo is created?
- How do I know about the quality of the eggs?
Ask about fertilization
Once the eggs are retrieved, the clinic will then fertilize and grow the embryos to blastocyst stage.
- How is the embryo created? What are my options? Does one option create higher success rates?
- Do you recommend we transfer fresh vs frozen embryos?
- Do you recommend we genetically test the embryos? What are the risks and benefits of doing these tests?
- If using frozen, when should they be dethawed and transferred?
- How many should be transferred at one time? What are the risks of multiples?
Final thoughts on how to talk to your doctor about egg donation
At the end of the day, although you are not expected to be an expert and understand every single aspect of donation, you do need to feel comfortable, confident, and knowledgeable about making decisions regarding your journey. Do not feel ashamed to ask a lot of questions! Knowledge is power, and a good physician will be there to guide you.
Problems typically occur when people are not on the same page as the clinic, or have unrealistic expectations because they do not fully understand the process. Ask the question over and over until you understand.
Just remember, even though it may feel as if you don’t have everything figured out, or that you still don’t understand how it all works, that is okay. So if you’re feeling overwhelmed, remind yourself that you are doing the best you can and that you are not alone. We got you.
