Archive for June, 2011
Tuesday, June 21st, 2011
From our companion site, Ask Kate:
Q: I’m going through the donation process, and have found that it’s so hard to find information out there about it. How long is the typical cycle from the beginning of the hormone shots until retrieval?
A: The length of a cycle can vary. I know that’s SUCH an annoying answer, especially when you’re skimming FAQ pages looking for a concrete number. It depends on where you begin your timeline – if you start with birth control, the cycle can be 5 weeks long (a couple weeks on BC to regulate your cycle and sync it up with the recipient and a few weeks on stim meds). So much is determined by the recipient, and where she’s at in her cycle. If your recipient is ready to go, you could be on BC less than two weeks and starting the injections within 10 days.
On the other hand, if your timeline starts with the stim medication, then the process could be as short as 14 days or as long as four weeks. I’ve done both versions. The short cycle is great, because it’s over so fast that you don’t have a whole lot of life interruption and the doctor’s appointments are daily, fast and routine — like a train through a station. That said, I was able to do a short cycle because I had good starting hormone levels and my recipient was alike in that way, so we were able to barrel through together.
When I was asked to do a third cycle, my doctors changed. I was at USC’s IVF facility and, as any scholastic approach to medicine goes, the longer it takes, the more we learn. I was annoyed at first, because I had gotten used to minimal interruption to my work, diet and physical life, but a couple of weeks into it — when I’d normally be wrapping things up — I realized how much better I like the “long cycle.” Since it was slower and more drawn out, the effects to my body were far more gradual, and my recovery was easier. I was more comfortable with the changes to my ovaries (it’s a pretty big physical change that is hard to imagine until you experience it) because what used to happen in a matter of 7 days was happening over the course of three weeks instead.
Your cycle would not take longer than 4 weeks, but it may take up to that long, for sure. By the end, you’ll feel fatigued and your retrieval will be welcome when it rolls around. But, be okay with the discomfort – it’s not forever, and the result is priceless.
- Kate Lee, 6-time BHED Donor
Tuesday, June 14th, 2011
I’d like to dedicate this entry to my needle fearing friends. You know who you are. The gal that hears the word “needle” one moment and finds herself hanging upside down from the ceiling fan the next. The thought of having blood taken is a minor inconvenience for some, but, for you, it’s a nightmare equal to that of having a spider crawl in your ear and hang a finely crocheted web on your cochlea. The smell of rubbing alcohol at a doctor’s office triggers a sort of Pavlov’s Dog response to pull down your shirt sleeves and put your veins on lock down. I know who you are because, a few months ago, I was you.
I’ll be honest, when I decided to donate I was so excited about the idea of helping someone have a child that I had sort of “overlooked” the logistics of injections and having weekly blood draws. This honeymoon phase vanished the moment I received my box of medication, which included about 30 needles. I quickly ran over to my roommate and showed her in horror. She shrugged and said, “They’re tiny”. Yeah, okay, tough guy, they’re tiny. But, let us not forget, they’re still NEEDLES. A tiny cockroach is still a cockroach. Besides, it’s all relative. Your tiny is my huge. Your “it’s just a needle” is my nightmare on ice with a sprig of nausea.
Fast forward to my first injection. The staff at my doctor’s office thoroughly explained the process of how to do a self-administered injection, so I did feel a little more at ease — empowered with knowledge as they say. **Side note: the staff at the office I went through were simply amazing. Take the opportunity to get to know the staff at whatever office you go through. They are an invaluable asset to the entire process, like your medically trained cheerleaders. Back to my first date with the needle: I got home and paced around like an anxious cat who kept hearing its name being called. I looked at the clock, it was ten minutes until I was scheduled to do my injection. I laid out my supplies — the alcohol pad, the needle, the vile of Lupron and (what I will reveal to you as the holy grain of injections, ladies) my slightly frozen can of diet coke. Who would have thought a diet coke could contain such power that, if wielded correctly, could erase a lifetime of fear. I suppose it did skyrocket Cindy Crawford’s career and make us all go cut our jeans into shorts. So here’s the deal: throw a can of soda in the freezer for a bit and let it get nice and cold. Five minutes before your scheduled injection, numb the area. My nurse suggested numbing it for a minute, but for this first go-around I decided to put every sensation in my skin to sleep… five minutes for me, thanks. I numbed the area, went over it with an alcohol pad, let it dry, and drew up my dose in a syringe. In that moment, I had an epiphany — if Katherine Heigl’s character on Grey’s Anatomy can do it, I can do it. I pinched the skin on my tummy, lined up the needle, took a breath, looked away and put it in (at a 90 degree angle). When I looked back down, the needle was in but I was completely shocked, I couldn’t feel anything. Nothing. Zip. I want to be clear here and say, I am a wus about this stuff and I honestly couldn’t even feel it. I released the tummy pinch, pushed the dose in, removed the needle (pull straight out), wiped over the area with alcohol and did a victory lap, calling about ten of my closest friends to tell them that I was a fearless Goddess Warrior who may have missed her calling as a professional shot giver. As strange as it sounds, I was actually looking forward to my next injection.
I think that my greatest piece of advice in regards to how to cope with injection anxiety would be to remember that we’re often our own worst enemies — psyching ourselves out, telling ourselves “I can’t do this”. I’m here to tell you that if I can, you most certainly can. Think of some of the stuff you’ve overcome in your life. In comparison, I’m sure that needle truly is tiny.
- Evan Ashley, BHED staff member and former donor
Wednesday, June 8th, 2011
Often, egg donors inquire about egg donation and expect that they will be donating just one of their eggs to an infertile couple. It just doesn’t work that way. When an egg donor is matched with a recipient, they are contracted to donate the eggs that they produce in a particular menstrual cycle. During that cycle, the physician that the donor is seeing intentionally increases the number of eggs that are produced. While a “normal” cycle might result in one or two eggs released in a month, those numbers would be cause to cancel an egg donor cycle prior to retrieval.
The number of eggs produced and donated in an egg donor cycle can range from about 8 to as many as 40 (although that is very, very rare). The average cycle results in a retrieval of between 12 and 20 eggs. The eggs are fertilized after retrieval, and often not all of them will successfully develop into embryos. About 12 to 14 healthy embryos generally result from 20 eggs. Some of these embryos (possibly 2) will be transferred to the recipient or a gestational carrier, and the remainder are frozen for future use.
We always encourage any questions a prospective donor might have. Please refer to our main site for more information about becoming a donor and feel free to contact us directly at any time.
- Ellie Goldman, BHED Cycle Coordinator
Monday, June 6th, 2011
One of the questions Intended Parents often ask is “Can you recommend a good doctor?”. Other variations include “Should I stay with my current doctor?”, “Should I move to a doctor closer to where the egg donor lives?”, and sometimes “I’m not sure if I should move doctors or not – what do you think?”
Here are the answers to those questions, in our opinion…
1) “Can you recommend a good doctor?” Yes, we can provide recommendations for you.
We have been fortunate enough to work with many of the top Reproductive Endocrinologists (“fertility doctors”) in the country, and from those experiences (and client feedback) we have a good sense of who most of the better doctors are. We base our recommendations on a number of factors, including:
- General reputation and feedback from past patients
- Quality and professionalism of the office staff (front office, nursing, etc.)
- General compliance with current “industry standards”, including information such as number of embryos typically implanted, compliance with common testing, administration of medication, etc. (Note that since we are not physicians, we cannot comment, and would not deign to comment, on any particular doctor’s medical protocol. However, when we see a lower success rate and highly unusual protocol used, we get concerned…)
- General office “vibe” (for example, many clinics with in-house egg donor programs are very negative towards working with agencies)
- Specific success rates (sometimes per SART, sometimes per our own information or in-house statistics)
Note that we do not limit our work to any particular group or clinic, but as we gather first-hand information, we will use it to help our clients make the best choice for them.
2) “Should I stay with my current doctor?” “Should I move to a doctor closer to where the donor lives?” That all depends…
We believe that the most important criteria in choosing or keeping your physician include:
- Your comfort level with and trust in your doctor. If you love your doctor and totally trust him or her, as long as they are supportive of using an egg donor from an agency, definitely keep that doctor. We think that if you are calm during the process, and are willing to do what your doctor says because you trust in that doctor, you are more likely to have a successful cycle. This is only said from anecdotal evidence and other’s opinions, but being in a good place psychologically as you’re on buckets of hormones (and going through a somewhat surreal process) can’t help but benefit you.
If finances are an issue (as they generally are) and you choose an egg donor from another city, you might want to consider moving to a doctor in that city. However, if you love your current doctor, the difference in dollars is probably irrelevant — certainly in the long term. If you do choose to use or keep a doctor in a city far from where the donor lives, make sure that you’re aware of the outside monitoring costs as early in the process as possible. (The finance person at the doctor’s office, along with our cycle coordinator, can help you with that.) The less surprises that happen in this process, the better.
All of BHED’s clients are assigned a cycle coordinator — a senior member of our staff who follows your case through from the time you choose your donor until retrieval (and often, beyond.) The Cycle Coordinators will be in regular contact with your doctor’s office from the time you sign your contract with us, and she will alert you if we have any unexpected challenges with the doctor’s office. Most of the time things work out just fine.
Note that we stay with you until you become pregnant or decide to discontinue trying. Your choice of doctor is certainly an important part of this process, and is one of the keys to the success of your pursuit to begin or build your family.
We look forward to helping you realize your dream through egg donation!
Friday, June 3rd, 2011
The post-retrieval recovery is very manageable. Truly. If you’re active and healthy, there’s no reason why you shouldn’t be able to bounce right back. It’s important to take about a week to recover – take it easy, drink lots of Gatorade and Vitamin Water, and follow your doctor’s instructions. Allow your body to heal. Everything inside of you has just gone through the ringer, and you’ll feel tender, sore, and bloated in the days following the retrieval (not unlike what you’d experience with a heavy period). You can expect to get your first post-cycle period about 10 days after your procedure (10-12 days after your HCG shot) and once that’s come and gone, you’ll feel a million times better. If you wish to donate again, you’ll need to have two normal periods before you’re cleared to go for another cycle. Any weight gain can be chalked up to fluids, so be sure to drink enough electrolytes (the swelling and retention usually go down quickly).
Every doctor is different, and your clinic will have specific instructions for your recovery (you’ll also get more information regarding when you can get back to your “normal routine” – including working out, having sex, etc.), but the most important advice for a smooth recovery is to let the body do its thing, drink plenty of fluids, and be good to yourself. You’ll be smooth sailing in no time.
Wednesday, June 1st, 2011
When choosing an egg donor, it is understandable that women will want to select a donor who is similar to themselves in appearance and ethnic background. As with many aspects of Jewish Law, what may seem obvious and desirable may not conform to rabbinical interpretations of the Law. Ironically, since it is sometimes difficult to find suitable Jewish donors, these legal twists can actually help some people “let go” of their desire to work only with Jewish donors.
While Reform Judaism recognizes that parentage can come from either parent, traditionally most, but not all, rabbis have agreed that if a Jewish woman gives birth to the baby, that child is fully Jewish. The Laws determining a child’s family and religion of origin were established thousands of years ago — long before genetic testing — and so Jewishness is passed from the mother who gives birth rather than from the genetic parents.
The following principles can guide most Jewish couples considering egg donation:
A Jewish donor is not legally required for a Jewish couple. Based on the concerns about accidental incest and the legal status of eggs, a non-Jewish donor may actually be preferable. Accepting this idea can alleviate much of the angst over trying to find a Jewish donor (which, again, can be difficult).
If a Jewish donor is chosen, she should be single or married to a non-Jewish man. If she is divorced, she needs a Jewish divorce, including a “Get.”
The process of choosing an egg donor is different for every family. There are an endless number of things to consider in making such an important decision. If observing Jewish Law is a priority for the Intended Parent(s), then finding a Jewish donor is not as necessary as one might think. Ideally, this will be helpful to some (as the pool of potential donors will be enlarged significantly).
- Michael Feinman, MD
Medical Director, HRC Fertility