September 23rd, 2011
While it may seem logical to assume that “more is more” in terms of increasing your chances of getting matched for a donation, registering with multiple agencies can actually work against you — and lead to a host of problems down the road when and if you do get chosen by a couple.
At BHED we ask all of our active donors to sign an exclusivity policy before being added to our database, in which the donor agrees not to register with, or commit to a donation through, any outside agency or clinic during her first six months with us. We adopted this policy after years in the industry and countless conversations with intended parents, doctors, and colleagues about the issues that come up when a donor is registered with more than one agency. We know that our donors are eager to get matched and help a couple in need (and the sooner the better!), but our clients have frequently told us that they’re very uncomfortable seeing donors listed on multiple websites and often shy AWAY from booking those donors who seem to be spreading themselves too thin. Beyond that, we’ve had clients who have gone to reserve a particular donor for a cycle to start right away, only to find out that she’s already accepted a match elsewhere and is – in reality – not available for several months. For intended parents who have spent weeks, months, and often longer searching for their perfect donor, this can be incredibly disappointing.
Of course, if a donor hasn’t been matched through BHED by the time her exclusivity policy expires we completely understand that she may want to register elsewhere. After six months, donors are free to sign up with one outside organization provided they notify us in writing and inform us within 24 hours of accepting an outside match.
Donors can always feel free to contact a member of our staff with any questions or concerns about this policy. As always we appreciate your commitment to our program and look forward to working with you to help create a family.
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donor, egg donor agency, Southern California egg donor
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September 8th, 2011
 Understandably, couples faced with the decision of choosing an egg donor typically have concerns about the donor’s genetic makeup. Fortunately, there are options available to help a couple identify any genetic disorders their donor might have and reduce the risk of passing these traits on to the child/children born from the donation.
There are two approaches when it comes to donor genetic screening, which are not mutually exclusive. The first and more traditional approach begins with genetic counseling. The genetic counselor will take a detailed family history from the donor and recommend specific genetic tests based on this history (and the ethnicity of the donor). Though this is still considered the standard approach in the industry, it has two potential flaws. First, the donor may be unaware of a specific genetic disease in her family or, worse, may choose not to disclose it. Also, single gene testing can be very expensive, especially when it comes to the “Jewish Panel” (performed on Ashkenazi Jewish donors), which can cost over $2,000!
A new alternative that has become more prevalent in recent years is Universal Genetic Testing (UGT). With UGT, a single saliva or blood sample can be analyzed for the presence of multiple recessive genes at a relatively low cost. Currently, the first such test available is called “Counsyl.” This test costs $350 and evaluates 100 recessive traits, including the Ashkenazi panel).
If a serious recessive trait is discovered, the intended father needs to be tested for that gene, or the donor should be excluded. Most doctors tend to encourage the latter choice.
Critics of UGT are uncomfortable with its “shotgun” approach. Detection rates for diseases not common in specific ethnic groups can be low, however, these women would not ordinarily be tested for these diseases so not much is really lost. In contrast, the cystic fibrosis screen in Counsyl contains more mutation than most of the traditional single gene tests currently available. Also several less-serious diseases (that do not have life-threatening affects) are included in Counsyl, and finding such a disease may unnecessarily create anxiety on the part of the recipient couple. Some doctors have started customizing the panel to exclude such conditions.  One genetic disorder not included in the Counsyl panel is fragile-X. Women carrying this mutation can produce boys with severe mental retardation and autism. Fragile-X is the most common cause of mental retardation in boys and one of the few proven genetic causes of autism.
Both the traditional approach and UGT are appropriate options for screening egg donors. I personally recommend Counsyl and fragile-X testing on all new donors. If for some reason Counsyl is not desired, Caucasian non-Jewish donors are screened for cystic fibrosis, spinal muscular atrophy (SMA), fragile-X, and Tay-Sachs enzyme. I also recommend that a complete blood count be donor to screen for thalessemia. As always, your doctor and genetic counselor will be able to help in deciding which genetic tests are most appropriate for your donor.
- Michael Feinman, MD
Medical Director, HRC Fertility
Tags: Beverly Hills Egg Donation, BHED, Counsyl, Dr. Michael Feinman, egg donation, egg donor, egg donor agency, egg donor genetic screening, HRC, HRC Fertility, IVF, Jewish Panel egg donation, UGT, Universal Genetic Testing
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August 31st, 2011
From our companion site, Ask Kate:
Q: Do you ever think about the kids that are running around out there with your genes? Â I told my parents about my decision to donate when I was getting information about my family’s medical history, and this is their number one concern. Â How did you deal with that question?
 A: Great question. Â First of all, my parents don’t know for that very reason – most people don’t know for that reason. Â I’m not sure they’d have a problem with it, but – at the same time – it wasn’t open for discussion, so I didn’t even want to go there. Â And this is what I mean when I say over and over: Â You need to do this for you. Â One hundred million percent, the decision to donate your eggs has to be something that you have thought through in every respect. Â Assuming your donation is successful, yes, of course, you will have a half-You running around out there the second you sign on the dotted line. Â That is a fact. Â That is not a possible variable, that is simply the outcome of this process.
But to answer your question, no, I don’t think about it. Â I’m sure I could, but I’ve chosen not to consider it. Â I can’t. Â My donations – all 6 of them – were anonymous for that very reason. Â I didn’t want to walk into a restaurant and see the recipient couple and my half-child. Â That would not be something I’d be able to let go of, so I eliminated that facet of possible anxiety from the equation. Â I really don’t know what else to say about it other than you’re either going to think about it, or you’re not. Â I don’t. Â I’m really good, in general, about picking my battles and picking what I’ll obsess over and picking when I’ll argue. Â And this was easy for me: I have chosen not to consider it, so I don’t ever. Â It doesn’t cross my mind.
It’s okay to be a little iffy about how you feel about the weight of the commitment while you’re considering it all – how do you feel morally (what will mom and dad thing)?… how do you feel spiritually (am I playing God)?… how do you feel ethically (is it wrong to be excited about the money)?… but then once you’ve decided to, in fact, commit, you need to have resolved these issues, or decided they are not issues worth resolving. Â Move forward owning the process and be, maybe, more discriminating with information that will garner critique or questions from the peanut gallery.
- Kate Lee, 6-time BHED donor
www.askaneggdonor.com
Tags: Beverly Hills Egg Donation, egg donation, egg donor, egg donor agency, egg donor question
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August 29th, 2011
Second in a series of posts for intended parents from HRC’s Dr. David Tourgeman…
Perhaps the most difficult and emotional decision a person or couple is confronted with when trying to have a child is choosing whether or not to use an egg donor. For some, the decision may be relatively straightforward. Perhaps the adoption process has reached a dead end, or the woman has premature ovarian failure or another medical condition in which the ovaries will not produce eggs.
In most cases, the intended parents have already attempted many rounds artificial insemination and/or in vitro fertilization without success by the time they come to consider egg donation, and have been burdened with the bad news of multiple negative pregnancy tests. For most, the decision to move forward with a donor comes at the end of a long road of struggle and disappointment.
 One biggest issue intended parents considering egg donation must confront is deciding whether they feel their genetics must play a part in conceiving a child, or if having a baby (despite the maternal genetic origin) is most important.
Intended parents are faced with two options: working with an anonymous donor, or choosing a donor who is willing to be “known” (non-anonymous).  If the couple decides to move forward with known donor, typically a sibling or relative is chosen (although many egg donor agencies also have a list of donors who are willing to engage in an open cycle) and ideally that person is less than 35 years old and has children of her own. This provides a “bridge” in which (in the instance of choosing a family member) there can still be some genetic link to the intended mother. There are many patients who choose not to have a known donor because they either do not feel comfortable asking, do not have an age-appropriate relative, or simply do not want anyone to know that they’re using an egg donor.
On the other hand, choosing an anonymous egg donor can be a challenge. There are certainly many factors that the intended parents may want to address in their search. Physical attributes and similarities are often paramount, however, intelligence, ethnic origin, and family heath are also significant. From a medical standpoint, there are also many desired qualities to keep in mind that will help optimize the likelihood of success. I typically recommend that the donor be less than 30 years old, and that she have had testing for ovarian reserve that returned normal. She should have had all appropriate genetic screening tests and have been evaluated by a psychologist to make sure she is in a healthy state of mind and that her motives are genuine. Whenever possible I recommend choosing an anonymous donor who is “proven” (meaning she has done at least one successful donor cycle in the past – resulting in at least 15 eggs and a successful pregnancy).
Above all, the most important thing for the intended parents to consider is whether they will be fulfilled as parents if they decide to use a donor egg. As parents, you’ll have the opportunity to nurture and nourish your child in the way you have envisioned. The pregnancy and birth is the beginning of an amazing experience and, hopefully, the beginning of the intended parents understanding that, despite the egg donor’s genetic contribution, this baby is completely their own.
- David E. Tourgeman, MD, FACOG
HRC Fertility
Tags: assisted reproduction, Dr. David Tourgeman, egg donation, egg donation agency, egg donation los angeles, egg donor, egg donor agency, egg donor Southern California, HRC, IVF, Reproductive Endocrinologists
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August 22nd, 2011
 As a recipient preparing to embark on a donor IVF cycle, the most important initial step is identifying an egg donor that meets your “wish list.” In addition to physical and medical attributes, it is paramount to have the egg donor evaluated by a psychologist and genetic counselor. In general, the psychologist will administer a mental heath examination to verify that the egg donor is emotionally stable and that her motives are genuine. Additionally, a genetic counselor will review the donor’s personal and family history to assess whether there are any genetic predispositions or concerns.
Once the egg donor has received psychological and genetic clearance, she will be tested for infectious diseases according to the FDA guidelines. This is usually done by the intended parent’s physician, who will also evaluate the donor for any other medical issue. At this point, the only thing left to do is sign on the dotted lines. In addition to completing the contract wth the egg donor agency (typically done when the donor is reserved), an attorney is provided to protect both the egg donor and recipients.
Getting Ready
Before the process can begin, there will need to be an evaluation of the intended mother’s uterus. This is usually done by having a water-instilled ultrasound know as a hydrosonography or a dye-based X-ray called a hysterosalpingogram. In either case, the goal is to have a womb free of fibroids, polyps or other problems that may decrease the pregnancy rate
It is also common to perform a practice embryo transfer in which a small soft catheter is guided through the cervis into the uterus. This practice transfer is generally referred to as a “mock cycle,” during which the uterus is stimulated with hormones to test the response. Depending on the practice of your physician, the mock cycle may be followed by a uterine biopsy (although this is done much more rarely).
Ready, Set, Go
Believe it or not, at this point it’s time to begin the actual cycle synchronization. Typically both the egg donor and the recipient call the coordinating doctor’s office with their periods, and they are then started on birth control pills. Dependent on the stimulation protocol, the recipient and donor are then transitioned onto a daily injection of Lupron. This is done so that both the recipient and egg donor can begin at the same starting point in their menstrual cycles. Once the egg donor is started on the stimulation medication, the recipient will begin estrogen supplementation, which will thicken the uterine lining and continue the synchronization process. Estrogen is usually adminstered either orally, by patch, through injection, or via vaginal suppository.
The egg donor will typically stimulate her eggs to grow for about 10 to 12 days and will then take the last shot to “trigger” maturation of the eggs and prepare her for the retrieval.
Almost There
Based on the time of the trigger shot, the egg donor will be scheduled for her retrieval. In the cases where the egg donation is anonymous, the intended father will come at a different time (usually shortly after the egg extraction) to produce a sample. The intended mother will then stop the Lupron and begin progesterone supplementation. Progesterone is usually administered via either vaginal suppositor or injection. The progesterone and estrogen will continue through the end of the first trimester.
The embryologists will then combine the eggs and sperm, and the final steps begin. Your fertility doctor’s office will call you the next morning with a fertilization report. This will include the number of eggs extracted and the number of embryos that were achieved after fertillization. The embryos are then grown in a laboratory for three to five days. In most cases, there will be many embryos, and most fertility doctors will opt to grow them out to the fifth day (when the embryos reach the blastocyst stage in which they have 60 to 100 cells).
Final Steps
The time has come… the embryo transfer! Your doctor will review the number of embryos that are transferable and then make a recommendation as to the number that should be used, usually one or two. The embryos that are not transferred will be frozen for future use.
The embryos will be placed into the uterus with the same soft catheter that was used during the mock cycle. This is often done under ultrasound guidance, so that the embryos can be placed in the most desirable spot. The procedure is painless, other than the discomfort of the speculum. The embryologist will also double check to be sure the embryos did not stick to the catheter.
The process is done! In eight to twelve days your blood will be tested to see if pregnancy has occurred. About two weeks after the first blood test, you will have an ultrasound to confirm the viability of the pregnancy. Best of luck!!
- David E. Tourgeman, MD, FACOG
HRC Fertility
Tags: Beverly Hills Egg Donation, BHED, Dr. David Tourgeman, egg donation, egg donation advice, egg donation FAQ, egg donor, HRC Fertility, IVF, IVF clinic, IVF doctor
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August 16th, 2011
You love your doctor — you’ve been with him for a long time, completely trust him, love the staff, etc. — and have just found a great egg donor who you’re ready to book. The only issue? She lives out of town. Or — even scarier — out of state. What do you do? You’re confident that she’s the donor for you, and she’s said she’s willing to travel for a donation, but how would that even work? Do you book her travel? Does the agency? And how is all of this going to affect your overall budget for the cycle?
 BHED facilitates travel cycles all the time. In fact, 20 to 30 percent of our matches involve some travel on the donor’s part. For clarity: a travel cycle, in the egg donation world, is when your donor is required to travel more than 75 miles (one way) from her home to your doctor’s office. That means a donor coming from San Diego to Los Angeles is considered a travel donor just as much as one traveling from Chicago to San Francisco (although, of course, the coordination and cost differ significantly).
If your donor is traveling a “short” distance (one that requires automobile travel rather than air), BHED’s travel policy requires the recipient to reimburse the donor for mileage at the current government rate. Your doctor will definitely want her to come to town for her initial appointment, retrieval, and likely a couple of monitoring appointments once she’s started medication — although your BHED coordinator will also set the donor up with a local monitoring facility to cut down on the travel and associated costs. As long as your doctor approves (and most are happy to do so), your donor can do some or many of her check-ups in her hometown; that facility will coordinate with your doctor and follow your clinic’s protocol.
It’s a similar story if your donor is coming from farther away (i.e. out of state). Your doctor will want her to be in town for her initial appointment, and then again for five to seven days leading up to the retrieval. The first trip will be very brief and often doesn’t require an overnight stay. Your donor will fly in, take a cab to your clinic for her appointment, and then head back to the airport to travel home. Your BHED coordinator will then set her up with a local facility (which, again, will coordinate with your doctor’s office) for her monitoring appointments and she’ll be able to do much of the remainder of the cycle from her hometown. The second trip will happen between day three and five of the donor’s stim process, and from there she’ll stay in town through her retrieval. For this trip, she’ll need a companion to accompany her to make sure that she gets back to her hotel safely after her retrieval and is well taken care of.
 BHED doesn’t add any additional fees to coordinate travel — it’s all included in your agency fee. Your coordinator will take care of everything, from booking the donor’s flight and hotel to ensuring that she has adequate ground transportation to get to your doctor’s office and facilitating communication between your clinic and the donor’s remote facility. Working with a travel donor will generally add approximately $3,000 to $4,000 to the total cost of the cycle. This includes the donor’s flights, ground transportation, hotel stay for the longer trip, and a per diem of $50 per day, along with the flight and per diem for her companion for the retrieval trip. Your coordinator will book everything directly and will work to find the most cost-effective accommodations possible (while still keeping the donor comfortable).
While travel cycles do require more coordination, we try to make things as easy as possible for both the donor and the recipients. Our staff will work with your doctor to facilitate the cycle, whether your donor is coming from across town or from 3,000 miles away, and will keep you informed with regular updates as things progress. Feel free to contact us directly if you have any questions about working with one of our out-of-town (or local!) donors.
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donation agency, egg donation southern california, egg donation travel, egg donor, out-of-state egg donation
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July 27th, 2011
From our companion site, Ask Kate:
Q: I’ve been looking into egg donation and researching it for about three years now, and I’m at a place in my life where I think it would be beneficial all the way around. So now I just need to know how to get started, like – where to go?
A: Well, first start thinking about logistics. Translated: who will you tell, how much genetic information do you know, can you fulfill your obligation and also work or go to school, how do you feel about sticking a needle in your stomach… ? These sorts of questions.
 First of all, you’ll need help. You’ll need at least one friend who knows what’s up so that you have a support system, as small as it may be, and help when it comes time for your retrieval – you will need a chaperone to drive you home after (and it’s best your friend know what she/he is getting into, because they’ll pull up to a place that says “fertility clinic” – tell them ahead of time).
Secondly, you’ll need to know a lot of info about your family’s genetic history. Any and all “ish” in your lineage needs to be disclosed, so you’ll either need to know it, or find out about it.
Next, it’s not just a personal decision you’re making, it will take a decent amount of time and a massive amount of commitment. It will, most definitely, interrupt your daily life. Not in a bad way, but in a real way. If you have a Monday-through-Friday job that’s 9-5, your job will be affected. You will have twice-weekly doctor’s appointments, sometimes more often and possibly even daily as you approach your retrieval date. Once you have the retrieval, you’ll need a solid 4-5 days to recuperate. Depending on your body, you may need to be on your couch, not sitting at your desk. And the calendar you follow will be exact. The dosage is exact, the time of injection is exact – your life will revolve around your schedule of medication. But the timeframe is NOT exact, so you’re beheld to a timeline that might change.
And lastly, you have to consider the fact that you’ll be injecting a needle into your abdomen (or thigh, but abdomen is easier, oddly) once, sometimes twice a day. If you’re squeamish and/or hate needles and/or doctors and/or are afraid of anesthesia, this is not for you.
It’s a to-do for a few weeks. You don’t have to commit to two years of egg donation like I did, but it’s also not a decision that should be entered into lightly. Read up on my blog and see what you think, and if you’re into the ride, take it. It’s the most amazing experience I’ve gone through.
- Kate, 6-time BHED donor
Also, as a staff side note: We always recommend registering with an agency if you decide to pursue egg donation. This process involves a lot of coordination, especially if you’re asked to travel, and a good agency will guide you through the process from start to finish, help make all of your arrangements, and refer you to a great attorney when it comes time to review your donor contract. When you find an agency you feel good about, you can generally start the process by applying on their website. BHED will also schedule a time for you to come in for an in-person interview (or send you a webcam if you live out of the immediate area) so we can meet you face-to-face and you can discuss any questions you have with a member of our donor team. Best of luck!
Tags: Beverly Hills Egg Donation, egg donation, egg donation agency, egg donor, how to become an egg donor
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July 10th, 2011
As observed by “Donor Diva”, disclosure seems to be a hot topic in the egg donation community this week! Â This great post comes from Fertility Authority (www.fertilityauthority.com).
http://www.fertilityauthority.com/blogger/donor-diva/2011/06/29/egg-donation-disclosure
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July 7th, 2011
All intended parents are confronted with the decision as to whether or not they should tell their child (and others) that they used a third-party to conceive their child. Parents usually come to a decision based on their own comfort level and feelings regarding using an egg donor or surrogate. Most experts agree that honesty is the best policy when it comes to informing your child. A good website that goes into more detail about how to talk to your children in developmentally appropriate ways is www.donor-conception-network.org. The website has a great series of booklets entitled “Telling and Talking” – they offer advice on how to talk to your child at every stage. Before telling your child you want to asses 1) the child’s emotional and intellectual capacity to process the information and 2) the extent to which your family, culture or religion may be able to accept a child born through egg donation or surrogacy.
The decision to tell your child may be an easy one or one fraught with decision. Most family therapists would agree that telling your child is the easier path to take because there’s no room for misconceptions or false information, which inevitably leads to feelings of betrayal or mistrust. It’s also recommended to start giving some information at a relatively early age, from three to five years old. Again, the website above goes into thorough detail in advising how to talk to children of all ages regarding their conception.
- Brenda Fahn-Hardt M.S., MFT
Beverly Hills Egg Donation Staff Psychotherapist
Tags: assisted roproduction, Beverly Hills Egg Donation, BHED, egg donation, egg donation agency, egg donor, egg donors, IVF, Southern California assisted reproduction
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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
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donor, egg donor injections, egg donor shots, egg donors, how long does egg donation take, IVF
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