IVF
Monday, January 23rd, 2012
 When the year of the dragon – considered the luckiest Chinese lunar year – kicked off today, it brought with it more than the traditional Chinese New Year celebrations. It also heightened the stakes for Chinese couples eager to have “dragon babies.”
Today’s Wall Street Journal features top fertility companies – including BHED – in a front page article that explores the recent surge in Chinese and Chinese-American couples undergoing egg donation and IVF treatments in hopes of having a child in the year of the dragon. According to the WSJ, “Chinese often schedule important life events to take advantage of the luckiest times [...] even though births are trickier to plan, in 2000, the most recent year of the dragon, 202,000 babies were born in Taiwan than a year earlier.” BHED Managing Partner, Robyn Perchik, was interviewed for the piece – noting the huge surge in contracts signed for Chinese egg donors in recent months as compared to the same period last year.
Check out the full article here:
Having a Baby in Year of the Dragon Is Too Lucky to Be Left to Chance
Tags: Beverly Hills Egg Donation, BHED, Chinese New Year, egg donation, IVF, Robyn Perchik, Wall Street Journal, year of the dragon
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Thursday, 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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Monday, 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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Monday, 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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Thursday, 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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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
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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Tuesday, November 30th, 2010
My husband and I live in Australia, and we’re the proud parents of a beautiful little boy, thanks to the BHED team and our wonderful donor. From beginning to end, BHED walked us through the whole experience. Going into the process, we had so many questions: about how matching cycles would work, about the communication with the doctor, about the contracts and legal issues. They helped us make a final donor selection and coordinated everything (doctor’s visits, paperwork).
Dealing with infertility was difficult enough — knowing that someone else was looking after all the details of the egg donor process made us feel confident and comfortable. Our worries about the distance turned out to be for nothing, as we were in constant communication with the team via e-mail and phone. Putting our trust in dedicated, experienced professionals was the perfect decision — it was our first time, but they had done this successfully so many times before! Retrieval and transfer went smoothly, and our son was born nine months later. We are incredibly grateful for BHED’s compassion and expertise, and of couse for the extraordinary donor who made our dreams come true.
- M., BHED Recipient
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donation Australia, egg donor, international egg donation, IVF, US egg donor
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Friday, November 19th, 2010
When my husband and I were first given the news that we were unable to naturally conceive a child of our own, we were devastated. Having a family was something we dreamed of. The thought of never having children in our lives was just heartbreaking.
 After speaking with many doctors and specialists here in Australia, we were told egg donation was our only option since I had been diagnosed with premature ovarian failure. Egg donation in Australia has many laws and conditions attached which made it extremely hard, almost impossible for us to pursue. With such little hope left we researched egg donation in the United States and came across BHED. We read through all the information on the website and thought ‘there must be a catch, it can’t be that easy’. My husband and I decided to contact BHED to see if it really was too good to be true. We sent an email wanting to know more, and within a few hours we had a response…and had arranged to speak over the phone to clear up any questions we had. That night I was so nervous, couldn’t wait until the scheduled time for my phone contact…and it’s a day I don’t think I will ever forget. Greeted on the other end of the line, across the other side of the globe was Lisa Greer who explained the process and answered all our questions. All the laws and conditions we were confronted with in Australia were non-existent in the United States. We couldn’t believe it, she made everything sound so easy…and it was!
 Lisa and her staff at BHED outlined the process and guided us through every step. After carefully choosing our donor, the BHED team arranged everything for us. All we had to do was book our flights and arrive in Los Angeles ready for our ivf procedure. Within 2 months of that first phone call, my husband and I nervously boarded a plane and hoped we were fortunate enough for this to all work. And we were…we are now pregnant with twins and expecting their arrival in 8 weeks time. We feel so very lucky to have discovered BHED and will be forever grateful for their kindness, understanding and professionalism. BHED has made such a difference in our lives, what we dreamed of has now become a reality. We thank the team from the bottom of our hearts.
- V., BHED Recipient
Tags: Beverly Hills Egg Donation, egg donation, egg donation agency, egg donation Australia, international egg donation, IVF, US egg donor
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Thursday, September 9th, 2010
If you’re reading this, you are most likely as bewildered as my partner and I were when we started this process…
 So many moving parts, so many businesses ready to “help us create our family”.
How does one choose the perfect place? This was the biggest thing we’d ever take on. This was not buying a new car. Our fertility doctors sent us his top 4 recommendations for Egg Donor Agencies. We found 4 others on our own. We spent MANY weeks searching the sites. After awhile, it felt like online dating. Only the “date” would be the genetic mother of our child.
Fairly quickly, it became clear what we should focus on. In addition to the actual donor profiles, we realized the importance of the egg donor agency itself. Because we’d be going into business with BHED, the particulars mattered a lot. The fees , the management, the rules, it all became important. Of the 8 sites we kept searching, BHED’s language and demeanor was the fit we were looking for. Very upfront. Very reasonable. Very tidy. In terms of profiles, we found several profiles where the Donor only offered the perfect answers from top to bottom, with absolutely no familial health risks or conditions. It simply was not realistic. Because we’d be placing so much trust in someone, honesty was crucial to us, even if we never met that someone. Several times, we had specific questions about a donor. Not only did Lisa Greer answer them immediately (yep, I said immediately), she took it all a step further by providing her email, and all of her phone numbers to us. This spoke volumes to us about BHED’s level of dedication. How many Managing Partners make themselves completely available to you in this day and age? Not many.
Once we selected our Donor (not an easy process), Lisa hosted a conference call wherein we spoke to our donor. There’s an inherent awkwardness to that phone call, and Lisa could not have navigated it any more perfectly. She kept it discreet, kept it moving, and somehow kept it comfortable. Because we live close by, I wanted to not only meet Lisa, but see the office. I felt like it was a good idea to see the business in person. I’m very glad I did. It only made me feel even better about entrusting BHED with our Egg Donation.
 From then on, my partner and I were graced (yep, I said graced) with Liz Bader-Natal as our Case Manager. Over the next 3 months, Liz gently and firmly guided us with such straightforward knowledge, it was a gift. Granted this was all a business transaction of sorts, but given the nature of the process, there is very much a human element. I had no idea how important she would become to us in the coming months. Amazingly, Liz answered the phone each time I called. Each time. I still don’t know how she did it. My partner and I are 2 men, far from well-versed in terms of the Fertility world. Lupron? Follistim? Menopur? Each step of the way, Liz explained everything to us with the patience of a Saint. Really. As with anything complicated, so much can go wrong. Every single thing Liz and/or Lisa said to us we believed. We were never given a reason not to. And everything they said was true. In hindsight, I realize now how amazingly they anticipated situations, as opposed to only handling them as they occured.
We still have a ways to go. 8 months to be exact. Sadly, our actual time with BHED is finished. I’m not sure it Lisa and Liz know this, but they will be posted with all upcoming milestones. Given how tremendous they were with us at every turn, it’s the least we can do.
-Seth, BHED Recipient
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donor, egg donor agencies, egg donor agency, egg donor wanted, egg donors, IVF, ivf cycle, Southern California egg donor, surrogacy and egg donation
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When the year of the dragon – considered the luckiest Chinese lunar year – kicked off today, it brought with it more than the traditional Chinese New Year celebrations. It also heightened the stakes for Chinese couples eager to have “dragon babies.”
