Reproductive Endocrinologists
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, 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!
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donor, egg donor agency, egg donors, fertility doctor, fertility doctors, Reproductive Endocrinologists
Posted in Staff Corner | No Comments »
Tuesday, May 11th, 2010
 The following is the first in a series of postings from Beverly Hills Egg Donation staff psychotherapist, Brenda Fahn-Hardt M.S., MFT.  Brenda comes to us with years of experience working exclusively  with egg donors and couples dealing with infertility issues.  In this, and in posts to come, she will address some of the most common psychological and emotional issues that come up in her work with Intended Parents.
Intended parents usually come to infertility services after spending years on an emotional roller-coaster.  There are several emotional and psychological issues that intended parents typically encounter during this process.  The ones that I encounter most in my practice are 1) Dealing with the grief of not being able to conceive your own biological child 2) The anxiety associated with choosing a donor 3) Deciding whether to meet the donor during the process 4) Fears of not being bonded or connected to your child and 4) Deciding if, when and how to reveal to your child that an egg donor was used in their conception.
Grieving
The journey to the egg donor option can be arduous for most couples. Â The realization that you are unable to conceive without the assistance of a third party can be internalized in numerous ways – the most common emotions are feelings of failure, inadequacy, humility and anger. Â When couples arrive at an infertility office, frequently they have not dealt with the trauma and pain that usually exists. Â I always encourage couples to experience their unresolved grief before getting too far down the road in the process. Â However, in many instances, because couples have been waiting years to conceive a child, they often feel compelled to jump into the next stage without processing their feelings. Â It is common for couples to get caught up in the frenzy of doctor’s offices, tests, shots and drugs while neglecting to take a step back and let oneself absorb and process the grief.
 Elizabeth Kubler-Ross wrote the classic treatise on dealing with grief. Â In her seminal work, she identifies the five stages of grief – denial, anger, bargaining, depression and acceptance. Â In a perfect world, an individual would experience these stages sequentially. Â Yet, each of us approaches life’s complications in our own way. Â The process becomes inherently more complicated when dealing with two individuals simultaneously, given the complicated dynamics of relationships in general. Â It takes an enormous amount of patience and understanding to respect and understand your partner’s process. Â Therefor I encourage couples to attend support groups and couple’s therapy to assist them through the grieving process.
The goal in the last stage of the grief process is acceptance. Â Acceptance can take on different outcomes for different couples (or single parents). Â The one constant is the reality that one is unable to conceive his/her own biological child. Â When one comes to this acceptance, there are different paths from which to choose – using an egg donor agency and/or surrogate, adopting a child or choosing not to have a child. Â Whichever path is chosen, you want to be confident about your decision and optimistic about your future.
- Brenda Fahn-Hardt M.S., MFT
Tags: Beverly Hills Egg Donation, BHED, egg donation, egg donation california, egg donation southern california, egg donor, egg donor agencies, egg donor programs, egg donors, fertility clinic, fertility doctor, infertile, infertility, intended parent, IVF, ivf cycle, Reproductive Endocrinologists
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Wednesday, April 29th, 2009
 One of the questions Intended Parents ask often is “Can you recommend a good doctor?”.  Other variations of that question are “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 my opinion…
1) “Can you recommend a good doctor?” Yes, we can provide recommendations to 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 programs are very negative towards working with egg donor 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…
I 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.  I 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.  Does statistical research confirm that?  I don’t know – but it sure seems logical.
- 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 doctor until retrieval (and often, beyond.)  The Cycle Coordinator 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 you decide to discontinue trying. Â 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!
-Lisa Greer, BHED Managing Partner
Tags: Beverly Hills Egg Donation, fertility doctor, fertility doctors, Lisa Greer, Reproductive Endocrinologists
Posted in Staff Corner | No Comments »
Tuesday, January 27th, 2009
One of the questions Intended Parents ask often is “Can you recommend a good doctor?”. Â Other variations of that question are “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 my opinion…
1) “Can you recommend a good doctor?” Yes, we can provide recommendations to 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. Â 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. Â (Note that since we are not physicians, we cannot comment, and would not deign to comment, on any particular doctor’s medical protocol. Â 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 programs are very negative towards working with egg donor 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?” Â That all depends…
I believe that the most important criteria in choosing or keeping your physician include:
- Your comfort level with and trust in your doctor. Â 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. Â I 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. Â 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. Â Does statistical research confirm that? Â I don’t know – but it sure seems logical.
- 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. Â However, if you love your current doctor, the difference in dollars is probably irrelevant – certainly in the long term. Â 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. Â (The finance person at the doctor’s office, along with our cycle coordinator, can help you with that.) Â 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 doctor until retrieval (and often, beyond.) Â The Cycle Coordinator 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. Â Most of the time things work out just fine.
Note that we stay with you until you become pregnant or you decide to discontinue trying. Â 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!
-Lisa Greer, BHED Managing Partner
Tags: Beverly Hills Egg Donation, fertility doctor, fertility doctors, Lisa Greer, Reproductive Endocrinologists
Posted in Staff Corner | No Comments »
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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.
