Center for Women s Reproductive Care at Columbia University

Transcription

1 Center for Women s Reproductive Care at Columbia University Oocyte Recipients Greetings, Thank you for your interest in the Center for Women s Reproductive Care at Columbia University. We hope that the following information provides you with a helpful overview of our Donor Oocyte (Egg) Program and the professional services available at Columbus Circle. On a personal note, I would like to tell you about my approach to providing fertility care. My philosophy is to look for reasons to help people have children, rather than reasons not to. We are always looking for opportunities to enhance access to care and attempt to provide several treatment options for our patients. We are committed to providing the most comprehensive treatment required to achieve your pregnancy, thereby minimizing expenses. We have assembled an outstanding interdisciplinary team to provide you care and we have one of the largest and most successful Donor Egg Programs in the country. Our most recent SART/CDC pregnancy success rates are attached for your review. Our office is located at: Manhattan Location 1790 Broadway, 2 nd Fl. New York, NY Westchester Location 244 Westchester Avenue, Second Floor White Plains, NY Phone: Fax: am2028@columbia.edu We look forward to meeting you. Please do not hesitate to call if you have any questions or require additional information. Sincerely, Mark V. Sauer, MD, FACOG Professor and Vice Chairman Obstetrics & Gynecology Chief, Division of Reproductive Endocrinology College of Physicians & Surgeons Columbia University

2 INFORMATION FOR POTENTIAL OOCYTE (Egg) RECIPIENTS WHO IS A CANDIDATE FOR THE DONOR OOCYTE PROGRAM? You may want to consider oocyte donation if you do not have eggs of your own, if you carry a genetic disorder or if you have shown consistently poor performance using assisted reproduction with your own eggs. Previous chemotherapy, surgical procedures on the ovaries, premature menopause and absence of the ovaries from birth are some common reasons that the eggs might be absent or function poorly. In order to consider receiving donor oocytes, you must have a relatively normal uterus (womb). In addition your spouse s semen (sperm) analysis should be normal or close to normal, although you may also choose to use donor sperm. WHO ARE THE DONORS? While similar in principle to sperm donation, egg donation is more difficult since women donating their eggs experience considerable inconvenience, some discomfort and assume some medical risks. Ovum donors take daily injections, come frequently to the offices for pelvic ultrasounds and blood tests, and undergo a needle puncture procedure of the ovaries to collect the eggs. Most often they are college or graduate students, or young professionals who are compensated for their time and involvement. METHODS USED TO RECRUIT DONORS? 1. Anonymous Recruited Donors We recruit young healthy donors through advertisement, public speaking, worldwide recognition, and word of mouth. Many of our donors have friends or relatives who have experienced infertility and understand the significance of their gift. We feel that egg donors should be compensated financially for their time, discomfort, and risk. The cost of medical care relating to obtaining eggs is borne by the couple receiving the eggs. Recruited donors undergo a comprehensive screening process involving the following: page Questionnaire to profile past medical, genetic, ancestral, social, education and reproductive histories 2. View a 30-minute video What it Takes to be an Ovum Donor. 3. Comprehensive consultation by the Medical Director 4. Consultation by our team psychiatrist(s) or Social Worker. 5. Screening for general and reproductive health as well as infectious disease including HIV, HTLV, hepatitis, syphilis, gonorrhea & chlamydia 2

3 2. Non-anonymous Recruited Donors A couple receiving eggs may also elect to bring their own donor. This individual may be a relative, friend, or acquaintance. Although this donor is non-anonymous, our policy will still include the same comprehensive screening process required of our anonymous donors. However, we reserve the right not to use a particular donor. Rarely, some of our anonymous donors have agreed to perform cycles in a nonanonymous manner. WHAT PROCEDURES AND MEDICINES ARE INVOLVED? If you desire to explore oocyte donation, you will need to schedule an initial consultation. At this consultation, we will discuss whether oocyte donation is the right plan of action for you. A comprehensive visit is next scheduled to review the results of your completed checklist. If enrolled, you will receive your embryos resulting from donor oocytes obtained from oocyte aspiration following ovulation induction. During these cycles, you will be instructed on how to take medications to artificially regulate your cycle and optimize implantation. In the event that you still have menstrual cycles, we will prescribe a drug called Leuprolide acetate to regulate them. The Leuprolide acetate is given as a daily injection. Once your menses are regulated, you will be ready to start preparing the uterus to receive the donated egg. You will be receiving two hormones: estrogen and progesterone. During the appropriate times, you will be instructed on how to take the medications properly. This process takes approximately 4 1/2 to 5 weeks. During the month of the actual embryo transfer, you and the donor will be carefully monitored in order to synchronize your menstrual cycles. Be prepared that our proposed protocol may be adjusted accordingly. On the day of the donor s egg retrieval, the partner will come in at a predetermined time to give a sperm sample. This sample will be carefully prepared in our embryology lab for fertilization. On the following day you will be notified regarding fertilization results. It is not possible to predict how many embryos will be available for selection and ultimately for transfer. If less than 7 are growing in culture, then 2 or 3 of these embryos will be selected for transfer on the third day. In cases where more are growing normally by the third day, the embryos may be allowed to remain in culture until the fifth day (Blastocyst stage), because it is believed that the most viable embryos survive to the fifth day of incubation. A blastocyst transfer enables the physician to place only one or two of the most viable embryos into the uterus, therefore improving embryo selection and reducing chances of multiple birth. To further assist in selecting only the most viable embryos, an additional procedure called PGD, pre-implantation genetic diagnosis, is also available upon request and will be performed for no additional fee in 3

4 donor cycles. We will proceed with an embryo transfer if at least one egg has fertilized normally, and an embryo(s) has developed. The embryo transfer does not require anesthesia. This procedure consists of placement of a small catheter into your uterus through the cervix, and the embryo is passed through the catheter using gentle pressure. After the embryo(s) is/are transferred, we request that you remain for approximately 30 minutes in our suite. We generally advise you to take one to two days off from work and rest at home afterwards. Blood will be drawn for a pregnancy test approximately 9 days after embryo transfer and again 12 days after embryo transfer. ANONYMOUS DONOR Below, you will find a description of procedures for the typical oocyte donor/recipient cycle. Please be aware that individual circumstances may require additional tests and therefore additional charges. 1. Office Visits The recipient and partner (if applicable) must have an initial consultation with the primary physician, a comprehensive visit with the Medical Director and Nursing Staff to review medication instruction. A psychological evaluation, and consult with a geneticist may also be necessary. 2. Medical Work-Up At the time of the initial consultation, an initial medical work-up will be discussed prior to proceeding with a cycle depending on other medical conditions of the recipient. These expenses are not included in the overall donor oocyte cycle fee, and will vary among individuals. 3. Laboratory Visits Pertinent reproductive lab tests related to treatment cycles are included in the overall donor oocytes cycle fee. This includes hormonal as well as andrology and embryology services. 4. Semen Analysis This test is performed on your partner. A laboratory charge is due on the day of the semen analysis, paid directly to our andrology laboratory. 5. Payment Policies All fees for the Ovum Donor/Recipient Cycle are due and must be paid prior to initiation of the ovum donor s cycle. Please refer to the price list for the ovum donor cycle. The fees that are quoted do NOT include micromanipulation (ICSI), assisted hatching or 4

5 cryopreservation (freezing of embryos). These additional fees are highlighted on the attached price list. Quoted fees for the ovum donor/recipient cycle do NOT include any preliminary testing required prior to being accepted into our program, NOR any of the necessary medications for the ovum donor or recipient for the cycle. The costs incurred for all preliminary testing, medications and any other unanticipated or unusual expenses, are the sole responsibility of the ovum recipient. SPECIAL NOTE REGARDING INSURANCE COVERAGE It is the policy of this program NOT to have any interaction with the insurance companies, EXCEPT FOR THE APPROVED LIST OF INSURANCE COMPANY CONTRACTS. Please check with our business office to determine which insurance companies have contracts with our infertility practice. Other than the approved contract list we do not have any recommendations regarding whether or not our service is provided by your individual insurance plan. Insurance companies may not recognize donor services and therefore you are advised that you must pay all expenses incurred by your ovum donor. NON-ANONYMOUS DONOR As a part of the donor egg program, we may consider non-anonymous donors to provide oocytes (eggs) for a recipient if the recipient has provided the donor. If you are a recipient who receives all the eggs obtained from a particular donor cycle, then you are responsible for all program charges incurred by yourself, your partner and the nonanonymous donor (if applicable). Please be aware that individual circumstances may require additional tests and therefore additional charges. 5