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Third Party Reproduction

 

JCRM Offers All Available Donor Gamete Services.  The following services are offered and will be discussed individually in more detail below:

  • Donor Sperm
  • Donor Oocyte (Egg)
  • Donor Embryo
  • Surrogacy (Donor Uterus)

► Donor Sperm:  Donor sperm, a long utilized therapy for severe male factor infertility or the absence of a partner, is a very successful technique.  Compared to many high tech treatments of the fertility world this therapy is not difficult or uncomfortable.  Several commercial Donor banks are available where sperm samples can be purchased and shipped to our office for use.  This can be done on line where you can view numerous characteristics regarding the donors.  Use of donor sperm requires the intrauterine insemination technique (IUI).  This procedure is similar to a pap smear where a small catheter containing sperm is placed in the lower part of the uterus.  As the sperm are placed in the uterus, we know that they are also pushed up into the tubes where they will meet the egg.  The average number of cycles to pregnancy depends primarily on the females age.  If cycles are normal and ovulatory, the natural cycle can be utilized.  In general we would monitor and give hCG, an injection that stimulates ovulation, in order to time the insemination more carefully.   Prior to donor sperm cycles, patients /  couples attend a meeting with our infertility counselor to discuss potential issues for couples and their offspring.   Donor bank listings can be obtained by calling our office at 904-493-(BABY)2229

► Donor Oocyte:  Donor oocyte or “egg” is a process where a young female (synchronized cycle whereby her uterus is primed with hormones to be “in sync” with the donor cycle such that the endometrium or lining of the uterus is ready to accept the embryos when they are ready.   At the appropriate time an embryo transfer is performed.  This is a simple procedure similar to a pap smear.  Because the age of the egg determines the pregnancy rates with egg donation, the rates are very high and are approaching 60-70% if there are no adverse uterine influences.

Donor oocyte is certainly also an emotionally difficult decision for couples to make.  As with sperm donor, this certainly is not how any couples start out on their reproductive treatment journey. Despite this dramatic shift in thought processes, couples that choose egg donor do very well and by the time the pregnancy test is positive, most if not all the initial adverse reactions to the process have dissipated.  In contrast to men and sperm, studies show that women bond most closely to the pregnancy and the delivery and not to the egg.  As with sperm donor, couples undergoing egg donation attend a meeting with our infertility counselor to discuss potential issues for couples and their offspring.

Most couples facing Egg Donor are also considering or have thought about adoption.  We feel that egg donor offers some distinct advantages to adoption.  The recipient benefits most through the bonding process with the pregnancy and delivery.  This is not something achieved through adoption.  In addition, the recipient is in total control of the pregnancy in terms of smoking, alcohol and drug use and nutrition, all of which play important roles in fetal development.  Finally, the likelihood that a donor would ever challenge the parental rights to the child is minimal compared to traditional adoption.

► Embryo Adoption:  A relative newcomer on the third party reproduction scene, is Embryo adoption.  Due to a long history of cryopreservation of embryos associated with the IVF process, in the US alone there are hundreds of thousands of embryos stored in freezers.  Many of these embryos are orphaned, meaning clinics are unable to contact the conceiving couple.  As a result, programs now are offering and encouraging embryo adoption to those in possession of frozen embryos and going forward patients are given the option of donation.  While this idea is new, and the consenting process has only been around over the last several years, more and more “unwanted” embryos are coming available for adoption.   Embryos must be first identified either from our practice, another fertility patient (often on line), or through embryo adoption agencies.  Legal paper work is needed to affect the transfer and once received, the embryos can be transferred much like any cryopreserved embryo cycle and the recipient undergoes similar preparation to the egg donor patient described above.  The transfer itself is similar in complexity to a pap smear.

The biggest drawback to embryo adoption is the time required to identify the embryos and the coordination of embryo custody transfer.  Most embryos available result from donor egg or donor egg / donor sperm cycles, so generally the pregnancy rates are good.  Our experience has been very positive.  The underlying pregnancy rate does however, relate to the circumstances and the age of the eggs that created the embryos originally.  The cost is highest when agencies are utilized.

►Surrogacy (Gestational Carrier):  This is the most involved form of third party reproduction due to the number of parties involved and the length of involvement.  In this situation, in the state of Florida, a physician must determine that a woman is incapable of carrying a pregnancy before surrogacy can be entertained.  The surrogate or carrier receives the embryo transfer and carries the pregnancy to term.  At delivery, a pre-planned adoption takes place where the carrier (birth mother) gives up the child to the commissioning couple.  This is relatively ironclad with legal agreements when the embryos genetically belong to the commissioning couple.  Therefore, it would be unlikely that the birth mother could lay claim to the child.  This is less clear when donor sperm or eggs are utilized in the process of creating the embryos for the gestational surrogate.  Certainly as always proper legal agreements are sought prior to starting any cycle.  The process of identifying a surrogate is more involved than egg or sperm donor recruitment.  In addition to family or friend involvement, donor agencies often offer surrogates as well.  This also is often very successful due to the fact that the uterine factor is often the only fertility issue for the commissioning couple.  For more information on this or any of the above procedures, please call us: 904-493-(Baby)2229