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  Donor Egg Program  
 
 

Egg Donation is an exciting option in the treatment of infertility, as now almost all couples who desire to have children can do so.  With the advent of the use of donor eggs, women who once could not bear children are now able to conceive and deliver healthy babies. If anonymous egg donation is desired, recipients of donor eggs can be assured that their chances of having a healthy child are excellent, and that the entire process can be performed in a discreet and confidential manner.  It is indeed a thrilling option for women who wish to conceive who otherwise would not be able to do so.

  

Egg donation is the most complex of current assisted reproductive techniques.  It requires synchronization of the menstrual cycles of the donor and recipient; stimulating the donor to produce many mature eggs at once; retrieving eggs during ultrasound guidance; inseminating and fertilizing the eggs; placing the fertilized eggs or embryos into the recipient’s uterus and supporting the pregnancy with hormones.

Couples considering egg donation must set up an initial consultation with Dr. Levi.  The recipient must be in good health and meet age requirements.  Recipients over the age of 45 must submit a recent EKG, mammogram and a medical clearance letter from their primary care physician stating they are capable of carrying a pregnancy to term without compromising their health.  A medical history is taken and a screening with blood testing for infectious and sexually transmitted diseases are performed on both partners.  It is strongly recommended that couples consult with a clinical social worker or licensed psychologist to understand the ramifications associated with creating a child from donor egg.  Donors are compensated and all of their medical, psychological, pharmaceutical and travel costs associated with their treatment are paid by the couple.

   Egg Donation  
 

 

 

 

 

 


Park Avenue Fertility’s donor coordinator will also meet with the couple and discuss the process.  Couples will be asked about their donor preferences which will enable the donor coordinator to understand what attributes are important to the couple.  Couples have the option of selecting a Park Avenue Fertility donor or selecting a donor from an outside agency.  A listing of outside agencies can be made available to couples wishing to select a donor from an outside agency.  Outside agency fees can vary.  Couples are responsible for contacting the outside agencies directly.  The agency will explain what fees besides the donor’s compensation that the couple will be responsible for paying to the outside agency directly. 
A woman that desires to be an anonymous egg donor must be accepted into the Park Avenue Fertility program.  Women are usually recruited through referrals and advertising in local newspapers.  Our donors usually reside in Connecticut, New York, New Jersey, Rhode Island and Pennsylvania.  Donors are preliminarily screened for physical and psychological suitability as recommended by the American Society for Reproductive Medicine.  Women that apply to our program must meet its eligibility requirements.  Park Avenue Fertility requires that women are healthy, non-smokers between the ages of 19 and 33, and agreeable to a drug and nicotine screening along with other requirements.  Eligibility rules for screening donors mandated by the FDA are strictly adhered to by our program.  Potential donors provide a childhood photo, current photo and complete
a detailed questionnaire that includes demographics, family history, detailed medical and genetic information, and a psychological inventory.  Upon a thorough review of the questionnaire, a personal interview is set up with the potential donor and is conducted by the donor coordinator.  If the donor is accepted into our program, a detailed profile of the donor is established.  Donor profiles are made available to couples to choose from. 

Listed below is information regarding Park Avenue Fertility’s services during a donor cycle.  Please note that If the couple has selected an outside donor agency then the donor compensation and donor insurance fees are not payable to Park Avenue Fertility. 

Donor Compensation:  $9,500.00
Park Avenue Fertility donors receive $9,500.00.

Donor Insurance: $395.00
Prior to the donor beginning the cycle, a Lloyds of London short term, specialty policy is put in place for the donor so that she will have medical coverage in the rare event a complication should occur.    

Donor Matching:  This service is available for patients that would like to use a Park Avenue Fertility donor or have the physician and the donor coordinator review donors from outside agencies.  If you wish to use a Park Avenue Fertility donor, the donor coordinator and the physician will match and present donors for the couple to review and select from.  A comparative analysis of the couple and donor is performed.  The couple’s donor preferences are used in the analysis along with notes from consults; phone conversations with the couple; demographic information, and detailed questionnaires (profiles) of the donors.  Preliminary matches are made by the donor coordinator and a profile with photos of the proposed donor is presented to the couple for their review. 

Cycle Management:  This is for the close administrative coordination, clinical coordination and synchronization of the donor and recipient throughout the entire donor cycle.

Donor’s Psychological Evaluation and Report:  Donors are evaluated by a licensed psychologist regarding their understanding of the physical, emotional and legal ramifications along with their psychological preparedness and suitability.  A PAI (Personality Assessment Inventory) will be administered to the donor, interpreted by the psychologist and will be a part of the report.

Parents’ Psychological Evaluation and Report:  At the discretion of the physician, parents may be required to meet with a psychologist or licensed clinical social worker.  Parents are responsible for the cost of the session. 

Donor’s Screening:  The donor is screened in our office for half a day or longer if needed.  She undergoes a comprehensive interview including completion of required FDA forms, history and physical including a pelvic exam with Pap smear and cervical cultures for GC/Chlamydia.  The donor is instructed at length regarding the administration, dosages, timing and safety of each medication including leuprolide acetate by injection, gonadotropins by injection and human chorionic gonadotropin (hCG).  Arrangements for the ordering and delivery of these medications will also be made.

Recipient’s Screening:  The recipient must have a history and physical including a pelvic exam with Pap smear and cervical cultures for GC/Chlamydia.  A mammogram within the past 12 months is required and a copy from your gynecologist or radiology office must be provided.  A letter of medical clearance is required from the recipient’s primary care physician and an EKG if the recipient is the age of 45 or above.
Recipient’s Sonohysterogram (SHG):  Based on the physician’s discretion, the recipient may have to undergo this in-office procedure.  This is a very sensitive procedure to detect myomas (fibroids), scar tissue, polyps and other types of uterine problems that can contribute to infertility or miscarriage.

Medications:  costs are not included and are paid directly by patient.  Prices for fertility medications can range dramatically from approximately $2,500.00 to $6,000.00 per patient if you do not have insurance coverage.  A protocol is designed and closely monitored based on the donor and recipient’s ages, diagnoses, past ovarian stimulation history if any, and other relevant factors.  Dosage and response to medications varies widely from patient to patient, and can also vary from cycle to cycle. A cost estimate for medications can be provided by Park Avenue Fertility if needed. 

Donor’s Blood and Urine Screening:  The donor must undergo comprehensive testing that includes a nicotine urine screen, drug panel for illegal substances and for genetic and infectious diseases.  HIV, HBSAg, HCAb, Rubella, RPR, Blood Group and Rh, Antibody screen, CBC, TSH, PRL, CF, VZV IgG, VZV IgM, CMV IgG, CMV IgM, Toxoplasmosis IgG, Toxoplasmosis, IgM.  A baseline FSH is also taken. 

Donor’s Blood Screen Required by the FDA:  The donor must undergo FDA required lab testing prior to the oocyte retrieval for any communicable diseases.  Tests include HIV1, HIV2 Ab, Hepatitis B Surface Ag, Hepatitis B Core Ab, Hepatitis C Ab, RPR, NAT GC/CHL Aptima, NAT for HIV, Hepatitis C and Hepatitis B.

Donor’s Endocrine Tests for Monitoring:  Estradiol, LH, and Progesterone tests are ordered periodically.

Recipient’s Blood Screening:  Comprehensive testing includes HIV, HBSAg, HCAb, Rubella, RPR, Blood group and RH, Antibody Screen, CBC, TSH, PRL, VZV IgG, VZV IgM, CMV IgG, CMV IgM, Toxoplasmosis IgG, Toxoplasmosis, IgM, HSV 1, HSV 2, HTLV 1, HTLV2.  A baseline FSH is also taken. 

Recipient’s Endocrine Tests for Monitoring:  Estradiol and Progesterone tests are ordered periodically.  Pregnancy/HcG test(s) are also ordered at the appropriate time.

Recipient’s Partner’s Blood Screen:  Testing includes HIV1, HIV2, HBsAg, HCAb, and RPR.

Known (Directed) Donor’s Partner’s Blood Screen:  A known (directed) donor’s male partner must undergo testing that includes HIV1, HIV2, HBsAg, Hepatitis B Core, HCAb, RPR, CMV IgG, CMV IgM, GC, Chlamydia Aptima.

Donor’s Ultrasound and Endocrine Monitoring and Interpretation:  The donor is monitored closely to determine hormone levels and regulate medications.  Multiple ultrasounds are performed to track follicle development.  Endocrine results are interpreted and evaluated.
 
Recipient’s Ultrasound and Endocrine Monitoring and Interpretation:  The recipient is monitored closely to interpret endocrine results and evaluate hormone levels, regulate medications and track development of the uterine lining for embryo transfer.  Office visits, ultrasounds, blood draws, an injection teaching class for the medications, an IVF class, and a trial embryo transfer (uterine sounding) are performed.

Anesthesia for Donor’s Ooocyte Retrieval:  Anesthesiology services are provided by Medical Anesthesiology Associates, P.C., for the donor’s oocyte retrieval. 

Donor’s Oocyte Retrieval Procedure with Ultrasound Guidance:  Eggs are retrieved transvaginally using ultrasound guidance.  The egg(s) are transferred immediately to the embryology laboratory where they are later fertilized and cultured. 

Intracytoplasmic Sperm Injection (ICSI) or Insemination of Oocytes:  In cases where the sperm may have problems penetrating the outer shell of the egg, fertilization is aided by ICSI which is performed by the embryologist, where a single sperm is injected directly into the eggs.  Insemination of oocytes is another method that may be performed by the embryologist where the embryologist incubates motile sperm directly to the eggs.

Assisted Zona Hatching or Extended Blastocyst Culture:  Assisted hatching is performed on embryos by the embryologist and involves creating a small hole in the zona pelucida that surrounds the embryo (a protective layer). Before an embryo implants into the uterus, it must “hatch” from the zona pelucida.  Thus, by making a small hole in the zona pelucida, the hatching can more easily occur.  The hatched embryos are then transferred into the uterine cavity.  Assisted hatching is not
performed on blastocysts (embryos that have grown for 5 to 6 days), since the zona pelucida is quite thin at this time. 

Recipient’s Embryo Transfer Procedure with Ultrasound Guidance:  The highest quality embryo(s) are transferred to the recipient’s uterus under ultrasound guidance. 

Medical, Embryology and Andrology Services:  This may encompass the following services – sperm motility and count, complex sperm preparation, thaw of cryopreserved sperm vial(s), thaw of cryopreserved embryo(s), paracervical injection (local anesthesia), oocyte identification in follicular fluid post retrieval, day 1 through 3 culturing of embryos, day 3 through 5 culturing, evaluation of embryos, and the preparation of embryo for transfer.

Optional Services

  • Embryo Cryopreservation
  • Embryo Storage
  • Sperm Cryopreservation
  • Sperm Storage 
  • Semen Analysis 
  • Thaw of MESA/TESA 
  • Sperm Identification from MESA/TESA
  • Transfer-in and handling of Donor Sperm from Sperm Bank
  • Transfer-in and handling of Cryopreserved Sperm
  • Transfer-in and handling of Cryopreserved Embryos without use of our tank
  • Transfer-in and handling of Cryopreserved Embryos with use of our tank



Preimplantation Genetic Diagnosis (PGD)
This service can be utilized to detect genetic and chromosomal abnormalities and may also be used for gender selection to determine the sex of an embryo to family balance or to avoid pre-disposed, genetic conditions inherent to a gender.  PGD is also referred to as “pre-pregnancy diagnosis”.  Dr. Levi can discuss this technique further with patients. Fees for PGD consist of Park Avenue Fertility’s fee and Reprogenetics’ fee.  PGD may be covered by your insurance for medical necessity.  PGD will not be submitted to insurance for sex selection since insurance companies do not cover sex selection.  For sex selection, the 5 chromosome panel must be performed by Reprogenetics in conjunction with Park Avenue Fertility performing the biopsy(s).

  • Biopsy of 5 or less embryos
  • Biopsy of 6 or more embryos
  • Biopsy of 13 or more embryos

After the biopsy is performed by the embryologist at Park Avenue Fertility, specimens are sent by courier to Reprogenetics in New Jersey who then analyze the cells from the embryos that have undergone biopsies.  Fees for services provided by Reprogenetics are listed below and are dependent upon which testing is selected.  Reprogenetics does not accept insurance and does not submit their fee to the couple’s insurance.  However, upon request Reprogenetics will provide the couple with a receipt if the couple wishes to submit the fee for testing to their insurance themselves.  Reprogenetics’ fee may be paid to Park Avenue Fertility for your convenience or to Reprogenetics directly.
 
Reprogenetics

  • Aneuploidy 12 chromosomes
  • Aneuploidy 9 chromosomes
  • Aneuploidy 5 chromosomes
  • Aneuploidy 5 chromosomes in addition to Reciprocal Translocation
  • Reciprocal Translocation or Pericentric Inversion
  • Robertsonian Translocation
  • Gene Disorder/Mutation

Additional costs you might incur
Courier service, express mail service, pregnancy ultrasounds if not covered by insurance, blood tests if they are not covered by insurance.  Park Avenue Fertility is not responsible for the cost of any blood tests.

Fee Schedule

Please contact the Practice Director Fiona Mullins, for Park Avenue Fertility’s fees document regarding egg donation.

Our Patient Care Coordinator will contact the patient’s insurance company to check for any services that are covered by their insurance plan.  Covered services will be submitted to insurance.  Please contact the Practice Director, Fiona Mullins to discuss any financial issues or with any questions concerning payment.  Payment is accepted in the form of check, cash, major credit cards, and Capital One Healthcare Finance.

Third party financing is available through Capital One Healthcare Finance.  If you would like a brochure for more information, please contact Fiona.  A fixed interest rate table begins at 1.99%.  There are no prepayment penalties.  Patients may confidentially apply for a loan via telephone directly to Capital One.  Park Avenue Fertility will receive a copy any loan approvals and contact you to confirm.

Regarding payment schedule for Park Avenue Fertility:  a customized financial statement is prepared and sent to the couple.  It will list the specific services and any optional services selected.

Initial Payment:  an invoice is sent reflecting the cycle management fee.  This invoice is due upon receipt.  Administrative and clinical work on the donor cycle cannot begin until payment of this invoice is received.      

Balance Due:  the remaining balance for the donor cycle must be received prior to the donor beginning her medications.  The date will be provided to the couple.

Cancellation Policy

The cycle management fee and the matching fee are non-refundable.  Any other services performed up to the date of cancellation will be deducted from the couple’s payment(s) and the remainder amount will be refunded to the couple if the donor cycle is canceled for any reason.  The Park Avenue Fertility donor will not be compensated if eggs are not retrieved. 

Consents

All appropriate consents related to the Donor Program must be read and signed by the couple and the donor within the appropriate timeframe.