Needing assistance to create your family

Needing assistance to create your family

So many couples struggle to conceive. Many are left with only one option to enable them to become parents and this is to explore the alternative of “third party” assistance.

The term “third party” assistance refers to the use of donor eggs or sperm that are given to the infertile person or couple (intended recipient / parents), to enable them to become parents. In South Africa, egg and sperm donation is anonymous.

Since the first pregnancy with egg donation in South Africa, performed at Cape Fertility Clinic, Cape Town in 1986, egg donation has become a regular and routine treatment over the past 22 years and the number of people seeking this form of fertility treatment has increased. Egg donors are identified and through the process of IVF (In Vitro Fertilization), eggs are obtained from the donors ovaries and donated to the intended recipient. Sperm obtained from the recipients partner or a donor is used to fertilize these eggs and once fertilized are transferring into the recipients uterus.

An egg donor is a woman between the ages of, preferably, 21 and 33 who donates a few of her eggs to other women, who is unable to fall pregnant with her own eggs. Once the 8 to 10 or so eggs have been removed from the egg donor they are fertilized with the recipient women’s male partners’ sperm. If fertilisation occurs the embryo/s are then transferred into the recipient woman’s uterus. This is the only way that the woman has a chance of becoming pregnant, carrying and birthing a child.

The assessment of the recipient couple is very similar to that of couples who undergo ordinary IVF. For the female extensive gynaecological testing (this sometimes will include a hysteroscopy and laparoscopy) and physical exams are completed. The male assessment will be a semen analysis.

Once the donor is chosen and full handover is done to the clinic, preparation of the donor for egg retrieval has to occur. The donor is given a combination of hormonal medications to stimulate the development of multiple eggs within the ovaries; this is referred to in medical terms as ovulation induction. This is done by using hormone stimulating injections which aim at inducing egg development. The growth of the eggs are monitored and measured regularly by the doctor using an ultrasound. When the eggs are mature and ready, ovulation is triggered by an injection of Human Chorionic Gonadotropin (hCG). The eggs are then retrieved approximately 36 hours after the hCG has been administered by a procedure which is called a transvaginal ultrasound aspiration. It is
performed under sedation by an anaesthetist. The transvaginal ultrasound is performed and a fine needle which is attached to the ultrasound is used to extract the eggs. The follicular fluid is examined under a microscope in the laboratory adjacent to the procedure room to check how many eggs have been collected. The eggs are examined for maturity and then are inseminated with the sperm of the partner / donor sperm which has been processed and prepared in the laboratory.

The recipient is prepared from this point for the embryo transfer. This is usually done by using methods of endometrial preparation. The recipient begins progesterone on the day after the donors egg retrieval to prepare the womb and lining so that the embryo is able to implant. The embryos are usually transferred within 3 – 5 days of the retrieval and after they have been fertilized in the laboratory.

The transfer is done by using a small catheter with the embryos through the cervix and into the uterus.
The recipient needs to lie down for 30 minutes after the procedure and then may return home and is suggested that she takes it easy for the next couple of days while implantation takes place.

Two weeks later, the recipient will be sent for a pregnancy blood test, to ascertain the success of the procedure.

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