The use of donor gametes (sperm and eggs) has a long history in its application to male infertility. When the male partner in an infertile couple has azoospermia (no sperm) or severe oligospermia (low sperm number), the only treatment which allows the female partner to conceive is the utilization of donor sperm for artificial insemination. Artificial insemination with donor sperm is a standard and widely practiced treatment for male infertility.
The use of the female gamete, the egg or oocyte, for treatment of certain disorders leading to female reproductive failure has only been possible since 1984. The oocyte from a donor can be either recovered as an embryo after it has undergone fertilization within the body (by uterine lavage (washing) in a process called ovum transfer) or recovered as an egg and inseminated in vitro (in the laboratory) to yield an in vitro fertilized embryo.
Ovum transfer, the transfer of a normally fertilized egg from a female donor to an infertile recipient, was developed in the United States and also performed in Italy. It has presently been abandoned in the United States. The major reasons for its present disfavor are: 1) The fertile donor, having to be inseminated with the recipient's husband's sperm would be at risk for sexually transmitted diseases, the most devastating one without a screening procedure being the Acquired Immunodeficiency Syndrome (AIDS), 2) if the conceptus created is not recovered by uterine lavage procedure, there is the risk of establishing an intrauterine pregnancy in the donor woman requiring its termination, and most importantly 3) without use of drugs to induce superovulation, the success of ovum transfer per each natural insemination cycle has been less that 10%.
The use of in vitro fertilized donor eggs has been more widely applied with births. There are two major advances in in vitro fertilization technology that have made the use of donor eggs more feasible. The first advance has been the introduction of ultrasound-guided egg recovery techniques. Ultrasound-guided transvaginal oocyte recovery is performed on an outpatient basis requiring only local anesthesia and sedation. Laparoscopy and general anesthesia are not required, making the procedure less risky and its use more justifiable in women for whom there is no direct medical benefit. The second advance is the success in cryopreservation (freezing) of in vitro fertilized human embryos. The cryopreservation of embryos makes it unnecessary to have perfect synchronization of the donor and recipient women's menstrual cycles making the logistics of donation much simpler.
It is important to remember that each patient has their own unique response to the medications they receive and that each ART cycle is different. This means, not only are you unlikely to respond as others do, but you may actually respond differently from one cycle to the next. For this reason, you will find that your treatment and testing differs from that of other patients.
The schedule you find here is to help guide you through your treatment cycle. Time changes and other adjustments will frequently be made in order to individualize your treatment.
