1What is the cause of infertility?
There are many causes of infertility. Research has shown that: - 30% the cause of infertility is found to be the woman. - 30% the cause of infertility is found to be the man. - 30% the cause of infertility is found to be both male and female. - The final 10% is believed that the underlying cause cannot be determined by diagnostic methods used today. To determine the cause of infertility you need to undergo tests. Many problems can be rectified which could increase your chances of successfully conceiving a child.
2What do I need to do after I have chosen an egg donor?
You need to complete the clinic’s medical questionnaire and return to them with the requested results. They would evaluate the results of tests that you have had previously. The tests that are most useful to them are: Wife/female recipient: Blood tests: (1) FSH + AMH test done on day 3 of cycle (2) HIV I and II (3) RPR (4) Hep B S Ag (5) Hep C Ab (6) Rubella IgG blood test Other tests: (1) Recent pelvic ultrasound (2) Hysteroscopy or Hysterosalpingogram (3) please include reports of previous operations Husband / partner: (1) Semen analysis (2) HIV 1 and II (3) RPR (4) Hep B S Ag (5) Hep C Ab
3What medication do I have to get prior to seeing the doctor in Cape Town?
1) Leuprolide acetate injection ( Lucrin, Lupron, Ginecrin) – This injection is given at the start of your period. The doctor will tell you which period will be best one to commence your injection on. This injection suppresses your own natural ovulation for 6 weeks so that we can co-ordinate your cycle with that of the donor. The injection can be given subcutaneously. Alternatively the daily luprolide acetate injections or the nasal spray, Synarel, may be used. sperm2) Estradiol valerate tablets 2mg – 84 tablets (Progynova, Estrace, Estrapause) – The doctor will tell you when to commence these tablets. They should be taken in the following way: – 1 tablet daily for 3 days, then – 2 tablets daily for 3 days, then – 3 tablets daily for 3 days, then – 4 tablets daily. Continue with 4 tablets daily until the doctor tells you to stop or increase. These tablets thicken and prepare the lining of the womb prior to the embryo transfer. 3) Progesterone in oil injections (100mg)– 20 ampoules (Gestone) – These injections will only be started after you have seen the doctor in Cape Town. You will be told exactly what day to start the injections. The needles and syringes will be provided from the clinic in Cape Town. Alternatively you can use Crinone Gel twice daily.
4How do I obtain these medications?
If you live far away from Cape Town your treating clinic will have the medication couriered to you. You can let them know if they should arrange this for you. On arrival in Cape Town The first visit to the doctor will be approximately 4 days prior to your donor’s egg collection. You will have a painless vaginal ultrasound scan performed to check the thickness of your endometrium (lining of the womb). If the lining is too thin your estradiol tablets will be increased. You are required to stay in Cape Town for about of 12 days.
5How are the embryos cultured?
Once the eggs are collected, they are fertilized using your partner’s or husband’s sperm. (Frozen sperm from our sperm donor cryobank can also be obtained if required). The clinic laboratory has excellent facilities for ICSI (injection of sperm into eggs), embryo freezing and blastocyst culture.
The clinic will inform you which day to come in for your embryo transfer. Usually 2 embryos are transferred. You may freeze remaining embryos for use at a later date, if their quality is good. The freezing is usually done by vitrification which promises high recovery rates. The embryo transfer is an easy procedure much like a gynaecological examination done under ultrasound guidance. Following the embryo transfer you are advised not to do any heavy exercise for a week.
A blood test for pregnancy hormone (βHCG) will be done 10 days after your embryo transfer. This can be performed once you have returned home. The blood test is usually repeated 2 days later to check the pregnancy hormone levels are rising appropriately.
The Egg Donor
1Who are the egg donors?
Most egg donors are young healthy women under 32 years of age. Many of them are university students here in Cape Town.
2Can we choose a donor?
It is the law in South Africa that egg donation is anonymous. However, we will provide you with profiles containing details about their physical characteristics, medical background, education, hobbies etc.
3What’s the legal situation on egg donation in South Africa?
The National Health Act of 2004 regulates all gamete donations and the procedure is legal in this country.
4What happens to the egg donor?
The egg donor has a detailed medical examination and psychological assessment prior to joining the programme. The investigations performed on the donor are: – HIV I and II – RPR – HepBs Ag – Hep C Ab – CMV IgM – Cystic Fibrosis – Blood group and antibodies Other investigations can be done on the donor on requested.
5What treatment does the egg donor undergo?
The egg donor has fertility injections for 10 days to grow the follicles. She has regular ultrasounds to check the development of the eggs. The egg collection is performed under ultrasound guidance. This is a 10 minute procedure where the eggs are collected using a vaginal ultrasound and a fine needle. This is done using anaesthetic in theatre.