“After years of not being able to fall pregnant more South African women are turning to egg donation IVF to become mothers. Dominique Oosthuizen explores how through egg donation women struggling to fall pregnant can have children.
Receiving the gift of life
Slowly the eggs (oocytes) are extracted through the vagina of the donor with a small needle. These eggs are her hope for a family. These eggs carry her dream to become a mother.
They are carefully fertilised in an in vitro fertilisation (IVF) laboratory with her husband’s sperm. The embryos are then cultured and grown over the next few days until the doctor cautiously transfer the embryos into her womb.
From these two cells all the babies’ organs and body parts will develop. From these two layers of cells a little miracle will form.
“When I saw their heartbeats for the first time it was surreal,” tells a donor egg recipient. “I cried and I cried and I cried. Finally! Finally it was my turn to become a mother.”
As she had only disclosed to her close family and friends of her journey with egg donation IVF the recipient decided to remain anonymous.
“There was no black or white explanation on why I could not conceive children, but I was determined to be a mother.
“Through the donation someone was able to give me such a selfless gift,” she says with great thankfulness to the anonymous donor.
She lightly laughs and adds, “The donor actually gave me twice the gift — she gave me twins. She helped me reach a dream that I once thought was unreachable.”
Donating agencies: collectors of apples
“The process of donating eggs can be compared to the collection of fruit,” says Jenny Curry, the owner of Baby2mom, a company that facilitates the egg donation process by co-ordinating the donor and the recipient.
“Every month a woman loses a certain amount of eggs — just as an apple tree will lose apples,” she explains.
“But, if you stand there with a basket to collect the apples it just means that they are going to good use. Those who are not collected will fall to the earth and rot.”
She says that instead of losing your eggs through menstruation they can rather be collected and put into good use.
“Egg donation is an extraordinary life-changing gift. It is a gift that offers hope to women who previously thought they could never have children.”
According to Curry, women who are in good health and who do not have any genetic illnesses or concerns can donate their eggs.
Companies such as Baby2mom, Nurture, and Gift ov Life have online databases where possible recipients can look at a profile of all the possible donors.
“The donor’s profile will among others provide a recipient with information about the donor’s physical profile, education/occupation, and behavioural traits,” she explains. Adding that the donor’s identity will remain anonymous.
“When a donor commits to donating her eggs she has the ethical responsibility to participate in the process as instructed,” says Curry.
“When the donor completes the process and does what is expected of her, she will receive a donation of R 6000 as approved by the South African Health Department.”
She emphasises that it is a donation and not a payment. “It is a gift for the donor’s effort, the incurred medical cost and the time the donor had put into someone else’s dream.”
According to Curry the donor has no rights towards a child that is conceived through egg donation.
“South African law says that the birth mother holds all the rights and responsibility when it comes to the child. Legally the child is the recipient’s child.”
Donating the ultimate gift
“We are born with over 2 million eggs and we lose them during our lifetime,” says Jamaine Krige, an egg donor who has donated eggs twice. “If they are going to be lost why not give them to someone that can benefit from it?
“We all know someone that is struggling to have a baby. While having children is not a priority for me right now — I know the importance that it carries to a lot of women,” she says.
“For the recipient it means the world. You are helping them get the family they have always wanted.”
Krige explains that egg donation is an important process. “Unlike adoption or surrogacy it actually affords the women a chance to play a part in the process of giving birth to her baby.
“The donor might provide the genetic material for conception, but the recipient still carries the baby. She still nurtures the baby in her womb.
“She plays a vital part in bringing the baby in to this life.”
Dr Paul le Roux, a reproductive medicine specialist at Cape Fertility Clinic, says that infertility exists when a women is unable to conceive after 12 months of unprotected intercourse.
“Ovarian failure may be due to previous chemotherapy, radiotherapy and/or prior surgery,” he says. Adding that infertility can also be due to poor egg quality because of age related deterioration or due to inherited genetic conditions.
According to Le Roux one in every three women, above the age of 40, will not be able to conceive naturally and will need fertility treatment in order to get pregnant.
Le Roux explains that once an egg-recipient has found a donor, either through a donor agency or through someone they know, both the donor and the recipient will see a fertility specialist for treatment.
“The recipient will have medication to prepare her womb lining for the embryo transfer, while the donor will have medication to grow the eggs. The donor will have to take daily injections of Follicle-stimulating Hormone (FSH) for approximately 10 days,” he expands.
“The donor will then be monitored with trans-vaginal ultrasound every couple of days until the eggs are ready to be extracted.”
According to Le Roux the IVF success rate in South Africa is approximately 35% per embryo transfer.
The reproductive specialist says egg donors should preferably between the age of 21 and 34 as “any eggs of a donor, older than 34, might decrease the success rate of the IVF”.
He also says for health reason the South African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG) suggest that oocyte donors should be limited to 6 donations.
“Medical risks for the egg donor are generally small, but risks may include ovarian hyper-stimulation syndrome, pelvic infection, ovarian torsion, intra-abdominal bleeding, loss of future fertility and anaesthetic complications,” says Le Roux.
A mother’s words
“A mother is a woman who will love her children unconditionally until her last breath,” says the egg donor recipient.
“As a mother you choose to put someone else’s happiness and well-being ahead of your own. As a mother you will have your patience tested to the ends of the earth.
“You will learn about your personal strengths you did not know you had and you will deal with fears you did not know existed. No greater privilege exists. Everybody deserves to be a mother.”
With thanks to journalism student, Dominique Oosthuizen for sharing her investigation into the Egg Donation industry with us!
Lying back and thinking about the beach – or wherever else one finds relaxing – can increase the chance of getting pregnant, claim researchers.
Researchers found that women who actively took part in stress management therapy, including visualisation techniques like imagining being on a beach, significantly increased their chances of pregnancy
Researchers found that women who actively took part in stress management therapy, including visualisation techniques like imagining being on a beach, significantly increased their chances of pregnancy.
In a small study of Israeli women undergoing IVF, 88 per cent of those who committed to a ‘talking cure’ therapy programme became pregnant, compared to just 60 per cent who were not on it.
Jo Czamanski-Cohen of Ben Gurion University in Israel, said many women undergoing IVF convinced themselves they would never become pregnant as a self-defence mechanism.
They told her “I’m never going to be a mother,” she said.
She commented: “I think a lot of the negative thinking is preventing disappointment for them. It’s to stop them being disappointed if it does fail.”
The sessions involved breathing exercises, muscle relaxation, and ‘guided imagery’ techniques such as imagining oneself in a relaxing place.
“Eighty percent of the people I work with use the beach,” she said.
Dr Alice Domar, a psychologist and assistant professor at Harvard Medical School, said becoming less fertile was an evolutionary response to intense stress, as being pregnant during times of high stress – such as famine – endangered both woman and child. Managing that stress could therefore help them become more fertile, she reasoned.
Via The Telegraph
5 tips to improve IVF success
Eating avocados and foods high in monounsaturated fat can triple the success of your in vitro fertilisation (IVF) treatment. But is there anything else you can do to improve your IVF success?
A new study carried out by researchers at the Harvard School of Public Health found that eating monounsaturated fat – found in olive oil, sunflower oil, nuts and seeds – could help women trying to have a baby through in vitro fertilisation (IVF). It’s believed that these “good fats” – which are already known to protect the heart – could improve fertility by lowering inflammation in the body.
In contrast the research revealed that women who ate a diet rich in saturated fat (found in red meat and butter) produced fewer healthy eggs for use in fertility treatment. Another study showed that drinking five or more cups of coffee a day halved the chance of successful IVF treatment.
Dr Ulrik Schixler Kesmodel, from the Fertility Clinic of Aarhus University Hospital in Denmark, said: “Although we were not surprised that coffee consumption appears to affect pregnancy rates in IVF, we were surprised at the magnitude of the effect.”
But along with eating a healthy diet, what else can you do to improve your chances of conceiving under IVF? Tertia Albertyn, Owner of Nurture Egg Donor and Surrogacy Program, provided the following tips:
5 tips to improve your IVF success
1. Make sure you are at the best fertility clinic for your needs. “Best” can be defined in many ways – highest success rate, best bedside manner, most value for money. You are making an enormous financial and emotional investment, so make sure your expectations are met.
2. Make sure your expectiations are realistic. If you are 45 years old and you are using your own eggs, your chance of success is probably only around 5%. Your chance of having a baby through donor eggs is around 65%. If you only have the resources for one attempt, make sure you maximise your odds.
3. Prepare yourself emotionally. Know that IVF takes a huge toll emotionally; be prepared for the roller-coaster ride. You will feel so many emotions at once: hope / fear / excitement / terror. Have someone to support you through the process. Go online and join a fertility support forum, it can be done anonymously if you are keeping it private and confidential. Don’t be ashamed to seek professional support if you need it.
4. Prepare yourself physically. Stop smoking, cut down on the wine. Eat well. Drink water. Stick to one cup of coffee a day. Don’t eat fatty foods. Step away from the cheese cake, burgers and fries. But don’t punish yourself, have that glass of wine on a Friday night. Enjoy that rare cappuccino. Infertility is hard enough without denying yourself the occasional indulgence.
5. Go alternative: Just because you are doing something high tech / traditional medicine, doesn’t mean you can’t use alternative approaches to maximise your chances. Investigate things like fertility acupuncture, fertility reflexology or fertility astrology. Make sure you go to someone reputable who has experience in this area. Always check with your doctor first.
Lastly, always have a Plan B, said Albertyn. “Having a Plan B (another IVF / another option like donor eggs) kept me sane. If this one doesn’t work, then we will do XYZ or try ABC. Knowing that this wasn’t the end of the road made the failures more tolerable for me,” she said.
Women preparing for fertility treatment typically get a series of daily, sometimes uncomfortable hormone shots to kick their ovaries into over-drive — but a new review of previous studies suggests one long-acting shot may work just as well.
For in vitro fertilization, extra follicle-stimulating hormone, or FSH, is used to trigger the ovaries to grow and release multiple eggs, which are then fertilized outside the body and re-implanted in the uterus.
In an analysis of four past studies including over 2,300 women with infertility, researchers found the women were just as likely to get pregnant — and didn’t have any more complications — when they got a single, long-acting dose of FSH rather than daily shots.
“Long-acting FSH (weekly injection) is a good and safe alternative to daily injections in the first week of ovarian stimulation for IVF,” Dr. Jan Kremer from Radboud University Nijmegen Medical Center in the Netherlands, who worked on the review, told Reuters Health in an email.
However, he said there is still limited data on how the weekly hormone shots work in certain groups of women, including older women with less of an ovarian response and those with fertility problems because of polycystic ovary syndrome, whose ovaries might over-respond.
The long-acting shot is used in Europe but not currently available in the United States, because it hasn’t been approved by the Food and Drug Administration.
The new findings are published in The Cochrane Library and include all high-quality data Kremer and his colleagues could find on the shots.
Out of 2,335 women included in the analysis, 987 got usual daily FSH shots for a week and 1,348 had one long-acting shot at a range of doses, along with the usual course of other IVF hormone injections.
In studies that used the lowest dose of the long-acting hormone — between 60 and 120 micrograms — fewer women in the one-shot group got pregnant than in the daily FSH comparison group.
However, at slightly higher doses (150 to 180 micrograms), pregnancy and birth rates didn’t suffer: 343 out of every 1,000 women getting one long-acting shot had a baby, compared to 336 out of 1,000 in the daily-shot group.
And the long-acting shot didn’t seem to come with a higher risk of miscarriage, having twins or developing a pregnancy-related complication, including swollen ovaries.
IVF typically runs for about $15,000 a cycle. Kremer said the cost of the two types of injections is “more or less comparable.”
Dr. Samuel Pang, medical director at the Reproductive Science Center of New England in Lexington, Massachusetts, said the main advantage of the single shot is convenience. FSH shots are simple injections that women can give themselves, similar to insulin, he said, but the process can still be a hassle for some.
“In my mind, based on the studies that have been done and based on my own experience, it is a safe and effective product,” Pang, who wasn’t involved in the new review, told Reuters Health.
“The only caveat is it really needs to be used in well-selected patients.”
Like Kremer, he cautioned against using the long-acting shot in women who are unlikely to respond to the hormone — or those who may over-respond.
A week after getting the long-acting shot, many women still need a few daily injections of FSH before they’re ready to have their eggs harvested, he added.
Pang worked on research that has been submitted to the FDA on the hormone shot, but says it’s at least a year or two away from being available in the U.S.
“At this point in time, while it’s very promising based on the studies that have been done and the experience in Europe, it’s not anywhere near market here.”
So-called post-marketing studies in Europe and Australia continue to suggest the drug is safe and works well, according to Dr. Arthur Leader, from the University of Ottawa and Ottawa Fertility Centre who also didn’t participate in the review.
“It simplifies the whole process, makes it easier for the woman while not compromising her health or the health of the children that are born,” he told Reuters Health.
Advocates for infertility patients say Ontario should follow the lead of Britain, where a powerful health advisory agency recommended on Tuesday that the U.K. extend free fertility treatments to women up until the age of 42 and to same-sex couples.
In Ontario couples struggling with infertility continue to pay for costly treatments and there is no indication that the provincial government is moving toward funding in vitro fertilization (IVF).
“I think it’s fantastic what’s happening in Britain,” says Jan Silverman, a Women’s College Hospital infertility counselor who’s also a member of Conceivable Dreams, a grassroots organization representing infertile couples across Ontario.
“What makes me frustrated is that these models have come up in other areas, such as Quebec and now Britain, and yet we cannot budge the Ontario government right now.
“It is shameful that Ontario has let the needs of the infertile population go unrecognized and undealt with, causing unbelievable expense to people for wanting to have a child.”
The British health system usually pays for up to three cycles of IVF for couples who have been trying to get pregnant for at least three years. Previously, women had to be under the age of 40 to qualify. Many government-funded clinics already treat gay and lesbian couples, but the recommendations now make that explicit, though they are not binding. (The recommendations will likely be followed by many of the U.K.’s medical centres.)
The guidelines are likely to affect only a minority of patients, and it will be up to hospitals to decide whether to pay for IVF treatments. Britain’s health service is being forced to trim $31 billion USD from its budget by 2015 and many hospitals often ration who gets IVF and deny the treatment to eligible patients. One IVF cycle typically costs about $4,730 USD.
Adam Balen, chairman of the British Fertility Society, said the new draft guidelines recognized the importance of treating infertility, citing the psychological harm it can cause. “No one who stands a reasonable chance at conception should be denied the opportunity,” he said in a statement. “These (new) guidelines outline how that can be achieved.”
The draft guidelines issued Tuesday also say the government should pay for IVF in people with diseases such as HIV, or patients facing cancer treatment who want to preserve their fertility. About one in four IVF cycles results in a baby; that drops to about one in 10 for women over 40.
Elsewhere in Europe, many countries including France, Germany, Italy and Switzerland ban gay and lesbian couples from receiving IVF and often impose similar age limits for eligible women, cutting off treatment to women over 40.
In all Canadian provinces, except Quebec, IVF treatment is not covered. According to the Canadian Assisted Reproductive Technologies Registry, in 2008 – the last year for which statistics are available – 9,904 live births in Canada were the result of IVF.
The Royal Commission for New Reproductive Technology found that a quarter of a million couples in Canada are affected by infertility, which is defined an inability to conceive after 12 months.
In Ontario, because treatment is not covered by OHIP, most couples transfer multiple embryos rather than a single embryo. But multiples are 17 times more likely to be born pre-term, to require a caesarean delivery and to need expensive care at birth and throughout their lives, according to Conceivable Dreams.
In 2009, Ontario’s Expert Panel on Infertility and Adoption recommended that the province fund up to three cycles of IVF for women up to age 42, not discriminate against same-sex couples and adopt policies that reduce the number of multiple pregnancies through IVF.
The panel estimated that the savings to the healthcare system through a reduction in the number of multiple births through IVF would be between $400 million and $550 million.
“I understand that it’s a time of fiscal restraint,” says Silverman, who was part of the panel. “However, the arguments we have put forward are about cost-saving methodology not about further spending.”
During the last provincial election, advocates sought a commitment from all three political parties to provide OHIP coverage of IVF and encouraged Ontario to follow the lead of Quebec.
In August 2010, the Quebec government began funding up to three rounds of IVF treatment for couples, on the condition that only one embryo be transferred at a time. The aim is to reduce the number of multiple births, which are riskier than births of singletons.