Patients will be
recruited through standard referral by their GP or Consultant, alternatively
current patients can be recruited into the scheme if they fulfill the following
criteria:
·
< 3 6 years
·
FSH < 8
·
Greater than 25 day cycle.
·
Completed donor screening
·
No previous evidence of poor ovarian response to stimulation with
gonadotrophin drugs
·
Informed consent
·
Independent counselling
·
No genetic disorder or history of recurrent miscarriage
·
No evidence of adverse embryology in previous cycle (e.g. poor embryo or
oocyte quality)
Each potential
donor will receive the HFEA leaflets entitled "Egg Donation" and
"Sperm and Egg Donors and the Law" plus our unit's information
leaflet “Egg Sharing”. Interested women
will contact us for an appointment to discuss the programme in greater detail.
CONSULTATION
Ensure, at initial
contact, that the woman is between 18-35 years old. The woman should not have participated in
more than 2 previous egg-sharing schemes.
On arrival, the
woman is seen by the nurse co-coordinator who takes details of her name, date
of birth, address, telephone numbers and the name and address of her G.P.
The woman then sees
the clinician for a full consultation.
Please record her
past obstetric and gynaecological history, whether she had any problem
conceiving and if any children then are her children physically and mentally
normal.
Ensure that there
is no family or personal history of inheritable disorders, which could
potentially be passed on to any offspring as a result of the donation. Emphasise that it is illegal to donate eggs
if such a history is known and that she may be sued for damages by the child if
he or she is born handicapped as a result of deliberate misleading information.
Determine the
woman's general health. Make sure that
there are no contraindications for the patient undergoing this treatment i.e.
cardiac problems or hypertension etc.
Enquire if she is
on any medication that she will need to stop during the treatment.
Discuss the need for
HIV test plus other tests such as hepatitis B and C, plus other sexually
transmitted disease tests. Discuss the
implications of any of those tests being positive.
Discuss fully the clinical aspects of egg donation i.e. the ovarian
stimulation drugs used and their potential side effects, method of egg
collection, anaesthetic used, in the same way as one would counsel ordinary IVF
patients. Emphasise the potential risks
of OHSS and other complications.
Discuss fully the arrangements of the egg
share scheme as follows:
Make the patients
aware that arrangements must be agreed before either donor or recipient enters
treatment cycle.
The arrangements
should be signed in the relevant consent form.
Discuss the
following principles:
·
For the purposes of this treatment an egg is defined as that structure
judged to be an egg by the embryologist at the time of egg collection.
·
The donor will receive all the eggs if 7 or less eggs are collected.
·
The egg share arrangement will only be triggered if 8 or more eggs are
produced. In the event of less than
eight eggs being produced all the eggs will go to the donor and the egg share
arrangement will not proceed.
·
The recipient will bear the major part of the cost of the treatment.
·
The donor can cancel the arrangement up until the time of embryo transfer
but if they do so they will be liable for the full cost of the treatment and
any drugs used.
·
In the event of the donor receiving eggs and the recipient receiving
none, the recipient will be allocated the next available donor cycle at no
extra cost
Distribution of
eggs
Number of oocytes
|
Destination.of oocytes
|
1 – 7
|
Donor
|
> 8
|
Split equally to
donor and recipient with odd number eggs to the recipient.
|
Discuss what will
happen if the recipient is left with no eggs?
This unfortunately
is a possibility. In this case the recipient will be offered the next
available donor at no extra cost
Discuss how much
treatment will cost?
a)
The donor will pay a reduced price for her IVF (£1000.00)
b) The donor and
recipient will pay for their own consultation fees.
c)
The recipient will pay at least the full cost of an egg donation cycle
plus the cost of the screening required for the donor and counseling fees.
d) If ICSI is required
by either donor or recipient they will pay half the normal additional cost of
ICSI.
e)
The donor will pay for the cost of drugs used after her egg collection
unless supplied by her GP (~£30.00).
f)
The recipient will pay for all hormone drugs used to prepare the
endometrium for embryo replacement and those drugs used to support the embryos
after they are replaced in the uterus.
g)
If less than 8 eggs are produced the donor will pay the price quoted for
the egg share arrangement.
h) If the recipient
withdraws at any stage, the recipient will pay the full cost of the drugs used
by the donor. No others fees will be
levied.
i)
If the Donor withdraws from the egg share agreement then the donor will
pay full treatment costs plus the costs of the drugs.
j)
If embryos are frozen for the recipient the normal freezing fee will be
applicable.
k)
If embryos are frozen for the Donor no fee will be applicable.
Discuss the reduced
possibility of having embryos
frozen. As eggs are being shared there
is a reduced chance of either donor or recipient having spare embryos to
freeze. If there are spare embryos of
good enough quality from either donor or recipient, freezing will be offered in
the normal way.
ANONYMITY
The donor will not,
under any circumstances, be informed of the outcome of the recipient’s
treatment. The Donor will also not be informed about fertilisation
and embryo quality of the recipient’s cycle.
The Donor will
always be seen by a different nurse co-ordinator to that of the Recipient.
COUNSELLING
Both the donor and
recipient will receive independent counselling in addition to the implications
information session and written information provided by the clinic.
Fill in a
"Green Form" (91)4
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