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Egg donation long, hard process



By Christy Oglesby
CNN

(CNN) -- Men got $50. Women received $2,500. Both provided the seeds of life that yielded embryos for a scientific study on stem cells at a Virginia medical school.

The disparity in compensation is indicative of the invasive and time-consuming nature of oocyte, or egg, donation. Recent news of Virginia scientists creating embryos specifically for research put bioethics, stem cells and gamete donation back in the headlines.

But while many understand semen donation, egg donation remains a mystery to most. The process involves injections, ultrasound and anesthesia to remove the eggs, and entails three steps -- ovary stimulation, patient monitoring and extraction.

Women who donate eggs take a combination of hormones and drugs for up to two weeks to stimulate egg development and suppress the normal ovulation cycle, so that the egg release is prevented until doctors are prepared to retrieve them.

Becky Chrisope of the San Diego Fertility Center in California said the staff teaches donors how to give themselves daily hormone injections to stimulate ovarian follicles. The number of days women take the hormones depends on the effect.

Monitoring developments

Doctors try to strike a balance between spawning egg development and preventing Ovarian Hyperstimulation Syndrome (OHSS), which causes ovary enlargement and abdominal pain.

That requires daily donor monitoring with blood hormone tests and vaginal ultrasound. As follicles develop, the amount of estradiol estrogen they secrete increases. The level of the hormone indicates how the ovaries are responding to stimulation.

The ultrasound tests generally begin about a week into the donation cycle and continue regularly to assess how the follicles are developing.

In the case of the embryonic stem cell research project, female donors had vaginal ultrasound exams daily after day seven.

Retrieval and risks

Once ultrasound indicates that eggs are mature enough for extraction, doctors administer human chorionic gonadotropin, a hormone, to trigger ovulation. About 35 to 36 hours later, doctors, directed by ultrasound to determine which follicles have matured, use a minor surgical procedure to extract egg-containing fluid from ovaries.

Physicians use general or local anesthesia to minimize discomfort during the egg retrieval process, which takes about 30 minutes. Donors schedule follow-up visits about four weeks after the procedure.

In addition to the possibility of developing Ovarian Hyperstimulation Syndrome, potential risks from the procedure and the hormones include the development of cysts on ovaries, or abdominal swelling. Doctors say both are temporary and go away shortly after the onset of a normal menstrual cycle.






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