Step By Step Process for IVF and Egg Donation in India

1 What the Intended Parents Need to Do

The First Decision you need to make is how badly you want a baby. We strongly suggest you have a long discussion with your partner and discuss both the personal and financial commitment that it takes to go through the egg donation and if needed, the surrogacy process.

Using an Egg Donor in the USA will typically cost around $16,000 for frozen donor fees for six eggs and about the same for IVF Center costs, or a total of about $32,000.

If you are willing to go to India and use an Indian Egg Donor, the cost will be around $16,000 plus travel costs to Delhi or Mumbai of about $3,000 or so for a two to three week stay.

We have both options available through our agency.

2 Medical Tests and Investigation Results

Before starting the process of choosing a donor, you need to choose a fertility clinic in the USA or Canada and get checked to ensure you are medically ready to proceed down this exciting path. Also, the clinic will prepare you for the first four to five weeks using the protocol from the clinic in India. What this means on a practical level is that your most recent blood tests and pelvic ultrasound are not more than one year old. Your chosen fertility clinic will ask you to complete a Medical Information Questionnaire, providing the results of all your most recent tests.

If you need a recommendation on an IVF Clinic to use in the USA or in India, we can give you some excellent recommendations.

The clinic will require copies of your test results (no older than 12 months), so start collecting the results ASAP and forward them directly to the clinic. Unfortunately, the clinic will not start any treatment without receiving your results first. Although clinics do vary as to which results, they require, most of them will ask you to provide copies of the following tests:

Female Partner:

A: Blood tests:

  • HIV I & II antibodies
  • RPR/VDRL/TPHA (Syphilis)
  • Hepatitis B surface antigen
  • Hepatitis C antibodies
  • Rubella IgG (immunity)
  • Day 3 FSH
  • TSH
  • Prolactin

B: Transvaginal ultrasound scan of the pelvis

C: Other:

  • *An HSG (hysterosalpingogram), hysteroscopy, or saline infusion sonogram may be requested by your treating doctor after reviewing your medical history and ultrasound scan results. While not compulsory, these tests might be recommended.)
  • *Similarly, if available, a laparoscopy report may be requested by your treating doctor after reviewing your medical history. Again, it is not mandatory, but it could be recommended.

Male Partner:

A: Blood tests:

  • HIV I & II antibodies
  • RPR/VDRL/TPHA (Syphilis)
  • Hepatitis B surface antigen
  • Hepatitis C antibodies

A: The short answer is around $16,000. This includes the cost of the IVF Cycle, the donor and implantation in the female intended parent.

The process is as follows.

  • You decide you would like to use an Indian Donor and have the process done in Mumbai or New Delhi
  • We will send you the forms to complete, which you complete and return to us.
  • Upon receipt of the forms, you receive the following:
    • a. A welcome letter from the clinic
    • b. Travel, car, and hotel options for your 10 day stay in India.
    • c. A protocol for the female Intended Parent to prepare herself for four weeks before going to India.
    • d. Upon receipt, please take the protocol to your local physician to get started on the protocol. These charges are not included in the $12,000 fee and may be covered by your health insurance.
    • e. In parallel we will send your donor preferences and photo to India, for donor selection. They will go through their database of several hundred donors and send you about 10 profiles for you to select from. You will send them back your top two choices and one of these will be assigned to you.
    • f. You then schedule your trip to India.
    • g. On arrival, you will be greeted by a Car with an English-speaking driver who will take you to your hotel and be at your disposable throughout your stay.
    • h. The next morning the driver will take you to the very luxurious clinic where the male intended parent will give a sperm specimen and the female intended parent will be examined medically and prepared as needed for the IVF donation.
    • i. Only 1 or 2 embryos at most will be implanted due to the elevated risk of having twins. This will depend on the female intended parents lining and personal wishes on the morning of the transfer.
    • j. Upon completion of the embryo implantation, the intended parents will rest for 48 hours and then fly home.
    • k. The female will then schedule a pregnancy test on day 10 of the embryo implantation and if everything goes well, will be pregnant!

A: We have found them to be similar. The biggest difference is that in the USA, we see mostly one egg being implanted. In India, you see mostly two eggs being implanted. This may be a reflection of the different medications and state-of-the-art equipment in the USA.

A: Indian Egg Donors works with the top fertility clinics and doctors in India, and we will assist you to choose a clinic and doctor that is best suited for you.

A: We will ask you to complete a short info sheet so that we have your details; the clinic will ask you to complete a full medical questionnaire with all your most recent test results.

A: That is one of the best things about our donor program – We have many donors available immediately! The wait is only as long as it takes for you to find a donor who meets all your requirements. If you are a six-foot tall, Physician from Punjab and you are looking for someone exactly like you, who is your twin sister, you will have to wait a while. For anyone else, there should be one of the over 500 immediately available donors who should fit your profile.

A: Unlike some other donor programs, future parents can view full information about prospective donors, including personality and character information, family history going back two generations, education history, medical information, etc. as well as photos of the donor as a child.

A: That is an impossible thing to predict as each donor will respond individually to the stimulation protocol, and even the same donor might respond differently each time she donates. What we can tell you is that most Indian fertility clinics follow best practices and do a low, gentle stim on the donors to ensure that an optimum number of excellent quality eggs are retrieved (rather than many poor eggs) and more importantly, so that the health and wellbeing of the donor is never compromised. The average number of eggs retrieved is 12-14. However recent legislation in India has limited these to about seven.

A. No in India. Sex selection is illegal in India.

A: One or Two (depending on your preference.)

A: They will be frozen using the latest/best freezing technique.

A: Short answer: Yes, from India. However, it is often easier and cheaper to come back for a FET in India. FETs are cheap and require a much shorter stay.

A: Two to Four weeks

A: Three months. We do not hold donors for longer than three months unless there are exceptional circumstances.

A: You should only book your flight and accommodation details once the fertility clinic has issued your treatment plan. You will have tentative dates to work around, but please do not book your air ticket until the clinic says ‘go.’ (This will happen once the donor has been through all her screening appointments and blood tests)

A: In your initial discussion with the doctor and fertility sister, you will let them know when you would like to be in India – i.e., your preferred dates for your 10- 12 day stay. They will then confirm those dates with the donor, and then they will work out a treatment plan based on your chosen dates. In summary, it involves working back from your preferred dates to see when the donor should stop the pill, when her first injections start etc.

A: Depends on the donor. They donate for a variety of reasons, some for money, but mostly it is around giving back something to other people. You know how you get some people who volunteer, who recycle, who seem to genuinely care about their fellow human beings? That is the type of donor we have on our database. Genuinely amazing people. To illustrate this point, check out this email we just got from donor ‘C’: “Thanx, would it be possible to rather have the money (if chosen) donated to a charity as I’m not after this for the money?”

A: Donors are thoroughly pre-screened by the IVF Center they are sent to. Once selected, the donor will undergo a psychological assessment and a medical assessment. The psychological assessment has three main purposes: (1) that the donor is fully aware of what is involved in donating in her eggs and that she understands all the implications and risks involved, (2) that she is mentally healthy to donate and (3) that there are no known psychological disorders that would disqualify her from donating. The medical assessment must be repeated each time the donor donates to ensure that the results are current. This involves blood tests which include (but are not limited to) testing for infectious diseases including HIV I and II antibodies, RPR (Syphilis). Hepatitis B surface antigen, Hepatitis C antibodies and CMV (Cytomegalovirus) IgM. In addition, the donor will have a pelvic ultrasound to ensure that her ovaries are in an optimum state to donate.

A: While some of the information can be verified, we rely on the donor’s integrity to be honest. Because there is limited financial incentive to donate, there is also no incentive for the donors to lie about any of their information. Unless someone has a penchant for having needles jabbed in them, suffering PMS-like hormone swings, bloating, and undergoing an invasive medical procedure, it is highly unlikely that anyone would want to lie their way onto an egg donor program.

A: We provide the donor’s details and your details to the fertility clinic. The doctor will specifically check that the donor who is matched with you is the same donor you have chosen.

A: Our contract stipulates that egg donation should be anonymous, unless it is a known donor (friend or family member). This means that no contact is allowed between donor and recipient.

A: Short answer: Up to 70% of the time it does work, first time. But obviously it does not work the first time, every time. You might need to come back to do a FET, or to try again. We hope you are one of the lucky 70% for who it works the first time.

However, even with the highest success rates globally, no procedure guarantees a 100% success rate. This implies that for some individuals, the procedure may not yield results on the first attempt. It's advisable to have a contingency plan in place if you find yourself among the unfortunate few for whom the procedure doesn't succeed initially. A highly recommended backup option is for the male partner to provide a second sperm sample for freezing at the clinic. This ensures that if a second trip to India becomes necessary, only the female partner needs to travel, and for a much shorter duration. With the frozen sperm readily available on the day of egg retrieval, it reduces the time away from home and minimizes travel expenses. Discuss with your doctor the possibility of storing a second sample of frozen sperm at the clinic in case a second attempt is required.

In most cases, storing the extra frozen embryo is an adequate backup plan.

Summary of the donation process

In terms of how the process works at the clinic, it will resemble something like this:

  • The clinic will require that you forward all your test results and medical history to them. This process can run simultaneously with the donor selection and screening process. However, the results need to be current (not older than 12 months)
  • The donors’ results will be available within 7 working days from her appointment date.
  • As soon as this is received, and we have all your completed documents and results we can plan your cycle. Your arrival can normally be 8 weeks or more from the donor’s first appointment.
  • The donor will be taking the oral contraceptive pill from day 1 of her period following her appointment. She must be on this for at least 1 month/more.
  • If your cycles are regular, we will use the most appropriate period date for you to start your medication to synchronize your cycle with that of the donor.
  • If your cycles are irregular, we will advise that you also take the pill (if there are no contraindications) to regulate your period.
  • Your medication: You will take a Leuprorelin depot injection (Lucrin) on day 1 of your period which should start between 2 and 6 weeks prior to your arrival date in India. This will inhibit the release of FSH and LH in your body, thereby halting the growth of follicles and preventing ovulation.
  • Two weeks prior to your arrival you will start with Estradiol tablets to thicken the lining of the womb.
  • The donor’s cycle will be planned so that she is on day 10 of her cycle when you have your first appointment . She starts her injections on day 3 of her cycle and will have scans on day 8, 10 and 12 with retrieval on day 14. This is the norm and depends on her response.
  • At your first appointment a lining scan will be done, and you and your partner will have a consultation with the treating doctor and sign consent for the procedure.
  • If your lining is fine, you will continue the same dosage of estradiol tablets.
  • The donor is normally ready for egg retrieval on her day 14 (your 5th day in India )
  • On this day, your partner must provide a sample in the morning. You will also start with Progesterone injections on this day.
  • The day after the egg retrieval the lab will inform you about the fertilization and tell you when transfer is expected.
  • Embryo transfer takes place 3-5 days after retrieval depending on the number of eggs retrieved, number that fertilized and quality and quantity of embryos on day 3.
  • We always plan for day 5 transfer and advice that patients can travel home 2 days after embryo transfer.
  • This constitutes a 12 day stay in India.
  • Your pregnancy test is performed 10 days after embryo transfer and can be done at home.
  • If you are pregnant, you will continue taking the estradiol tablets and progesterone injections for 6 more weeks and can then stop.

The donor’s psychological assessment and counselling

While we conduct thorough pre-screening of our egg donors to the best of our ability, we are not equipped to professionally assess their eligibility to donate. This responsibility falls upon qualified professionals. Each donor must undergo medical and psychological assessments as well as counseling before being deemed suitable to donate. Given that individuals' circumstances and health may change over time, screening occurs at the time of matching. Medical assessments are required for each donation, while psychological assessments are conducted annually.

The purpose of the assessment is threefold:

  • The counselling aspect includes ensuring that the donor has thought through her offer to donate thoroughly and that she has the emotional capacity and social support to enter a donation process.
  • Based on the information provided, the psychologist will determine whether the donation would not pose psychological harm to the donor. In essence, this ensures that the donor is mentally healthy enough to proceed with the donation.
  • Lastly, the assessment includes gaining an accurate understanding of her and her family's mental health.

During this process, a family history of mental illness/challenges may be identified. This information may not have been included in the donor's profile because she might not have been aware of the illness/challenge when she completed the agency's information. Alternatively, she might not have been able to provide all the necessary details about the illness/challenge when she applied to be a donor.

Should the psychologist become aware of any mental illness/challenge the donor or her immediate family has she will notify you via email. This will allow you to ask any further questions you may have.

 

NEXT STEPS:

Contact us today at (212) 392-6124. Learn more about our surrogacy program, financing options, health insurance coverage and finalize which option is best for you. Discover how we can help you achieve your dream of parenthood.

Indian Egg Donors, founded in 2006, is a large New York area, internationally oriented, physician owned surrogacy service. We focus on providing state of the art IVF and surrogacy services to Intended Parents irrespective of age, sex, religion, sexual orientation, or color, at the lowest possible cost in the world.

For more information, please go to surrogacy4all.com and IndianEggDonors.com

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