Welcome

This website provides important information for anyone who thinks she might need donor eggs as part of a fertility treatment programme.

Bridge provides a range of solutions involving both UK and overseas treatment. Our priority is to ensure that patients requiring treatment using donor eggs receive this treatment within a reasonable timeframe.

Please read the following pages carefully and call on 020 7089 1455 or email us in total confidence if you need any further information or assistance.

Introduction

The first pregnancy resulting from the use of donor sperm was as long ago as 1884 and the first pregnancy from a donated egg was achieved a hundred years later, in 1983.

Since then, donated eggs have provided a solution for many women without ovarian function, e.g. as a result of premature menopause, and have enabled us to address two other serious problems - of poor response to IVF treatment and repeated miscarriage after treatment.

The use of donor eggs has also enabled us to address even more complex cases, including those involving the possibility of hereditary disease arising from chromosomal abnormalities.

Recipient Programmes

Bridge Recipient Programmes provide a linked series of treatment opportunities for women who need donor eggs. We work with each individual to find the best solution, providing an escalating range of approaches which addresses the need of each of our patients for a donor in a variety of practical ways.

Who might benefit from egg donation?

Option 1: Women without ovarian function

• Premature menopause The most commonly accepted definition of premature menopause is ovarian failure before the age of 40. This affects approximately 1% of all women under this age. The condition is thus not rare, affecting over 110,000 women in the UK alone. Ovaries may cease to function due to genetic disease or following surgery or chemotherapy. However, in many cases, the reason for premature ovarian failure is unknown. Women with this condition may experience symptoms of menopause, especially hot flushes and night sweats.

• Resistant ovary syndrome Patients have irregular periods, low oestrogen levels and high FSH (Follicle Stimulating Hormone) levels. Their ovaries contain normal numbers of follicles in an early stage of development, but they have defective ovarian receptors for FSH and thus follicles do not develop properly. Patients with this syndrome will ovulate spontaneously from time to time, but spontaneous pregnancies are rare.

Option 2: Women with ovarian function

• Women who either have, or carry, an inheritable genetic disorder.

• Patients who repeatedly fail to respond to ovarian stimulation in IVF programmes.

• Patients who have experienced repeated failure of in-vitro fertilisation of apparently normal eggs and sperm.

• Women who have had repeated miscarriage

The Treatment Procedure for Recipients

What does the procedure involve?

• Initial consultation with a fertility specialist: before joining one of the Bridge egg donation programmes you will need to have an initial consultation, during which the doctor will take a full medical history and may perform a physical examination.

• Meeting with a programme co-ordinator: this involves the completion of a Donor Characteristics Form in which you will be able to identify the characteristics you require from your egg donor.

• Implication counselling: this is partly to explore the potential social and emotional issues that may arise as a result of non-genetic parenthood, also to provide an opportunity to consider the rights and the needs of any child conceived through donated gametes and you will be able to share your thoughts and feelings on these subjects. We require all counsellors to be either qualified psychologists or counsellors with specific infertility counselling training, including genetic implication awareness. This service is available at any stage throughout the treatment process and afterwards, if necessary.

• Screening blood tests for recipients: the tests required are dependent on which programme you join. However, the screens for all programmes will include Rubella, HIV, Hepatitis B, Hepatitis C and Syphilis. Screening blood tests for male partners include HIV, Hepatitis B and C.

• Semen analysis: your partner will be asked to produce a semen sample for analysis. Three days sexual abstinence is required prior to producing the sample.

• Ultrasound scan: this is necessary to check the pelvic organs. In some circumstances, the uterine cavity may need to be assessed in a more detailed way, by Aquascan or keyhole diagnostic surgery.

• A Mock Cycle: prior to your treatment, this may be requested by your Consultant to ensure that the lining of your uterine cavity develops as required on medication.

• Drug Regimen: this will be explained in full by a member of the Egg Donation Team.

• Appropriate consent forms must be completed prior to the start of a treatment cycle.

• Pre-treatment arrangements: a programme co-ordinator will book the relevant appointments for the rest of your treatment.

• Matching to an egg donor: a programme co-ordinator will take all the donor characteristics you have identified into consideration and will offer you an appropriate match. You will be advised of the donor's characteristics and we will wait for your approval before proceeding with treatment. Please note that full payment for the treatment must be made when you accept your egg donor.

• Start treatment: the objective of this stage of the treatment is to prepare your uterus to receive the embryos selected for embryo transfer.

• Fertilisation: this involves the fertilisation of the donor eggs with your partner's semen sample or donor sperm. Following fertilisation you will be informed of the number of embryos created.

• Intra-Cytoplasmic Sperm Injection (ICSI): ICSI is routinely advised when donor eggs are used. This will be discussed with you at the initial consultation and following a review of your partner's semen sample. There may be an additional charge for ICSI dependent on which programme you choose. Please see our Schedule of Fees.

• Embryo transfer. your embryos will be placed in your uterus. This procedure takes about 15 minutes and, while it may involve minor discomfort, you will be able to leave and continue with normal daily activities after a short rest.

• Embryo freezing: if applicable, all suitable embryos will be frozen and stored for you. There is an additional charge for embryo storage. Please see our Schedule of Fees.

What is the drug regimen?

There are two basic drug regimens: -

Option 1: Patients who are menopausal (i.e. with no periods) Oral Oestradiol Valerate (Progynova) is typically given for 10-12 days to thicken the uterine lining (endometrium). An ultrasound scan will then be performed to check the endometrial thickness. Progesterone support will commence 3-4 days before the embryo transfer.

Option 2: Patients with naturally occurring periods (i.e. not thought to be menopausal) In order to control your cycle, you will first need to take medication from day 2 or day 21 of the menstrual cycle before starting treatment with oral Oestradiol Valerate to thicken the lining of the uterus, and with Progesterone support, as above. This enables us to synchronise your menstrual cycle with the egg donor's schedule.

A more detailed explanation of the medication and any possible side effects will be given to you by the Egg Donation Team.

The Donors

What information will I be given about my donor?

• Build

• Weight and height

• Hair colour

• Eye colour

• Occupation

• Education

How can I be sure that the donation will be safe?

Potential donors have to meet the following criteria as an initial condition for their acceptance:

• Less than 35 years old

• No personal history or family history of genetic or familial illness

• BMI of less then 32   Click Here To View a BMI Chart

• FSH level not more than 8

• Two ovaries

All potential donors then go through a series of investigations to make sure that there is nothing that might prevent them being a qualified donor.

Each donor has a meeting with a fertility specialist and with a counsellor to review their medical and familial history in detail. They also have to pass the following screening tests:

• Chlamydia

• CMV

• Cystic Fibrosis Gene

• Hepatitis B

• HIV

• Normal chromosome analysis

• Syphilis

• Thalassaemia (if applicable)

• Hepatitis C

Will the donation be anonymous?

Yes, when in accordance with national regulations at the overseas centre.

When the treatment occurs in the UK no identifying information will be given to you about the donor at the time of donation. Likewise, the donor will not receive any information about you. Identifying information about the donor will be given, on request, to any child born as a result of a Recipient Programme as changes in UK law enable children born as a result of donation since April 2005 to request identifying information about the donor on reaching the age of 18.

This change in the UK law affects the International Recipient Programmes in the following ways.

Treatment programmes using the frozen embryo transfer (FET) procedure, with embryo transfer taking place in the UK, will be required to comply with UK Anonymity Regulations.

Treatment programmes which require the patient to travel outside the UK are unlikely to fall within the provisions of the new UK regulations and sperm or embryos cannot be transferred to or from most overseas centres.

Human Fertilisation and Embryology Authority (HFEA) Register and Confidentiality

The HFEA keeps a confidential register of information about donors, patients and treatments. This register was set up on 1st August 1991 and therefore contains information concerning children conceived from licensed treatments from that date onwards.

As from the year 2008, people aged 16+ (if contemplating marriage) or 18, who ask the HFEA, will be told whether or not they were born as a result of licensed assisted conception treatment and, if so, whether they are related to the person they want to marry.

As the law now stands, children born as a result of treatment in the UK using donor eggs will have the right to learn the identity of the donor on reaching the age of eighteen if the treatment was carried out on or after 1st April 2005. No information about patients, their children and donors related to treatment before this datewill be given out by the Authority under any circumstances other than those outlined above. The names of the children are not collected.

*An exception would be if the child was born with a disability as a result of a donor's failure to disclose inherited disease. If he or she were to sue a clinic for damages, a court might require the HFEA to disclose the donor's identify under the Congenital Disabilities (Civil Liabilities) Act 1976.

General Information

How much will my treatment cost?

The fee to join any of the Bridge Egg Recipient Programmes is £250. You should then budget £7,000-£12,000 depending on which Egg Recipient Programme you choose to join. Please refer to our Schedule of Fees for further details.

How many sessions of counselling are included in my treatment?

Two sessions are included. One is required prior to treatment starting, the other session can be taken any time during or after, if you so wish.

How long will the treatment take?

This varies on a case-by-case basis, however, from the moment you are allocated a donor, treatment is unlikely to take more than six weeks. During this period of time you will need to visit Bridge approximately three to four times.

Are there any age limitations?

Our current protocols suggest that women over the age of 48 will not automatically be accepted for the UK waiting list. This, however, may vary on a case-to-case basis. No age limitations have been defined for the overseas egg donation programme and we would be pleased to invite you for an initial consultation to discuss the options open for you.

Programme Options for Recipients

Approach One: The UK Recipient List

You may join the Bridge Recipient Programme as a potential recipient. This involves an initial consultation with a fertility specialist for the assessment of your medical history and the required implication counselling. Your full medical history will be reviewed and, if necessary, medical tests will be performed. We will then advise you of your position on the waiting list.

Currently, the needs of Recipients are fulfilled in two different ways, through altruistic donation or egg sharing, but waiting time on the UK list can be 12 months or more.

Altruistic Egg Donation

Altruistic egg donation means that women who are healthy and do not need fertility treatment are willing to go through the egg collection procedure in order to help infertile couples. Currently, the law in the UK only permits payment of reasonable expenses to egg donors, therefore the women who come forward as egg donors are doing this solely from the goodness of their hearts.

The Egg Sharing Programme

This programme was developed in response to the needs of two separate, but nevertheless complementary, groups of patients seeking help - that is, couples urgently awaiting donor eggs and patients for whom the cost of fertility treatment excludes them from the treatment which they very much need.

The national shortage of eggs for donation and the progressive increase in the number of couples seeking this type of treatment together present an opportunity for a mutually beneficial approach to 'treatment sharing'. By sharing her eggs with a woman who is unable to produce her own, the egg sharer gives another couple the chance of having a child and, in return, has access to an IVF cycle of treatment at a significantly reduced price.

The waiting time for the UK Recipient programme is approximately 18 months.

Approach Two: Active Donor Recruitment in the UK

We work closely with our patients to address the problem of the shortage of donors and the associated waiting time. As part of this support, we provide detailed advice and assistance to those who decide to take the initiative and take positive action to find a donor themselves.

Your first option is to recruit a known donor. This can be a relative or a friend who is prepared to donate eggs on your behalf. The eggs can be donated to you directly or, alternatively, to Bridge, in which case you will be automatically placed at the top of our waiting list. The second option is to recruit an anonymous donor. This is more expensive but has achieved results for a number of our patients. Ask for a copy of our Donor Recruitment Pack which tells you all about the support we give you if you choose to take your own donor recruitment initiative.

It is also important to mention that, unfortunately, eggs from ethnic minorities are rarely donated and we strongly recommend Active Donor Recruitment to recipients from ethnic minorities.

There is no waiting time for treatment of UK recipients if you successfully recruit and proceed with your known egg donor.

Bridge Websites

For more information about all aspects of assisted conception visit www.thebridgecentre.co.uk.

The Next Step

If you would like to register for one of our programmes, or if you have any further enquiries, please do not hesitate to contact our Programme Co-ordinator on 020 7089 1455 or eggdonation@thebridgecentre.co.uk

Bridge is licensed by the Human Fertilisation & Embryology Authority to perform IVF, microsurgical fertilisations and treatments using donated eggs and sperm and to store genetic material.

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