Instructions

Donor Egg In Vitro Fertilization

    • Who are eligible to borrow eggs?
    1. People with a decline in ovarian functions due to aging or unknown reasons.
    2. People with irregular ovarian growth due to congenital diseases.
    3. People unable to ovulate due to infections, surgeries, immune factors, and chemotherapy.
    4. People with inherited genetic disorders and the preimplantation genetic diagnosis (PGD) is not helpful.
       
    • Sources of the donated eggs
    At present, Lee Women’s Hospital has owned its own egg bank. The average age of donors is 26, and their eggs have passed highly specified examinations. Apart from meeting the requirements laid out by the Health Promotion Administration,a chromosome screening test is added to make sure that the donated eggs are in high quality.
     
    • Introduction to the Donor Egg In Vitro Fertilization Process
    Domestic patients:please come straight to the hospital for registration.
    Oversea patients:pleasecontact the International Affairs Department.

    We will ask for your identity card, marriage certificate, a family table within the fourth degree of relationship, a certified consent form for recipients of egg donation, and a consent form for in vitro fertilization. After collecting all the documents, a matching process will be performed that takes about two weeks to complete. We will then administer related examinations for you, including hormone test, hysterosalpingogram, hysteroscopy, semen analysis, and sperm cryopreservation. Any factors discovered that hinder pregnancy will be eliminated through surgeries or medications, after which the proper course of treatment will begin.

    You will be taking estrogen from Day 3 of your menstrual cycle to regulate the endometrial thickness, followed by progesterone supplementation from Day 11 of your menstrual cycle, depending on the blood flow volume and the endometrial thickness, making your body suitable for conception. Sperm- donated egg fusion will take place at the same time, followed by implantation between Day 18 andDay 20 of the menstrual cycle. Oversea patients only need to come to Taiwan 2 to 3 times the minimum, and they will conceive successfully at the soonest within 1 ~ 2 months.

    We have clinical experiences with in vitro fertilization since 1986, and hassecurely increased the conception rate of donor egg in vitro fertilization to over 80% withpreimplantation genetic screening (PGS) and time-lapse monitoring of embryos.(article written by Dr. Bing-Yao Ling.)
     
    • The flowchart for donor eggin vitro fertilization
    ⋙ Registration
    1. Donee registration
    2. Related body and blood examinations

    ⋙ Matching and document preparation
    1. The husband needs to go to the Household Registration Office to fill in the fourth-degree relative application form, hand in the form to the consulting room, and wait for the matching to be done.
    2. Please go to a Notary Public to apply for notarization (the purpose is to ask a third-party notary public to confirm the marital relationship between the husband and the wife and verify that their future child isa child legally born in wedlock.)
    3. Wait for the consulting room to notify you of successful matching.
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    ⋙ The Course of Treatment and Implantation
    1. Report back onthe first day of the menstrual cycle.
    2. Start taking oral medication from Day 3 of the menstrual cycle.
    3. Come back to the hospital to adjust medication on Day 11 of the menstrual cycle.
    4. Wait for the donor’s eggs to be retrieved.
    5. Day 12 ~ Day 16 of the menstrual cycle: sperm retrieval from the husband and sperm cryopreservation (preimplantation genetic screening (PGS) will be performed after 5 days of culturing. Report will be ready in about a month.)
    6. Day 18 ~ Day 20 of the menstrual cycle: the embryo will be implanted after 2 ~ 5 days of embryo culture (the doctor will decide based on the number and quality of eggs, and the blood test index.)
    7. Day 33 ~ 36 of the menstrual cycle: pregnancy test.
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  • The questions below are answered by Dr. Chun-l Lee.
    (The present director of the genetics laboratory and the chief executive officer of Lee Women’s Hospital)

    1. What are the criteria to borrow eggs for having a baby?
      The husband and the wife can borrow eggs to conceive a child when one of them has been diagnosed with infertility or suffers from a critical hereditary disease as announced by a competent authority that natural way of childbirth would easily give birth to a child with abnormalities. They are not allowed to borrow sperm if they have already borrowed eggs. Also, the present law states that once an egg donor’s egg makes a couple conceive successfully, the other eggs from the same donor cannot be offeredto another couple and need to be destroyed. Besides, the fourth-degree relative application at the start would avoid kinship; hence ties of blood is not of concern.

      Obstetrics & gynecology doctors generally do not recommend aging women over 45 years of age giving birth, although there is no limit to the technology that helps them do so. Both the parturient women and the babies will be at high risks, and parenting issues may easily appear. Even if the technology has increased the conception rates of aging women from less than 1% to over 50%, doctors still recommend the women who want to give birth to do so best before 37.
       
    2. What problems will patients possibly encounter when they borrow eggs to have children?
      Egg donors have to be 20 years of age or older and under 40 years of age by law. The average age of women donating eggs to Lee Women’s Hospital is 26. However, it does not mean that patients’ conception rates reach 100% using these donors’ eggs, as donees’ physiological ages remain unchanged. The conception rates are also affected by the uterus environment and husbands’ sperm quality.

      Female sex hormone supplementation can increase endometrial thickness to above 0.8cm, creating an environment that is similar to the environment in which embryo implantation in natural cycles occurs. During the process, the ovulation cycles of the donee and the egg donor must match, and the sperm of the donee’s husband need to fertilize the donor’s egg in vitro, followed by embryo culture and transfer in the donee’s womb that is ready-for-implantation. This hormone treatment does not exert adverse effects later in life as the hormones are only used for a short period.

      The husband’s sperm quality, if poor, can be adjusted with medications. If poor sperm penetration is the problem, sperm microinjection and spindle positioning can be performed to increase the fertilization rates and avoid harms to chromosomes during the in vitro fertilization process.A higher-quality embryo can be obtained, whichincreases the conception rates.
       
    3. How much does it cost approximately to borrow eggs?
      The fee for the donor egg in vitro fertilization treatment lies approximately between 400 ~450 thousand dollars(NTD). The overall cost is, however, comparatively much cheaper for those patients who need to retrieve eggs several times for they are aging or have a meager ovarian reserve. This treatment not only saves time but also hugely increases the success rates. Just change your mind and borrow eggs, your dream of becoming a parent can come true sooner.
       
    4. What is the donor egg in vitro fertilization process in general?
      For the course of treatment, domestic patients need to come straight to the hospital for registration, and oversea patients need to contact the International Affairs Department. We will ask for your identity card, marriage certificate, a family table within the fourth degree of relationship, a certified consent form for recipients of egg donation, and a consent form for in vitro fertilization. After collecting all the documents, a matching process will be performed that takes about two weeks to complete.

      The examinations to be done after matching is completed are hormone test, hysterosalpingograms, hysteroscopy, semen analysis, and sperm cryopreservation. Any factors discovered that hinder pregnancy will be eliminated through surgeries or medications, after which the proper course of treatment will begin.

      You will be taking estrogen from Day 3 of your menstrual cycle to regulate the endometrial thickness, followed by progesterone supplementation from Day 11 of your menstrual cycle, depending on the blood flow volume and the endometrial thickness, making your body suitable for conception. Sperm fusion with the donated egg will take place at the same time, followed by implantation between Day 18 and Day 20 of the menstrual cycle. Oversea patients only need to come to Taiwan 2 to 3 times the minimum, and they will conceive successfully at the soonest within 1 ~ 2 months.
       
    5. What are the success rates of donor egg in vitro fertilization in general?
      According to the data provided by the Health Promotion Administration, the conception rates are possibly only 20 to 30% for women under 40 years of age attempting in vitro fertilization and are probably just over 10% for women over 40 years of age. If donor egg in vitro fertilization is tried, the overall conception rates can reach over 80% due to the use of healthy and young eggs,coupled with Lee Women’s Hospital’smature techniques and facilities, such as preimplantation genetic screening (PGS) and time-lapse monitoring of embryos.
       
    6. What is the donor egg in vitro fertilization process in Taiwan for oversea patients?
      It is actually not hard to come to Taiwan and borrow eggs. The couples can come to Taiwan any time for their first doctor’s visit as long as they make an appointment with the International Affairs Department of Lee Women’s Hospital beforehand. The couples need to stay in Taiwan for approximately 3 days, during which they need to hand in the fourth-degree relative application form and get on with the matching. Matching takes about 2 to 8 weeks to complete.The hospital will draw the wife’s blood and perform an ultrasound test to exam the states of her ovaries and administer hysteroscopy to see if there are any polyps and myomaspresent that would affect pregnancy. The husband will do a sperm test to get to know the motility, quantity, and penetrating ability of his sperm. The hospital will deal with any problems arisen, or the husband will bring medications back to his country to improve the issues.

      If matching is successful and preimplantation genetic screening (PGS) is not necessary, the couples need to stay for 10 ~ 12 days during their second visit to Taiwan. During the stay, the origin ofeggs will be certified, and the wife will have the endometrial thickness regulated with medications (an endometrium with a thickness over 0.8cm is suitable for implantation.) The husband’s sperm will be retrieved at last for fusion with the egg, followed by embryo culture and implantation. The couples can go back to their country after implantation and do the pregnancy test after 2 weeks.

      If PGS is required, the couple only needs to stay for 3 days during their second visit to Taiwan to certify the origin of eggs and carry out sperm-egg fusion for embryo formation. They can then go back to their country and wait for the examination results (the results will be out in 3 weeks.) After 3 weeks, if there are suitable and healthy embryos available, we will contact the couple and ask them to come back to Taiwan for implantation. They need to stay for 10 ~ 12 days during their third visit to Taiwan. The wife will have the endometrial thickness regulated with medications, followed byimplantation. The couple can go back to their country after implantation and do the pregnancy test after 2 weeks.
       
    7. Why choose Lee Women’s Hospital for donor egg in vitro fertilization?
      Lee Women’s Hospital, the top infertility treatment authority possessing the highest number of in vitro fertilization cycles and over 30 years of clinical experiences, understands every infertile patient’s expectation to becomea parent. We, therefore, have a stricter egg donor selection process. The average age of our egg donors is 26. Before egg donation takes place, the examinations related to chromosomes, fragile X syndrome, and spinal muscular atrophy (SMA) in addition to egg donors’ initial examinations can make sure there will be no chromosomal inheritance problems present. Furthermore, egg donors cannot donate eggs if their follicles on both sides, assessed through trans vaginal sona, are in bad condition. That is why the matching step takes 2 ~ 8 weeks. Nonetheless, it is worth the wait for the sake of the future baby’s health.

      Besides, the success rates of conception will not be 100 % even when donor egg in vitro fertilization is attempted, because conception also has something to do with the husband’s sperm quality and the uterus environment. However, Lee Women’s Hospital’s facilities and techniques both take the lead in infertility treatment in Asia. Any problems discovered during the first doctor’s visit will be dealt with through medications or surgeries. The success rates of donor egg in vitro fertilization will be raised to over 80% through preimplantation genetic screening (PGS), and time-lapse monitoring of embryos after the embryo is made. For aging women who have little or no eggs, and whose bodies are unable to bear the burden of repeated egg retrieval, donor egg in vitro fertilization is the most practical choice for them to become parents.
       
    8. Am I a good candidate for donor egg in vitro fertilization?
      Good candidates for donor egg in vitro fertilizationare:
      A. People with a decline in ovarian functions due to aging or unknown reasons.
      B. People with irregular ovarian growth due to congenital diseases.
      C. People unable to ovulate due to infections, surgeries, immune factors, and chemotherapy.
      D. People with inherited genetic disorders and the preimplantation genetic diagnosis (PGD) is not helpful.

      Patients encountering the above four problems are recommended to conceive safely and efficiently through donor egg in vitro fertilization. Over one hundred couples from overseas have fulfilled their wishes of becoming parents with the assistance of Lee Women’s Hospital every year. For instance, the 47-year-old Ms. Chang, working in Shanghai, could not conceive naturally following 13 years of marriage. She has started in vitro fertilization treatment 10 years ago and visited all the top three hospitalsin every province in China. Ms. Chang has even traveled to Japan, Thailand, and other hospitals in Taiwan for in vitro fertilization treatment for more than 20 times but without success. She then came to Lee Women’s Hospital after her friend’s recommendations. After assessing Ms. Chang’s body conditions, age, and past medical conditions, her doctor reckoned that donor egg in vitro fertilization could lighten her body and financial burden, and Ms. Chang was also willing to try the method. Finally, she has successfully become a mother after implantation for the second time and given birth to a healthy, 3200g baby boy this year.