Egg Donor IVF: Enhanced Convenience and Success by Using Selective Cryobanking of CGH-Normal Blastocysts and Deferred ET (i.e. "Staggered IVF")

Conventional IVF with egg donation is very complex. It begins with an intensive phase of donor recruitment and selection, followed by the execution of a binding legal contract between the donor and the recipient (couple). Then follows painstaking coordination of the respective timetables of both parties, followed by the egg donor and the embryo recipient both having to take a birth control pill (BCP) for varying lengths of time. Upon discontinuing the BCP, both parties will menstruate at virtually the same time, thereby insuring that the initiation of the donor’s cycle of controlled ovarian stimulation (COS) will coincide with the embryo recipient commencing hormonal supplementation to prepare her uterus to receive freshly transferred embryo(s) at the precise stage of optimal endometrial receptivity (i.e. the “window of implantation”).

This process is not only complex, but is almost always inconvenient as well. In my Las Vegas practice, more than 80% of my IVF-egg donation patients travel from abroad or from out- of- state for treatment with us. This requires careful synchronization of the cycles of two different parties, while at the same time (in order to protect the privacy and confidentiality of both the donor and recipient) avoiding their coming into direct contact with one another. Then there is the ever-present possibility that unforeseen (albeit infrequent) events such as ovarian hyperstimulation, failed fertilization and/or poor embryo quality might inadvertently disrupt the synchronization and even threaten the success of the entire process.

So, how can we dispel most of these uncertainties and, at the same time, simplify the entire process, making it much more efficient, convenient, and tolerable, less risky, and also less expensive, without compromising the success rates?The answer lies in separating the cycle of egg retrieval from the embryo transfer which would be performed in a subsequent cycle. The embryos/blastocysts generated following fertilization of Donor eggs, would be vitrified and be cryobanked for dispensation to Recipient's uterus in a subsequent cycle. Such separation of the egg retrieval and the transfer cycles is referred to as “Staggered In Vitro Fertilization (St-IVF)”

The combination of St-IVF with CGH for Egg Donation requires two (2) distinct stages:

The 1st stage includes ovarian stimulation, egg retrieval (ER), egg fertilization, embryo biopsy for CGH analysis, and finally, embryo vitrification (freezing) and storage.

The 2nd stage involves electively thawing/ warming of the frozen embryo(s) several weeks later, once the results of CGH tests are available. This is followed by the selective embryo transfer (ET) of CGH-normal embryo(s) to the recipient’s uterus.

Thus, by using the Staggered IVF approach, the egg retrieval and embryo transfer are separated in time. This allows for the retrieval to be performed without first having to synchronize the menstrual cycles of the recipient and the egg donor, and for the transfer to be conducted at the convenience of the recipient couple. In fact, with Staggered IVF, the recipient does not even need to be present at the IVF center for the 1st stage. All that is needed is for the designated sperm to be available (fresh or frozen) for fertilization purposes on the day of egg retrieval.

Once the CGH test results are available, the recipient can, subject to the availability of at least 1 “competent” embryo, conveniently schedule the ET electively and not be required to spend more than 6 days in total at the IVF center.

Simply stated, through Staggered IVF, recipients of embryos derived from donor eggs can now avoid unnecessary travel and inconvenience, and minimize stress and cost by spending but a few days with us, culminating in a better than a 60% chance of a live birth on average. At the same time, with the use of CGH tested embryos, this approach reduces the chance of miscarriage and chromosomal birth defects as well as a minimizing the risk of a high-order multiple births.