Part 2 of Egg Donation Series
If I thought the application process was long, then the screening process was an eternity. I was told to prepare for an 8-hour day of appointments back to back at the hospital. I first met with a reproductive medicine physician who would be performing the retrieval. She completed a physical exam, including pelvic exam and transvaginal ultrasound. It was my first time undergoing a vaginal ultrasound, and I remember thinking the ultrasound wand looked very – um, phallic-like and strange. I always remember that the doctor was strikingly beautiful, with long, dark brown hair pulled neatly into an enviably smooth yet voluminous, bouncy ponytail. She casually applied the blue, translucent ultrasound gel to the wand and covered it with a condom. My younger self found this to be a fascinating and clever use for the condom…obviously they’d need to cover the wand with something, but I’d just never thought about vaginal ultrasounds before that moment. The exam itself was only mildly uncomfortable. “Cold, wet and lots of pressure,” the doctor said as she began the exam.
In that moment, I had no idea that someday I’d be saying those very same words to patients of my own, as I’d carefully perform pelvic exams. I’d never achieve as sleek a ponytail as my doctor had, but I would at least attempt to emulate her gentle yet confident bedside manner.
The doctor also helped me work through my prior fears about future reproduction. What if I lost one or both ovaries? Would I have enough eggs? Would this cause infertility or cancer? I learned that I was no more likely to experience infertility than someone who had not donated eggs. Infertility is common, something like 1 in 6 or 1 in 8 women experience it, so if I experienced difficulty with pregnancy in the future, I knew that it would have occurred regardless of egg donation. If I suffered a very rare complication during the procedure and lost an ovary, I’d still have the other, if I lost both, that would be devastating both on my hormones (immediate menopause) and reproduction. But, I knew that occurrence would be exceptionally rare and I trusted the skill of my physicians. I was at excellent, reputable facilities and I felt reassured this would not occur.
Next, I met with a geneticist who reviewed my personal and familial medical history, assessing for any inheritable diseases. Fortunately, I come from a relatively healthy family, so this meeting was fairly straightforward. And as far as cancer? He screened for genetic and hormone sensitive cancers within the family and we are fortunate to have none.
From there, I took the Minnesota Multiphasic Personality Inventory (MMPI) – yep, that five hundred something odd question personality test you may recall taking as an undergraduate at some point.
Once completed, I met with a clinical psychologist who reviewed my application and presumably evaluated my mental status.
Next, there was routine bloodwork of about 5-6 vials to screen for things like blood type, drug use, infections and genetic diseases such as Tay-Sachs, Cystic Fibrosis, blood disorders and much more. Some of the screening is very similar to blood work you might receive during pregnancy at your OB/GYN office.
For my last appointment of the day, I met with a nurse who taught me how to perform the daily injections.
When the blood work returned and I passed all of my screening, I met with an attorney who presented a lengthy contract between myself and the intended parents. Here, it was clearly outlined that I would have no parental rights or contact with any future children produced of the eggs. On my end, it is open. If future children or parents wish to contact me for any reason, whether it is medical, psychological or simply curiosity, I felt it was important to provide that option.
After the third week of my cycle, I would come back to the hospital for another ultrasound and begin administering the injections.
There are two phases of the egg donation process. The first phase involves injecting medications that cause the ovaries to produce multiple mature follicles. The second phase is the retrieval process, in which the eggs are removed by a transvaginal ultrasound-guided aspiration.
As you can imagine, someone undergoing a cycle with these fertility medications is highly fertile, and the likelihood of a multiple pregnancy (twins, triplets, etc.) is greatly increased. Not only would a pregnancy have been an unwanted consequence of egg donation for me, but further, it would have been devastating for the intended parents whose cycle would have been cancelled and hopes for pregnancy dashed. For this reason, I was under contractual obligation to refrain from intercourse during the entire process.
The side effects of these medications include unplanned pregnancy, bloating, weight gain, hot flashes, abdominal fullness/tenderness, headaches, fatigue, mood swings, injection site reaction, allergic reaction and ovarian hyperstimulation.
Throughout the course of my six egg donations, I experienced all of the common side effects but found them to be very tolerable. I gained about 5-10 lbs per cycle and lost it all within two weeks after the retrieval. I could quite literally “feel” my ever-growing ovaries as they jostled around in my pelvis. Even walking “too hard” made my ovaries feel as though they were bouncing around like large ping-pong balls. My abdomen did feel full, and my jeans wouldn’t fit toward the end of each cycle.
But, quite possibly the worst and most feared side effect occurred during one of my six cycles.
I developed Ovarian Hyper-Stimulation Syndrome (OHSS). This was the only cycle during which I felt that no one was in my corner (medically speaking) or concerned about my health outcomes. I was simply a commodity (by my own choosing, of course), and my eggs were the goods. Thirty two eggs were retrieved during that cycle and I was told this was a high amount.
I was sent home after the procedure, and over the course of several hours, I developed shortness of breath. My abdomen was visibly distended, and the abdominal pain was the worst I had ever experienced. It is still the only time I have ever vomited from pain. I had also gained approximately 10-15 lbs. After calling the facility, I was reassured it would resolve over the next week. In hindsight, I believe that a referral to the emergency department or possibly admission to the hospital for monitoring was warranted as my symptoms constituted moderate OHSS. It did eventually resolve, however, and I suffered no serious adverse effects such as torsion (twisting) of ovary, lung or liver complications, or blood clot.
It is possible that the development of OHSS was unavoidable, but when I completed another cycle with a new physician, she reviewed my medical records and told me that my medications could have been adjusted to possibly avoid over stimulation. She felt that both the bloodwork and ultrasounds indicated OHSS earlier in the cycle. In the end, my run-in with OHSS was only a minor blip of negative in an otherwise largely positive experience. Given that 1-2% of individuals develop OHSS in any given cycle, it’s not that surprising that it happened to me at least once.
The egg retrieval procedure itself was not bad at all. I enjoyed a wonderful propofol slumber and woke up feeling quite rested. Again, I’ve never felt fearful of medical procedures, and I knew serious complications were rare. The recovery for 5 out of 6 donations was also very easy, requiring only Tylenol and one day’s rest before resuming my normal activities.
After completing 6 egg donations over the course of a few years, I was able to finally quit the uninspired real estate job that I disliked so much. During that time, I also completed all of my pre-requisites and was accepted to physician assistant school. I developed a strong desire to work in women’s health, although the idea of looking at vaginas all day was initially a deterrence.
I went on to marry my now husband!
And shortly after, we found out we were pregnant with Everett!
My experience with egg donation is something I would not change. I believe it is one of the reasons that I have the life that I love today.
Thank you so much reading. The final part of the egg donation series is also up on the blog where I discuss how my feelings about egg donation have changed since becoming a mother.