Life is difficult. There’s no way around that. It’s why I believe that the most important thing to find is love and family. No matter what’s going on in the world people still come to my office looking for family connection. I remind them that DNA does not mean family.

I was honored to recently be featured in People magazine  for my work in helping to guide Prison Break actress, Camille Guaty.

You can read the full story about Camille Guaty and what she went through in her journey to pregnancy in the print issue of People magazine which has Kelly Clarkson on the cover.

Camille’s journey led her and her partner to work with an egg donor. The fact that a TV celebrity has shared her story has already made an impact on the world around her. She’s making other women feel less alone in their journeys to parenthood.

I received an email from a patient who could personally relate to Guaty’s story:

Just like her, I had a really hard time letting go of the idea of not using my own egg.

She goes on to mention that part of her difficulty accepting the idea of a donor egg was because of the lack of stories you hear about it and as a result the stigma that’s been associated with it.

This is a very important point. When we share our stories we break down barriers. We connect. We feel less alone. The lesson here? Keep sharing your stories!

I’ve heard from so many patients that have read her story and feel like the stigma is being lifted. Especially if you’re 40s. Obviously there are many scenarios where you may use an egg donor — a male couple, a single dad, a woman without viable eggs.

I like to think about egg donation like any organ that’s stopped functioning. If you have a liver that stops working then you get a liver transplant. Then you go on living your life in the healthiest way possible.

For many people receiving an egg donation to realize their dreams of becoming a parent is a big part of them living their healthiest, most joyful life. It’s why I’m in full support of it and want more and more stories to be shared so the stigma and shame associated with it can be squashed.

If you’re my patient or have watched my shows in the past then you know I am fairly well known for three questions I like to ask. These are universal and can be applied to just about anything in life. They work especially well when it comes to planning for a family.

Ask yourself these three questions

1. What do you want?
2. What will it take to get what you want?
3. Are you willing to do what it takes?

When it comes to egg donation and the process you have the be ready. What I mean is that you have to get to the point where you have IVF closure. You need to be at the place where you feel like you’ve done everything possible with your own eggs. You have to go through your own process and know that you’ve done everything you can to have a baby using your own eggs. If you’ve done that and still haven’t found success then ask yourself, Am I ready for an egg donor?

If not, then hit the pause button. Talk to people that can help you understand your options and mentally prepare you.

It’s why I believe your fertility TEAM is so important.

The T in TEAM is for, therapist. I can’t stress enough the importance of finding a really good one to be part of your fertility team and to help you. Regardless of your situation, it is critical to have the sounding board and guidance that a professional can offer.

Here is my list of therapists in the Bay Area of San Francisco.

Katherine Tarnoff — Bay Area, California

Beth Jaeger Skigen — Bay Area, California

Parijat Deshpande — Bay Area, California

Mary Coleman Allen — Georgia

Ellie Schwartzman — Bay Area, California

Fenella Das Gupta — Phone Consults

Lisa Schuman — New York, New York

Madeline Feingold — Bay Area, California

Megan Gredesky — Bay Area, California

Andrea Bryman — Southern California

Like Jana says in her book, “Three Makes Baby”. In some cases it’s more than three people involved as you may have extended family right alongside you.

Read, do research, get educated, talk to people and make sure you are well informed and comfortable about the process before beginning. All of this will help make the stigma go away for you so you can be proud of what you’re doing, proud of your body and know that it’s doing everything that it needs to do in support of a healthy pregnancy.

All pregnancies are natural. Some are just supported by science.

I know it’s funny to hear someone say that it’s a natural way to get pregnant using IVF and a donor egg. But how you frame it is so important. You’re doing the work you need to do to have the family you’ve always wanted. But at the end of the day when you put that embryo in your body, it’s a very natural process. No matter how you get there. It’s a natural process when the embryo sticks and grows. When we start the process it’s not as easy as getting a donated egg and then everything is going to work out. We still need to start with the TUSHY method.

Checking Your TUSHY Ensures Diagnosis Before Treatment

I know, it sounds simple. Get your diagnosis before treatment, or in this case egg donation. Yet, you’d be surprised. Not everyone is thoroughly getting an understanding of their body and ensuring they can accept an egg. I want you to have a full understanding that your fallopian tubes, for example, are clear. If they are blocked with fluid, then it doesn’t matter if you have a donated egg as it may make implantation less likely.

Look at the uterus. If there’s a fibroid you don’t want to find out right when you’re selecting an egg donor. Make sure you get an ultrasound early in the process.

Check sperm health. Make sure the swimmers are healthy. Do extra genetic testing on the sperm if needed. Do your preconception panel testing, genetic testing, and get your hormones checked up front. You want to do all of this before beginning the process of finding an egg donor. You want to make sure there are no unexpected roadblocks and that everything is smooth and set up to work as well it can once you get the egg.

Think about the IVF Process through the IVF Pyramid

When you’re using donated eggs you want to make sure that you understand what the expectations are from the treatment that you’re doing. For example, how many viable embryos you’ll get from the egg you start with? Talk to your doctor about this.

For example, if I have an egg donor and I get nine mature eggs and four blastocysts, and three are normal — I am stoked! But if a patient didn’t expect that and thought all nine were going to be healthy embryos, that can be really hard. It can carry with it a huge amount of disappointment. So talk to your doctor upfront so that you can understand expectations for numbers and prepare yourself accordingly.

Decide if you’d like donated eggs from a bank or a fresh donor

You will tell me if you want me to use a donor from an egg bank or use a fresh donor that we cycle entirely for ourselves.

How do you know which path to choose? Well, it’s relatively easy — you HAVE to be excited about the egg donor.

You have to start searching. You need to be ready and excited for the search. Include your doctor in the process. I love to help my patients find a donor. Typically this works by me asking a patient to rank the egg donors. I do the same. Then we compare and what’s interesting is that often time our rankings are the same or very similar. Once we have aligned on our favorites then we can go and talk with the agencies or the egg banks and begin the screening process to filter down to our top choice. This can be a fun process if you let it be.

Once you’re really excited about an egg donor from an egg bank we want to know the following:

• How many eggs are available?
• What is their previous history?
• How many pregnancies have they had?
• What was their fertilization rate?
• What was the blastocyst formation rate?
• How many embryos were available for transfer?

These are all very important questions to get answers to. But if you didn’t know these questions, then how would you know to even ask them?! That’s why I’m sharing this now.

I want you to go through this process not after an egg donor cycle doesn’t work, but before.

For my process, after I’ve talked through these questions with my patients here’s what I’ll do next.

• I’ll connect egg bank directors directly with my patients via email. There are about five that I work with. Simplify at Pacific Northwest, Fairfax Egg Bank, The World Egg Bank, Cryos, and Donor Egg Bank USA.

These are the five that I’ve had very positive experiences with and multiple positive outcomes — healthy pregnancies and babies.

Several of these egg banks also do embryo creation, which we’ll talk more about later.

• If a patient hasn’t found an excellent match through an egg bank donor, I recommend going the fresh egg donor route.

In this type of scenario where someone isn’t satisfied with egg bank options, I’ll ask that they share with me a photo of themselves. I will then send this photo to the agencies that I work with. I have several egg donor agencies that I work with and trust for their transparency and historical success rate. The best thing is that they allow me to interview the donor and screen them before my patient pays any fees to the egg donor agency. We learn that the egg donor will be a good match before my patient spends thousands of dollars. I interview and screen egg donors in person or over video which helps me get to know them well beyond anything that’s written on paper.

Many times when one of my patients is ready for egg donation we have already been working together through IVF cycles that have failed. We know each other well. They know me and my limited outfit selection (spoiler alert — I wear the same outfit every day) and I know them well enough to have a good sense for what type of egg donor may fit well with them.

Ultimately I treat my patients how I’d want to be treated. That is why I get as involved as I do.

• Whenever I’m meeting an egg donor personally, not only am I talking to them but I’m also doing all of the screens. I’ll make sure we do genetic, the psych, and medical screening. I also help to make sure that the legal contract is done as well.

Those are the steps involved in selecting a donor. Now I want to share more about embryo creation and the steps involved.

What you need to know about embryo creation

Once you have the egg from the egg bank chosen we then have the sperm source that’s frozen ahead of time shipped to the egg bank. These embryos are created where we have the option of genetic testing. Then the embryos will fly back to my office. It sounds like a lot of flying and back and forth! It is, but it works! With the cryopreservation system we have today it’s actually very stable and the survival rate of the eggs that I’ve coordinated with sperm to create an embryo has been consistently 100% so far.

We also ensure that the egg and sperm sources are not carriers of the same genetic diseases.

We do testing upfront. We have genetic carrier screens that have up to 500 genes. So if an egg donor has done a donation three years ago, it’s possible the sperm source is a carrier for a disease that the egg donor hasn’t been tested for simply because of the date at which they had blood work done. This is why it’s important for the egg bank you work with to have good relationships with the donors. In this case, the bank would reach back out to the donor and run additional blood tests to screen for the new tests when available.

Preparing for the transfer

There are two tests that I like to talk about with my patients.

1. The Endometrial Receptivity Assay
2. The ReceptivaDx test

Both tests are very beneficial. However, I don’t make the decision to go through these tests until after I know how many embryos I have to transfer.

Say I have 15 embryos. Well, I don’t think I need to put my patient through all of that stuff.

If we have 2 embryos and my patient wants 2 kids, then, in that case, we may want additional testing. I want to improve the chance of pregnancy.

If you’re using a fresh egg donor an important question to ask is: What are you going to do with the leftover eggs?

I have a program, Freeze and Share which helps connect egg donors with worthy recipients.

Even if an egg donor isn’t part of the Freeze and Share program, then a family can consider donating back the extra eggs to the donor. This is a very meaningful gesture as the donor may need to use them for later in life.

If you’re using a fresh egg donor please write her a nice card or consider some token of your gratitude for the gift she has given you and your future family.

I know it may seem wild to think about now, but there’s a possibility that you end up with as many as ten extra embryos. For that reason, I like to talk about embryo disposition of unused embryos including embryo donation early on with patients.

Another option is to freeze some eggs, as just eggs, so you don’t end up with unused embryos. It’s a very big problem in our country so something to consider ahead of time.

The Difference between an Egg Bank vs. an Egg Agency

Pros of working with an egg bank:

• Eggs are readily available so there are fewer steps and coordination required between a donor.
• Sometimes they do embryo creation.
• It may be more cost-effective.
• You only get a set number of eggs.

This may mean you need to buy another set of eggs in the future if you want to expand your family, which may mean using a different egg donor.

These are all things to consider before you do the transfer.

Pro of a fresh donor:

• The doctor gets to know her — talk to her and screen her medically.
• You can get all of the eggs donated to you and opt for additional tests, if you’d like, with your donor.

Other things to know:

Your donor may not end up being the perfect match for you, for a host of reasons.

You may uncover things about your egg donor medically that make them not a great match. This may be really disappointing to you. However, I don’t want it to be earth-shattering for you.

Make sure she goes through all of the tests you want her to.

Decide if and who will be involved in the process. Do you want to skype with your donor? Do you want to share parts of this process with your extended family? Friends?

Sometimes an egg donor cycle doesn’t stimulate well. It may not go as your doctor planned for it to go. They may determine your egg donor isn’t good for you and that you need to start over.

Be prepared for setbacks that may get in the way of your timeline. A donor at a baseline ultrasound may have a cyst. She’s done nothing wrong, but it may shift your timeline by a few weeks.

She may have a test for infectious disease that’s positive. In my experience, there are many false positives with this test, but it could mean your egg donor can’t donate.

By the time you have decided on egg donation, most of my patients have already had so much heartbreak. I’d like to prevent the heartbreak as much as possible from this point forward.

How I ask my egg donors to prepare:

1. Take CoQ10 600–900 mg daily.

2. Ensure they are at a healthy body max index (BMI).

3. Refrain from smoking.

4. Minimize their alcohol intake.

5. Eat a healthy and nutritious diet.

In Summary:

Thank you for taking in this information and I hope that it’s been helpful to you and that you reach your family goals.

If you’re going through the process of considering egg donation right now and there’s something I haven’t mentioned that you’d like to know please send me a note at [email protected].

You can also catch more of me and topics like this through The Egg Whisperer Show. The episodes are live-streamed onYouTube, Facebook, and Twitter and on Wednesdays at 7 PM PST. Subscribe to the podcast too!)