It’s a scary, unexpected thing, when as an egg donor you have your hormones drawn and an ultrasound performed, and then are told you don’t qualify medically for an egg donor program. In addition to the disappointment of not being able to donate your eggs to a couple who wants a pregnancy, there's a new worry: Do I have fertility problems?
What does it mean? What is your best course of action? Can you do anything to change these levels?
Tests We Run on Potential Egg Donors
A significant part of the medical screening of a potential egg donor involves tests that predict egg quality and quantity. These ovarian reserve tests involve measurement of four hormones: estradiol, luteinizing hormone, follicle stimulating hormone and anti mullerian hormone, and an ultrasound to measure antral follicle count.
The estradiol (E2) test can indicate how well the ovaries are working. Estradiol is a form of the hormone estrogen, and it’s also called “17 beta-estradiol.” The ovaries, breasts, and adrenal glands make estradiol.
Luteinizing hormone (LH) is an important part of your menstrual cycle. It works with follicle-stimulating hormone (FSH), which is another gonadotropin made in the pituitary gland. FSH stimulates the ovarian follicle, causing an egg to grow. It also triggers the production of estrogen in the follicle. LH is an important hormone women produce. This hormone is known as a gonadotropin, and it affects the sex organs in women. It affects ovaries and plays a role in puberty, menstruation, and fertility.
Follicle-stimulating hormone (FSH) is a hormone associated with reproduction and the development of eggs in women and sperm in men. This test measures FSH in the blood or urine. FSH is made by the pituitary gland, a grape-sized organ located at the base of the brain.
Anti-Mullerian Hormone (AMH) is a protein hormone produced by granulosa cells (cells lining the egg sacs or follicles) within the ovary. AMH can be measured in the blood at any time in the menstrual cycle as it is stable throughout the cycle. It is a marker for ovarian (egg) reserve.
These four hormones, combined with the results of a follicular ultrasound (to measure antral follicle count), will tell the physician if the candidate for the egg donor program would be suitable as an egg donor for an intended parent. The physician will be able to tell how fertile the potential egg donor is, how likely she is to respond to stimulation medications, and whether or not they would expect to retrieve a high number of high quality eggs from this potential donor.
Were You on Birth Control?
Sometimes it will be suggested that if you have been on a hormonal method of birth control that you discontinue it, use a barrier form of birth control, and then check your hormones after being off of the artificial hormones for at least thirty days.
What happens when you find out that you are not within the normal range of an egg donor? Is your own fertility at risk?
Can You Still Get Pregnant?
Your physician at the fertility clinic should explain to you what the levels detected in your tests mean in regards to your own fertility. Sometimes potential donors are considered “borderline”—they don't qualify for our egg donor program, however, they should still be able to achieve a pregnancy on their own.
If you were attempting a pregnancy on your own, you would be able to try to get pregnant over the course of a month, for a couple of months. When doing an egg donation cycle, there is only one attempt, one retrieval for the intended parents.
What to Do if Tests Indicate Fertility Problems
If all of your levels are far out of the normal range, (i.e., if your FSH is very high and/or your AMH is very low), fertility preservation (egg freezing) might be discussed with you. Egg freezing could be what saves you from being a potential egg donor and needing an egg donor for yourself.
Egg donor recipients often spend $20,000 to $30,000 for a donor egg cycle. The screening process is therefore quite rigid, and fertility clinics will sometimes reject several candidates before accepting one as a potential egg donor. Ovarian reserve tests predict response to stimulation and ability to conceive with assisted reproductive technologies.
These tests do not necessarily predict who will and who will not get pregnant naturally. Just because you are not an "ideal" egg donor, that does not mean you will have trouble when you try to get pregnant naturally.
To work with a fertility clinic that has an in-house donor program and appreciates every egg donor applicant, make an appointment at one of InVia’s four Chicago area fertility clinics.