FERTILITY ROAD ARTICLE
Fertility Journeys: ORM Donors
The team at Oregon Reproductive Medicine is in the process of selecting the recipient couple for its Fertility Journey – a donor egg IVF cycle with genomic screening. While this is ongoing we share some of the elements that make the ORM Donors program special.
The couple that is selected to receive ORM’s Fertility Journey will match with an egg donor from the ORM Donors program. ORM’s in-house egg donor program is overseen by its physicians and clinical team and is designed to provide ORM’s patients with donors that are selected for optimal fertility and the characteristics that are important to them.
ORM Donors are fully and rigorously screened and medically approved for donation. ORM’s patients are empowered with comprehensive information about the egg donors they are considering so that they can pick the one that is right for them. They can also decide whether they wish to have an anonymous donation or one with some level of actual or possible contact. This compares to egg donation in many other countries where patients may receive little to no information about their egg donor; have no choice regarding anonymity or contact; and/or have to accept that the clinic will select the donor for them.
Egg Donor Screening
The screening of egg donors is an extensive process at ORM that takes several months and many in-person appointments before a donor is finally approved. Only about 7% of women that are interested to become a donor pass ORM’s screening and are ultimately approved. Through the detailed application, lengthy process and many in-person appointments, the dedicated ORM Donors team gets to know each egg donor personally.
Medical and Ovarian Reserve Screening at ORM includes an overall medical assessment, drug and communicable disease testing and ovarian reserve screening based on an AMH (Anti-mullerian Hormone) test and BAF (Basal Antral Follicle) count. In addition, if an egg donor has donated previously then the results of her prior donation are assessed as part of her approval. All donors that have donated previously must be medically re-approved for each subsequent cycle up to her sixth donation, which is the maximum allowed. To be medically approved donors should be between the ages of 20 and 29 and have healthy a BMI (Body Mass Index).
Genetic Screening of ORM Donors reflects the emphasis ORM places on reproductive genomics and helping patients have a healthy baby. It involves both a Genetic Disorder Carrier Screening and a Genetic Family History Evaluation, which is a unique part of the ORM Donors program.
All ORM egg donors have expanded genetic carrier screening for > 150 recessive conditions using the Counsyl Family Prep Screen. This occurs before they are approved and this screening is significantly more extensive than the standard practice of many clinics and egg donor agencies. It also includes a number of X-linked conditions.
In addition, all ORM egg donors complete an extensive family history questionnaire. A stringent set of exclusion criteria are applied to exclude applicants with a significant personal or family history of a number of severe health conditions, birth defects, and mental illness. Donors who pass the initial exclusion criteria have a consultation with an ORM in-house certified genetic counsellor to review their family history in detail. ORM’s genetic counsellor obtains a complete three-generation family history and asks follow-up questions to clarify diagnoses, ages of onset, environmental contributors, and potential patterns within the family.
ORM 2015 Live Birth Rates Per Transfer
|Frozen Embryo Transfer|
|US National Average(1)||ORM All Cycles(1)||ORM CCS-Tested Cycles(2)|
(1) As reported on the Centres for Disease Control website and includes both single and dual embryo transfers
(2) Only those cycles with CCS (Comprehensive Chromosome Screening) testing (170 out of 283 frozen embryo transfers involving donor oocytes).
Genetic counsellors are expertly trained toassess family histories for the presence of major genetic diseases, which may go unnoticed in a questionnaire because they may have different features and levels of severity within a family. ORM’s genetic counsellor also assesses the presence of common health problems with a familial/genetic component, such as heart disease, cancer, diabetes, and mental illness. ORM has developed its own donor exclusion criteria by following and expanding upon the American Society of Reproductive Medicine recommendations.
ORM’s genetic counsellors also work with patients to understand their own genetic disorder carrier screening and genetic family histories and whether the match with a donor poses any heightened risk to the children that will result from that match. Where there is a concern, ORM’s patients can select a different egg donor before proceeding with treatment.
Psychological Screening of ORM Donors involves an in-person assessment by a member of ORM’s in-house team of clinical psychologists as well as the MMPI personality test. In addition, ORM’s psychologist is able to confer with the rest of the ORM team members who have interacted with a prospective donor during her many appointments to form an overall picture of her psychological well-being and suitability to be an egg donor.
Egg Donor Profiles
ORM Donor profiles contain more than 30 pages of detailed information covering 10 sections and hundreds of questions. The key areas covered in an ORM donor’s profile include:
• Photos (adult and childhood)
• Physical characteristics
• Education and career
• Interests• Personal qualities
• Prior egg donation experience and outcomes
• Reasons for donating
• Compensation and travel reimbursement (if any required)
• Openness to contact (anonymous, semi-open via the Donor Sibling Registry, or open)
• General health history
• Reproductive health history
• Family description
• Family health history
In addition, patients are provided an egg donor’s comprehensive Genetic Information and Family Tree (GIFT) summary which is a further several pages of detail prepared by one of ORM’s genetic counsellors. This assessment helps patients interpret the genetic risks present in a donor’s family history. This also provides a record of the donor’s family medical history that can relied-upon in the future if needed.
Egg Donor Matching Coordinator
Sometimes patients need a little help to find a donor that is right for them. ORM has a Donor Matching Coordinator who works with patients to find a donor with the characteristics they are looking for and who is available to donate at a time that works for the patients based on their treatment plan.
Anonymous, Semi-Open or Open Egg Donors
Unlike in most other countries, there is no regulation in the USA that requires egg donation to be anonymous or otherwise. Each egg donation program in the USA determines its own policies on this point, and some programs only contain anonymous egg donors whereas others have both anonymous egg donors and ones open to some level of contact.
The ORM Donors program is the latter and contains many donors that are open to contact with patients. Where contact is desired, this may take the form of an in-person or Skype meeting prior to the donation. Or it can be openness to future contact via the Donor Sibling Registry, an independent organization that facilities indirect contact between donors, patients and donor-conceived children. This allows ORM’s patients to choose the level of contact (if any) with their egg donor that is right for them.
To register for access to the ORM Donors database visit https://app.oregonreproductivemedicine.com
Oregon Reproductive Medicine
Oregon Reproductive Medicine (ORM) is one of the world’s leading fertility clinics for IVF with egg donation. For over 25 years we have been helping patients who have come to us from 40 countries build their families. Founded with the goal of building the best fertility program possible, ORM is recognised globally for its consistently high live birth success rates, individualised care, and innovation leadership.
Our live birth success rates are consistently among the highest across the various reporting categories. They are recorded in the public databases for US IVF clinics that are available on the websites of the US Centres for Disease Control cdc.gov/art and the Society for Assisted Reproductive Medicine sart.org.
Our team of more than 125 people – including our doctors, nurses, embryologists, genetic counsellors, psychologists, patient coordinators, donor coordinators, surrogacy coordinators, and financial counsellors among others – cherish the work they do each day with our patients and are committed to helping each of them have the very best chance of success on the first attempt and a healthy baby.
We are based in Portland, Oregon in the beautiful Pacific Northwest of the USA.
We look forward to welcoming you to ORM in Portland and to helping you build your family!
More information can be found at the ORM and ORM Genomics websites oregonreproductivemedicine.com and ormgenomics.com