By Heather A’Lurede, Donor Coordinator
Heather has been a Donor Coordinator at ORM Fertility since 2011. She provides clinical support to matched egg donors to help them through the donation process.
There are many things to consider when becoming an egg donor. One common question is whether it is painful to donate eggs. The honest answer for most people is: it hurts a little.
For many candidates who are starting to think about egg donation, the injections can be the first intimidating consideration. Injections three times a day? “No way!” you might say. BUT… the most common thing I hear after a donor has given her first injection is, “That wasn’t as bad as I thought it was going to be.”
Still feeling skeptical? Let’s talk it through. When you have made it through the application process and all of the pre-cycle testings, you will get the news that you have been matched with a recipient couple. Congratulations! This is the official start of your egg donation. A Donor Team Coordinator (maybe me!) will be assigned to you and will contact you to get the process started. We start you on birth control pills, we plan the calendar, and then one of your first appointments will be a two hour teaching appointment. On this important teaching day, you will meet with an ORM physician to discuss the egg retrieval process and risks in-depth, and you will meet with a Donor Team Coordinator for extensive training on each medication involved in the donation and how to administer the injections.
First, we will teach you how to prepare each of the injectable medications. This is an in-depth, hands-on training where we work with each medication used during treatment:
- Menopur® is an injectable medication that you administer in the mornings. It comes in a powder form and is mixed with saline before injection.
- Follistim® is an injectable medication that you administer in the evenings. It comes in a cartridge that is placed inside a pen device used to help with administration.
- Ganirelix Acetate is an injectable medication that you administer in the mornings for the last few days of treatment. It comes in a pre-filled syringe for injection.
We will make sure you feel comfortable and confident. You can even bring a friend or partner if you are feeling nervous. It is absolutely ok to have your partner inject your medications for you or to self-administer. I will say that many people who plan to have help from their partner find the injection is relatively painless, and they prefer the convenience of being able to do it themselves.
Next, we will teach you how to inject. All of the injections we use are given “subcutaneously,” that is, under the skin and into the soft tissue in your belly. We use tiny needles for these injections, like the kind used to inject insulin. All the supplies will be provided to you by the pharmacy. A fourth injection is given the last night of treatment, two days before the egg retrieval. It is called the “trigger” and there are different types of trigger medications used, depending on the person. For all the medications, you will use the same subcutaneous injection technique, even the trigger. The average egg donor takes the injectable medications for about 10 days, though it can vary from 8 to 12 days, depending on your body’s response. Many people find the injections much easier and less painful than they had anticipated.
The next thing many women worry about when considering egg donation is the pain experienced during the egg retrieval itself. After all, it is surgery, right?
The official name for this surgery is oocyte aspiration. It is a minimally invasive procedure in which a needle is inserted through the vaginal wall and into the ovary on each side. The procedure takes place in our clinic surgery suite. The surgery only takes about 30 minutes, but you will be at the office for approximately two hours including prep and recovery time.
Since you will be given anesthesia to put you asleep during the retrieval, you must have a companion to accompany you back home or to your hotel. When you arrive, you will consult with our anesthesiologist and anesthesia will be administered.
Now, let’s talk about how you may be feeling on retrieval day and the days immediately following. You will need the rest of the retrieval day off work or school to rest. Depending on the nature of your daily tasks, you may also want another one to two days for recovery. I usually recommend this to anyone who has an active job where you are on your feet or constantly moving all day. If you have a desk job or a job that does not require a lot of movement, then going back to work the day after the retrieval would be completely doable.
Most people feel bloated and experience cramping in the days just following the retrieval. This could last two to five days depending on your body. The pain is not severe but can be uncomfortable. The surgery team will call to check in on you the next day if you live locally. If you are from out of town, we ask you to come in for a post-operative exam the day after retrieval before heading back home.
There are things you can do to help reduce the bloated and cramping feelings. I cannot stress enough how important it is to stay well-hydrated and increase your fiber intake during the cycle and just after the retrieval. Many donors experience constipation as a result of the increased hormones and the pain medications used on retrieval day. Being constipated can be quite uncomfortable, especially when you have large ovaries. We do prescribe a stool softener, docusate sodium, which we highly recommend you take. Sometimes the stool softener isn’t enough and you may need to take a laxative.
Many donors that experience constipation after their egg retrieval think they have developed Ovarian Hyperstimulation Syndrome (OHSS). OHSS is one of the possible risks of being an egg donor. It is a condition where fluid can collect in the abdominal cavity and cause more bloating and distention. We monitor you closely for OHSS symptoms and may ask you to be seen at ORM or a local clinic if you are at risk. Symptoms include nausea, vomiting, abdominal pain, and cramping, decrease urination and shortness of breath. The treatment for OHSS is to remove the fluid from the abdomen in a procedure similar to the retrieval. This can correct or significantly improve the symptoms in most cases. In very severe OHSS cases, the fluid may disrupt other body systems or even damage the reproductive organs. Severe OHSS happens in less than 1% of egg donors and usually occurs as a result of not being evaluated early on when symptoms are less severe. For our donors’ additional protection, ORM purchases an insurance policy for each and every donor in our program before they begin taking the injectable hormones. This policy will cover you during your cycle and after the retrieval, should you need medical attention that cannot be given at ORM.
Except in the case of very severe complications, any pain, cramping or side effects from the medications and egg retrieval will resolve by the start of the first period after retrieval (7-10 days later). ORM has a lower than average complications rate, and a staff of dedicated donor advocates who will be checking in with you regularly to ensure your comfort and safety throughout the donation.
Your time and generosity have made it possible for a donor egg recipient to expand their family and you will have changed their lives forever. Egg donation is truly an amazing altruistic act of kindness and we hope you will be inspired to join our program. For more information, reach out to our Donor Team.
Learn more about becoming an ORM Egg Donor and apply today!