Professional Documents
Culture Documents
By
Tami Sussman & Dawn Blank
South Africa
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Gift ov life: A WORLD OF HOPE RESTORED Egg donation as a path to parenthood: www.giftovlife.com
Contents
About the Authors
Mourning the loss of your genetic material
The Emotional challenge
Resources for Coping and Triumphing
Choosing an Egg Donor
The egg donation process & associated timing
To tell or not to tell
Egg Donation Terminologies
Helpful Resources
About Gift ov life
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On the initial hearing that you will not be able to conceive with your own eggs, shock is often the first thing to
hit you. Absolute disbelief that this unimaginable horror is actually happening to YOU. The numbness,
tearfulness, fear and confusion that follow are all understandable and accepted as expected emotions. This is
ORVV
2IWHQZRPDQZLOOVD\LIRQO\,KDGVHWWOHGGRZQHDUOLHU,ZRXOGQRWEHLQWKLVVLWXDWLRQRULIRQO\,KDGQRW
SXWP\FDUHHUILUVWSelf-blame is often at the center of the loss of ones fertility, only because it could have
been averted with youth, which is now hindsight.
If not immediately, then certainly thereafter, anger is often an emotion that hits you, along with the frustration
and irritation that having a baby is not within your control. :RPDQ KDYH EHFRPH VR HPSRZHUHG LQ WRGD\V
ZRUOG DQG QRZ KHUH LV D SURMHFW WKDW LV RIWHQ DV D UHVXOW RI ZRPDQ WDNLQJ FRQWURO of her life and delaying
childbearing. For some woman anger is transitory and depression is immediate. Feeling helpless, without
purpose and energy are often part of this awful path.
The reality is just that reality. Moving backwards is not possible, moving forward to find a way to deal with
the reality, a solution, a path that will lead to the yearning that often never leaves a woman until it is fulfilled
that of having a baby. Acceptance, if not of the situation, then of the fact that you long to have a child, is the
motivation that leads woman to explore the egg donor route. And so the world of hope restored, of renewed
fertility, is born for so many women who find themselves facing this challenge.
It is true that you will continue to struggle with questions, emotional seesawing over and over again before,
during and for some even after the egg donation process. As a UHFLSLHQWV KXVEDQGVDLG WR XV7KLV LV RQHRI
those processes in life where the end justifies the means7he rewards are life changing for so many couples
that choose egg donation as a means to conceive.
There will be a time when you will most likely look at the positive side of the situation, that at least there is a
greater chance of conception, that science has progressed to allow this treatment, that South Africa allows egg
donation, that being pregnant is a possibility via egg donation7KDWDOWKRXJKRQHRIOLIHVPDMRUKXUGOHVLWLV
not the end of the world. Then there will be times when your heart will ache at the thought of never seeing your
DNA created in a child. That you have been robbed. That life is not fair.
Its true that, in the same way one deals with any loss, only you
can find a way to process your loss and to look forward to this
SRVVLEOHVHFRQGFKDQFHDWKDYLQJDEDE\ We recall so clearly
DUHFLSLHQWVD\LQJRQFHDJRWWRWKHERWWRPRIP\QHHGIRUP\
own genetic baby, I realised that the need came from my own
ego. My view was that my genetics were superior. When I got
over my own ego, I was able to move forward with egg
GRQDWLRQ 6KH LV QRZ D FRQWHQW PRWKHU RI KHU EDE\ YLD HJJ
donation.
Those egg donor recipients that have had one baby via egg
donation and return for a second or third child will tell you of
the absolute love, devotion and bond that they have with their
children and often how much they appreciate motherhood after all the heartache.
We have worked with couples that have a child or children via natural conception and then a baby conceived
via egg donation and how they feel there is no difference. They do not feel that the child is not their own. They
feel no difference in love, bonding or commitment given the difference in the means of conception.
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Couples share with us that they could not love their child more, even if he/she had been conceived of her own
egg. The renewed hope and excitement comes once you decide to move forward and go ahead with creating
your family. $VRQHUHFLSLHQWRIHJJGRQDWLRQVDLG,I$QJHOLQD-ROLHFDQORYHDGRSWHGFKLOGUHQDVVKHORYHVKHU
own biological babies and keep adopting more, why canW,VHHDEHDXWLIXOVLGHWRWKLV"
Whether you have arrived at the decision to use donor eggs after years of fertility treatments or within days of
being advised that this may be the only option available to you to conceive a child, it may still be hard to come
to terms with the idea of using somHRQHHOVHVJHQHWLFPDWHULDOWR produce a child. You and your partner, if you
have one, may feel differently about the realities of donor conception. Sometimes one partner is less
comfortable than the other with the idea of conceiving and raising a child with whom you have only a part, or
no, genetic connection. Especially as this is a decision no one would choose to be making, these feelings can
seem insurmountable. Deciding to use donor eggs to conceive involves, at its very core, letting go. Letting go
RIWKHSDLQWKHHJRWKHFRQWURO2QHRIRXUUHFLSLHQWVVKDUHG,KDGWRGHFLGHZKDWZDVPRVWLPSRUWDQW being
a mother or passing on my genetic material. For me being a mother was the ultimate driver in my decision to
PRYHIRUZDUGZLWKWKHDVVLVWDQFHRIDQHJJGRQRU
The practical advise that we can give you, dealing with recipients everyday, would be:
- You are not alone. Because most couples choose not to disclose that they have used donor eggs to
conceive, this reality is know by very few.
- It is ok to fall apart. Not only is it ok, its expected and a part of the mourning process.
- Talk about the pain and the possibilities of using donor eggs. Confide in someone you trust
donation. It can only help to process the emotions and thoughts that you are having.
When you are struggling with the concept of egg donation and grieving after your own DNA, it seems that
motherhood will never be yours. Hundreds of mothers via egg donation, surrogacy and adoption will
however tell you that motherhood is about a love so deep it hurts
its about protecting your child to the death, about putting yourself nowhere in order to put your child
-stop.
Remember that attachment is not a function of genetic relatedness.
Am I the biological mother of the child conceived via egg donation?
The pregnant body is responsible for the growth of the fetus. The fetus takes its required fluids
and "food" compounds from the blood via the placenta for the 40 or so weeks of its
development. It is the flesh and blood that results in the baby's flesh and blood. She is the
biological mother and the child is her biological son or daughter.
for my child years later?
This is often a fear that woman express to us. The fact is that many couples come to Gift ov life from
Australia and the UK for IVF egg donation because of the legislation regarding egg donors in South Africa.
Egg donation in South Africa is confidential and anonymous. Egg donors and recipients never know each
ersonal details and never meet each other. For egg donors this is a sense of relief, as they do not
donate because they want to produce a child! For recipient couples this is an unimaginable gift as there is
no possibility that identities may become known at any time in the future. Couples are able to move
forward with their lives and family with complete confidence. In countries like Australia and the UK,
there is a central registry detailing all personal particulars, which is not acceptable for many couples or
potential egg donors.
How do I deal with my emotions towards egg donation?
Men and women are affected by infertility in different ways. This is related to the way in which society
trains and expects men and women to think, feel and act.
Women are typically seen, by others as well as
themselves, as the emotional caretakers or providers of
the relationship. Women typically feel responsible not
only for everyone's bad feelings, but also for anything
bad that happens. When women try to repress feelings,
their emotions can become more ominous until they
finally feel out of control. Their emotions can become a
monster about to swallow them whole.
Our experience is that a women of an infertile couple,
often protects her partner from her own pain and
feelings of failure and as such takes much of the
responsibility for the treatments and process upon
herself. Sound familiar? When it is suggested that men
accompany their wives for appointments, couples get concerned about issues like income loss, use of
time, etc. While these concerns are usually relevant and important, they also serve the purpose of
protecting husbands from their own responsibility in the conception process and from their own feelings,
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which could easily be intensified by the repetitive contact with the medical team, which is part of the
process.
Men are traditionally seen as the financial providers of the relationship and are responsible for
protecting the family from real or imagined dangers. Men usually feel more threatened expressing
themselves since they have often been conditioned to repress their emotions. They are trained to be
more instructional to take charge, to make decisions and to think without being sidetracked by emotions.
Males in infertile couples often feel overwhelmed by the intensity of their partner's emotions as well as
an inability to access and express their own feelings. They tend to focus their energy back into their work,
a place where they feel they can have more success.
As a result of taking responsibility for the emotional impact of the infertility, the woman experiences
intense feelings, such as pain, anger, fear and frustration. This can be a very lonely time for a woman. Be
aware of this and why you are feeling this way. Remind yourself of the facts that we have documented
above and try and keep your feelings and the situation in perspective.
Realise and accept that this may be one of the most challenging times in your relationship with your
partner. You are in an intensely emotional state and, whether he expresses it or not, so is your partner.
Interactions may be strained and affection inconsistent as you each try to come to terms with the facts,
options and road ahead. It is normal to feel out of control and not know how to ask for what you need
from the partner you are trying hard to protect. You may yearn for an emotional connection and
interaction at one moment and in the next withdraw emotionally.
For the man in this situation they may find themselves in a position where, regardless of how well they've
been trained to solve problems, they are helpless to make this situation better for the woman. As a result
they may give off messages that she is "too" emotional or sensitive, hoping that this will calm her down.
The woman may interpret this as criticism rather than as an expression of her husband's own fears.
If all you remember from this chapter is that its OK and NORMAL for infertility to challenge your
relationship, you will be doing well!
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wish to move excess embryos to your home country/town.) For out of town couples, travel and
accommodation costs need to be incorporated.
What is important when choosing which egg donor agency / program to work with?
result of more factors than an egg donor agency can take credit for? After all, the fertility clinic and
doctors and their treatment protocol, the age of the donor and her fertility screening, the quality and
quantity of the sperm used to fertilise, the ability of the uterus to facilitate the growth of the embryo.
These are all factors that must be optimal in order to achieve a pregnancy.
The fact is that all egg donor agencies in South Africa are governed by certain criteria that ensure donors
are viable as fertile egg donors. These factors include egg donors being between the ages of 18 and 35,
having a certain and optimal BMI and being screened before an egg donation cycle is undertaken. These
factors result in all agencies being created equal as regards the actual donor. Or does it? How does one
rate an agency? What after all is the role of the egg donor agency?
Passport factors are standard practices that allow an egg donor agency to remain viable and attractive to
recipient parents. They include: promptness in dealing with enquiries, a professional and understanding
approach and first-hand knowledge and experience of the IVF process.
What then differentiates one agency from the rest, if it is not the number of pregnancies achieved, the
level of professionalism and first-hand experience?
important to you...what would be the
differentiating factors for you? Would you not
want to know about the donors, whose genes you
choosing, inside and out? Surely her grades at
school, her tertiary education, her sexual
orientation, how her grandparents may have
died, whether she or anyone in her family suffers
from one of 97 different conditions that may be
passed on genetically, her parents hair and eye
on and on.
The fact that not all egg donor agencies take the interest, time or effort to make as much information
available as possible to prospective parents means that all egg donor agencies are not, in fact, created
informed decision? After all, as potential egg donor r
in choosing an agency that gives you all the information? If you are not being provided with detailed
information on a donor, ask yourself why.
A summary of factors to consider when selecting an egg donor agency to work with:
x Efficiency: How quickly does the agency respond to your emails or communication? Are they
available 7 days a week? The process that you are about to undertake relies on efficient, prompt
and after hours service. Start as you wish to continue.
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x
x
x
x
x
x
Preferred agencies: There are preferred agencies operating in South Africa. Is the agency referred
by ALL leading fertility clinics or are some excluded? If there is a clinic that has selected not to
work with a particular agency, call the clinic and ask them why. Our experience of the leading
South African fertility clinics is listed at the back of this book.
Personal attention & experience: Do the agency owners deal with you directly? Do they have
personal experience of infertility? This is a very personal journey and your agency support can
often be as necessary as the support of your clinic and doctor.
Face to face agency contact: Unless you are not based in South Africa, request a personal face to
face meeting with the agency. This will be valuable both in terms of establishing a rapport with the
persona in the agency that will assist you in selecting your donors and will provide an opportunity
to have any questions you may have answered.
Reviewing adult pictures: Will the agency be prepared to
review your adult pictures against those of the donor? Will the
agency share those pictures with the clinic in order to verify
their comments?
Egg donor database: Do you have a wide choice of donors?
Choice in selecting your donor is possibly the most important
factor that an agency can provide for you.
Donor age: The age of a donor is arguably one of the most
important factors as a prediction of her fertility. We suggest that
a donor should not be over the age of 33 this maximises her fertility based on the age of her eggs.
take.
Cost: If an agency is charging a match and management fee way below the market norm, ask
yourself why. Do not compromise on quality of donors or service for price.
Refunds & second attempts: In the event that the donor does not pass her medical and
psychological screening, after you have selected her and paid the agency match fee, are you
guaranteed a 100% refund as should be the case. Furthermore, if your first attempt is not
successful, will the agency give you a reduced fee for a second attempt with the same or another
donor?
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Choosing a Donor
The criteria with which recipient parents select a donor is as varied as the recipients that we meet and
deal with daily. It is also completely natural to have anxiety over and during the selection process.
It is important to remember that there is no rush in choosing a donor. It may take time to find the right
match or it may be almost immediate there are no rules. Whatever you are looking for as intended
parents; try to get as much information as possible from your egg donation agency regarding the donor,
while also tryi-
After consideration of race, In our experience, recipients tend to select their donor based on one or more
of the following criterion:
-
-
-
-
A note for Jewish recipients: After consultation with we have been advised that the status of a
child born is based on whether or not the birth mother is Jewish. The religious orientation of the egg
donor is of no consequence in determining whether the child is Jewish.
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Once a donor is selected the challenge and allowing the medical team and egg
donor agency to drive the process forward.
There are no guarantees in life, all of us who are parents usually begrudgingly learn that a lot more of life
is out of our control than we would like. Parenting is about being able to handle all the imperfections that
come with a child, whether you have your child through an egg donor or not. When couples do have
difficulty containing their anxiety during this process therapy can help.
The medical body governing gamete donation has allowed donors to be smokers, as detailed in the
Guidelines for Gamete Donation in South Africa.
It is not true that non-smoking donors produce better or worse quality or quantity eggs than
smokers.
How important is the birth mother given a child conceived via egg donation?
Genes are expressed within a given child depending on the environment
and its effects. The environment is the pregnancy woman's womb and its is
her genes, and not the egg donor's, that will determine how the genes
received from the egg donor, are expressed. Epigenetics is a new buzzword
in the field of egg donation for conception. Essentially Epigenetics refers to
factors outside the gene, such as a cell's exposure to hormones or genetic
variations that can modify a gene.
Such factors can change what is ultimately expressed; they can change a
phenotype i.e.: they can alter what an organism looks like as a consequence
of the interaction of its gene AND the environment. In terms of conception
via egg donation that environment begins with the womb of the birth
mother. Some unrelated examples of epigenetics include hormone and
reproductive factors in a woman that may influence the chances of breast
and ovarian cancer.
These factors are believed to be linked to a woman's exposure to estrogen and progesterone and their
effects on cell differentiation in the breast that occur during pregnancy. Conventional science has
historically linked cell behaviour to the genes present. Latest research suggests however that cells send
out signals unique to an individual that in turn receives signals from the outside. This is specifically
interesting for birth mothers where it appears our identities may be formed in the womb, linked to an
exterior field of energy.
World Epigenetics studies are now focusing on how donor conceived babies DNA may actually be
expressed based on the woman who carries that baby. The study of Epigenetics reveals that our lives are
more than the sum of our inherited genes. During growth in the womb and after birth differences begin to
reveal themselves due to specific genes being active in some people and non-active in others. There are a
number of reasons for certain genes to be active and others not including the way the hosts body
functions, lifestyle and how we think and feel our emotions and reactions. In the world of babies
conceived via egg donation, it is the woman carrying the baby at the conception of life, that starts the
process of determining which genes are active and non-active. The birth mother helps shape the baby she
carries from the moment that embryo is implanted in her uterus.
The assessments by your fertility specialist and psychologist will follow. From the time you choose your
donor until she has had her first consultation and you receive the results of her blood tests, usually takes
approximately 3 weeks.
This is a difficult waiting time for you as invariably you just want to get started! You need to be patient, as
need to be taken into account when making
appointments.
CYCLE CO-ORDINATION
Cycle co-ordination involves ensuring that when s
is ready to receive an embryo (or two!) five days later. The doctor and the IVF co-ordinator of your
preferred clinic will make direct contact with you to discuss your and the donors treatment plans. Your
cycle and that of your cycle will be co-ordinated synchronised - and the time line for donation
and embryo transfer determined.
The time required for this part of the process varies from one
donor/recipient to the next, depending on your cycles and whether
or not the donor is on the Pill. Often the donor will be prescribed the
Pill to assist with cycle co-ordination. Allow 6 to 8 weeks for cycle
co-ordination.
MEDICATION AND EGG RETRIEVAL
-ordinated cycle she will begin
her hormone treatment, designed to stimulate egg maturation. If you
have ever been through an IVF cycle you will know that this involves
her injecting herself with subcutaneous injections into the stomach.
You will also commence your medication treatment to prepare your
womb lining for receipt of the embryo/s.
The donor will be seen by the doctor throughout her treatment cycle with regular scans to ensure that
she is being optimally stimulated. Over stimulation can produce too many eggs (sometimes in excess of
36 eggs) and under stimulation may result in your not getting a good egg yield.
The doctor will, by way of a scan, determine when the donor eggs are ready for aspiration/ removal.
These scans are usually performed on day 8, day 10 and day 12 of her cycle. Usually around midnight on
day 12 the donor will be given her trigger injection to assist with the release of the eggs and prepare her
for her retrieval, which is usually performed 48 hours later. Egg retrieval is usually performed between
day 12 and day 14 of the donors cycle but this can vary, depending on the maturation rate of the eggs.
Your partner (or for some woman sperm donor) will be required to drop off a sample of his sperm on the
clinic on the morning of retrieval to allow for the embryologists to perform the fertilisation.
The process of medication to egg retrieval takes 2 weeks.
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reading. It is suggested that waiting for a menstrual cycle with a lower FSH level is not of any proven
benefit when attempting IVF.
AMH: Anti-mullerian hormone
AMH is a substance that is produced in ovarian follicles. AMH blood levels suggest the levels of the
remaining egg supply, or "ovarian reserve" of a woman.
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Helpful Resources
General
Netcells
Store your babies stem cells at birth and understand why its the greatest gift ov life
you could ever give your child
Johannesburg
Tel: +27 (0) 11 697 2900
info@netcells.co.za
www.netcells.co.za
Fertility clinics
Gift ov life works with and is referred to, by all the clinics listed below.
Medfem Fertility Clinic Johannesburg
Tel: +27(0)11 463 2244
medfem@medfem.co.za
www.medfem.co.za
Vitalab Fertility Clinic Johannesburg
Tel: +27 (0)11-911-4700
info@vitalab.com
www.vitalab.co.za
Cape Fertility Clinic Cape Town
Tel: +27 21 674 2088
info@ capefertilityclinic.co.za
www.capefertilityclinic.co.za
Sandton Fertility Clinic Johannesburg
Tel: 27-(0)11-883-1776
info@info@sandtonfertility.com
www.sandtonfertility.com
Gynomed Fertility Clinic Johannesburg
Tel: 27-(0) 11 796-1100 / 27-(0) 11839-1870/1
www. gynomed.co.za
Bioart Fertility Clinic Johannesburg
Tel: 27-(0) 11 484-5119
aziza@bioartfertility.co.za
www.bioartfertility.co.za
Gift ov life: A WORLD OF HOPE RESTORED Egg donation as a path to parenthood: www.giftovlife.com
Psychologists
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Egg Donation Program is supported by South Africa's leading Fertility Clinics ensuring the
best possible chance of conception via IVF egg donation as well as confidentiality and anonymity
guaranteed. We work extensively with International and Local recipients in need of egg donors in order
to conceive. We are proud to have facilitated egg donation cycles for couples from around the
world and notably from Australia, the UK, the US, Germany, Spain, Africa and New Zealand.
Gift ov life was born as a path to parenthood for so many that face infertility. Each and every egg donation
of our Egg Donation Program is personally and professionally handled by Co-Founders Tami Sussman
and Dawn Blank, who each intimately understand the infertility journey. Gift ov life has Co-Founder co-
ordinators based in Johannesburg and Cape Town and thus uniquely situated to meet the logistical
demands of our national and international Egg Donor Recipient Parents and Egg Donors alike. Gift ov life
offers an easy-to-access online Egg Donation Database, which you can access now by clicking here.
We have no prejudices...our aim is to assist those that long to be parents with the potential Gift ov life.
Our hope as the Authors, is that you now know a little more about egg donation as a path to parenthood.
That you feel less anxious about unanswered questions and more empowered to make your own
informed decisions. Should you like more information about the world of egg donation or should you
wish to begin your search for a donor, please go to www.giftovlife.com, where we are ready to assist you.
You may also email Dawn or Tami on info@giftovlife.com.
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