GIVF eNews

February 2013 eNews

Using Frozen Donor Eggs — A Success Story

When Kelly and Doug came to the Genetics & IVF Institute for a fertility evaluation, they did not know that their route to parenthood would include using frozen (vitrified) donor eggs to have the child they wanted so much, they just knew they wanted to become parents.

After trying to conceive for a year after they were married, Kelly and Doug met with GIVF reproductive endocrinologist, Dr. Sunita Kulshrestha. They learned from her that they had only a 5% chance every other month of conceiving on their own. "Dr. K was wonderful," Kelly says, "and took us through different plans and options for conceiving."

Using an egg donor offered a high probability of pregnancy for Kelly, who was 40 at the time, but "required me to go through my own mental process about not being the biological mother of the child," she says. After talking to a friend who has twins conceived through the use of donor eggs at GIVF, Kelly realized that, "I might not be the egg donor, but I was going to be the mother of this child, going through the pregnancy, controlling the prenatal care, experiencing birth and raising the child."

Soon after Kelly and Doug selected a GIVF donor, Doug learned that he was about to be deployed by the Army to Iraq. Kelly and Doug decided that he should freeze sperm before he left so that Kelly could continue the process of trying to conceive while he was away.

Suddenly, a new opportunity arose when Kelly learned that they were eligible to participate in the clinical trial GIVF was then conducting using vitrified (frozen) donor eggs. Excited by the prospect of being part of the trial, Kelly and Doug selected a donor in the program.

Like many women who use donor eggs, Kelly conceived on the first cycle while Doug was in Iraq. She told him the good news over Skype. "He was beside himself," she says. "GIVF was wonderful," Kelly added.

Doug returned from Iraq in time to be present when Kelly delivered their son, Zachary, who is now 19 months old.

"I would encourage anyone who is thinking about using donor eggs to really look into it. Ask questions. We asked GIVF staff lots of questions and they always took the time to meet or to call or email and answer us and helped us understand the process," she added.

"It is amazing to have Zachary. When Zachary was born and I found myself holding him, hearing him cry, with family all around us, I realized that all of this was a tremendous gift. The good Lord and technology came together to give us this child," Kelly says.

Thrilled with their first experience using frozen donor eggs, Doug and Kelly decided to try to give Zachary a biologically related brother or sister. Kelly is currently pregnant again. "We had one frozen embryo and were able to use that to conceive another child," she says. "Once again Doug and I were pleased with how compassionate and professional the GIVF staff was — especially Dr. K, Kristy Bahr and Jenn Machovina. We would not have the wonderful expanding family that we do if it wasn't for GIVF and staff," she concluded.

For more information on GIVF's frozen donor egg program, Fairfax Egg Bank, please visit Frozen Donor Eggs from Fairfax Egg Bank.

What's New:

  • Benefits from our military discount program
    Our SALUTE, military discount program offers 5% off on Multicycle and Donor Egg IVF services in addition to 25% off on single cycles. We are also offering 5% off on IUI packages and 25% off on testing not covered by insurance. We are proud to provide these discounts to the men and women who serve our country with distinction. Please visit our Financial Programs page for the complete SALUTE program details.

  • GIVF Donor Egg leaders attend national conference
    Dr. Laurence Udoff and Jenn Machovina are attending the Donor Egg Conference where they will hear about the latest developments in Donor Egg IVF. Learn more about GIVF's Donor Egg IVF program here.

  • Dr. Harvey J. Stern attended a meeting with other prestigious Human Reproduction editors of ESHRE Journals in Brussels.

Eliminating Huntington Disease in families through Preimplantation Genetic Diagnosis and Assisted Reproductive Technology.
by Brian Mariani, PhD
Chief Scientist
Genetics & IVF Institute

The Genetics & IVF Institute, besides offering a wide array of reproductive services, is the only clinic nationwide that also offers a Preimplantation Genetic Diagnosis (PGD) program under the same roof and it is available exclusively for our own patients. For those eNews readers unfamiliar with PGD, it is a technology that allows embryos generated by IVF to be screened for genetic diseases from couples who harbor inherited mutations themselves and who choose not to pass them on to their children. One of our most significant contributions to the PGD field is our non-disclosing program for Huntington's disease (HD) Prevention. Since 1996, the GIVF PGD program has assisted many at-risk couples in achieving the birth of a child free of the serious, late-onset dominant form of the disease.

Huntington disease is a slowly progressive neurodegenerative disorder that affects approximately 1 in 10,000 individuals. The disease usually becomes manifest around age 40, although behavioral changes may be apparent a decade or so before. Progressive physical disturbance including uncontrolled movements, abnormal swallowing and muscle stiffness is seen along with a progressive dementia which runs a course of about 15 years and ends in a vegetative state.

In many families, the diagnosis of HD is made in a parent when their children are of reproductive age. This places a tremendous amount of stress on at-risk children to make decisions regarding their own families. At-risk individuals can get tested to learn if they carry the HD mutation, however many individuals do not wish to be made aware of the information at this point in their life. Traditionally, reproductive choices for these families include testing of an ongoing pregnancy by chorionic villus sampling or amniocentesis. Unfortunately, if the pregnancy is affected with HD, the status of the at-risk parent is then known. Adoption, or use of gamete donors, is also possible however most people prefer to use their own genes in making children. Preimplantation Genetic Diagnosis (PGD) affords an attractive alternative for these families, as it avoids the above less-desirable scenarios. Couples opting for PGD will have their embryos tested for HD mutations prior to implantation in the uterus. Using this technology, only embryos known to be free of the affected HD gene would be used to attempt a pregnancy.

As for the non-disclosing component of the program mentioned above, couples would have IVF with PGD and molecular testing for the HD mutation without disclosure of the genetic status of the at-risk partner. Couples receive no information regarding the outcome of the IVF cycle or the genetic testing and are told only that HD-free embryos would be transferred to the uterus. This would occur if the at-risk individual is not affected (which we would find out ahead of time) or after testing of embryos reveals that it does not carry an HD mutation. The couple is not informed of their particular circumstance and the physician, after consultation with the couple, acts as their medical agent and makes decisions regarding the embryo transfer. This approach allows for exclusion of the HD mutation from the family line in future generations. In 2002 GIVF (Stern et al. Prenatal Diagnosis) published our experience with this non-disclosing testing for couples at-risk for HD. More information about this program can be read by clicking here.

The PGD testing program is unique in that the clinical genetic staff, our RE physicians, embryology lab, and the laboratory personnel all work in unison to provide HD couples with the best, most comprehensive medical care possible. The GIVF molecular genetics lab is not a 'reference' lab for HD testing, in others words, we are not set up like a factory where high test volumes and batching of cases is necessary to perform multiple cases at once, where embryos from different couples are put in the same queue. At GIVF, each HD case is performed on an individualized basis after the couple receives counseling from our knowledgeable genetic counselors and medical genetics staff. In the laboratory, their embryo samples are handled with care by our highly skilled molecular technologists one case at a time. Each HD couple has a custom PGD protocol designed to address their unique genetics resulting in a highly accurate and sensitive PGD test to yield data of the highest quality. Unique to our GIVF HD PGD assay, we have incorporated an additional feature that can test for chromosomal aneuploidy; a common situation where chromosomes can be incorporated into embryos in the incorrect number, such as trisomy 21, or pregnancy failure. In this manner the GIVF HD PGD test not only selects embryos free of the Huntington's gene mutation, but that are also free of chromosomal aberrations that can lead to a failed IVF cycle even in couples with otherwise normal fertility.

In closing, the concept underpinning the PGD program is that devastating diseases that cannot be treated or cured can instead be eliminated, a much more satisfying result that restores the quality of life for the families who have dealt with the heartbreak of inherited disease and who were faced with caring for affected family members when treatments or cures are ineffective at best or non-existent. Huntington's disease testing is only one of many genetic diseases our GIVF staff can offer to our patients. The Genetics & IVF Institute is dedicated to integrating the most current information on genetic disease from the Human Genome Project with cutting edge molecular technology to bring to our patients reproductive options not offered at other clinics. That's why Genetics has been in our Institute's name since its inception in 1984 and as we move forward we will continue to incorporate modern molecular genetics concepts into our efforts to eliminate genetic disease in families in need through the intelligent use of preimplantation therapies combined with assisted reproductive technology.

The Genetics & IVF Institute (GIVF) regularly publishes an informative newsletter featuring the latest infertility news and developments. The newsletter is sent electronically via email. To subscribe, click here.