1. PHYSICIAN FLIP CHART

2. Ottawa Fertility Centre The Egg Donation Process

3. Should I consider treatment with egg donation? Who are the egg donors? What are logistics between my cycle and my donor? What is recipient screening? What are the pregnancy rates? What are my financial options? TOPICS TO BE DISCUSSED

4. OPTIONS AVAILABLE Ideal choice would be using your own egg and partner sperm If the ideal option is not feasible the remaining options are: Adoption Donor Egg Choosing Not to have Children

5. WHEN IS EGG DONATION NEEDED? Decreased Ovarian Function Premature Ovarian Failure Genetic Abnormalities Failure of Other Treatments

6. GENETICS OF AGING OOCYTE Maternal Age Chromosomal Abnormality Newborns 301/385 351/192 401/66 411/53 421/42 431/33 441/26 451/21 Reproductive Medicine Associates: Genetics 2003-2004 ACOG publications

7. EFFECTS OF AGE ON PREGNANCY RATES

8. OOCYTE NUMBER

9. DONOR SCREENING REQUIREMENTS Women between the ages of 21 – 32 years Height & Weight Proportionate (BMI <28) Non-smokers Healthy Medical and Family History Normal Hormone & Ovarian Evaluation Consultation with physician or nurse practitioner Negative drug screening Negative for Communicable Diseases, in accordance to FDA protocol Genetic Screening (Cystic Fibrosis, SMA, Fragile X and ethnically indicated genetic disorders) Psychological Evaluation

10. Full profile includes : Physical characteristics Health and obstetrical history Family health history Likes & Interests Personal Essay Questions, including motivation for donation Childhood and adult photographs DONOR APPLICATION

11. REASONS FOR DONOR EXCLUSION Poor baseline hormone values and/or antral follicle count Psychological exclusion Problematic medical or family history Smoker Positive drug screen Positive genetic screen Donor changes mind, relocation, schedule conflict

12. FDONOR EGG BANK USA Recipients receive 5-7 mature eggs No need for synchronization with donor Widens donor selection No wait to select More control of cycle timing Less expensive Advantages Limited number of eggs Lower chance of embryo cryopreservation Disadvantages

13. SELECTING A DONOR Decide on a donor program: fresh or frozen View Donor ProfilesSelect Donor Make payment and start your cycle

14. TIPS FOR SELECTING A DONOR Take your time, you may not see someone you like immediately Expect to match the most important issues Expect to make compromises on some less important issues Look for intellectual potential (essay and skills section), not just education level Everyone has imperfections Matching blood types is not medically necessary and does not impact success rates

15. INFANT COMPLICATIONS FROM MULTIPLE PREGNANCY SingletonTwinTriplet Average Month at Birth9 mths8 mths7 mths % Very Premature (<7 mths)1.7%14%41% Average Birth Weight7.4lbs5.2lbs3.8lbs % Severe Handicap1.9%3.4%5.7% % Infant Mortality0.6%2.8%19%

16. DONOR EGG BANK USA THROUGH DECEMBER 31, 2013 Egg Thaws Embryos Transfers Average # of Eggs per Cycle Average # of Embryos Transferred Clinical Pregnancies (% ET) Miscarriages (% ET) Ongoing Pregnancies (% ET) 6265826.2 1.8 (day 3) 1.6 (day 5) 291 (50%) 36 (6%) 255 (44%)