Egg Recipient Application/Screening Form
Click here to download form.
Please print, fill out and send to:
NCCRM Donor Program
400 Ashville Ave.; Suite 200A
Cary, NC 27518
To see our current list of egg donor profiles, click here.
NCCRM has one of the largest donor IVF programs on the East Coast. Our location, with proximity to three major university centers and a young population, provides a great donor pool. Our recipients come from all over this country, Europe, Asia and the Middle East.
The recipient couple visits our center only once prior to their embryo transfer. During this visit, a thorough history is attained, a physical, and a saline ultrasound of the uterus is performed. The husband will provide a sperm sample for cryopreservation. The couple also will undergo a psychological evaluation by our psychiatrist who delves into the issues this couple will face in deciding to use donor eggs for pregnancy. The couple also will attend an education session about the medications and the different aspects of the cycle. The couple will then turn in their desires in a donor who will be chosen to match the wife physically (eye color, hair color, etc.) and match the husband’s family history genetically. For example, if the husband has a poor family history for certain conditions such as heart disease, a donor with minimal or no heart disease history would be chosen. The matching process usually takes two to three months. Once the match is made, the donor will be monitored in our center while the recipient will be monitored in her home town by her gynecologist or at NCCRM.
Qualifications for Admission
Recipient and Husband
- The recipient and donor will remain anonymous unless a known donor is involved.
- The recipient’s general and psychological health should be normal.
- The recipient should have a normal uterus or a uterine abnormality, which can be treated and corrected.
- The recipient’s husband should have a semen analysis adequate for assisted reproduction procedures.
- Informed consent to participate in the program will be obtained from the recipient and her husband.
Application for Admission to the Program
To be considered for admission to this program, the recipient is requested to send the following materials to the attention of the Donor Oocyte Nurse Coordinator:
- The downloadable questionnaire, completed in its entirety.
- Pertinent information from her gynecologist:
- X-rays and films of the uterus and tubes (hysterosalpingogram)
- Operative notes of any past surgical procedures, including laparoscopies
- Results of endometrial biopsies
- Gynecologist’s final diagnosis of the condition requiring oocyte donation
- A photograph of the husband and wife
- Infectious disease testing of husband’s sperm prior to storage of back-up sperm sample for cryopreservation. (Required by FDA)
- Bring all information to your initial visit
You and your husband will be asked to come to Cary for a preliminary consultation. You should plan to spend a minimum of five (5) hours in our office for this initial visit. The following activities will occur at this visit:
- The husband will produce a semen specimen. You must abstain from ejaculation for 3 – 5 days prior to collection of specimen. This sample will be cryopreserved as a back-up sample if the husband is unable to give a fresh sample on the day of egg retrieval.
- You will meet with the nurse coordinator for an education session.
- You will be seen by one of the NCCRM physicians for a history and physical. If further laboratory evaluation is required, it will be scheduled at a later time. A saline ultrasound and sounding of the uterus will be performed.
- A psychological evaluation will be done.
- You will discuss your plan of care with one of the NCCRM physicians.
- Finally, you will meet with a financial coordinator to discuss policies.
More details on Recipient program here.
Information on NCCRM’s Split Donor Program. Click here.
3rd Party Parenting Presentation by Dr. Sameh K. Toma, Medical Director of NCCRM.
Watch a couple’s story about using an egg donor to build their family. Video is courtesy of the Today Show:
To learn more or schedule a consultation:
Call (919) 233-1680 or