Egg Donation therapy explained

Candidates

Having a baby using a donor egg provides couples with the opportunity to become parents, when they may not be able to otherwise. The success rates are very high, even during the first cycle. This therapy is available to anyone, but is recommended to patients with no ovaries; ovaries destroyed by chemo; a severe form of ovarian endometriosis; premature ovarian failure (unable to produce quality eggs); frequent failure of fertilization, scoring, or implantation; those with an indication of genetic predisposition that is not solvable by preimplantation genetic diagnostics (PGT-a testing).

This therapy can be used with a partner's sperm creating a genetic connection or with donor sperm if the father’s sperm is of low quality or for single patients (in some countries).

Donor Information

An important step in the egg donation process is choosing a donor. All our clinics respect that the process of determining the right donor is a uniquely personal decision. Our physicians and the egg donation team will assist in the decision-making process. First, you fill out a donor-matching form that includes your phenotypes (a description of your physical attributes) and you can include as many requirements about your donor as you wish. It’s good to note, that the more requirements listed, or the more complex/unique characteristics of a donor you request, may require extra time to find the best match. Attaching your pictures can help too. All our partner clinics have a pool of donors they use to help accommodate your wishes. 

Recruited donors are usually well-educated young women with excellent reproductive potential who are compensated for their time and efforts in assisting other patients in becoming pregnant. By law, this treatment is strictly anonymous in the majority of our clinics (definitely in the Czech Republic, Spain, Slovakia). The donors are usually residents of the country where they donated (except Cyprus). 

Donating women undergo a full and comprehensive assessment to determine eligibility. The process includes a medical history, psychological exams to exclude mental disorders, a review of their family history to rule out hereditary disease, along with the following health exams:

• Blood tests to exclude infectious diseases (HIV, syphilis, hepatitis B and C, cytomegalovi
• Genetic tests (karyotype and cystic fibrosis, SMA)
• Blood tests (screening for ethnic genetic diseases, blood group, and Rh factor)
• Hormonal tests
• Ultrasound scans

Preparing for Implantation  

It is important for the donor and recipient to synchronize their menstrual cycles so that the recipient’s uterine lining will be ready for implantation at the same time the donor’s eggs are retrieved and fertilized. This usually is accomplished by the administration of birth control pills. When the cycles are synchronized, the donor is instructed to take the medications to stimulate the eggs, she will be monitored by ultrasound and blood tests over the course of 10-14 days, until the eggs are ready for retrieval. Meanwhile, the recipient will be taking hormone medications, specifically estrogen and progesterone, to prepare the uterine lining for the implantation of the embryos.

Egg Development

Once the donor’s eggs reach the point of maturity, egg retrieval is scheduled. The recipient’s partner or sperm donor will need to provide a sperm sample either in advance or on the day of the egg retrieval for insemination of the eggs. The eggs will be examined the day after to verify they fertilized. The fertilized eggs will be cultured in the laboratory anywhere from 3 to 5 additional days. Egg quality can be assessed from the second day of their development. The two-day egg should have 3-4 cells. The three-day egg is 6-8 cells. By the fourth day of development, the egg becomes a morula and its quality evaluation is difficult. By the fifth day, the egg should have developed into a blastocyst.

☝️Some clinics prefer not to do the synchronization process. In practice, it means to come to the clinic twice (for the initial appointment which gives you chance to meet the team, collect your meds and male partner can submit his sperm and then come over for the implantation). 

Implantation

When the egg reaches the proper stage it will be transferred into the uterus of the recipient. This is when it becomes an embryo. We typically recommend the transfer of one or two embryos from donor cycles. The decision regarding how many embryos to transfer will be discussed in detail with you by your fertility doctor prior to the transfer. The transfer of a single embryo will reduce the risk of having multiples at birth. Any high-quality embryos that are remaining from the cycle can be frozen and preserved for future use.

Here are a few tips for the implantation day:

• Make sure you have all the signed consent forms for your treatment with you. If you wish to freeze embryos, bring the signed consent form for cryopreservation.
• It is not necessary to have an extremely filled bladder, however, we don’t recommend emptying the bladder immediately before the transfer. A medium-filled bladder helps to straighten the uterus and this makes it easier to transfer embryos into the uterus.
• Uncomplicated transfers take a short time, around 10 minutes. You will not need anesthesia.
• After embryo transfer, you should remain lying for about 30 minutes. Then you can go home.
• If you wish, the presence of a partner during the embryo transfer is allowed.

Pregnancy Test

Two weeks after your embryo transfer, take a home pregnancy test. If positive or negative, follow up with a blood test in order to confirm beta hCG levels (sometimes late implantation can cause a negative home pregnancy test). If a positive pregnancy is confirmed, then schedule a heartbeat confirmation in another two weeks. Keep your fertility clinic coordinator informed, you will continue to receive advice about what to do if you experience spotting, cramping, or anything which might feel unusual (they know what to do in different scenarios). At this time, your fertility coordinator will also provide instructions on how to decrease your fertility drugs.

Questions

If you have further questions or want to start the process, contact Medistella.