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Process of IVF with donor oocytes abroad #IVFWEBINARS

EggDonationFriends had the pleasure to host our seventh free IVF webinar – watch it here! Due to enormous interest in fertility treatment options in Europe we have decided to organise an event focused around the topic of IVF with egg donation at one of the European clinics. Watch the webinar recording above and learn everything you want to know about the process of IVF using donor eggs abroad.

We have invited IVF Spain onboard for this project. The topic of the webinar presented was “Process of egg donation treatment abroad. How to prepare, number of visits & milestones” – the webinar was presented by a fertility expert, Dr Natalia Szlarb.

Dr Szlarb is a Medical Director at IVF Spain, clinic in Alicante, Spain. She graduated from a medical university in Poland in 2002 and then has worked in gynaecology and obstetrics wards at several German hospitals. During her medical studies she also took part in international internships in Egypt, Brazil and Poland. In 2011 Dr Szlarb obtained her PhD diploma in Immunology in the United States of America. Since 2013 she has been involved with IVF Spain. She has extensive experience in IVF with donor eggs and is known by patients as a friendly and warm doctor. Find out more about dr Szlarb, her experience and the medical services offered, check IVF Spain clinic profile.

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IVF Spain

Dr Natalia Szlarb, Medical Director

Dr. Szlarb speaks fluent English, Polish, German and Russian. In the EggDonationFriends’ webinar she was talking about the process every fertility patients needs to go through when undergoing IVF treatment using donor oocytes outside their home country, specifically in Spain. Dr Szlarb, as a medical specialist, explained how to prepare for such treatment and travel, what medical records or prescriptions are needed, how many appointments are usually required for different types of treatment and what the treatment milestones are.

We are glad that the event attracted so many viewers from all around the world, especially from Great Britain, the USA, Ireland, Australia, Canada, Germany, Israel, Hungary, Russia and France. It is great news that interntational patients keep appreciate what we do. The webinar aimed to present factual knowledge about patients’ options of having egg donation treatment at IVF Spain. During the webinar’s Questions & Answers session the participants were able to ask the doctor their own questions. Below you can find the complete transcription of them.

Process of donor oocytes abroad – Questions & Answers

Q1: Why does the price for egg donation program vary so much around Europe? From €3,500 to €7,000?

That’s a very good question. It has to do with the number of eggs you are given and the technology implemented in the embryo development process. If the clinic focuses only on day-three embryos, giving you three or four eggs, the price is going to be cheap because, basically, the clinic focuses only on one transfer. If the clinic focuses on a certain quality and a cumulative pregnancy rate, the price will be higher because in order to guarantee quality we need to have 12 or 16 donor eggs for you, basically giving you exclusively all, or almost all, the eggs from one donation. That’s why the price of egg donation is higher. If the clinic gives you a guarantee of a certain number of embryos or blastocysts then we have to give you even more than 12 or 16 eggs, because usually out of those eggs we have 3 blastocysts. We have programs that guarantee 5 blastocysts, so sometimes I have to repeat the process with the same or a different donor. We repeat only with donors who have had a successful pregnancy with us.

Q2: Which embryos are transferred: day 3 cleavage stage or day 5 blastocyst with donor eggs?

It depends on the program you choose. I would prefer you to have a transfer with day 5 embryos with blastocysts, because the embryos are well-developed and have a lot more cells than day-three embryos and the statistics for day-five embryos is a lot better than for day 3. So we highly recommend day-five embryos; either the 3-blastocyst or 5-blastocyst program.

Q3: Do the donors make a profit from donating eggs? In some countries making a profit has been banned.

In Spain, egg donation is anonymous and altruistic. The law allows us to compensate the donor about 700 Euros for one cycle. By the way, it is important to notice that Spain is number 1 in organ donation in general. At IVF Spain we have developed a special program where we offer donors a top class treatment included fertility check, genetic check, fertility preservation options. Furthermore, they have free gynaecological check-ups for the rest of their lives.

Q4: How many of these (egg donation IVF procedures) are actual births? For patients over 30 and in general?

We have to differentiate two things. The biochemical pregnancy rate means a positive pregnancy test, and then there is a clinical pregnancy and live birth. If you see the biochemical pregnancy rate, you have to subtract 10-15 %, which is the miscarriage rate, to give you the live birth rate. If I say that we have a biochemical pregnancy rate of 70%, automatically, I say that we have a 60% live birth rate per transfer. That’s why we are interested in having at least three embryos out of the egg donation cycle. The first transfer is always fresh, except if you do PGS, the second and third transfers are frozen. If you have a miscarriage after the first transfer, we do the second one, then we try to improve your endometrium. Then we try to work on your immunology. After two transfers over 70 % of all the patients have children at home. If we do three consecutive transfers, your accumulated pregnancy rate live birth rate at IVF Spain last year was over 80%. After four transfers it is over 90%.

Q5: How many embryos are you allowed to transfer in Spain?

In our clinic we are allowed to transfer one or two embryos – two is the maximum – on day 5. We see that the twin rate with two embryos is over 35% and we do not want to over-do our job. A good IVF centre should have a lower than 10% twin rate so our goal is always to transfer one embryo, the best one. If you want, we counsel you for the possibility of twins and then we have to decide whether you are ready for this in your life because a twins pregnancy is always high-risk. You have to go to the doctor more often, you are not seen by a midwife anymore, there is always the risk of preterm delivery, and when the twins are born life gets quite challenging. We would transfer no more than two definitely.

Q6: Do you facilitate open donation, where intended parents can meet the donor?

No. Egg donation in Spain is anonymous under Spanish law. You have to trust that the medical team will find you a donor, but you will never be able to meet her.

Q7: Why does IVF Spain match donors to IPs? In the U.S., IPs work with Clinics and Agencies to pick their own donors. Is this protocol in Europe that the Intended Parents cannot bring their own chosen donors to the clinics? In the U.S. RE’s can make suggestions, but it seems like you do not allow patients to choose their own donors from other donor banks, etc.?

American laws and the processes in the United States with egg donation it’s a lot longer than in Spain: there are many agencies and many people involved. The law in Spain allows only for anonymous egg donation. There are different countries in Europe which allow for donors with open ID, like the UK. The problem is that, if you allow for the open ID of a donor, you can meet the donor, but nobody wants to donate. So different countries in Europe have different legislation but when working in Spain we have to follow Spanish law.

Q8: Is the procedure for killer cells included in the price or an extra cost?

It’s an extra cost, but this is not something that we do upfront. We do NK cells testing if you failed the first egg donation cycle or the first transfer, or if you have a history of recurrent implantation failure. Then we would test your NK cells right away. It’s not obligatory, not something that we demand upfront.

Q9: I have Natural Killer issue too. Does it mean I have to stay longer or my treatment has to start months before transfer? I’m 44. My NK test result is 24 (should be between 12-20). I had 3 failed IVF transfers before with my own eggs.

At the age of 44, we have to realize that number of genetically normal embryos is quite low. Two years ago, the ASRN (American Society of Reproductive Medicine) showed that out of forty-six blastocysts at the age of over 44 years, only 10 are genetically normal. We would first focus first on finding genetically normal embryos for you. The NK cell of 24 does not scare me at all and at IVF Spain, before the transfer, we would put you on a low dose of prednisone after the transfer, and then raise the dose. In some cases we put patients on an intralipid protocol at the beginning of the transfer cycle, then another IV infusion on the transfer day or two or three days before the transfer, and then three six weeks after. This is our NK cells protocol. 24 is not ideal, but what we could do is, after the treatment with intralipid and prednisone, we could check the levels.

Q10: How exactly are these killer cells diagnosed?

We can diagnose them in blood or in the uterus lining. I don’t like the blood examinations because they are not sensitive enough. The endometrium test has a much higher sensitivity, as NK cells, like every cell, have certain HLAs. There is a way to test the cells according to which HLA they carry. We know that the bad NK cells, which express CD56 are uterine, in the womb, and not in the blood, and are best are diagnosed through biopsy.

Q11: Can I ask what the overall cost is?

A fresh egg donation cycle with three blastocysts costs 9,700 euros. The first transfer is always included and, if we need to repeat transfers, the frozen embryo transfer is 1 800 euros. Medication is paid on top, but this shouldn’t scare you. Oral estrogens and vaginal progesterone, the same kind of medication used in substitute cycles of women who are menopausal, is very cheap, about 200 euro up to the twelfth week of pregnancy. The donor’s medication on us, so you just pay for the certain number of embryos that we guarantee you depending on the program you chose.

Q12: I have premature ovarian failure. I am 38.  My cycles are very irregular. How will this affect the timing, how will I know when to attend?

In reproductive medicine, you can organize your cycles in a very simple way. When you come to us, we do an ultrasound transvaginal scan and if the lining is thin, if there are no dominating follicles we can start a cycle straightaway. If we see that there are dominating follicles, we let you ovulate and put you on birth control pills for 7-10 days. We then get rid of dominating follicles, you have your period and when you want to you can start a cycle. We can start with a period or after an ultrasound evaluation and then we can plan how we start a cycle. You have to come to the centre, we have to examine you and then we make a medication plan and so you can know when everything is going to happen.

Q13: Do you offer PGS or CGS with donor egg programs?

Yes, we do PGS but we do not do CGH (Comparative Genomic Hybridization) anymore. Genetics has made huge progress in the last couple of years. We do PGS, which is a lot more thorough and a lot more sensitive than CGH. We know that, even though donors are young, 60-70% of the embryos that they generate are good, genetically normal but some of them only look good and may be genetically abnormal. Also, the embryo quality depends on the sperm quality, too. So if we suspect that the sperm quality is too low and might affect the genetics of the embryo, we can indicate PGS with egg donation. This is the reason why we perform them in selected cases. We are aware that PGS cycles are quite expensive but in specific cases, it is the guarantee of a better outcome.

Q14: Is there a BMI (Body Mass Index) limit?

I had a patient today and her BMI was high. I cannot and I will never allow any of my doctors discriminate you because of your age, because of your a skin colour or because of your BMI, but we have to be realistic – with a lower BMI, you have a higher probability of getting pregnant. We can have a first appointment with the BMI that you have, and we can talk about it and what we can do about your BMI, so that, when we transfer, that your BMI will be good enough to achieve pregnancy.

Q15: I may have to take HRT (Hormone Replacement Therapy), will this be a problem?

Not at all. We will put you on hormone replacement therapy. The hardest job in egg donation is done by the donor because she is generating the eggs and embryos. The ‘easier’ job is done by done the patient where, with artificial estrogens, we mimic your natural cycle. We give you 14 days of estrogen and five days estrogen and progesterone. This is something that your doctor does with HRT but in HRT you are on two to four milligrams of Progynova daily, and in egg donation, you’re on Progynova, six to eight milligrams daily. We want your lining to be thick enough, between 7 and 8 millimetres when we transfer. In HRT, doctors are not interested in the lining growth, they want the lining to be thin, they just want to get rid of the side effects of the menopause. Basically, we will design something like an HRT cycle but with a little higher dose of hormones to have a proper lining for implantation.

Q16: What is the full price of Egg Donation in the Alicante clinic?

With three blastocysts, it is 9,700 euros, with the first transfer included. Medication is euro 200 on top. For Exclusive Plus, it’s 10,700 euros, with medication at 200 Euros extra. There are no other hidden costs.

Q17: Do you show photos of the donor and her family?

We are not allowed – egg donation has to be anonymous. You can only find out the age and blood group of a donor and nothing else.

Q18: What if I do not have access to scans in my own country?

I know countries where you pay $400 for an ultrasound. The average dose that patients respond well to is Progynova six milligrams and what you can do, if you do not have access to your to your scans in your country, is that you can come to IVF Spain on day 14 of a cycle and we will scan you. If the lining is good, we transfer the embryo. If the lining is too thin, we will keep you on Progynova for a couple of days more for the lining to grow. You will have to be ready to extend your stay in Alicante. When you come to Alicante for the transfer, you are already synchronized with the donor.  Two weeks before you have a period, the donor starts injections and you start Progynova. I can only synchronise you through your periods. When you come, I can scan you and if the lining is too thin, you will have to extend your stay in Alicante. It will not be possible to transfer them in the synchronised cycle. We will have to freeze the embryos and then when your lining is a ready, transfer one or two embryos. The post-thawing survival is 99% so this should not be a problem.

Q19: Does your clinic have a partnership with clinics in Canada for donor egg programs?

Unfortunately, we don’t have any partners in Canada.

Q20: For double donations is it just one embryo or can you have more?

For double donations, it depends on how much you want to pay. If your budget is very limited and you just want one blastocyst, it will cost you not more than 4,000 euro. If you want to have 3 or 5 blastocysts guaranteed, the price is the same as Exclusive or Exclusive Plus egg donation and you have to add the price of sperm on top. If the sperm is from Spain it costs 750 euro extra if the sperm is from European sperm bank then the price is euro 1,000 extra. We then guarantee you, depending on which agreement we sign, 3 or 5 blastocysts.

Q21: What are the benefits of fresh eggs vs. frozen eggs? Is it better to use fresh rather than frozen sperm for fertilisation?

There are centres in Spain that work only with frozen eggs: we do not. We see that sometimes there are some donors, and this is how the embryology lab puts it, who thaw very well, that the thawing of the eggs is very good, the post-thawing survival is very good. There are other donors where it goes badly, even though they are young and healthy. Not all the eggs that I freeze survive thawing and nobody knows why. We are a clinic where, for us, it is very important to work with you on a certain quality and not repeat cycles. We want to do our best from the very beginning, we want to work with fresh eggs because we do not have to worry post-thawing survival and so generate you more good embryos at once, from fresh eggs.

Q22: Does it cost more to fertilise using ICSI as opposed to normal IVF as my partner has low motility etc?

No. IVF and ICSI are both included in the price we discussed.

Q23: How much does it cost for a second transfer if the first one is not successful? Is the cost of the first transfer the same as the 2nd and 3rd?

No. The program that you pay for, let’s say five blastocysts, is 10,700 euros with the first transfer included. If we see that it’s not working, my obligation is to have four more frozen embryos for you. The second transfer, the frozen embryo transfer, costs 1,800 euros.

Q24: How long should I be on birth control pills before my egg donation embryo transfer? My clinic says 4 months.

Not at all. We have people come here, where the lining is thin or they have just had a period, and we start a test cycle right away

Q25: Do you have African sperm donors in your donor bank?

Well, we do not have a sperm bank at the clinic; we just have our own donor bank. This is because we have in Spain and in Europe, very professional sperm banks, dedicated to this activity, which provide us good sperm quality of any kind of phenotype, including African sperm donor. You know, coming from Detroit originally, I had to differentiate between different skin tones. When speaking about egg donation, girls from Ethiopia, who have a very special phenotype, have features like Caucasian Europeans but a different skin tone.  We have donors from Nigeria, who have a different shape of nose or mouth. We match different donors according to your needs, according to the phenotype of our patient. It is the same for sperm donors, whether the sperm donor is from one part or another of Africa. When you describe yourselves, you also put down what your donor sperm donor should look and that your sperm donor should be from one part of Africa. My obligation as a medical professional is to follow your needs and if I see that what you would like is not available, we can meet to discuss it further.

Q26: Are the medications included in the overall cost?

No, the medication is not included. The medication of the donor is included, but your medication, which in Europe is cheap, 200 euro per cycle, is not included. You have to pay extra.

Q27: Do you believe in epigenetics i.e. do the babies end up being more like the recipient?

I do, a lot, you know. My life changed completely five years ago when I delivered my daughter and I was diagnosed with an autoimmune disease and I had to come to Spain. My daughter is a blessing for me. She’s seven years old now and believe it or not, when I was pregnant, I used to listen to Tchaikovsky, and my daughter now, when she falls asleep, listens to the same concerto. Even though she’s seven years old, she wants this concerto to fall asleep to. And then, you know, when you are pregnant you have crazy levels of progesterone in your body and you eat pickles with marmalade. I used to crave salmon, and now, the only fish that my kid eats is salmon, she doesn’t touch any other fish. When I see this kind of behavior in her, I strongly believe in epigenetics.

Q28: How many embryo blastocysts for double donation?

It depends on your budget. It can be from one to five.

Q29: Does the clinic close over the summer at all?

No. Our Spanish colleagues at the clinic want to have their summer vacation in August. All doctors have to present their vacation calendar for the entire year in January, so of course, we already have the calendar for this year. I will be not at work for the first week of July and then the last week of August. In the meantime, Dr. Álvarez will be on vacation at the same time as me. In August, Dr. Rogel will be working but he only speaks Spanish. The international team works over the summer.

Q30: Do you do combined transfer procedures with  own and  donated eggs? What would be the cost of both procedures (IVF+Donor egg program)?

No. This is not allowed in this country. I can only transfer embryos which are genetically the same, either from your own eggs or from donor eggs. If you would like to work with us, we have to take it one step at a time. We will try with your own eggs and if we see that it’s not working and you are here in Europe, in Spain, what we have developed is a program called Switch. This is for when you do the IVF cycle and egg collection but there are no eggs or we obtain poor quality eggs are bad, your follicles are producing estrogens to let the uterus lining grow, but I have nothing to transfer. Once again, this is a case by case situation in terms of medical and economic possibilities, but we will analyse the option of undergoing an egg donation during the same cycle.

Q31: How many embryos do you normally freeze after the first fresh transfer? That is, how many further transfers can be done from that first fertilisation?

We only generate all the blastocysts of your chosen guarantee if you choose the family planning. Otherwise, we will try to generate 1 or 2 blastocysts at once for the first transfer. This way, if the donor is not right for you for immunology reasons for instance, we have the option to change the donor for the rest of the guarantee. In any case, our obligation is to stimulate a new donor for you, without any extra cost, to fulfil our guarantee.

Q32: Is the doctor in the home country our local one, or is it someone you work with, and if so, how much does it cost?

You can go with your local doctor without any problem. If you don’t have your own GP or you are not comfortable to undergo a fertility treatment with him or her, we can give you names of GP that we knows that are OK to do this follow-up from all over Europe.

Q33: Are there additional costs for time-lapse, embryo glue, assisted hatching, endometrial scratch? What are the costs for those?

The time-lapse, where we put the embryo into an incubator and get a memory stick, is about 600 euros. We do not routinely use embryo glue because we believe that if you have a good lining, embryo glue is not needed but it costs about 200 euros. Assisted hatching, I don’t remember the cost exactly, but it’s not more than 250 euros. Assisted hatching, costs €80.

Q34: Does your clinic have a partnership with clinics in the UK?

A lot. We have partner clinics in London, Bristol, Manchester, Belfast and Glasgow. On a regular basis, we attend patient meetings in the UK.

Q35: What about patients with adenomyosis and big uterus?

This not a problem. Adenomyosis is endometrium in the wall of the uterus. What can we do is that we can down-regulate you. This means we can, before we start treatment, put you artificially into menopause. We can give you hormones that stop production of all the female hormones in your body. You will hate me for this; no one likes to have hot flashes, so we only do it when it’s really needed. Adenomyosis is an immunological phenomenon. We know that in adenomyosis there are inflammatory cells which can negatively influence implantation. But there are a lot of things we can do about this. We can down-regulate you; we can give you Prednisone to immune-modulate you. I cannot shut down the immunological process completely, but at least we can prevent the immune cells from producing the inflammatory factors which contribute to adenomyosis. When you work with adenomyosis patients, implantation rates are no worse than for patients without adenomyosis.

Q36: What are your success rates with just 1 embryo at day 5?

Biochemical, a positive pregnancy test, is 70% per transfer; 60% live birth rate per transfer. Per cycle, it is cumulatively a lot more.

Q37: Who decides if IVF or ICSI will be done? Is IMSI also possible?

We doctors do not decide this. We have a lot of different things to decide, but we have brilliant colleagues from the embryology lab for this, two of whom are senior embryologist. In order to gain this title, you have to go to the European Society of Human Reproduction, show that you have been working at least four years as a biologist, pass a very hard test and then they allow you to be independent in an embryology lab. We have two senior embryologists and they decide how to proceed.

Q38: Would it be easy to match an egg donor to an Indian recipient?

The Indian recipient has to be aware that I do not have a lot of Indian donors. If you look online, you’ll see that I have blonde hair and blue eyes, so I do not look Spanish at all. With an Indian background, you look, with all due respect, a lot more Spanish than I do. If you agree to have a donor with your features, with your colouring, but from a Spanish or South American region I’ll be more than happy to help you.

Q39: Is Spain lobbying your government to allow Surrogacy and paid Surrogacy under Spanish laws?

Unfortunately, not. This is a step in infertility treatment that will be allowed in Spain in two or three years. There is a big lobby working on it, but for now, surrogacy is not allowed in Spain.

Q40: I’m starting treatment for endometriosis, how soon after the decapeptyl injection, can I start the cycle with egg donation?

It depends on how you feel and it depends on how the womb looks but, basically, no longer than a month. The treatment of endometriosis is complex. Usually you have surgery to get rid of the big islands of endometriosis in your belly, and then you have to be down-regulated, or you have to be on long cycles of birth control pills. So, if after laparoscopy and endometriosis removal you are down-regulated, in a month you can start treatment. Not a problem.

Q41: If issues such as cysts are evident in the womb before the cycle, can anything be done beforehand to improve the ‘environment’?

It depends where the cysts are. If they are in the wall and are due to adenomyosis, this does not bother me at all; you can live with this, you can be pregnant with this, you can enjoy your life with this. If they are cysts in the uterus lining, we have to postpone the transfer; the lining has to be perfect; cysts in the uterus lining will not transfer. With cysts in the ovaries, it depends on how big they are and whether they are hormonally active. We cannot do anything here; we have to wait for the second cycle. If they are not hormonally active and small, less than two centimetres, we can transfer. If they are bigger than 2 centimetres and not hormonally active, you would be wise to remove them. But this has to be decided on a case-by-case basis. You could come over to the clinic, we could scan you see where we are and then decide, so there are no surprises in the transfer cycle.

Q42: As egg donation is anonymous, I am a bit worried about genetic siblings for my baby that might exist in the world. What if they end up in a relationship in the future!

You know, we have considered this. We do not repeat donors from the same countries as the recipients. The same donor can be repeated, but we perform only once egg donation cycle for Germany, one for Switzerland one for the United States, etc. This is how we try to avoid the issue that you talked about.

Q43: Coming back to epigenetics, do babies end up looking like the egg recipient?

My obligation is that the child looks like the recipient. Because according to Spanish law, the child that we are going to generate has to look like a combination of you and your husband, so we have a program in the egg donation database that shows the shape of your eyes, the shape of your nose, the shape of your mouth and this is how I match the egg donor to you. It’s quite systematic work, so the children not only mimic our behavior, and this is epigenetics, when they are in the womb we do something and then we have a feeling when they are born like déjà vu, but also our obligation here, as doctors, is to make the matching of a donor to you as if it were you, 20 years ago. So when the child is born, it has to resemble you.

Q44: Is mammography necessary for a 41-year-old woman or is ultrasound scan enough for an IVF or Egg donation procedure?

Yes it is. Mammography and pap-smear dated from less than a year the day of the transfer are mandatory at the clinic for women over 40. Another option is that they can also sign a refusal form.

Q45: Are middle-eastern donors also an issue like Indian ones? I guess it’s true about Spanish or South American.

We do not have this ethnicity here. If you want to have a child from egg donation in IVF Spain, it’s very difficult to find an Indian donor in Alicante. You would have to agree to a donor from Spain or South America, having your features. When you look at me, I have blonde hair blue eyes and when I open my mouth everybody thinks that I’m German, but I have very strong Russian roots. If you were to choose a donor for me from Poland Ukraine or Germany, these girls would look very similar to me. This is what we would do for somebody with blond hair and blue eyes. We would not be able to find an Indian donor for you but when I see the girls with your ethnic background that I remember from my from my childhood, in Detroit, in the neighbourhood of Dearborn, with the highest population of Arabic and Indian people living in the same city, I hope that, visually, you would be happy with South American or Spanish donor. The question is if you will feel psychologically comfortable with this. But, feel free to contact us to discuss it. Drop us an email and let us verify whether we have a Middle-Eastern donor in the databank or somebody with your colouring, but with a different ethnic.

Q46: Can a patient partner provide his sperm to your partner clinic in London instead of going to Spain?

Of course, but, from London, you have an amazing connections to us. Take the Gatwick Express from London Victoria and you’ve got five flights every day by easyJet. You can catch a flight at, I think, 6 o’clock in the morning from Gatwick, and take the latest flight back at 5 in the evening, basically, you can do it in one day. But I understand we are all busy people.

Q47: How can we find out the ethnic range of your bank of 500 donors before starting with you please, from our home countries?

The ethnic diversity is quite amazing here in Alicante. Europe does not really have borders anymore. Erasmus student exchange programs mean that people study two years in Berlin and then two years in Alicante so the majority of our donors are from Europe. Talking about different phenotypes, we have Polish and Ukrainian donors for girls with blonde hair blue eyes, for girls with darker complexions, the typical Spanish beauties, we have a lot of Spanish donors, and we have girls from Asia and Africa. The majority of them either study here or they have they have a Spanish passport.

Q48: Would you recommend Septate uterus removal before egg donation?

In the classification of a uterus septum, if we see that the septum goes down more than two-thirds of the uterus, it has to be removed. It is an easy procedure to remove the septum with a hysteroscopy. It is not a big deal if the septum is more than one-third, we can perform the transfer without any problems.

Q49: Is there any significant difference when using fresh or frozen sperm for fertilisation?

It depends on the sperm quality. If we have a patient where everything is okay then it doesn’t matter if I use fresh or frozen sperm. If we see that the sperm quality is low, if there is a problem with motility, we would recommend treatment and fertilization with fresh sperm.

Q50: Does your clinic have a partnership with clinics in Poland, Italy or other countries in Europe for donor egg programs?

No. We have our own donors from here from Alicante.

Q51: So is the EggDonationFriends database synched to IVF Spain’s database (the same exact donors)?

No. EggDonationFriends donor database is increasing all the time but it’s not our database and is much broader and also includes the egg donors from other clinics. EggDonationFriends is an institution where a lot of clinics compete but we have our own donor database where the key is anonymity. I cannot show my donors on the Internet or on any webpage because then I would be breaking Spanish law. I cannot share our database with anybody. It belongs to the clinic.

Q52: I am from Australia. What would be the time frame I will need to be there in the country, can my husband provide his sperm sample and be send without him attending due to work?

I already have children in Australia, twins even. The only problem is the European border. Basically, our patients ship the sperm of their husband to Europe, the sperm arrives at the European border and then the problems start, because it’s arriving from outside of European Union. Our embryology lab has to write documents to the border control that everything is legal, that we ordered the sample. This process takes about two months before the sperm is physically in Alicante. Once we know that the sperm is at the border, we can plan the entire preparation while this paperwork is ongoing. Six weeks to two months later, after we confirm that the sperm is here in the clinic, you can come for the transfer. If we were to start work on today in March, realistically in June or July we could do the transfer.*

*Please note that the doctor’s answers published may slightly differ from the recording version. The answers were carefully checked and revised to make sure patients get the most up-to-date information and pricing.

Patient journey in Alicante

No matter if you are already considering treatment abroad, in Spain or in another country, or just doing research and checking for more convenient and affordable options, we recommend watching the webinar video. Why? Our webinars are free and are tailored to the needs of the patients. We also encourage you to take part in our webinars for the unique opportunity to ask your own questions before you even book a consultation at the clinic or set your foot in the clinic. EggDonationFriends do believe that reliable knowledge and information can give you power to make well-thought-out and well-informed decisions regarding such important things like fertility treatment.

Once again big thanks to all webinar participants for your great questions to dr Natalia! Follow us on our social media for more knowledge rich content and more webinars.

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