What does the qualification for egg donation program look like – visits, tests, etc.?

The egg donors go through a very very extensive screening. So the first one is really them filling out their profile and talking about themselves, their health, their family history and they also talk a lot a lot about their favorite book and so on but that’s mainly for you kind of to get to know them a little bit on a personal level. Already in the profile, sometimes, there could be red flags to us, for example, there are all kinds of diseases that carry some genetic component, for example, sometimes we see in the family a lot of history of cancers: the grandma had breast cancer and the aunt had breast cancer, there’s a lot of colon cancers – a lot of cancers and then we worry that there is a genetic component to it and we’re bringing some genes that can increase the risk of cancer. Nowadays there is technology that can check for genetic mutation responsible for many cancer but the problem is that it’s not for all – meaning, let’s say somebody in the family have a lot of breast cancer and we do all the genetic cancer for all the genetic testing for cancer gene even if those genetic testing come back completely negative, there is obviously still some genetic predisposition in that family for breast cancer that we cannot detect and we know that there is increased risk. So, the profile itself is very very important so that’s the fourth layer for us to make sure she can even qualify to be an egg donor. After that she goes through very extensive screening: we check her fertility making sure she has enough eggs that her AMH is good and or fertility testing; she go through genetic testing; she go a lot of the times through genetic counseling, psychological evaluation, urine drug screen, STD – so it’s a very extensive screening to make sure: one – that she really wants to donate for the right reason, two- that she doesn’t carry anything in her family that could be transmitted to the next generation, three – that she will be doing it successfully.

Ok, so basically, we start with an initial consultation with the couple, we review their medical history and the treatments they have already been through. In most cases, we will recommend egg donation if the patient has a very low ovarian reserve or if she has gone through premature ovarian failure, which can have a variety of different causes – for example, genetic causes or because they have undergone treatment with chemotherapy for cancer.

Other indications could be previous ovarian surgery that led to premature ovarian failure, or age, which is an important factor. Egg quality is the main reason why the treatments are not working, or in patients who have already undergone several IVF treatments with their own eggs. These have not worked because the embryo quality issue could be related to egg quality and the age factor. The basic tests which we usually require the patient to undergo before we accept them for the egg donation program are the ones required under European Legislation for both members of the couple, which are the serologies and virals, HIV, hepatitis, and syphilis.

Then, for the woman, we are also going to ask for the thyroid function tests, check the prolactin, that she has a normal full blood count, a normal pap smear test, and depending on her age and medical history, maybe a mammogram. We would also do an ultrasound to make sure that the uterus is normal and there are no issues with implantation. On the male side, we will also require virals and infectious disease tests, semen analysis, and a karyotype.

Once we have all the results, we can see if the couple is eligible and everything is ready to start, then we start searching for an egg donor that is compatible with the couple, and then we will undergo the process according to the dates that will suit the couple.

A complete medical history of the patient is the basis to start the fertility treatment. Together with the basic gynaecological and hormonal examinations. These can be done by medical providers at your place of residence and can be sent to us digitally. What follows next is an initial consultation. This can be done personally in our clinic or via phone or Skype. If the couple decides to have a personal consultation in our clinic, the partner’s semen sample is usually cryopreserved, which is cold, petrified, and stored for subsequent use. Blood has to be taken and tested for transmission of infectious diseases, for example, hepatitis B, C, HIV, Lues, and others.

In the case of the availability of frozen semen or sperm samples from other IVF clinics, we can facilitate the transport of these samples into our clinic in Pilsen. Usually, only one subsequent ultrasound examination before an embryo transfer is necessary. This can be done either at the doctor’s in the place of residence or directly in our clinic. Our patients only have to come to our clinic once it is time for the embryo transfer.

But in practice, it has been found that most of our patients come to our clinic at least twice. For the first consultation and the embryo transfer. However, some couples wish to come to us for ultrasound examinations, mainly because they like to know our team better or get some insight into our clinic. We believe a mutual relationship is very useful for both of us to choose the best therapy option and for the couple to build up their trust.

Patients intending to undergo egg donation programs have to meet several criteria before they start. First, the intended recipient has to be healthy and under 49 years of age on the day of embryo transfer. The whole process, beginning at matching a donor to the embryo transfer, takes from one and a half to about two months. It’s an anonymous process; neither the patient nor the donor is allowed to meet each other, nor can they learn any personal information about the other party. The matching is performed by the clinic staff based on the physical characteristics of the patient. All egg donors are young, between 19 and 39 years of age, and in good health. They go through rigorous health tests and screenings as established by the European Tissue and Cell Directive. They are disqualified if they carry genetic diseases such as cystic fibrosis, muscular atrophy, etc.

The process starts with gathering the necessary medical history and data. The patient fills out the so-called “first visit questionnaire”. This can be done in person, or, if impossible, by means such as Skype. After this is done, the synchronization process begins – this will synchronize the menstrual cycle of the recipient to the menstrual cycle of the donor. The patient receives a personalized hormonal medication plan. Following the medication cycle, the recipient can visit her local gynaecologist for a uterine ultrasound; once the results are delivered to the clinic, and the readiness of the uterus to receive the embryo is determined, egg collection is scheduled for the donor. On that date, the male partner will come into the clinic to deposit his sperm sample. If that is inconvenient, however, he may visit the clinic at an earlier date to make the deposit and freeze the sample.

After that, the recipient visits the clinic for the embryo transfer. Embryos are implanted on their fifth day of development after they reach the blastocyst stage. Once the embryo is implanted, the patient is free to return home; two weeks after implantation, a blood pregnancy test needs to be performed, with the results reported to the clinic. If a successful clinical pregnancy is established, further recommendations will be issued; if the implantation fails to result in a pregnancy, another consultation will be scheduled.