Qualification for IVF egg donation program: what does it look like?
Egg donation programs are continuously gaining in popularity. More and more patients interested in fertility treatments are considering donation as an option – and for good reason! The success rates speak for themselves. Not everyone is a candidate for an egg donation program, however. What does the qualification process look like? What criteria would I have to meet in order to participate in an egg donation program?
To explain the processes behind egg donation programs, we invited three fertility specialists to take part in 3on1 #IVFANSWERS.
Our experts are:
- Dr Nataliya Kushniruk, FertiCare Prague, Czech Republic
- Dr Renáta Krmíčková, IVF Zentren Prof. Zech, Czech Republic
- Dr Maria Arque, Fertty International, Spain
Answer from Dr Kushniruk
Patients intending to undergo egg donation programs have to meet several criteria before they start. First of all, 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 are 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 to 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; as such, they are disqualified if they carry genetic diseases such as cystic fibrosis, muscular atrophy et cetera.
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.
Answer from Dr Krmíčková
A complete medical history of the patient is the basis to start the fertility treatment. Together with the basic gynecological 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, semen sample of the partner 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 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 in the place of residence or directly in our clinic. Our patients do only have to come to our clinic once which is at the time of embryo transfer. But in practice, it has been found that the most of our patients come to our clinic at least twice. For the first consultation and for the embryo transfer. However, some couples wish to come to us also for ultrasound examinations, mainly because they like to know our team better or to 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.
Answer from Dr Arque
Ok, so basically we start with an initial consultation with the couple where we review their medical history and the treatments which 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, and egg quality is the main reason for why the treatments are not working, or in patients who have already undergone several IVF treatments with their own eggs, but 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 programme are the ones required under European Legislation for both members of the couple, which are the serologies and virals, HIV, hepatitis and syphilis, and then for the woman we are also going to ask for the thyroid function tests, check the prolactin is normal, that she has a normal full blood count, a normal pap smear test, and depending on her age and medical history, maybe a mammogram. Obviously, we would also do an ultrasound to make sure that the uterus is normal and there are no issues for implantation. On the male side, we will also require the 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.