Is egg donation treatment a solution to recurrent and spontaneous miscarriages?
Even the care of the best fertility specialists can’t prevent a spontaneous miscarriage. Some patients are unfortunate enough to experience them more than once. The reasons for recurrent miscarriages vary from patient to patient; for some, undergoing egg donation may be the answer.
But is it the answer for everyone? To help us understand, we asked three specialists to explain recurrent miscarriages and how egg donation can help.
Our experts are:
- Dr. Harry Karpouzis, IVF Pelargos, Greece
- Dr. Natalia Szlarb, IVF Spain, Spain
- Dr. Elena Santiago, Clinica Tambre, Spain
Answer from Dr. Karpouzis
Yes, donor eggs can be a cure when we know for sure that the reason for the recurrent miscarriages is chromosomal or embryo-related. As I said before, the reasons for recurrent miscarriages can be related to many different factors—immunological, endometriosis, hydrosalpinx, polyps, fibroids, infection. Lots of things can affect and cause recurrent miscarriages. First we need to rule out all these options and determine if it is related to the male or egg factor. This means that if we do an initial PGS because we have ruled out all the other factors and we cannot find any chromosomally normal embryos, then the option is egg donation so that we can reduce the likelihood of recurrent miscarriages. However, if the cause of recurrent miscarriages is related to the womb, the uterus, then maybe surrogacy would be a better option.
Answer from Dr. Szlarb
Is egg donation a cure for patients with recurrent implantation failure? Egg donation is not a cure for implantation failure. Before we decide to perform egg donation, we have to find the reason for recurrent implantation failure. There are 3 main areas or reasons why embryos do or do not implant. The first is the euploidy rate—the number of genetically normal euploid embryos that patients generate due to their age. The second reason why embryos do not implant is the lining, or the receptivity window which could be moved. The third reason why embryos do not implant is immunology. In our body, in the womb, there are natural killer cells that see the embryo as a foreign body and can reject it. Focusing on the euploidy rate before patients are recommended for egg donation at IVF Spain, we strongly suggest coming to the centre for an initial appointment to examine the ovarian reserve, to determine if it is still possible to work with the patient’s own eggs. At IVF Spain we wouldn’t like to focus on the morphology of embryos with patients of a certain age. We perform embryo selection on the patient’s own eggs through Preimplantation Genetic Screening. In order to do so, you have to have a good lab with a highly skilled embryologist who knows how to biopsy the embryos. If we are able to generate genetically normal embryos from the patient’s own eggs, we have to focus on putting them in the lining on time because or recurrent implantation failures. Before transferring embryos from the patient’s own eggs, we perform receptivity window testing and the third area that we would like to focus on is immunology. So, basically on the day of receptivity testing, we also perform immunology testing. We add immunological support for each transfer with recurrent implantation failure after a certain age.
Answer from Dr. Santiago
Egg donation programs can be of benefit for such patients but it is very important to take into account the reasons for the miscarriages. So, this is why first of all you will have to undergo some tests. We will have to make a recurrent miscarriage study to find out the reasons for the miscarriages, whether there were genetical reasons or perhaps a blood disorder in the woman. Of course, this type of treatment will be of benefit for those patients who had genetical disorders on the woman’s side, not the man’s—due to the egg, normally, in patients aged over 40.