We get a lot of questions about women that have pregnancy losses or unexplained infertility or immunological diseases such as thyroid or other autoimmune disease and the question is: “is egg donor the solution?” and the honest answer is maybe. There is some misconception that if somebody have a lot of pregnancy losses or they have unexplained infertility then moving to egg donation will solve the problem and I’m always very careful about that because I think that egg donation can help a lot and many times it does but we need to prepare to the fact that it won’t solve all issues. So, it will provide us with stronger embryos and it will provide us with a lot of embryos but if there is an implantation problem, it won’t solve that part, if there is a pregnancy loss – it won’t solve that problem. So that doesn’t mean that we shouldn’t be moving to egg donation but it also means that we need to do our homework well and talk about it ahead of time knowing – okay, we definitely gonna get stronger embryos and we’re definitely gonna get a lot of them but down the road, we will need to address those other potential issues and the key in situation like that is choosing an egg donor that have a lot a lot of eggs and embryos because we have to take into account that if there is a pregnancy loss issue we might still lose an embryo due to pregnancy loss, if there is an implantation problem – it might not work the first time. So we just need to take into account that going into cycles like that, we don’t want an average egg donor – we want an egg donor that produces much more embryos for us to be able to address more failure that we expect out of a normal egg donation cycle.
The answer is not so easy. To experience recurrent and spontaneous miscarriages in spontaneous pregnancies or IVF pregnancies, there could be more reasons for it. About recurrent spontaneous miscarriages, we intervene when the woman has had two or more miscarriages, and at least here in this country after two miscarriages, genetic examination and consultation are recommended. So, of course, the egg donation could be a cure but the patient has to undergo a thorough examination. It’s recommended to perform genetic screening for both partners, reproductive immunology examination, and last but not least is hysteroscopy. And of course, then egg donation might be the cure.
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 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. That way, 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.
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 genetic reasons or perhaps a blood disorder in the woman. Of course, this type of treatment will be of benefit for those patients who had genetic disorders on the woman’s side, not the man’s—due to the egg, normally, in patients aged over 40.
