Dr Laura García de Miguel, Medical Director at Clínica Tambre the process of choosing the right egg donor. Dr García explained the importance of medical screening for potential egg donors, what information about the donor’s history is provided and how are they matched with the recipients.
As we all know, egg donors are essential when a woman or couple is recommended to undergo egg donation or double donation. During this webinar, Dr Laura García de Miguel focused on egg donation. Instead of using eggs from a patient who will become pregnant in the future, we use eggs from a donor. The selection and matching of egg donors depend on various factors, particularly the country, legal aspects, cultural differences, and the specific protocols of each clinic, even within the same country.
Egg donation in Spain – legal and ethical considerations
Spanish legislation mandates that egg donation must involve anonymous, voluntary, and altruistic donors. Donors must undergo a rigorous selection process, including medical and psychological evaluations, to ensure eligibility and minimize genetic and other risks. All Spanish fertility clinics report donor data to a system called SIRHA, which limits donations to individuals whose gametes have already contributed to the birth of six babies. This ensures proper regulation and control.
How is the egg donation treatment process performed at Clínica Tambre? There are several indications for undergoing egg donation treatment, such as premature ovarian failure, menopause, previous IVF failures, low egg quantity or quality, hereditary issues, or certain medical conditions like chemotherapy or endometriosis.
The treatment at Clínica Tambre involves a series of steps, including confirming the treatment, collecting essential medical data, undergoing ultrasounds, and preparing the uterine lining. The egg collection, fertilization with sperm, and embryo transfer follow this. The recipient continues with estrogen and progesterone medications, and a pregnancy test is done at home, followed by scans during the pregnancy.
What is involved in egg donor selection at Clínica Tambre? The selection criteria include women under 35 (preferably under 32) with specific height (1.55 m) and body mass index (max 30) requirements. Medical evaluations, psychological tests, and genetic tests are conducted. The donor’s race and ethnicity are considered, as the clinic has experience with various phenotypes. The selection also factors in immunological matching when needed.
The physical selection of donors takes into account their characteristics, blood type, and the patient’s preferences. This selection is always done by the clinic to ensure anonymity.
Fenomatch technology is utilized to assess genetic similarities, using biometric facial techniques. The best donor match is determined by physical characteristics, questionnaire responses, photos, and blood type compatibility. Immunological matching is considered for patients with a history of failures or miscarriages, while genetic matching can reduce the risk of inherited diseases.
What is the immunological matching KIR HLA-C combination? In patients with a history of previous failures and a long track record of unsuccessful embryos, we explore the compatibility between uterine KIR lymphocytes and HLA-C molecules presented by the embryos. This means that in cases where patients have a history of both failures and miscarriages, we conduct a blood test to assess the KIR receptor in the lymphocytes. This test, which is not widely available in many countries, is easily administered at Tambre. If the KIR receptor is aggressive, signified by KIR AA, we require specific donor selection in the immunological system, specifically involving HLA-C1C1 of the donor. This approach helps prevent an aggressive immune reaction.
Genetic matching is another essential aspect of discussion when considering egg donation. This involves a blood test that assesses the status of more than 300 recessive genetic diseases for the recipient. It’s important to note that every person can carry one or more recessive mutations, and this is not inherently problematic. However, if we were to fertilize an egg from a recipient who shares the same recessive mutation as the donor, there would be a potential risk of the baby being born with a genetic disease. Consequently, when patients express interest in genetic matching, we need to ensure compatibility through our laboratory and genetic testing to eliminate any risk. It’s crucial to emphasize that the likelihood of this scenario is exceedingly rare, with less than 1 in every 1,000 babies being affected each year.
In conclusion, there are no ‘good’ or ‘bad’ donors, but rather compatible ones. Compatibility extends beyond physical characteristics to include blood type, immunological matching, and genetic compatibility if desired. It’s vital for patients to have comprehensive information about the donor screening process at their chosen clinic to make an informed decision.- Questions and Answers