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Egg donation – when is the time to consider it?

Greet Lammens, MD
Gynecologist & Obstetrician at IMER, IMER Instituto de Medicina Reproductiva

Category:
Donor Eggs

When to consider egg donation?
From this video you will find out:
  • about the difference between premature ovarian failure (POF) and primary ovarian insufficiency (POI)
  • risks of an advanced maternal age
  • hereditary disorders
  • multiple miscarries
  • repeated IVF/ICSI failures
 

When shall I consider egg donation?

Dr. Greet Lammens from IMER Valencia, Spain, talks about when it is the best time to consider egg donation and when egg donation treatment is recommended to IVF patients by doctors.

When shall I consider egg donation? - Questions and Answers

I was advised by another doctor to try ImMap and/or ErMap test before moving to egg donation. Could you tell us more about how helpful those tests are? I was never advised it at my current clinic although I have a history of many failed IVF attempts. 

It sometimes depends on your history. If you have had several embryo transfers without becoming pregnant, it is a possibility to try. We call these tests differently but do these tests to define if the moment when we transfer an embryo is in the right implantation window or not. That is possible with us. It is dependent on the details of your medical history.

I am looking at possibly using an egg donor, but she’s already booked for her next cycle with another intended parent so how soon should we ideally use an egg donor after her last retrieval for best quality and number of eggs. 

In our clinic, it is the donor department in combination with a medical team who defines which donor is appropriate for a patient. When it comes to synchronizing a donor with a recipient, we seldom do that because it gives a lot of stress for the recipient and the results are not so good.

Do you have any experience about the use of Mesenchymal stem cell for ovarian rejuvenation? I mean to establish ovarian reserve? 

The treatments we do and the tests we perform on patients are all tests that are evidence-based and that give the patients a proven better chance for a pregnancy and we do not have any experience with the use of Mesenchymal stem cells for ovarian rejuvenation.

My NK cells have been checked by the immunologist. Results are above the norm, I was advised to do intralipids or immunoglobulin vaccines after a few failed attempts. My IVF doctor suggested quitting those therapies because the cost is quite high because they are not proved to help. How about egg donation with high NK cells? What is your attitude towards this problem and these immunological therapies?

There are a lot of additional treatments along with egg donations, and one of them is intralipid immunoglobulins vaccines. We do not do that. There is not enough evidence that it will make your chances better or greater to conceive.

You said you don’t work with synchronized cycles, so you probably do the most of the cycles from frozen oocytes. What about success rate when using frozen eggs. Are they really on a similar level as from fresh oocytes?

In the beginning, when I joined the clinic I asked that question as well. And I have seen all the figures. Indeed, that way we have a great possibility to match a donor and a recipient because we have a lot of eggs frozen from donors. We do that because the pregnancy rate and the live birth rate is as good as with freshly fertilized eggs these days.

Are there any transfers are done at Imer clinic or this point or everything has been postponed until further notice as well?

Since the middle of March, the transfers that were scheduled after mid-March have been cancelled. The embryos are frozen, so nothing happens with them. They can be frozen for a longer time if needed. At the moment I am working from home, as are my colleagues. A lot of our work is not only seeing patients at a clinic but as well as making treatment plans, filing results the patients are sending, and we are now busy. We are contacting every single patient, and my assistant is scheduling telephone calls, and I have to speak with more than 50 patients one by one, asking how they are, how they are doing, if they are healthy or not, or if they have any questions. We are now waiting what the Spanish government will say about the measures when there is ease down and in what form and also the people in their own countries are subject to the lockdown. In general, the measures everywhere are the same, but there are also other problems. The airlines have to fly so from the moment when we can travel more freely then we will contact each and every one of our patients to inform them that they can begin treatment. I have a lot of video conferences with possible new patients who have a lot of questions. As we always do when somebody is interested in the treatment, we all always offer them a free conversation with me or by videoconference or I often go to Holland and in Belgium in person so that I can listen to their story, listen to their questions and answer them as well as possible. They have time to consider their choices as it is a difficult decision whether to go for an egg donation or to stop your fertility journey.

What is the average number of transfers to achieve pregnancy from a donation?

When we look at our numbers, we see that independent of the age of the patient, of the recipients. When we look at the patients who become pregnant after the first transfer of one embryo, and then the group of patients who are pregnant after the second embryo transfer, we see in our clinic a pregnancy rate of 75%. And in each case, I’m always talking about a single embryo transfer. When we understand that every pregnancy has a risk of 15% of a miscarriage, that means that in 60% of those cases a healthy child is born.

My family advises me to wait with fertility treatments until the vaccine for COVID19 is discovered. I wish to start ASAP after the lockdown is finished. What is your opinion on this? I am 38.

First of all, before answering that question I want to emphasize that any questions I will get on my email address that is through IVF media are very welcome after this webinar, and I will try to answer them to my the best knowledge and to my experience. Now we know about several coronaviruses such as influenza that they do not harm a child in the womb of a mother. You can even have a vaccine for influenza when you’re pregnant. Whether you’re two months pregnant or 6 months pregnant. About COVID 19 we do not know that and as nobody knows. We do not know when there will be a vaccine. I do hope that it will be sooner than later. You are thirty-eight. It’s an age when you’re already in a declining part of fertility. It depends how we all behave shortly if that if it will be a society where we keep our distance when we walk around with masks on. I cannot say exactly you should do this or you can’t do that. I think you can wait a bit longer until we know if the COVID/coronavirus harms the baby in the womb or not.

Authors
Greet Lammens, MD

Greet Lammens, MD

Dr Greet Lammens is a Doctor in Medicine, Surgery and Obstetrics. She grew up in Flanders, the Netherlands, where she could develop her expertise and passion for reproductive medicine. Dr. Lammens has been a Fertility specialist at IMER Instituto de Medicina Reproductiva. Valencia 2017. She is fluent in Dutch, English, French, German and Spanish.
Event Moderator
Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is an International Patient Coordinator who has been supporting IVF patients for over 2 years. Always eager to help and provide comprehensive information based on her thorough knowledge and experience whether you are just starting or are in the middle of your IVF journey. She’s a customer care specialist with +10 years of experience, worked also in the tourism industry, and dealt with international customers on a daily basis, including working abroad. When she’s not taking care of her customers and patients, you’ll find her traveling, biking, learning new things, or spending time outdoors.

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