Dr Anna Galindo Trias, from Gravida Barcelona clinic, is answering patients’ questions in regard to the reception of oocytes. This event can be informative for anyone who is interested to have egg donation treatment, being the recipient of donor eggs and learning more about egg donors and donor eggs.
Dr Trias started her presentation on the reception of oocytes by explaining that this is a social phenomenon that goes against the biological women’s structure. Women have optimal fertility between the ages of 20- 30, that’s the optimal age to have children. What happened in the last generations is that women have got into professional fields, they went out of their homes, which was a standard social rule in the past when they mostly stayed home, had children and were raising them. This frame of having children has been delayed in the Western world. In Spain, for example, the average age of having a first child is around 32, which is like the middle of the threshold between optimal and starting to decline. This phenomenon means that women want to be mothers later in life, and sometimes nature is against us, the quality and quantity of the eggs declines with age. Sometimes, women have a good quantity of eggs in their ovaries, but the quality can be bad, and women don’t produce new oocytes, there is a certain number of oocytes that a woman has had since she was a fetus. The oocytes that are of low quality will create embryos that will also be of low quality and thus will not develop or implant or miscarry.
The limitation of fertility clinics nowadays is that the doctors know how to work with eggs and sperm and how to take care of them, but it’s still not known how to improve the egg quality, most of the time. The doctors are capable of giving a prognosis of pregnancy, and diagnosing the patients, but most of the time are not capable of improving the eggs or embryos. These, created a new scenario to offer women with poor quality eggs or the number of eggs or menopause, eggs from another woman who has good quality eggs. There is a possibility to use an egg donor and inseminate the eggs with a partner’s or donor’s sperm.
In Spain, egg donation is voluntary, anonymous, and altruistic but they get compensation for the medical treatment, it’s compensation for the effort. The donors need to be between 18 and 35. Their family history and personal history are checked to decrease the risk factors of genetic diseases in the offspring. They have to be in good physical and mental health, they go through some tests to evaluate any mental pathologies and exclude them. There has to be the absence of sexually transmitted diseases, their Karyotype is checked, Carrier map is also performed to minimize the risk of any diseases in the offspring. In Spain, there can only be 6 offspring from the same donor.
A woman who would like to go through egg donation needs to have a medical indication for this treatment. It’s either menopause, failed IVF cycles before, low quality of embryos, a very low ovarian reserve, advanced maternal age itself or patients who are born without ovaries or have lost ovaries because of surgery. All these patients have a medical indication, on the other hand, there mustn’t be any contraindication for pregnancy. For example, a woman can’t suffer from any disease that could compromise her or the child during pregnancy, such as not controlled very severe high blood pressure or some Thrombosis history, active cancer or sicknesses that compromise the pregnancy. A woman has to have a normal uterus that can carry a pregnancy to the end, there are only some minor alterations of the uterus that are accepted because the doctors think that this uterus is going to be able to carry a pregnancy.
Phenotype matching is necessary, the donor is matched with the recipient. The embryos coming from the egg donation have a high implantation rate expected, therefore it is recommended to transfer just 1 embryo. A few years back, mostly 2 embryos were transferred because the technology wasn’t as developed as it is today. The conditions in the lab didn’t allow the embryos to stay in the media culture enough not to damage the embryos.
Such embryos are a high implantation potential, so transferring 1 embryo at a time is safer, the risk of twins is much lower, and the risk of preterm delivery complications or high blood pressure during pregnancy complications is much lower as well.
The pregnancy rates are high because embryos from egg donation treatments have a high potential, so it’s independent of maternal age, it is dependent on the donor characteristics. On the other hand, pregnancy risks are dependent on maternal age and other risk factors of the mother. That’s why it’s important to evaluate the mother very closely before starting this kind of treatment. These treatments have a high pregnancy rate, but it is necessary to make sure that the mother and baby are going to be safe and have a good prognosis.
- Questions and Answers