Are you planning to start IVF treatment using donor eggs? Do you have lots of questions about egg donation, donors and the qualification process? You are in the right place. Watch the webinar by EggDonationFriends and Assisting Nature Greece: “Donor eggs – it’s all about quality, no. of eggs & qualification process“. We have again invited Dr. Robert Najdecki, MD, Ph.D., Co-Founder and Scientific Director of Assisting Nature, fertility clinic located in sunny Thessaloniki, Greece.
Deciding whether to use donor eggs or become a donor, is a huge decision to undertake. The process should be sensitively managed, with trust and respect operating between all parties involved, especially the clinic. So how can medical professionals ensure this happens, and how are the right donors and recipients matched, in order to create a positive treatment experience, for all?
In this webinar, dr Robert Nadjecki, co-founder and Scientific Director of Assisting Nature college of reproduction, in Greece, discusses the issues surrounding the use of donor oocytes (eggs), and outlines the procedures, and protocols, his clinic uses.
In today’s society, egg donation has become a widely accepted and pragmatic solution for many couples who have struggled to conceive, due to female factor infertility. Dr Nadjecki advises that, from research, no adverse effect on the relationship between mother, father and child, has been shown, despite the lack of a genetic link between the mother and her offspring. He describes egg donation as “the gift of parenthood”.
There are many factors as to why donor eggs may be considered, for couples trying to create their family. Low oocyte quality and quantity is widely accepted as the main reason, and this can come from varying determinants, such as early menopause, chromosomal and/or genetic anomalies, and in women who have undergone cancer treatment, and whose ovaries may now not respond to hormonal treatments.
As with any cycle of IVF, whether using donor or own oocytes, the primary, the objective is to transfer a healthy embryo for implantation, with the aim of a successful pregnancy and live birth. When using a donor, the medical process of fertilization is no different when a woman uses her own eggs; the donor undergoes the process of stimulation and the oocytes are retrieved, these are fertilized with the recipient partner’s sperm, and the embryo is transferred into the recipient, to carry.
For couples, who have undergone prior IVF treatment themselves, the majority of questions and concerns raised, tend to revolve around how donors are selected and screened, and how the actual process will be coordinated and carried out.
As Assisting Nature clinic is based in Greece, dr Nadjecki explains that he can only advise on Greek law; differing legislations could apply, depending on where treatment is sought.
In Greece all donors of oocytes, sperm and embryos must, legally, remain anonymous, and the act of donation is altruistic; it is voluntary and unpaid; however, compensation is permitted for travel and time off work. At Assisting Nature, all potential donors are initially screened and, if they are found to be suitable, further, intensive, testing is then carried out, including medical, genetic and psychological analysis. In order to donate, with this clinic, donors are required to be mentally and physically healthy, fertile and between the ages of 19 and 32. Alongside the donor, the recipient couple will also undergo tests, including blood analysis, endometrium screening and, for the male, a sperm analysis, checking for DNA fragmentation, or other potential issues, which could affect the outcome of the treatment cycle.
Despite the similarities, IVF with donor oocytes is a more complicated process, than IVF between just one man and one woman. In a donor cycle two women are being treated simultaneously, therefore schedules must be aligned and compassion, is required. Dr Nadjecki stresses how it’s the responsibility, of each clinic, to ensure that both women involved are shown due respect and care.
Once recipients have decided to go ahead with donor egg IVF, the matching can begin. At Assisting Nature this is completed by searching their database, using criteria such as phenotypes; height, weight, hair, and eye colour, skin tone and ethnicity. Blood and rhesus groups are also matched, along with education and personality types e.g. the introvert or extrovert natures, of the recipient and subsequent donor. After confirming a match, the final steps for the treatment are confirmed.
Assisting Nature will transfer embryos at blastocyst (five-day) stage, wherever possible, although dr Nadjecki warns that the route from oocyte to blastocyst is not always easy, or even guaranteed. It’s important to remember that, even from the same individual, not all eggs are identical and, as with embryos, they may vary in condition. This can be due, in part, to the stimulation protocol followed; donors should not be overstimulated. For embryos, the calibre of sperm used also plays a major role.
How then, can clinics ensure that only good quality embryos will be transferred, into the recipient, and therefore increase the chances of a successful outcome?
PGS (preimplantation genetic screening) and NGS (next generation sequencing) can now be used to detect any abnormal, or aneuploid, embryos. The screening is usually carried out by embryonic biopsy and analysis, with the results enabling embryologists to select the euploid (“normal”) embryos, for transfer, which should then offer over a 60% possibility of implantation.
IVF, with the use of donated oocytes, can be a very successful way for couples to conceive and research, from Assisted Nature, shows a 59% ongoing pregnancy rate from their treatment when using donor oocytes. For an egg donation program to be a positive experience, for all involved, dr Nadjecki advises that recipients, and donors, should look for clinics with a high ethical core, offering sensitive and well-orchestrated coordination, between all participants, in addition to a well-trained medical staff, demonstrating professionalism whilst understanding that each fertility journey is always unique. His belief is that all donors and recipients are individual and need to be treated that way; donation programs should be tailor-made, and personalized, for every person involved in the journey.- Questions and Answers
Low AMH tells me there’s an issue with your ovarian reserve. The dose of hormones you receive during your next cycle has to be adjusted to match your AMH. Some low AMH patients experience more success with a smaller dose of hormones. However, if your embryos cannot achieve the blastocyst stage, this means your egg quality has deteriorated to the point where the only viable option would be egg donation.