Egg donation treatment – is it for me, and when should I start to consider it?

Esther Marbán, MD
Gynecologist & Fertility Specialist at Clinica Tambre, Clinica Tambre

Category:
Advanced Maternal Age, Donor Eggs

From this video you will find out:

What are the main indications for egg donation treatment?
How is the egg donation procedure performed?
How are the egg donors selected, and how are they screened?
Why is Single Embryo Transfer (SET) always preferred?
What are the success rates for egg donation treatment?

Egg donation treatment – is it for me, and when should I start to consider it?

During this webinar session, Dr Esther Marbán, Gynaecologist & Fertility Specialist at Clinica Tambre, covered important topics such as the suitability of egg donation for different situations, the process involved, success rates, emotional aspects, and much more. Considering egg donation as a fertility treatment raises several key questions: Is it the right path for me, and when should I start contemplating it? Dr Marbán addressed each aspect step by step in her presentation.

Defining Egg Donation & its indications

According to the European Society of Human Reproduction and Embryology (ESHRE), egg donation is a treatment aimed at women who cannot produce their own eggs or face a high risk of transmitting genetic diseases. The process involves fertilizing donor eggs with partner or donor sperm, akin to conventional IVF, with embryo transfer for pregnancy. A central indicator for egg donation is advanced maternal age, typically defined as 35 or older. Diminished ovarian reserve and embryo quality decline with age, raising the chances of genetic anomalies. Maternal and fetal risks rise, particularly with twin pregnancies. One of the most critical issues arising from age is the risk of chromosomal disorders such as Down syndrome, emphasizing the importance of informed decisions.

Egg Quality & Age

Age plays a pivotal role in egg quality, influencing ovarian reserve, follicle count, and AMH levels. A significant decline in ovarian reserve starts around 35, leading to decreased fertility. Genetic anomalies also become more likely, urging prospective parents to consider egg donation as a viable option.

Age is an unchangeable aspect of fertility, but modern medical advancements empower us to make informed choices that transcend its limitations.

While advanced age is a prominent factor, other indications warrant egg donation consideration. Premature ovarian failure, previous unsuccessful IVF cycles, medical conditions like cancer treatment, and endometriosis are all reasons prompting the exploration of egg donation. Each case requires tailored evaluation, considering both medical and emotional aspects.

The Egg Donation Process: Step by Step

The egg donation process involves meticulous steps. Initially, selecting a suitable donor matching physical and genetic attributes is crucial. Donors undergo ovarian stimulation, while recipients prepare their uterus. The embryo transfer takes place, either with fresh or frozen embryos, aiming for successful implantation. Patients can await a pregnancy test around 11 days post-transfer.

Donor Selection

Donor selection entails evaluating a potential donor’s medical history, family background, and genetic tests. Advanced technologies like Fenomatch aid in selecting donors with facial resemblances to recipients. Genetic matching tests further mitigate potential risks, offering patients peace of mind.

Genetic Screening

Genetic screening tests for common genetic disorders. Genetic matching, an optional advanced test, expands the screening to over 300 diseases. While not mandatory, this step can alleviate concerns regarding hereditary diseases, creating a stronger foundation for family planning.

Embryo Testing

Pre-implantation Genetic Testing for Aneuploidy (PGT-A) optimizes embryo selection by identifying chromosomally abnormal embryos. This minimizes miscarriage risks and bolsters the chances of a successful pregnancy, particularly for patients with specific indications like male factor infertility. Despite the high success rates associated with egg donation, age remains a vital factor in determining pregnancy outcomes. While the implantation rate remains constant across different age groups, the risks associated with pregnancies after 45 years old should be carefully considered.

Conclusions

Egg donation is a profound fertility solution, offering hope to those facing various challenges. Advanced techniques, careful donor selection, genetic screening, and embryo testing collectively contribute to enhanced success rates. By understanding these factors, individuals and couples can make informed decisions on their journey toward parenthood.

What does FSH stand for, and what is its role in fertility?

FSH stands for Follicle-Stimulating Hormone. It is produced in the brain and plays a crucial role in stimulating the ovaries, promoting follicle development, and triggering ovulation. As the number of potential follicles decreases, FSH levels increase, signaling the ovaries to produce more eggs.

When is it recommended to get a Fluorescence in situ hybridization (FISH) test done?

The necessity of a FISH test depends on the patient’s case. For instance, patients with certain chromosomal alterations or male factors might be candidates. However, undergoing Pre-implantation Genetic Testing (PGT-A) during embryo selection is often beneficial. If PGT-A is being performed, FISH might not add significant value.

Does endometriosis affect fertility?

Yes, endometriosis can impact fertility. The abnormal tissue growth in the ovaries can reduce both the quantity and quality of eggs, affecting fertility by potentially reducing the number of viable follicles and compromising egg quality.

Are black egg donors available at Clinica Tambre?

Yes, we do have African egg donors available, ensuring a diverse range of donor options.

What is the success rate for live births with egg donation?

Live birth success rates can vary due to factors like age and medical history. Generally, the success rate is approximately around 50%. However, it’s important to remember that individual cases differ and success rates can be influenced by many variables.

Why does the pregnancy rate increase with cumulative transfers?

With cumulative transfers, if an initial transfer doesn’t succeed, the body might become more receptive to pregnancy, potentially leading to higher success rates in subsequent transfers. Although it’s a general trend, each patient’s case should be evaluated individually.

Does Clinica Tambre offer guarantee programs for egg donation?

Yes, we offer guarantee programs that provide patients with the possibility of successful embryo creation. The programs consider the health of the sperm, and depending on the selected program, they can guarantee a certain number of healthy embryos.

What access do children born from egg donation have to donor information?

In Spain, egg donation is completely anonymous, and children born from this process don’t have access to donor information or contact. The law maintains strict privacy between donors and recipients.

How necessary is PGT (Pre-implantation Genetic Testing) for embryos in cases of male factor infertility?

PGT-A’s necessity depends on the specific circumstances. If there’s a history of unsuccessful IVF cycles or sperm issues, PGT-A might be considered. However, it’s not always mandatory, and factors like sperm quality and previous cycles play a role in the decision.

How can I prepare my body for implantation at 46, being an active acrobat dancer?

Apart from a healthy lifestyle, regular periods are crucial. If you have regular cycles, a natural cycle with minimal hormone intervention might be suitable. If not, or if you want more control, a monitored cycle with hormone support is an option. The results are similar in either case.

Is HLA-C KIR testing necessary for egg donation with teratospermia?

HLA-C KIR testing isn’t automatically recommended. Its necessity depends on the patient’s history and background. If there’s a history of repeated failed transfers, HLA-C KIR testing might be considered to explore potential factors affecting implantation.

What’s the maximum age for women to receive egg donation treatment?

The maximum age for egg donation treatment at Clinica Tambre is 50 years old.

Does undergoing PGT-A reduce the chance of live birth in egg donation cycles?

No, undergoing PGT-A often increases the chance of live birth by ensuring that only healthy embryos are selected for transfer, enhancing the success rate.

What is the maximum number of times a donor can donate per Spanish legislation?

Spanish law doesn’t specify the maximum number of donations a donor can make. However, the maximum number of pregnancies resulting from each donor in Spain is 6.

How does donor selection work? Is there a waiting list?

We maintain a group of registered donors who have undergone tests. When a match is needed, donors are contacted to see if they’re available and willing to donate. Donors go through testing before they are ready to donate.

If I have only one embryo of my own, should I do a donor embryo transfer first?

The rate of success for patient embryos and donor embryos is similar. If you only have one of your own embryos, it doesn’t necessarily mean you should prioritize it over a donor embryo. The decision should be based on factors like embryo quality.

What type of counseling is provided to patients regarding egg donation’s implications?

We offer specialized counseling with a psychologist to address potential emotional challenges, discussing topics like family implications, telling the child about egg donation, and processing grief or concerns over not using one’s own eggs.

Does Fenomatch consider age difference between donor and patient?

No, Fenomatch primarily considers facial biometry for donor selection, rather than age or other factors.

Is there a recommended waiting period between transfers after a failed cycle?

While consecutive transfers might show increased success, it’s not necessary to rush into another transfer immediately. The decision should be based on the patient’s individual case and considerations.

What is the maximum age for women to receive egg donation treatment?

The maximum age for egg donation treatment at Clinica Tambre is 50 years old. This applies to our practice in Spain.

Does Clinica Tambre provide support for surrogacy or adoption?

We do not participate in surrogacy, and our services are limited to assisted reproduction and egg donation. We are unable to provide support for surrogacy or adoption.

Is DNA fragmentation testing more recommended than FISH testing for sperm quality?

Yes, DNA fragmentation testing is often more valuable for assessing sperm quality compared to FISH testing. DNA fragmentation testing provides more accurate insights into sperm health and can guide better sperm selection.

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Authors

Esther Marbán, MD

Dr Esther Marbán has been part of Clínica Tambre’s medical team since 2010. She is a gynaecologist specialized in Human Reproduction with a brilliant academic career. In fact, she obtained a special honourable mention in her Master’s Degree in Human Reproduction that she completed during 2009-2010 (organised jointly by the Spanish Fertility Society and the Faculty of Medicine of the Complutense University of Madrid). Dr Marbán is known for her restless and proactive personality and her innate talent for empathizing with people which she proves every day by working with patients.

Event Moderator

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.

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