Evangelos Papanikolaou, MD, PhD
Founder of Assisting Nature , Assisting Nature – Human Reproduction & Genetics
Petroula Tatsi, BSc
Clinical Embryologist at Assisting Nature , Assisting Nature – Human Reproduction & Genetics
Category:
Donor Eggs, Success Rates
A 100% certainty can’t ever be achieved – who’s to say the child won’t resemble its father more than its mother? This is true for natural births as well. The aim of the phenotype match is to ensure the donor’s contribution to the process is as close to your own as possible.
encourage parents to strongly consider this issue during the first five or ten years of the child’s development. According to our research, children conceived through egg donation have a less than 1% chance of accepting the circumstances of their birth. Parents usually talk about the topic with their children once they are mature enough to understand that the source of the egg doesn’t actually matter; that the egg recipient is the actual mother, as she is the one who gave birth to them and who raised them their entire lives.
We only recommend day 5 transfers. The blastocyst stage is the final period of the embryo’s development at which it can be kept in the laboratory. Those two days matter – they allow us to observe embryos longer in order to more accurately estimate their chances of implantation, as well as perform diagnostics such as PGD.
I don’t think PGS testing should be used universally at this point; it’s still an invasive procedure which only examines the karyotype and not actual genetic markers that matter in implantation. It’s a screening tool, but it’s not a genetic testing tool. However, great effort is being put into making it less invasive; in several years, I believe nobody will perform IVF without PGS.
We have our own database, which is also made available to an international authority for auditing purposes. Currently, we have around 250 phenotypes within the database.
We addressed that during the presentation. Freezing of embryos does not harm their implantation potential. The rates are the same, although freezing eggs allows us more time to perform additional testing or to prepare the recipient’s endometrium.
In the majority of cases it is not necessary to freeze the embryo – for instance, PGT-A testing is done before freezing the blastocyst. However, if the embryo is already frozen, what we can do is thaw it and perform a microarray PGT test, which gives us a result in 24 hours. Afterwards, we can perform a day 6 transfer – as you know, many clinics perform day 6 transfers with excellent results.
In our clinic, we only had one case of miscarriage after transferring a PGS tested embryo. The probability of something like that happening is extremely slim – below 5%. You should undergo testing for thrombophilia, immunological testing, maybe even a hysteroscopy to rule out any congenital abnormalities with the uterus. If the tests come back negative, try another cycle using PGS. If it fails again, the next step would be to look for genetic anomalies that can’t be discovered using a simple karyotype mapping.
Sometimes, however, the reason for recurrent miscarriage may be something simple – for instance, the mother being immune to her male partner’s rhesus group.
The appearance of the child – its phenotype – is not only decided by the donor’s DNA, but also the DNA in the sperm. As such, what the child inherits is dictated by both the egg and the sperm, and which genes are dominant or recessive. Some traits can also skip a generation – children may sometimes inherit traits such as eye colour from their grandparents.
However, because donor matching is performed primarily on the basis of the phenotype, characteristics such as eye colour, hair colour, skin colour, height, weight, blood type and others are always shared between you and the donor.
At the moment, everything is stored in accordance with the GDPR. However, European guidelines also clearly state that in case of a genetic problem which can affect the health of the child or the donor, either the parents of the child or the donor are required to disclose that information to the national authority concerned with regulating IVF treatments. If it turns out that every child born through the donor’s donations need to be tested, the court may decide to break the anonymity clause.
There are many studies that show no difference between the two types of cycle. However, some patients respond better to no hormonal treatment at all. The only disadvantage of a natural cycle is less flexibility when it comes to scheduling the transfer. Otherwise, there are no other drawbacks. If your embryos are frozen, we can perform the transfer during the natural cycle without any preparation.
This is a very easy question – we thaw the embryo in the morning and transfer it in the evening. As the embryos are already in the blastocyst stage, there is no reason to wait another day.
You only need to live in Greece for just a month to realise we have access to almost every phenotype – we have Mediterranean donors, European donors, North African donors, Arab donors… the list goes on. Greece is a very diverse country due to our location and history.
In cases of repeated implantation failure we provide high doses of corticosteroids combined with intralipid infusions. However, like I said in my presentation, I’m not convinced that immunological issues are a major cause of RIF – I believe it’s only the cause of less than 1% of all cases.
Both, actually. These types of treatments are quite rare, as few couples donate their embryos. For male factor infertility, we would recommend a sperm donation.
You can find our pricing information on our clinic’s website.
As long as none of the myomas are sub-mucous, they shouldn’t be a problem – I saw women with eight, even ten myomas deliver healthy pregnancies. However, without having ultrasound or MRI results, I cannot give you an accurate answer. If there are more than five myomas, you should consider a laboroscopic myomectomy. Within four months you can be healthy enough to attempt another cycle.
As for the thyroiditis, your endocrinologist can help you control your thyroid levels and, if there are no contraindications, we can increase your dosage of corticosteroids during the progesterone treatment phase.
There will be another webinar with Assisting Nature in May. All the information will be available on our website. We host a different webinar every Tuesday.
We do phenotype matching, although it’s impossible to be strict in this procedure, as there are fewer patients when compared to regular egg donation. Whether you’re single or not, it makes no difference – the procedure is available to you.
The first question should be: why did your clinic perform a transfer if you had your own ovulation? It does happen – about 5-10% of the time recipients experience ovulation. It’s our obligation to identify if you’re ovulating. If that happens, we can cancel the transfer, freeze the blastocysts, change the patient’s medication and wait a month; because of the changes to medication, we have a 100% certainty this situation does not repeat itself.
Yes – we stop all of the medication after ten weeks of pregnancy, including the corticosteroids. We halve the dose over three days, quarter it over the next three days; after six days you take no corticosteroids.
In cases of repeated implantation failure they are always available. The patient can also request intralipids themselves.
Disclaimer:
Informations published on myIVFanswers.com are provided for informational purposes only; they are not intended to treat, diagnose or prevent any disease including infertility treatment. Services provided by myIVFanswers.com are not intended to replace a one-on-one relationship with a qualified health care professional and are not intended as medical advice. MyIVFanswers.com recommend discussing IVF treatment options with an infertility specialist.
Contact details: The European Fertility Society C.I.C., 2 Lambseth Street, Eye, England, IP23 7AGAnalytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc.
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