By fertility experts from Spain.
In this webinar, Joshua Rackstraw, Product Owner at Fenomatch together with Dr. Laura Garcia, MD, Medical Director at Clinica Tambre, Madrid, Spain have been explaining how the phenotype matching algorithm works and how it can help with finding the best match in anonymous egg donation.
It’s just to confirm a limit in regards to height. It’s extremely rare, to have a recipient who is shorter than this height and, of course, if we have a recipient that it’s really shorter than 1.55m, we will select another donor if necessary, but the majority of women in Europe that are applying for treatments close to our clinic, they are at least 1.55m. If they are sorter, it could be because of some genetic conditions, but of course, it also could lead to any medical problems, so that’s the reason why.
Basically, the best thing to do is ask. If you go to a clinic, they’ll be able to tell you what methods and what techniques they use for donor selection. Another option that you can do is if you go to EggDonationFriends.com, you can search for clinics there, and it will tell you if Fenomatch is available or not.
For the Fenomatch process, we need a photograph of you as an adult because that is when we can see the fully developed facial features, so that works best when we’re doing the matching with the artificial intelligence. However, as Dr. Garcia said, if you’re at the Tambre clinic, you can send them as many photos as you want. You can send them photographs of yourself as a child, you can send photographs of other children that you already have, and all of that can be taken into account as criteria.
The majority of our treatments are done with fresh eggs, but we also have our own egg bank, so people that really need to organize their treatment, organize the exact day of the embryo transfer can do it with frozen eggs.
It’s not a rare case, I have lots of patients, especially from France and also the UK that is mixed, that are from different ethnicities. Our law considers that we really need to give the best candidate, not only in terms of ethnicity but also in terms of physical characteristics. As I’ve said before, we are flexible, and we really enjoy talking and communicating with our patients. In the past, I had black recipients asking for white as a donor, and I was always explaining that it was not permitted in Spain, as long as I had black donors in the clinic. In your case, which is more specific, I’m always very honest with my patients, and it’s extremely rare to have a Filipino/Caucasian donor in a donor sperm bank. We will be flexible, and we will select the best candidate. If’s a Caucasian and not a Filipino or Asian, that’s something that really can be taken into consideration, so it’s not the only ethnicity, but as I’ve said before, we match the color of eyes, hair, the physiology done by Fenomatch, so it’s really a global process, it’s not only regarding ethnicity.
The short answer is no. The Fenomatch is done with artificial intelligence, which is much quicker, as Dr Garcia said. At Tambre, I think there are over 2 000 samples, so for a doctor to go through that many donors would take a very long time. With Fenomatch, a lot of that process can be done very quickly, so the answer is no. It’s not really a failure or a success. This is important to be aware of, all Fenomatch does is give a score based on facia resemblance, and then the doctor decides to decide if that score is good enough or not, or if the facial resemblance is good enough or not. Like with all the other factors essentially, this is something your doctor can help you with, and you should be able to speak to your doctor about it.
You can search by education level, which is not exactly the same as intelligence or intellect, but it’s definitely a good way of measuring that, and I believe Dr. Garcia, you also do some psychological tests. At this point, it’s not matching, it’s the confirmation if the candidate is good to be a donor or not, so it’s not really a question of intellectual matching in terms of likes, etc. It’s more confirmation for each candidate if they have a normal personality and a minimum intelligence, so that will be carried out, with our psychologists.
Let me explain that the majority of our donors are extremely honest, and they just come to our clinic, they really want to help people, they know via Facebook or via other ways that this is really a problem for some people to have children with their own sperm or eggs, so that’s something that it’s not really related with the compensation in terms of financial issues. It’s more to do with helping other people. If they have some problems, our psychologists will reveal that. The majority of them are just telling the truth, and they are just reporting they had some problems, not only criminal problems but also other issues such as disorders, etc. The psychologist will confirm 100% that everything is all right, and we can work and go ahead with the donation with that candidate.
Yes, of course. Fenomatch technology was designed in Spain to solve a very specific problem because in Spain as the patients can’t see the photographs of the donors. However, as you say, Fenomatch technology can be used as long as we have a photograph of the adult face of the donor, we can use it.
When we look at the literature, it’s not 100% clear about that. Usually, the best success rates are with fresh eggs, but it’s more to do also with the egg donor, we have extremely good donors that work very well with a fresh donation, and by contrast, when we work with their frozen eggs, they do not work correctly at all in terms of the development of the embryos. With the frozen eggs, you really need to confirm with your clinic that the thawing of the eggs will be guaranteed, the number of a minimum of eggs because this is very important. With frozen eggs, there is a slight tendency for a chemical miscarriage. If we need to do the genetic screening of the embryos, we definitely need to use fresh eggs from a donor.
Doctors can share as much information as they think is relevant for you because it’s not identifying data. One of the reasons that patients have to be careful when knowing the Fenomatch resemblance score is that everybody wants 100 and if not 100, then they want 99. In fact, if you have a score of 99, you’re likely looking at two photographs of the same person, and if you have a score, which is between 80 and 90, you could well be looking at twins. If you have a score that’s between 70 and 80, you could be likely looking at a photograph of your brother and sister, and you don’t want to have children with those people for various reasons related to genetics, essentially. That’s one of the reasons why we tend not to talk about the precise mechanics of the score because a doctor would tell you that a score of between 60 and 70 is a very good score, but for a patient, 60 to 70 sounds not good enough. My advice would be that you speak to your doctor about the specific case and make sure you’re getting enough information. The thing is that without me knowing enough about your situation, your doctor, your history, your Leeds, what your face looks like, I can’t really tell you properly and communicate exactly how the Fenomatch score works. In summary, my answer is you should talk to your doctor about that.
Yes, we do have embryo donation, and once you apply for embryo donation, we ask you to send your physical characteristics, and we confirm if embryos that are already created are available in your bank. I think there are embryos in our bank that are mixed as the patient were half- Asian and half-Caucasian, but I would need to confirm that in my data.
At this point, if the sperm is absolutely normal, there is no difference if it is fresh or frozen, and our recommendation is to work with frozen, and that will confirm that everything is alright, we will not have problems if there is a problem with the sample. It is also helping the clinic to be more flexible with the donor. By contrast, if there is the Oligoasthenoteratozoospermia, if we need to use a specific technique in our laboratory such as Chip Fertile, then fresh sperm is necessary, so what we always recommend is the first consultation with the advanced tests and freezing that sample, and if everything is all right, we will work with the frozen, and we will confirm that everything is absolutely fine. If there are some problems, then we will just confirm what type of vitamins and pre-treatments you need to take, and we will ask you to come for the fresh sample the day of the egg retrieval.
What we do in our practice and it’s always important in our treatment, there are no extra costs for this. It’s up to the clinic whether they want to include it or not. Most clinics do tend to include, it just because it’s quite an important service.
The majority of embryos are coming from egg donation, but also, it could be embryos that come from patients that used their own eggs, but if they are coming from own eggs, the woman must be younger than 35 years old. Usually, a patient having IVF they try to do as many transfers as they can without the donation. A lot of patients are a little bit older, they are in their 40s or 45s, so perhaps they want to transfer and have 1 or 2 children, and if they have extra embryos, normally they donate to other people, so that’s usually the origin egg donation with sperm of the partner or double donation.
If the clinic doesn’t have a Fenomatch, there’ll be a couple of things that most clinics do, so that will be things like they are checking ethnicity, skin tone, eye color, hair color, hair type, height, body type, and a few other features like that. Fenomatch is different because instead of just selecting the eye color, you can do the whole facial matching thing like the jawline, the size and shape of the eyes, and this kind of feature. Some clinics don’t use Fenomatch, and they do that manually, but the advantage of Fenomatch is that if you have many donors or many samples, it’s a way to get objective, scientifically verified results, and it often saves time.
We already work with around 100 clinics around the world, and I should say the majority of them are in Europe, although we’re also in Argentina, Peru, Brazil. You can send me an email, and that is probably the quickest way for a clinic to get access to Fenomatch. If the contracts are signed, it just takes something like 24 hours to get the clinic signed up.
In Spain, it is absolutely necessary to select an anonymous donor, so if eventually, you want to do egg donation treatment with eggs from another bank, I can accept that as long as you have no idea of the resemblance and all this image and selection of the donor. If it is 100% anonymous, we can accept that, but it’s not worth it because I cannot guarantee the success rates of our treatments with eggs that are not coming from our bank.
We have not yet been able to do any testing of the Fenomatch babies because babies tend to have those lovely chubby cheeks because their phenotype hasn’t fully developed, so how do we know that it works that’s a good question. We trained the algorithm on photographs of members of the same family. In the initial training, and I’m talking about 2017, we used around 600 photos of individuals, and they were from 108 different families, so what we defined as a successful match is if the algorithm is able to identify members of the same family. Members of the same family have the same phenotype, and that’s what our algorithm is looking for. A couple of weeks ago, this was at the beginning of this month, I did a test where I gave the algorithm 600 random photographs, and one of those photographs was of my brother. Then, I compared them to my own face, and I personally think my brother and I look very different, he’s I have to say, is a lot skinnier than I am, but the algorithm was able to identify from a sample of 600 people, the phenotype which was shared between us. It takes a couple of seconds to do. That’s how we know that it works.