In this webinar, Joshua Rackstraw, Former 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.
Fenomach is a company that has been operating in clinics since 2018, and the first Fenomatch babies were born around May 2019. As of this moment, around 100 clinics use facial matching software to find a donor for patients, and they helped more than 7 000 families so far. Fenomatch offers a platform that allows clinics to find egg donors and sperm donors thanks to facial matching technology. It allows searching for facial features, which are inherited through DNA, and the objective is to have donor-assisted children that have a greater facial resemblance to their parents.
Fenomatch was designed to give more information to the doctors who are choosing donors. Firstly you can search by the industry standard criteria, so for example, you can search for things like eye colour, hair colour, hair type, ethnicity, skin tone, height, and body type but not weight because body type is something phenotypic and weight is something that can vary throughout your life depending on factors that are not genetic. This technique allows us to analyse a map of the patient’s face and compare it with the potential donors, it works with egg or sperm donors, it’s possible to use photographs of men or women, and it works with heterosexual and homosexual couples, so it doesn’t matter if you are a male or a female or you’re looking for an egg or a sperm donor. The doctors can use that alongside the other criteria, which might include things like genetic testing, etc. A photograph of your face is needed where the phenotype is visible so that we can see the structure of the face, and we’re looking for some degree of facial similarity.
Dr Laura de Garcia described the general selection of donors in Spain, where egg donation is anonymous. Regarding the law, the physical characteristics of the recipient, the blood type, the facial resemblance carried out with Fenomatch technology and doctor-patient communication is taken into consideration. Based on that, the best donor is not only regarding physical characteristics but also in a general aspect to make the recipient feel sure that the best donor is chosen. If it is necessary because of implantation failure or repetitive miscarriages, sometimes it is necessary to perform immunological matching (KIR AA/ HLA C1C1), it is also possible to do genetic compatibility testing for the status of recessive mutations for more than 300 genetic tests.
Patients are given a questionnaire, it is also consent for egg donation or sperm donation treatments, and patients need to fill it out. They also need to provide a photograph, this can be taken at the clinic to perform the facial matching, or if someone is living abroad, they can just send it via email for the most accurate results. The patient needs to look straight into the camera, without a smile and make sure the hairline is visible, without glasses, or jewellery and have the minimum makeup, only one photograph is required. The patients can also share photos of their children, also grandmothers, and mothers so that the doctors can see them.
Egg donor selection
The selection criteria for egg donors are as follows:
- women less than 35 years old
- minimum height: 1 meter 55
- maximum body mass index (BMI) is 30
The first step is a visit with the nurse to exclude medical conditions, and that there are no hereditary diseases within their families, and that is when the process of egg donation is also explained. If all is okay and accepted by the recipients, the next step can start. It is an interview with the psychologist, which usually takes around 1 hour and 30 minutes to confirm that everything is okay, there are no mental pathologies, there are no abnormalities in personality, and that the lifestyle is normal. The last step is a medical test where a general health checkup is done with complete blood count, blood type, biochemistry, and serology, such as Cytomegalovirus (CMV) infection, HIV, Syphilis, Hepatitis B and C and others. An ultrasound with the count of antral follicles, smear tests, and vaginal cultures for chlamydia and other pathologies are also checked.
Then, also the genetic tests, including karyotype and 15 important recessive mutations are screened to confirm that they are not carriers, for example, Fragile X syndrome, cystic fibrosis, Muscular Dystrophy, etc. The carrier status test of the more than 300 genes is also screened.
Sperm donor selection
The selection criteria for sperm donors are as follows:
- less than 35
- minimum height 1.70
- maximum body mass index 30
The first step is a consultation with the andrology team, carried out by an andrologist. During this consultation, any medical conditions should be excluded, no background of diseases in their families, and the process is explained.
Then, there is again an interview with a psychologist. The last step is the medical test and again general health check-up, such as complete blood count, blood type, biochemistry, serology, etc. Sperm count will be reviewed altogether with urine culture and PCR for Chlamydia, if all is okay, the last part will be the genetic test including Karyotype, cystic fibrosis and other basic recessive mutations. Then, the Carrier status test on more than 300 genes is performed.
At Clinica Tambre, there are more than 2 500 samples available in the bank, including a wide range of phenotypes, not only Caucasian or Spanish, European donors, but also Asian, and Black donors, and we always use facial matching provided by Fenomatch because this gives tranquillity to confirm that the process regarding physical characteristics and physiology is going to be perfectly matched. There is no waiting list for treatment with donations.