Have you noticed that some fertility clinics offer egg guarantees and embryo guarantees? Which option is best for you? What’s the difference in cost and treatment success? Watch the webinar recording above “The difference between the number of eggs guaranteed and the number of embryos guaranteed” and find out the answers. Such guarantees are offered by most fertility clinics and we have asked dr Łukasz Sroka from InviMed Fertility Clinic to tell us more about the pros and cons of these two options.
M.D, Ph.D. Łukasz Sroka is an obstetrician and gynaecologist working at InviMed Poznań in Poland. His professional interests include gynaecological endocrinology, reproductive medicine and endoscopic surgery. Dr Sroka is a member of the Polish Gynaecological Society.
The use of IVF using own or donated oocytes inevitably leads to many differing outcomes. The number of eggs collected can vary, as will the all-important development of good quality, healthy embryos. Many clinics offer programs that guarantee a certain number of oocytes and, whilst it’s a popular belief that more eggs retrieved will automatically lead to a higher fertilisation rate; that isn’t necessarily the case.
In this webinar, MD Lukasz Sroka, obstetrician gynaecologist at InviMed clinic, Poland, discusses whether it’s better to guarantee oocytes or embryos, outlining donor selection criteria and the process of IVF with frozen donated eggs.
It’s crucial for patients to understand that egg donation treatment is IVF. It’s not a specialised or differentiated form of treatment, the process is the same; eggs are retrieved, fertilised and transferred. The only difference is that the eggs are collected from one woman and the embryo is transferred into another.
Oocyte (egg) donation is an established standard of practice for the treatment of female related infertility and is associated with increased rates of pregnancy success. It would be recommended where women have experienced difficulties in conceiving, when using their own gametes. Egg donation IVF is highly effective in cases of early menopause, low ovarian reserve and inheritable genetic disorders.
In order to achieve a successful outcome from IVF, quality is key. Embryonic health is vital for implantation, but to create healthy and viable embryos, high calibre sperm and eggs are a necessary requirement. It’s therefore imperative that donated oocytes are of good quality.
Donors will usually be healthy women under the age of 35 with proven fertility. Before they can donate, all potential donors must undergo intensive testing and genetic screening. A full medical history is also required.
Becoming a donor isn’t easy. Once approved, donors are required to go through the usual IVF ovarian stimulation regimen, resulting in general anaesthetic for the egg retrieval procedure. Donor safety is paramount, and donors should not be overstimulated. However, as the embryo isn’t being transferred back into the donor’s uterine cavity, some clinics will use more specialised procedures for stimulating donor oocytes, in order to achieve maximum potential.
It’s also important to note that too many eggs can actually lower the overall quality. The question of how many eggs are optimum has not yet been answered, despite being a constant subject of discussion for many assisted reproductive specialists around the world. Dr Sroka advises that, in his opinion, between 15-25 is a good result.
At InviMed all retrieved donated oocytes are frozen. Again, the arguments surrounding fresh versus frozen are rife and, even though Dr Sroka advises better results are usually obtained from fresh oocytes, he believes that frozen eggs are best for donor egg IVF.
Once the eggs are collected, they are immediately frozen and put into quarantine. Even though donors have been checked and tested numerous times before the treatment, it’s not impossible for a fresh, new infection to develop. Freezing and then quarantining the oocytes ensures the eggs are re-checked, meaning an extra safety measure is in place.
The use of frozen eggs also creates more flexibility and reduces the risk of a missed cycle. Synchronising donors and recipients for a fresh transfer is incredibly difficult to accomplish. Extra time may be needed for the donor stimulation or for thickening the recipient’s endometrium, trying to prepare both women simultaneously will not always be successful. Frozen eggs provide a viable workaround option allowing the transfer to go ahead as scheduled.
Donor egg freezing also allows for larger donor pools and therefore lower waiting times. In most countries, it is a legal obligation to match donor and recipient phenotypes (hair and eye colour, build and ethnicity) in order to go ahead with egg donation IVF. Donors can also become ill or resign, which can delay fresh cycles, however, when using frozen eggs, the donor has already been found and the oocytes have already been retrieved; they are ready to be used immediately.
Clients looking into the various egg and/or embryo guarantee schemes should also think around future family planning. Whilst obtaining a decent number of eggs could help to achieve a good number of viable embryos; it’s not a given. Sperm quality can be low, fertility rates differ, and embryonic development is unique for each situation. A guaranteed amount of embryos allows couples the potential to, more easily, create genetic siblings from any subsequent frozen embryo transfers.
Whilst harvesting a good amount of eggs is obviously intrinsic to the IVF process, Dr Sroka once again stresses the importance of quality over quantity. Whilst schemes which offer an assured number of eggs may be promising, they can be misleading as it’s ultimately embryos, not oocytes, which result in a successful pregnancy and live birth outcomes.- Questions and Answers