IVF abroad – how to prepare, number of visits, and milestones

Due to enormous interest in fertility treatment options in Europe, we have decided to organise an event focused on the topic of IVF with egg donation at one of the European clinics. Watch the webinar recording above and learn everything you need to know about the process of IVF using donor eggs abroad.

The subject presented was called “The process of egg donation treatment abroad. How to prepare, the number of visits & milestones” – the webinar was given by a fertility expert, Dr Natalia Szlarb.

IVF and donor oocytes abroad

Deciding to use an egg donor can be an overwhelming and daunting prospect, feelings which could be compounded if that treatment is to be given abroad. In this webinar, Dr Natalia Szlarb explains the individual steps, and the unique process of seeking treatment with donated oocytes (eggs), overseas.

In modern times, parenting is being delayed. There are many sociocultural reasons for this, including financial stability, education and career, alongside those who have, sadly, been struggling for years to conceive.

However, these, valid, reasons aside, the problems arise with the fact that whilst societal preferences might be changing, our fertility isn’t, and our bodies are not always in sync with modern lifestyles; oocyte quality and quantity are known to diminish, with age.

Becoming pregnant and creating a family is an emotional journey and, for many of us, can lead to disappointment and heartbreak. With improvements in medical science and procedures, egg donation now offers a pragmatic solution for those experiencing repeated failure to conceive, due to female factor infertility.

Dr Szlarb describes how the percentage of “normal” blastocysts (five-day old embryos), created by IVF, is seen to decrease with the maternal age. However, she goes on to explain how, when donor eggs are used, the pregnancy rates appear to be unaffected by the age of the mother.

How then do potential patients decide whether egg donation, with an overseas clinic, is the best option for them, how does it work, and what is the process?

Before continuing to outline the donor egg procedure, Dr Szlarb advises it’s important to note that the legalities, she mentions, are specific to Spain; differing legislation could apply, depending on where treatment is sought. Spanish law, currently, allows for the anonymity of donor eggs, sperm and embryos, and there is an age limit, of 35 years, for women who donate their eggs. The procedure listed here may also differ, from clinic to clinic.

Dr Szlarb is keen to stress that each fertility journey is unique. She is aware that travelling may feel intimidating and explains how clinics need to consider the individual needs, of each person, who contacts them.

The timescale, for physically being at the clinic, using donated oocytes, would typically be between seven and ten days, allowing time for the collection of eggs, from the donor, fertilisation, embryo monitoring and cultivating to blastocyst (day-five) stage, ending with the embryo transfer.

Following the agreement between patients and clinic to proceed, various medical protocols are, firstly, undertaken, on both clients, including sperm analysis and a “mock embryo transfer”, for the female. Dr Szlarb also advises that if fertility problems persist, even when using donated eggs/oocytes, then endometrium immunology testing might be advised to help the medical team find the best protocol for continuing. Ultimately, the clinic wants each patient’s outcome to be a pregnancy, to term.

As with any cycle of IVF, whether using donor or own oocytes, the objective is to transfer a healthy embryo for implantation.

Clinics, therefore, monitor embryos and look for those which appear to, scientifically, offer higher odds of progressing and developing into pregnancy and live birth. Embryos are monitored by looking at many things, including cell division, appearance and whether there are signs of fragmentation or any anomalies. It’s expected, that after fertilisation has taken place, within 24 hours the impregnated oocyte should begin its first cleavage division, of becoming two cells, and then continue doubling to reach between 100-200 cells, on day five (blastocyst stage).

Four steps in choosing the right egg donor

Obviously, any medical treatment takes place after the donor has been chosen and, in the webinar, Dr Szlarb outlines four steps in choosing the right donor for each individual.

Donors are all screened, physically and psychologically, and are limited to a maximum of six live births, resulting from fertility treatments.

Once patients have decided to venture along the IVF egg donation path, the first step, in selecting a donor, is to look at the basics and legalities; the donor and mother-to-be should have similar phenotypes (observable physical properties), such as eye and hair colour, body shape and ethnicity.
An initial search, of the database, will then take place, using basic phenotype grouping, and will usually result in around 100 options, for consideration.

Clients are also asked to fill in a more specific, phenotype questionnaire, detailing which characteristics are the most important to them, for example, height/body type/education level. The 100 options, from the first search, are then whittled down to around 20 candidates, who match the clients’ individual preferences.

After the in-depth database searches have been completed,  each case is discussed, selecting the best two to four donors to present to the patients. Finally, scheduling and arranging can begin. The selected donors are contacted, one is linked to the parents, and treatment starts.

Choosing whether to use a donor and then seek treatment with a clinic abroad, is an incredibly personal and unique experience. Dr Szlarb believes it is a highly individual patient journey and one which should be undertaken with professionalism and compassion from the chosen clinic.