Watch the OnlinePatientMeeting with Dr Pavel Otevřel, Fertility Specialist at Reprofit, the Czech Republic, who answered patients’ questions about IVF treatment using donor eggs with PGS testing vs. success rates, cost and time frame.
The decline in fertility corresponds with the loss of eggs as a woman ages. Dr Pavel Otevřel explained that older women in the age group (+40) with age-related fertility decline are the main group of patients where egg donation will be recommended. In this group of patients, egg donation provides the highest chance of pregnancy. Another group of patients is younger women who suffer from an early ovarian failure (POF) or ovarian insufficiency, where their number of eggs and ovarian function are greatly diminished. There are also patients after chemotherapy, previous surgeries where ovaries were removed, a subgroup of patients born without ovaries. The most common syndrome is Turner’s syndrome, and many times, women born without ovaries are afraid that they have no source of estrogen, therefore their chances will be lower. Dr Otevřel ensures that their chances are extremely high, preparing the womb to accept an embryo is quite routinely done. Even if own estrogen is not produced, the outcome in patients with Turner’s syndrome is very promising. Another group of patients that will benefit from egg donation are patients with endometriosis. It is a disease that negatively affects the egg and consecutively embryo quality. Also, patients with repeated IVF failures often are recommended to go through the egg donation route.
Dr Otevřel emphasized that the age of the oocyte is the most important. Spermatozoa are created every 3 months, but a woman is born with a certain number of oocytes, and this is all she has for her entire life. Dr Otevřel compared the egg to a battery. Its energetic supply inside must be strong enough because all energy in the embryo is originated from the egg. The spermatozoa are totally exhausted after penetrating the egg. All energy in the embryo that is needed for implantation originates from the egg. If the egg is strong enough, it is a good start for implantation. The idea of egg donation is simple, we can substitute old batteries with young batteries. The recipient’s age doesn’t matter because we will use a young egg. Also, because the egg is under the negative influence of pollution and negative impacts from our environment. There is a higher risk of a genetic disorder in older eggs than in younger ones. For instance, the risk of Down syndrome being carried in a 25 years old donor is approximately 1:3000. While, in a 35-year-old woman, it’s 1:300.
Dr Otevřel later explained that at his clinic (Reprofit), fresh embryo transfers are performed. Therefore, the cycles of the donor and the recipient have to be synchronized. For this reason, birth control pills or hormone pills to trigger menstruation of both ladies are used on the same day, so it is a crucial moment that allows us to use fresh oocytes for further treatment. Before the synchronization, it is necessary to have time to find a suitable donor. There is no waiting time when it comes to egg donation. However, finding a suitable donor, preparing the synchronization, and endometrium can approximately take up to 3 months, from the decision until the pregnancy test.- Questions and Answers