Dr. Solvita Funka, Gynaecologist, Reproductologist & Obstetrician at Clinic EGV, is answering patients’ questions on preparing for IVF treatment with donor eggs.
It’s very important to think not just about technical things which doctor will choose for you, but it’s always necessary to think about what I can do and improve by myself to increase possibilities of becoming a mother. When we are talking about the body, it means a lot of physical activity, healthy eating, no smoking and no drinking alcohol. If we are talking about the mind, the psychological state is very important. Women sometimes need psychological help provided by a specialist, family doctor or even a friend. However, in many cases you will need to choose a doctor. To prepare the mind for the procedures, which you will have in the near future, women shouldn’t be afraid to talk to the professionals about their concerns, not just with the gynecologist, whom they will see in the clinic where they will visit.
If we are talking about the partners, at the beginning they need to at least a spermogram. The spermogram has additional tests, such as HBA tests, DNA fragmentation tests, tests that can help embryological doctors to choose the right way how to work with the sperm, and for the assisted reproductive doctor to choose what kind of treatment to perform. And then he can do a test for infection diseases like STD, infection diseases from the blood like hepatitis C, HIV, syphilis. Those are the tests that need to be done, I think all over the world, before IVF treatments.
At the moment, in the whole world vitrification is used in the embryo freeze process. It’s a very fast technique that freezes embryos almost immediately. However, there is no difference between a fresh or a frozen embryo at all. At the moment the techniques are really precise, and if we’re talking about the results, they will be the same for fresh or frozen transfers. And sometimes it’s better to choose the frozen embryo for the transfer.
It varies from country to country, because of the law and anonymity of donors. In case of non anonymous donation, you know how you donor are and how they look. For example, in our country egg donation is anonymous. That means the patient will know about the donor’s age, height, weight, blood type and group. For example, if you want some special features in your donors; e.g. to be a musician, then we know our donors and we can try to match those things as well. But it’s not always possible. We also need to match other things such your menstrual cycle with the donor’s menstrual cycle, and others.
That will happen in a situation when doctor already knows their patient, have talked with them, seen the patient’s ultrasound, maybe the doctor has performed a hysteroscopy or laparoscopy or other kinds of investigations to be sure that everything is clear and good. For example, using the test like endometrium receptivity test, it will help to know what’s the exact date when we need to put the embryo inside the womb. And there’s a lot of other things we can propose for every patient when we know each individual situation.
If we are talking about the endometrium, then it’s a very common thing. if you are from UK that I guess the ultrasound in UK is done by the technicians. For example, here in Latvia e.g. in our clinic we look at the endometrium completely differently. Sometimes we can see the polyps or stretch marks inside the endometrium, or any other issues that should be solved before the embryo transfer. If we’re talking about the micro biota, then we perform e.g. hysteroscopy. We take the sample from there for the micro biota. It sometimes might be an infection that could affect the embryo transfer. Before the procedures we need to know what’s going on in your womb.
If it’s a progesterone and estrogen that’s not weird, it’s a normal thing that means there might be some problems with your endometrium that is not growing well or your cycle is not regular. It depends on the individual situation of the patient. It’s not weird, it means your doctor tries to help your endometrium to be ready for the embryo transfer. And aspirin will improve the blood supply before the embryo transfer.
The corpus luteum is a normal thing for any woman every month that means she did the ultrasound after the ovulation. When she visits the doctor to do the ultrasound after her menstrual cycle, the corpus luteum might already disappear, and she can start the cycle. In some cases we choose the birth control pill as well to be sure there will be no ovulation forwards. Healthy diet is always very helpful .
If we are talking about the adenomyosis, then the question if you have myomas as well or just adenomyosis, and if you have endometriosis somewhere else as well. The adenomyosis is actually one kind of the endometriosis as well that means that endometrium cells are inside your muscular part of the uterus. The medication you are asking about could help you become pregnant.
There’s no difference.
It depends on the individual patient’s situation. I need to know more details about your situation to answer which scenario will be best for you. If we are talking about frozen eggs, it’s much easier. You don’t need to wait till the donor will have a cycle, so you can have the procedure earlier. E.g. if you are 47, you need to get pregnant as fast as possible. If you are 25 years old, and you have no tubes and some additional issues that impact why you have not your oocytes, then your time is not so limited. It also depends on other issues, such as your blood pressure, diabetes, endometrium, myoma, and so on. If you do not have any other problems, and we’re talking about fresh eggs or frozen eggs, the opinion of your doctor is also very important. For example, Spain is the country where the highest number of doctors work with frozen eggs. But I would say the results would be the same.
It could be different medications and depends on the individual situation. It could be just estrogens and then progesterones, it could be the gonadotropin releasing hormones to stop your menstrual period, and just then start the estrogens and progesterones. It can be also additional medicines such as Aspirin or Fraxiprin.
Success rates vary depending on diagnosis and each individual case. In our clinic our success rate is 56% after the first cycle. If we are talking about compatibility, you will never know whether it will work. It will depend on eggs, spermatozoa as well, because there are two cells, not just the one, that form the embryo. And then will be you, the carrier of the embryo, so there are a few sides that are involved in the final result.
It won’t eliminate the possibility of miscarriage. There are various reasons why you can’t get pregnant. Even if all 7 embryos are healthy or not, it does not mean you will get pregnant. If you are worried about that child doesn’t look like you, I can explain how we work. In our country the program is anonymous as well, our doctors or coordinators see your features, and then we match the donor. So, you can be sure if you get pregnant, then the baby will have your DNA as well. Till now I haven’t seen such a case where baby is completely different.
Nowadays, during COVID- 19 people use a lot of soaps and liquids that kill bacteria which is normal for our skin, and sometimes those allergies are related to very clean environment, while others might be related to family situation. I am not sure that choosing a donor without any kind of allergies will mean that your kid will not have any allergies in their life.
You can use it until your doctor is able to start with your cycle. That means you are using the Thermostone and then the doctor will change those medications for those he will use before the embryo transfer.
The question is why you think you are having any problems with endometrium. The second point – if you eat healthy and do not have any infections, then I would say there is no problem with your endometrium. Have you done a test for endometrium receptivity? If you have not done, I would recommend it.
If you are taking those medications just before the embryo transfer, you have some infections, then I guess yes, because you sometimes need to treat something with something. For example, the Doxycycline wouldn’t be very good for a man before IVF cycle.
In my opinion, if a woman eats healthy, does not smoke and drink, eats veggies, meat and fish, and her diet is varied, then I would say just vit D and maybe folic acid. There’s no need for additional synthetic vitamins.
Lactobacterias for women for flora, if you really want to take any supplements.
I can’t say any numbers that vary from clinic to clinic. There is a possibility you will have twins, but at the same time you can have twins from one embryo. I would say, as always, 50/50. But in most situations women do not have twins.
It depends of the situation, the endometrium, the situation of the womb. I would say that if you are planning to cycle again, there is one possibility to start the treatment is to take the hormonal replacement therapy to have periods.
The question is if your endometrium is 9.7 at the moment, for example, five days after they had done the transfer, then it’s good. But there are some differences how the doctor is preparing your yolk before the embryo transfer. Doctors usually prescribe to take drugs and then they perform the transfer. Other situation is when doctors perform the transfer during your natural cycle, and anyway you will have additional ultrasound before the embryo transfer and doctor will decide will you need to take medications, which kind and how long.
It depends. For example, if you are a patient with one period per year, taking contraceptive pills is a wise plan. But again, your doctor can help, as he knows your situation. There could be more additional reasons why you need them.
A doctor needs to know that your endometrium is good and it can sometimes help to predict the amount of medications which you need before the embryo transfer to be sure that your endometrium will be good.
I would say the minimum number is 6.
In this case I would say you need to develop a good communication with your endocrinologist because you will need to have those medications, anyway. And if you feel fatigue, then dosage might need to be changed. I would recommend seeing your endocrinologist to discuss your plans.
63 is not high, the lowest level of vitamin D is 50, so your levels are good.
I have already discussed vitamins and supplements, plus healthy diet: fish, meat, veggies, and maybe vit. D.
If she wants, she can take. However, the vitamins you mentioned, should be taken by a recipient.
Medications vary from country to country. There are good supplements for men, but before taking any supplements you need to know whether he needs to take them. Oxidative sperm test shows if your husband needs any vitamins.
It depends on the situation. If there are any genetic diseases in your or your husband’s family, you are 40+ or have any genetic issues, then yes. From 11th to 13th week of pregnancy, there is a screening program that includes ultrasound and tests that can say if everything OK with your baby. If someone from your family has cystic fibrosis, then definitely, yes.
There are a lot of tests to be done to say that you are having some problems with your hormones that you might have as you are 47. We can talk about the menopause if you do not have periods during a year. Now you are premenopausal, you need to visit your doctor and do some tests.
If you are 25, 35, 38, 39 or 45 I would say one embryo because we choose two embryos for patients with previous clinical problems or with other conditions, when we need to do that. In case of two embryos (twin pregnancy) you might have problems during your pregnancy. If you are not in the situation when you need two embryos, I would say one.
The doctor will help to understand what levels better for you. You need to wait to see your reproductive endocrinologist.
Yes, definitely. If it’s inside the endometrium level, yes
It’s supplement, yes, you can use it.
Sometimes when your AMH is low, your doctor can use hormonal replacement therapy for a while (one or two months), and vitamin D, zinc and selenium, and fish oil, prior to your cycle. If AMH is low, then the donor egg program is definitely for you. Or the second option is you can do your cycle and take additional eggs.
In our country the surrogacy is not allowed, but for a surrogate mother there’s no difference. I think, in most situations the surrogate mother carries your embryo.
In my opinion it will depend on you, as parents, and your baby psychological health. If you talk with your kid and explain how you became a mother, how it happened, etc. then I guess your baby will have no problems.