Preparing for egg donation

Solvita Funka, MD
Gynaecologist, Reproductologist & Obstetrician at Clinic EGV, Clinic EGV

From this video you will find out:

How to prepare my body and mind for egg donation?
What kind of tests can my partner perform?
Fresh or frozen embryos? Is there a difference?
Selection of the donor. How is the matching process organized?
How can I improve the implantation process?

Preparing for egg donation

How to prepare for IVF treatment using donor eggs?

Dr Solvita Funka, Gynaecologist, Reproductologist & Obstetrician at Clinic EGV, Latvia, has answered patients’ questions on preparing for IVF treatment with donor eggs. Dr Funka explained the egg donation process step-by-step and how the donors are selected and matched with the recipient in Latvia. She also talked about all the necessary tests that need to be undertaken by both the recipient, partner or an egg donor. After this, Dr Funka described that nowadays, there are no differences in success rates in fresh vs. frozen transfers and that a frozen embryo transfer many times is a much better option for some couples, for example, if a couple needs to perform PGT-A, in such situation all embryos need to be frozen. Later on, Dr Funka also informed about the selection process of an egg donor. It is an anonymous and altruistic programme for women or/and couples. Egg donation is one of the most successful methods of infertility treatment, as the egg donors are young and thoroughly screened. It’s possible to know some details about an egg donor, such as age, hair colour, eye colour, weight, height, blood type, education and hobbies.

How to prepare for IVF treatment using donor eggs? - Questions and Answers

How to prepare my body and mind for Egg Donation?

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.

What kind of tests can my partner perform?

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.

Fresh or frozen embryos, is there a difference?

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.

Selection of the donor: how is the matching process organised?

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.

How can I improve the implantation process?

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.

How can we improve the quality of endometrium, the microbiota of the endometrium?

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.

I’m going to have frozen eggs. I have been given a course of tablets. How long do you need to take them for? If you get pregnant, do you need to take those tablets throughout the pregnancy? Some are for menopause, which I found weird.

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.

What is your view re a donor having a corpus luteum that is filled with some yellow liquid? Would this affect the quality or the number of follicles or both? She did a preliminary test which showed this. What do you suggest she should do to get rid of it e.g. should she go on the birth control pill? Any diet change e.g. no white flour, simple carbohydrates, add extra veggies, etc. How quickly can she then do a cycle?

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 .

I am waiting on MRI for possible adenomyosis. How can this impact my chance of getting pregnant and miscarry after a couple of months of taking Lupron?

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.

Should I choose frozen or fresh donor eggs if I have adenomyosis?

There’s no difference.

Could you go through the reason for and against using fresh or frozen eggs?

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.

What medications are required prior to frozen egg donation?

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.

Are there any risk that the donor and receiver or the husband are not compatible? What are the tests to be done to ensure it works? What is the success rate of donor egg cycle for a woman aged 37?

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.

I am using an egg donor in Spain. All information is anonymous. I am worried in case the child doesn’t look like me, although we are using my husband’s sperm and we are having the PGS test done on all 7 embryos. Will this eliminate all genetic conditions and the possibility of miscarriage

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.

When choosing a donor, if the donor has medical conditions like allergies to nuts, eczema, and asthma, should we stay away from these conditions as they could be passed down genetically?

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.

I’m on hormonal therapy medication, how far ahead should I be off medication prior to IVF with egg donation? With regards to hormonal therapy, I’m on Femoston 1 for premature ovarian failure.

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.

What can we, patients, do “at home” to improve the microbiota? Any supplements/ diet? My clinic is not offering the microbiota test of the individual endometrium sample. Ultrasounds are not showing any abnormalities or infections. I have problems with implantation using donor eggs.

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.

Can I use Doxycycline antibiotic or Azithromycin for both in case of infection?

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.

My donor has 3-4 months until I’m ready to travel to the clinic. What medication/ vitamins do you recommend for donors to start taking ahead?

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.

Any supplements?

Lactobacterias for women for flora, if you really want to take any supplements.

What is the more or less percentage to have twins after two embryo transfer from an egg donor? I am 38 after five failed IVF with own eggs.

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.

I have had two failed egg donation cycles, last one in March this year, but I haven’t had a period since, could no periods affect my chances for a third attempt? I am 42.

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.

On the scan my endometrium was triple line 9.7 millimeters thickening. They stated this was good. Would I still need to take the drugs prior to the procedure?

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.

How long before egg donation (I’m recipient) should I be on contraceptive pills? Is it the longer the better? (I have three- four months waiting).

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.

Is it necessary to do a mock cycle to due to small fibroids to test endometrial lining?

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.

How many donor eggs are recommended for implantation in a 46 year old?

I would say the minimum number is 6.

I have Hashimotos. I stopped taking Levothyroxine several months ago because it was making me feel fatigue. My blood tests showed that my thyroid is still unbalanced. My question is should I restart Levothyroxine in order to help with implantation and development of the baby?

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.

My vitamin D level is 63. Is it too high planning treatment in September?

63 is not high, the lowest level of vitamin D is 50, so your levels are good.

Which vitamins should an egg donor take for best quality eggs. Is there anything she should not take?

I have already discussed vitamins and supplements, plus healthy diet: fish, meat, veggies, and maybe vit. D.

In terms of vitamins, what should not she take? Folic acid, iodine, prenatal, etc.

If she wants, she can take. However, the vitamins you mentioned, should be taken by a recipient.

Is there any recommended vitamins for my husband’s sperm?

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.

Do you advise genetic testing on the embryos prior to transfer or genetic testing on the foetus at 9 weeks?

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.

I am 47, I had three failed own egg IVF and one with donor eggs (miscarriage) after 7 weeks. Now I am not having my period and I always have my periods on time, I checked with the high street clear blue, but it’s negative. I should have my periods on the 2nd of June, I tested today, it is ten days late, but still negative. Does it mean I got my menopause and I can’t have a baby anymore?

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.

How many embryos should be implanted in a 46 year old?

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.

My TSH is 3.7. I’ve read that 2 is better for ttc but my GP says she’s not aware. Still waiting to see RE. What do you suggest?

The doctor will help to understand what levels better for you. You need to wait to see your reproductive endocrinologist.

I am 43 in early ovarian failure, I have fibroids one inside the uterus about six centimeters. Does it have to be removed before egg donor IVF?

Yes, definitely. If it’s inside the endometrium level, yes

Is Vitex safe?

It’s supplement, yes, you can use it.

I am considering egg donation, I have low AMH and not many follicles. Is egg donation our best option? Would DHEA help improve my egg quality?

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.

When do you suggest looking into surrogacy if you have failed donor eggs attempts. Also, can the surrogate use donor 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.

Given the anonymous nature of egg donation, can it cause psychological issues for the baby when they grow up?

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.

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Authors

Solvita Funka, MD

Dr Solvita Funka is a gynaecologist, reproductologist and obstetrics specialist at Clinic EGV. She is able to find an individually tailored approach to each patient. She specializes in the treatment of infertility and management of high-risk pregnancies, thus helping many patients diagnosed with infertility to fulfil their dream of parenting. Dr Funka performs also minimally invasive surgeries. Dr Solvita is a Member of ESHRE (European Society of Human Reproduction and Embryology) and she regularly updates her professional knowledge at international workshops and medical congresses all around the world.

Event Moderator

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.

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