In this webinar, Dr Esther Marbán, Gynaecologist & Fertility Specialist at Clinica Tambre, Madrid, Spain has thoroughly explained what egg/sperm donor selection process looks like and what is important to check.
Egg donor selection
Dr Marbán started her presentation by explaining all the steps and criteria that need to be met to become an egg donor in Spain. The first selection criteria for the donors are that they should be up to 30 years old, the minimum height is 1.5 meters, and the maximum Body Mass Index should be 30. The first visit is performed with the nursing team in which an anamnesis will be done, and any medical conditions, as well as familial diseases, will be discarded. The nursing team will explain what the process looks like, and an interview with the psychologist will be done, including a physiological test to discard any psychological diseases or conditions. Later on, some medical tests will be done starting with a general health check in which a complete blood cell count will be included as well as blood type and other blood tests such as serology, then the gynaecological test will be performed in which ultrasound, and AFC (Antral Follicle Count) will be checked, a smear test and vaginal swab to discard an infection. Apart from those general tests, some genetic tests, including a karyotype, will be performed. Other genetic tests include the most common diseases such as cystic fibrosis, X fragile, basic recessive mutation, etc. All donors need to do a Carrier Status Test of more than 300 genetic illnesses to reduce the genetic risk that the patients may have.
Sperm donor selection
Regarding the sperm donors, the selection is almost the same. The first criteria are the age, they have to be 35 years old or under, the minimum height is 1.70 m, and the Body Mass Index is 30. During the first consultation with the andrology team again they check if there are no medical conditions and familial diseases, then the psychologist will do the examinations to discard any psychological problems and some medical tests will be performed. The general health research is the same as in the female donors, but some andrological tests, including sperm count, sperm and urine cultures, and PCR for chlamydia are checked. The genetic evaluation is the same as with the egg donors.
The selection of the donors is always done by the centre to respect anonymity. It is based on different steps, such as physical characteristics, blood type, a special program called Fenomatch, doctor-patient communication, and in some specific cases, immunological matching (KIR HLA) and genetic matching.
Egg donation treatment
One of the most common treatments is egg donation. There are two different parts of the process, the egg donor has to follow all the steps as well as the recipient. As mentioned above, the donors have to be 30 years old or under with no reproductive problems, the psychological assessment is also required. In Spain, the donation is anonymous, but the medical team of the clinic always takes a picture of the donors to use that photo in the future. The egg donor has to be phenotypically matched with the recipient, and then the eggs are retrieved. The cycles are synchronized between the patient and the donor, it’s best to do both treatments at the same time so that the patient doesn’t have to wait for a long time until the donor performs her stimulation. The patients will do an endometrial preparation for the embryo transfer.
Donor sperm treatment
When we’re talking about the idea of treatment with donor sperm, the main indications are: failure of artificial insemination, advanced maternal age, pathology of the fallopian tubes, severe male factor, the need for implantation genetic screening, and this is a treatment suitable for single mothers or same-sex female couples. What about the physical characteristics? At Clinica Tambre, there are more than 2 500 samples stored in the bank respecting very strict security rules, and there is a wide range of phenotypes. There is no waiting list even though almost all the physical characteristics are available. That means the patients will have a greater chance of finding a perfect donor.
The first step of donor selection starts with documents that the patients need to sign. The document includes the patient’s characteristics and consent form of treatment, with a photograph of the patient.
Fenomatch is a facial mating with a scientific tool that uses biometric technology to identify facial point distances. It allows a very accurate selection of the donor regarding concrete facial features. Using a photograph of the patient’s face, the algorithm scans more than 12 000 data points to find the donor with the greatest biometric similarity. This means that the donor-conceived children are more likely to look like their parents. The donor with the highest score and the most suitable one is chosen. The patient receives a report certifying the use of Fenomatch during the selection process.
Take home messages
- There are no ‘good’ or ‘bad’ donors, but compatible donors
- Therefore, not only the physical characteristics are important, but also the compatibility
- Not all the clinics do the same pre-screening of the donors, the patient needs to have all the information about it to make a good selection