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Going solo – all you need to know about single motherhood

Ruth Sánchez, MD
Gynecologist & Obstetrician , UR Vistahermosa

Category:
Advanced Maternal Age, Donor Eggs, Embryo donation, IVF Abroad, Sperm donation

going-solo-single-motherhood-ur-vistahermosa
From this video you will find out:
  • What traits are exposed during the sperm donor selection, and how does it look?
  • What are the differences between IUI and IVF with donor sperm?
  • What is a double donation, and how does it work?
  • What does embryo adoption mean, and how does it work?
  •  What should single mothers consider before starting this journey?

Going solo – all you need to know about single motherhood

During this webinar, Dr Ruth Sánchez, Gynaecologist & Obstetrician at UR Vistahermosa, Alicante, Spain, discussed all aspects of becoming a solo mum, including available options, such as sperm donation, egg donation, embryo donation, etc. and its main challenges.

Solo motherhood

In recent years, there has been an increase in the number of women choosing to become solo mothers. This can be attributed to the modernization of society’s mentality and advancements in assisted reproductive techniques. Typically, these women are between the ages of 35 and 40, well-educated, financially stable, and without partners. They fall within the age range for achieving pregnancy. The Spanish Fertility Society estimates that approximately 1,500 women without partners opt for assisted reproductive techniques each year. However, many women still have doubts and uncertainties about becoming a single parent, as well as concerns about how they will adapt to a society without a father figure.

Having the support of close friends and family who understand their situation is crucial for solo mothers. They provide emotional support and help reconcile work-life balance. Other fears that may arise when considering solo motherhood include personal and economic concerns. In such cases, a strong social support network is vital. Connecting with other mothers who have been through or are going through similar situations can be incredibly helpful. Hearing about their experiences can eliminate barriers and serve as positive examples for others.

When undergoing fertility treatment as a solo mother, it is essential to gather as much information as possible and have all your questions answered. This ensures greater security and confidence throughout the process. Finding a trusted and reliable fertility centre is important. At UR Vistahermosa Center, we understand these needs and the difficult decision-making process that leads women to us. From the beginning, we provide unwavering support and understanding.

Solo motherhood – options

At UR Vistahermosa, there is a sperm bank that allows you to make the best choice of donors through a meticulous selection process. Various reproductive techniques are offered and are tailored to each woman’s circumstances, including emotional and financial considerations. The techniques available for women without a male partner include artificial insemination and in vitro fertilization, both utilizing donor sperm. Additionally, sperm donation or embryo adoption options are available.

Sperm donor selection

One concern often expressed is how a suitable sperm donor is selected. At UR Vistahermosa, they follow stringent selection criteria that surpass legal requirements. Psychological, genetic, and medical evaluations are conducted to confirm the suitability of donor samples. The reproductive unit benefits from having an in-house genetic lab, which enables it to perform genetic studies on donors to identify potential diseases that could be passed on to offspring. Additionally, an artificial intelligence system called Fenomatch is available, which assists in selecting the most compatible donor based on physical and facial characteristics.
Before deciding on the specific technique to use, a series of medical tests to assess the ovarian reserve, uterus and ovaries morphology, and tubal patency are conducted. These tests involve ultrasound and vaginal ultrasound examinations. Based on these results, as well as the patient’s age and medical and family history, the most appropriate technique for each individual is selected.

For treatments involving donor sperm, we recommend genetic testing for recessive diseases in the patient to ensure the best possible match and minimize the risk of genetic disorders in future offspring. This test is conducted through a blood test to determine if the patient is a carrier of any genetic illnesses. If any mutations are detected, we can select a donor accordingly without the same mutation to avoid the risk of transmitting the disease to any offspring.

Assisted Reproductive Techniques (ART) – options

There is intrauterine insemination(IUI) with donor sperm. It involves introducing a concentrated sample of the donor’s sperm into the woman’s uterus, allowing for natural pregnancy inside the fallopian tubes. Among the artificial techniques, this is the most natural option. It doesn’t require anaesthesia or analgesia and is usually performed after a light pharmacological ovarian stimulation.

The next step is in vitro fertilization (IVF) with donor sperm. IVF involves stimulating the ovary to retrieve as many eggs as possible and fertilizing them with the donor’s sperm in the laboratory (in vitro). This allows us to obtain multiple embryos, which are later transferred to the maternal uterus, typically at the blastocyst stage on the fifth day of development. The decision on the number of embryos to transfer (one or two) should be made in agreement between the patient and the doctor, taking into consideration the patient’s age, medical history, and personal situation.

IVF also enables to performance of a genetic diagnosis test called Preimplantation Genetic Test for Aneuploidies (PGT-A), which checks the chromosomal makeup of each embryo and allows to selection of the most suitable one for transfer. This technique is indicated in certain cases, particularly for women of advanced maternal age or those who are carriers of chromosomal alterations. If multiple embryos are available on the 5th day of development, the best quality embryos will be transferred first, with the remaining embryos frozen for future attempts in case the initial transfer doesn’t result in pregnancy or for a second child later on.

Another step is IVF with a double donation, which involves using both donated eggs and donated sperm. This treatment is performed when it is not possible to use the patient’s own eggs, either due to age-related decline in ovarian reserve or when the patient is a carrier of a transmissible disease where the use of their own eggs is not recommended. This technique has the highest success rate as it utilizes donors who are under 35 years old, and undergo thorough screening.

Lastly, there is embryo adoption. This option is available for women who require donated eggs and sperm. Typically, these embryos come from a previous cycle of double donation when surplus embryos have been anonymously donated. The advantage of this technique is that it is less costly than double donation treatment. However, the main disadvantage is that all the embryos are frozen, making the physical matching more challenging as we do not have the option to select the embryos individually. Nonetheless, it is a good option to consider with high success rates.

Conclusions

In conclusion, we must acknowledge that solo motherhood is becoming increasingly prevalent in our society, and fertility centres should provide support and offer responsible results with maximum security.

- Questions and Answers

Can you recommend any sperm banks that you work with?

We have our own sperm bank. In some cases, if we require a donor with very specific characteristics or a different ethnicity, we may have contacts with other sperm banks. Generally, we do not need to rely on external sperm banks, unless there is a specific requirement for a donor of a different ethnicity, such as Asian. In those cases, we explore other options because it can be more challenging to find a suitable donor.

What information can you provide about sperm donors?

In Spain, the law strictly requires sperm donation to be anonymous. Therefore, we cannot provide personal details about the donors. However, we can provide information about their characteristics, such as age, eye and hair colour, weight, height, and educational background. We also provide information about their blood group and any significant illnesses. However, we cannot provide photographs or any additional personal details.

Do you consider women over 40 for treatment?

Personally, I do not consider a woman at 40 or even 50 years old as “old.” However, it’s important to note that the quality of eggs decreases with age. So while a woman may be healthy and have a good lifestyle, the eggs may not be as viable for fertilization. Age is a significant factor when it comes to fertility. Even if a woman is physically fit and healthy at 40 years old, her eggs still have the same age. Unfortunately, with increasing age, more than half of the eggs are genetically altered, and there is no way to prevent this. For women over 40, if their ovarian reserve is good, they can try using their own eggs for in vitro fertilization (IVF). However, the success rates with their own eggs are very low, especially after 42 years of age. At this point, we begin to discuss the option of egg donation, depending on the ovarian reserve. We always recommend genetic testing, such as preimplantation genetic testing for aneuploidy (PGT-A), as more than half of the embryos are likely to have chromosomal abnormalities.

Can a woman around 43 years old undergo IVF with a donor egg?

Yes, it is more probable for women in their early 40s to consider using donor eggs for IVF due to the decrease in egg quality with age. Regarding the frequency of sperm donation, the law in Spain states that a donor can have no more than six births resulting from their donations. Once there have been six successful births, we cannot use any more samples from that particular donor.

How many times can a sperm donor donate?

In Spain, the law states that a donor can donate no more than 6 times. If there are already 6 children born from the same donor, we cannot use their samples anymore due to the legal limit.

Are donated embryos available at the clinic?

Yes, we usually have embryos available for donation. Many of these embryos come from surplus double donations, as our success rates with double donation transfers are high. We have a sufficient number of frozen embryos donated by satisfied patients, which allows us to offer them to those in need.

Is it possible to use donor sperm and insert it into a woman’s egg without necessarily undergoing IVF?

I believe you are referring to intrauterine insemination (IUI) as an alternative to IVF. However, to achieve fertilization, we need to collect the egg and perform in vitro fertilization (IVF) by inserting the sperm into the egg. This is the standard procedure for achieving fertilization outside the body. IUI, on the other hand, involves inserting sperm into the uterus and allowing natural fertilization to occur in the fallopian tubes. IUI is recommended depending on factors such as age and tubal patency, but it is not the preferred option for women over 40, as success rates are generally low at this age.

Do you always recommend trying IUI with medication (Clomid) instead of natural IUI for women over 40?

For women over 40, we usually recommend IVF with medication rather than IUI. In a natural cycle, the success rates are very low. However, if there are no demonstrated infertility issues, IUI can be considered, but the success rates for women over 40 are still very low. We generally advise going directly to IVF for women over 38 years old due to better results.

Any advice for a 34-year-old woman going for her frozen embryo transfer with her last 2 embryos tomorrow of her 1st IVF cycle?

If these are your last 2 frozen embryos, it is likely that you are undergoing endometrial preparation and have been provided with the necessary medications. The specific medication protocol may include anticoagulants or corticosteroids, depending on whether it is a natural or medicated cycle. Follow the instructions given by the professionals and remain hopeful for a successful transfer.

What is the difference between Spain and the UK regarding donors and treatment?

Well, I’m not exactly sure about the situation in the UK with regards to donors, but I believe that in the UK, donation is not anonymous. This is a significant distinction, and I don’t have much information about the differences in the UK. In Spain, donation is always anonymous, and even if the law were to change, the anonymity cannot be altered retroactively. This means that all treatments conducted prior to any potential law change will remain anonymous. In the UK, there are options for both anonymous and non-anonymous donation. When the child turns 18 in the UK, they have the right to access information about the donor. In Spain, this is not possible, and donor information remains anonymous. That’s the main difference.

How long does it take to find an egg donor.

We have a large pool of donors, and usually, we don’t encounter any difficulties in finding a donor. However, if we are specifically looking for certain characteristics or traits, it might take more time. Currently, we don’t have a waiting list for donors.

Can a child conceived using a donor sperm/eggs in Spain find out about their donor at a certain age or for health reasons?

If it’s for a health-related purpose, we advise patients to contact us and provide a report from the child regarding any diseases or diagnoses. We then provide this report to our genetics department to determine if the disease can be genetically carried or if it’s an inheritable condition. In some cases, we have DNA from donors in our bank, and this DNA can be studied to determine if the donor was a carrier of the illness or not. This is a specific and individualized process that takes time.

Despite the anonymity of donors, is it possible to know the ethnic background of donors? Can we request a specific ethnicity?

Yes, it is possible to know the ethnicity of donors, and you can indeed request a specific ethnicity. However, if we don’t have donors with that specific ethnicity, we will inform you that we don’t have a suitable match. While it is not common, sometimes we have patients searching for donors who don’t have a specific ethnicity requirement. In such cases, it is crucial to focus on the quality of the donor rather than specific ethnicity.

Do you have black or half-cast (usually refers to someone of mixed racial heritage) egg donors?

We do have mixed race donors in our donor bank, so it is possible to find black or half-black egg donors.

According to your experience, what are the most important aspects a solo mom should consider when embarking on this adventure?

I believe the most important aspect is to understand that getting pregnant is the more accessible part while raising a child alone is a lifelong commitment and can be challenging. As a solo mom, you must make all the decisions and take on all the responsibilities. Having a good social support system is crucial, and knowing you won’t be alone. It’s not just about wanting a baby; it’s about realizing that this is a lifelong commitment. This decision should not be taken lightly.
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Authors
Ruth Sánchez, MD

Ruth Sánchez, MD

Dr. Ruth Sánchez has been working as a gynecologist at Clinica Vistahermosa since 2000. She has been an attending physician in the Gynecology & Obstetrics Dept. at the General Hospital of Elda (Alicante) and has been treating patients as a Doctor of Medicine and Surgery, at the hospital since 2015. Dr. Sánchez obtained her medical degree from the University of Alicante in 1995. She has published many articles, publications, and delivered many talks at various Congresses on Assisted Reproduction and Gynecology. She is also a member of scientific associations such as the Spanish Association of Gynecology and Obstetrics, Ultrasound Section of the Spanish Society of Gynecology, Valencian Community Association of Gynecology and Obstetrics and Obstetrics and Spanish Fertility Society.
Event Moderator
Caroline Kulczycka

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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