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What are the advances of embryo donation, and when is it indicated?

Halyna Strelko, MD
Co-founder& Leading Reproduction Specialist, IVMED

Category:
Embryo donation

embryo-donation-indications
From this video you will find out:
  • Are there any specific criteria or factors that determine when embryo donation is indicated as a viable option for individuals or couples?
  • How does the process of matching recipients with suitable embryo donors work, and what factors are considered during the selection process?
  • What options are there for individuals or couples who wish to donate their surplus embryos, and what factors should they consider before making this decision?

What are the advances of embryo donation, and when is it indicated?

Dr Halyna Strelko, Co-founder & Leading Reproduction Specialist at IVMED Fertility Center, discussed the latest breakthroughs in embryo donation. Dr Strelko explained when it is indicated and how the procedure is performed.

Embryo donation is a seemingly simple topic that can become complex when considered thoroughly. Patient consultations often bring forth numerous questions that highlight the intricacies of this process. In this discussion, Dr Strelko discussed the critical aspects of embryo donation, addressing frequently asked questions and exploring crucial points related to Next-Generation Sequencing (NGS) testing.

Understanding Embryo Donation

Embryo donation involves multiple parties: donors of sperm and eggs, recipient couples, and potential offspring. The concept extends to potential half-siblings, raising psychological and ethical questions. Legislation varies across countries, affecting the ease and feasibility of such donations. Additionally, there’s a distinction between embryo donation and embryo adoption, the latter involving existing embryos from couples who have completed their fertility journey.

Legal Frameworks and Donor Selection

Legislation on egg and embryo donation varies globally. Understanding the legal landscape of the chosen country is crucial. Embryo sources can range from donor eggs and sperm to embryo adoption. Donor selection involves medical evaluations, and success rates are influenced by this selection. Adequate preparation protocols are also pivotal in determining the overall outcome.

The age limitations for donors and recipients vary across countries. Understanding these age restrictions is vital as exceeding them can impact the feasibility of the process. Moreover, there are specific requirements for donor qualifications, including proven fertility and genetic testing, to ensure the health and well-being of potential offspring.

Genetic Testing and Embryo Quality

Genetic testing of embryos has become a topic of interest. However, recent studies suggest that while genetic testing can mitigate certain risks, it might not significantly impact pregnancy rates. The quality of embryos remains a significant factor in successful implantation and, subsequently, a healthy pregnancy.

Cryopreservation, a method of preserving embryos, has become a standard practice in most clinics. Vitrification, a rapid freezing method, has improved success rates and pregnancy outcomes. Concerns about potential negative impacts, such as increased free radicals and genetic changes, have not been conclusively proven.

Embryo Transfer & Preparation

The method of endometrial preparation for embryo transfer significantly affects pregnancy outcomes. Natural cycle preparation, involving a woman’s own hormones and corpus luteum, has shown better success rates than hormone replacement therapy. Advanced maternal age and specific complications must also be considered in the choice of preparation protocol.

Embryo donation demands a comprehensive understanding of legal, medical, and procedural elements to ensure a successful and ethically sound process.

Conclusion

Embryo donation is a complex process involving legal, medical, and emotional considerations. It is imperative to understand the legal frameworks, select appropriate donors, and consider genetic testing and embryo quality. While cryopreservation and preparation protocols impact the process, success rates remain influenced by multiple factors. Comprehensive awareness and adherence to medical guidelines are crucial for a successful embryo donation journey.

 

- Questions and Answers

Are there any age restrictions for female recipients for embryo transfers?

It depends on the country where you will do the transfer. In most European countries, the age restriction for female recipients is around 50 to 53 years old. In some countries, it’s 50 years old. In some countries, there is no exact restriction, but it’s necessary to have a certificate and agreement confirming your health. This question depends on the country. In Ukraine, we have no such restriction. There’s no specific age mentioned.

What are the pregnancy rates with embryo donation for women over 42?

The pregnancy rate doesn’t show a significant difference in women over 40 with embryo donation. It depends more on endometrial quality and receptivity. The probability of pregnancy is mostly the same at 40 years old and 45, slightly lower after 46 or 47 years old. The pregnancy rate relates more to egg quality than age. With embryo donation, egg quality should be good because those are donated eggs.

Are donated embryos genetically tested?

It depends. Embryos may or may not be genetically tested. If it’s embryo adoption, embryos from patients who haven’t given birth yet might be genetically tested, but it’s not a strict rule. This question should be discussed with your doctor. If you’re doing egg donation with sperm donation, genetic testing can be considered. However, for donors under 38 years old, genetic testing of embryos might not bring significant benefits.  

How necessary is the HLA-C receptor test for egg donation with husband’s sperm?

About 10 years ago, there was a lot of interest in these tests, claiming to help with repeated implantation failure. However, recent publications suggest insufficient data to support the test’s effectiveness. In cases of egg donation, it might not be very helpful, as changing the donor would change the HLA receptor expression.

I’m 41 and had 7 unsuccessful cycles. What can I do to prepare for a frozen embryo transfer?

n your case, it’s complex due to multiple unsuccessful transfers. A natural protocol might be beneficial. It involves measuring follicle growth, adding estrogens if needed, triggering with ACG, and starting progesterone after follicle size reaches 18 millimeters. A double transfer might be interesting, and genetic tests like Emma error can show chronic endometriosis. The implantation window isn’t exact and can vary between cycles.

What type of psychological therapy do you recommend for egg donation recipients?

Psychological support varies based on patient needs. Accepting egg donation can be challenging for some due to fears of not connecting with the baby. Others worry about donors searching for their children. There’s no single protocol, and it needs to be individualized.

I had many failed transfers with my embryos. What’s the preparation for a natural embryo transfer?

From a gynaecological and psychological perspective, stress might impact implantation. Techniques like yoga, reflexology therapy, or herbal therapy could help. Some propose self-gynaecological massage. Different approaches are available to improve relaxation, blood circulation, and implantation chances. It depends on your preference and situation.
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Authors
Halyna Strelko, MD

Halyna Strelko, MD

Dr Halyna Strelko is the Co-founder & Leading Reproduction Specialist at IVMED Fertility Center, Kiev, Ukraine since 2012. Dr Strelko is a certified member of ESHRE (European Society of Human Reproduction and Embryology) and ASRM (American Society of Reproductive Medicine), UARM (Ukrainian Association of Reproductive Medicine). She had a medical practice in France and medical practice in leading Kyiv’s infertility clinics with over 23 years of experience. She speaks English, French and Italian.
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.