In this webinar, Dr Victoria Walker, a Fertility Specialist at Institut Marques, Barcelona, Spain. Dr Walker has explained what the egg donation procedure looks like in Spain, and also provided the reasons and when it is best to turn to egg donation.
When you’re thinking about when it might be time to go for egg donation, one of the first things you think about is your ovarian reserve. It doesn’t always match your biological age or the way you look. Looking at the graph, we can see that live births are quite steady to the age of 35, but then it starts to slide down. From the age of 35, there are only 10% of the eggs we’re born with, and both the quantity and the quality of the eggs decrease quickly after this age. From 35 years of age, the chances of a miscarriage happening increase quite rapidly. We can diagnose your ovarian reserve with AMH and AFC. AMH is produced by cells in the ovarian follicles, and it doesn’t vary much during the menstrual cycle, however, the AMH can vary quite a lot between populations.
When you should start thinking about egg donation? This option is indicated in women whose eggs do not have the quality to achieve an evolving pregnancy, either due to their age or other circumstances. such as menopause or premature ovarian failure, a condition in which the menopause seems to have started much earlier, typically before the age of 40. This is where your AMH might have gone right down and often you will be making very few eggs, you could have a diminished ovarian reserve meaning that the eggs that you have seem to be of poor quality, and you can be a carrier of a genetic illness that could be passed on to your child, and so you prefer egg donation, you may have a history of IVF failures with your own eggs if you’ve had some kind of treatments for cancer.
When you’re thinking about egg donation, you need to decide whether you want an anonymous donation or a non-anonymous donation. For example, in UK or Ireland, you can do a non-anonymous donation, while in Spain, only an anonymous donation is possible. country for non-anonymous donations. In anonymous donation, the physician will choose the donor according to the physical and psychological characteristics of the recipient, he or she will give the donor physical traits, age, and blood group to the recipients but you won’t see a photograph and a child created will never be able to know the donor even when the child reaches the age of 18.
Female donors must be between the ages of 18 and 35. The medical team guarantees the most suitable donor for each patient, and the matching process takes into account the recipient’s blood group, physical features, eye, hair, and skin colour but also psychological parameters. The donors themselves undergo a psychological assessment and medical check-ups, and blood tests, including their karyotype, which is a test of their chromosomes, and several tests to rule out infectious diseases and others test to rule out the most frequent genetic mutations in the European population. The donor’s family medical history is also reviewed to try to make sure you don’t have anyone with any genetically transmitted illnesses. The donation is an altruistic and anonymous act, and only the medical team who selects the donor will know his or her identity.
Many times, the egg donation cumulative success rate for all the embryos created from one donation cycle is at 91%. It doesn’t mean that each transfer you have will give you a 91% success rate with egg donation, you will get around a 60% success rate per transfer. At Institut Marques, a single embryo is transferred in 90% of all treatment cycles, with a very low twin pregnancy rate of 5%. Single embryo transfers help to avoid many medical risks to the mother and the baby, as well as the possibility of having a twin pregnancy. Twin pregnancies are complicated obstetrically, and once the babies arrive too, therefore, this safety aspect. Embryoscope incubator allows patients to see their embryos in real-time as they develop in the laboratory just before transfer, and that gives you an accurate and live report of your embryo quality. n
The egg donation procedure starts with the donor synchronization directly with the recipient. This allows the recipient to go to the clinic just once for transfer, the sperm sample from the partner can be frozen and then sent from the patient’s country of residence to Spain. Then the female partner will complete all her preparatory tests in her own country, and then the donor is synchronized, and the embryos are created using your partner’s sperm. The female patient can go to Spain for just one day for the embryo transfer to occur into her uterus. If a patient needs an anonymous sperm donor, either for IVF or insemination, the same procedure happens.
Pre-implantation genetic testing (PGT-A) is something that you might have thought about for IVF. It’s principally used in IVF, but it’s also used occasionally in egg donation treatment. The main reasons for doing PGT-A would be to try to exclude embryos with an inherited illness or from patients who have an abnormal karyotype, so they carry abnormal chromosomes. It can also be used in recurrent miscarriages. If there’s a male factor, that’s when it might be used in egg donation because sometimes when you go for egg donation, there may be some male aspect that hasn’t been examined, and so you might want to do genetic testing of the embryos even though egg donation has been completed.
This is a treatment where embryos from healthy people under 35 years of age donate their remaining embryos to the clinic after they’ve completed their own treatments. It’s very similar to adopting a child because you don’t have any link with the gametes that created the embryo, but the recipient has a pregnancy and can rest in the knowledge that the embryo comes from healthy people. Particular groups are interested to use this treatment, it would particularly, be people who are looking at the adoption of a child, people who have chosen not to do any fertility treatment possibly for religious or ethical beliefs, and often women who don’t have a male partner and who are no longer able to use their own eggs may wish to do embryo donation to have a child. Many times, people with very long-term infertility problems are keen to do embryo donation, and also people who’ve had repeated IVF failures, and also patients with recurrent miscarriages. At Institut Marques, the embryo donation program’s success rate is at 57%.- Questions and Answers