egg donation (Donor/Recipient)
While the primary indication for egg donation is premature ovarian failure or early menopause, this treatment modality can be recommended to women who mature very poor quality eggs, too few eggs or eggs which are abnormal due to genetic reasons. Prior to advising egg donation, the female partner would have received a stark fertility assessment (see female fertility tests in this web) and perhaps receive one or more IVF treatments with failure to conceive. Menstrual recipients will be asked to perform a baseline ultra sound scan just before ovulation so the status of their uterus is evaluated. Pending their medical history a HyCoSy scan may be advised so that the status of the tubes and the uterine cavity are examined. Further to these, simple tests associated with sexually transmitted diseases and CMV will be requested. Non-menstrual recipients enrolling for egg donation will be advised to undergo a ‘mock cycle’ for endometrial preparation using an estrogen prescription regime hence their uterus can be assessed for its receptivity. The depth and accessibility of the uterus for both menstrual and non menstrual recipients is also evaluated via ultra sound imaging.
Each candidate receives counselling regarding the procedural aspects of the treatment its associated risks and success rates. Regardless that half the genetic material of the embryo is contributed by a third party mother is considered the person who gives birth. Motherhood starts soon following conception and scientific evidence exists to support this. The demand for egg donation today constitutes 20% of all types of assisted reproduction treatments inclusive of conventional IVF. Requests for egg donation have substantially increased over the years and at times outnumber donor availability. Genesis has a dedicated team of accredited professionals who provide continuous support and individualised care to patient/couples. The selection criteria for recruiting a particular egg donor are very strict.
Currently egg donation in Cyprus is anonymous but attempts are made to legalise directed and known egg donation too. Egg donors are recruited on the basis of their age (30 years old or less), proven fertility potential and baseline characteristics. All candidates receive counselling so they are informed with elaborate details the nature of the treatment they pursue. Moreover, they receive a psychological evaluation in view of affirming on the healthy cognitive, emotional, and behavioural pattern of each donor. Following basic clinical examination a donor will receive comprehensive biochemical screening which includes a thorough hormonal profile test (on day 2 of a menstrual cycle) to establish amongst others an understanding on her fertility potential, genetic testing to investigate besides the chromosomal complement (Karyotyping) single gene predispositions such as Cystic Fibrosis (50 mutations), full blood count and sexually transmitted disease testing. An elaborate internal ultra sound scan is finally performed early in the cycle (day 5) so the status of the ovaries is determined. The antral follicular count is assessed and/or the presence of multi-follicular or polycystic ovaries is determined. Mediterranean candidates are also screened for thalassaemia trait while African donors for sickle cell anaemia.
The current legislation limits the age of egg donor recipients to 50, however, there can be some flexibility upon official requests to the Cyprus controlling board of assisted human reproduction. Following an enquiry for a particular donor Genesis will forward a list of potential candidates for review. Genesis has a comprehensive egg bank from which a recipient couple can select their preferred candidate. Egg donation treatment can be undertaken immediately or shortly thereafter.
Whether frozen or fresh, egg donation programs at Genesis secure the same chances for a positive outcome. Egg donation is undertaken most often in the single scheme which means that each recipient will benefit from the whole cohort of eggs harvested from their selected donor.
A minimum of 10 premium quality eggs is guaranteed with surplus embryo freezing always materialising from each treatment cycle. Embryo cryopreservation which may not be possible with shared cycles allows for future frozen embryo replacement treatments, therefore, the prospect for a genetic sibling is very much a possibility. Menstrual recipients pursuing a fresh egg donation cycle are prescribed a synchronisation regimen where they receive endometrial preparation while their donor contemporaneous controlled ovarian stimulation. Both cycles are monitored frequently via ultra sound scan examinations and blood tests. At the time of the egg collection, the recipient’s endometrium should have grown to a satisfactory size (>7 mm) with regular shape and contour.
Endometrial preparation is managed by the administration of simple estrogen supplements in the form of pills and/or patches. On the day of the donors’ egg collection, the recipient’s male partner is requested to produce a fresh semen specimen for the fertilisation process. The recipient herself commences on progesterone supplements so the endometrium is prepared for embryo implantation
Aspirin and at times low dose cortisone is also prescribed during egg donation endometrial preparation treatments. Neither estrogen nor progesterone can be discontinued until later on during the pregnancy and within the first trimester.