Treatment with donor eggs (IVF / ICSI)
 
Where, for medical reasons, treatment with the oocytes and sperm of the couple is not possible (because they are not produced or there is not enough for use in the treatment or there is a risk of transmitting genetic disorders), the only solution for the couple to achieve its desire to have children is through the use of donor gametes or transfer of embryos donated by another couple. In such circumstances the donation process is anonymous and completely confidential and there is a set of procedures to ensure the whole treatment is done according to the strictest standards of quality and safety, according to the requirements set by the National Council of Medically Assisted Procreation (the Portuguese equivalent to the UK’s Human Fertilisation and Embryology Authority) and also to standards and recommendations for good internationally accepted medical practice.

 

IVF / ICSI with donated oocytes ler mais

IVF/ICSI with oocyte donation is a treatment that allows women with ovarian failure (premature or age-related), poor oocyte quality or certain genetic diseases to fulfill their dream of getting pregnant and becoming mothers.
In these situations the selection of the donor is made considering the physical characteristics of the receptor couple (race, blood group, height, weight and skin, eyes and hair colour). All donors are subjected to very strict process of selection and prior exclusion of genetic diseases.
The donated eggs are fertilized with the couple’s male partner sperm, thus allowing for the creation of embryos. These embryos (usually two, sometimes just one, exceptionally three) are transferred to the receptor’s uterus. Surplus embryos can be frozen and used in a later treatment, should the couple want to.
At Ferticentro this treatment is performed in synchronised cycles - the stimulation of the donor’s ovaries is taken while preparing the womb of the recipient to receive the embryos, always with complete assurance of privacy and anonymity throughout the process. Sometimes the treatment can also be done with frozen oocytes, since in recent years the developments of the oocyte vitrification techniques have allowed significant improvements, which made the American Society for Reproductive Medicine issue the following statement: “There is good evidence that fertilization and pregnancy rates are similar to IVF/ICSI with fresh oocytes when vitrified/warmed oocytes are used as part of IVF/ICSI for young women. Although data are limited, no increase in chromosomal abnormalities, birth defects, and developmental deficits has been reported in the offspring born from cryopreserved oocytes when compared to pregnancies from conventional IVF/ICSI and the general population. Evidence indicates that oocyte vitrification and warming should no longer be considered experimental”. The original document with these practice guidelines can be downloaded here . The use of vitrified oocytes allows better cycle programing, and an increased number of available oocytes (at least 6 in regular cycles).

The receptor’s treatment (the endometrium preparation to receive the embryos) can be done according to several protocols that essentially vary according to whether the woman still has menstrual cycles or not. It’s always necessary to use some drugs (tablets and in some cases a single intra-muscular injection in the beginning of the treatment) and ultrasound scans, in order to check if the endometrium (which is the tissue that coats the uterus) is already thick enough to allow for the implantation of the embryos.
This preparation stage usually lasts 15-20 days, during which Ferticentro will always be in contact with the patients, in order to properly coordinate the endometrium preparation process with the donor’s oocyte pick-up procedure and embryo culture.
Once obtained, the embryos (normally just two) are transferred into the woman’s uterus so they can implant and originate a pregnancy.
Usually the embryos are transferred 2, 3 or 5 days after fertilization, with no extra costs to the couple if extended culture is required.
A few days before the transfer, the receptor starts to take progesterone (vaginal tablets or gel) to prepare the endometrium for a successful embryo implantation.
The high costs of IVF/ICSI with oocyte donation are due to the fact that two treatments are done simultaneously, to the receptor and the donor. Also, to become egg donors all volunteers have to be submitted to a very thorough selection process, with multiple clinical analyses and medical exams. Besides, although egg donation is an altruistic process, the Portuguese law states that oocyte donors should receive a monetary compensation covering expenses directly related to it (628,83€, as currently defined by law).

Unlike what happens in the UK, in Portugal all oocyte donors are anonymous, as defined by law. At Ferticentro we don’t have waiting lists for oocyte donation treatments and our donors are essentially students or newly graduated young women from the University of Coimbra. In Coimbra we have a fantastic university community with more than 20.000 students and some very high-tech research institutes, in whose activities there are thousands of potential oocyte donors.

When is IVF/ICSI with egg donation recommended? ler mais

IVF/ICSI with egg donation is specially indicated in these situations:

> Primary ovarian failure;
> Gonadal dysgenesis;
> Repeated failure of IVF/ICSI (implantation failure after several attempts, repeated fertilization failure after ICSI);
> Age of women over 43 years;
> Diminished Ovarian reserve;
> Hereditary diseases (diseases related to chromosome X, recessive autosomal diseases, chromosome translocations).

Adverse reactions to treatment ler mais

Like any medical treatment, IVF / ICSI with oocyte donation can cause adverse reactions, which however are not very usual and when they arise typically moderate and transient in nature. Although couples at Ferticentro are closely monitored by their doctor (who is always available by phone) and all procedures are done according to the most strict and internationally accepted safety criteria, it’s important that our patients are aware that less pleasant situations, although highly unlikely, can also occur, since these are also part of Medicine.
Adverse reactions to drugs used in IVF/ICSI cycles with oocyte donation are not very common and are generally mild. The most frequent symptoms include hot flashes, irritability, fatigue and headaches. Generally, they pass after a while, with no reasons to concern.
If these side effects persist or worsen you should contact your Ferticentro doctor.
IVF / ICSI with oocyte donation is an extremely safe procedure for the recipient couple.

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