1. Selection of egg donor
The donor isselected by Ferticentro using strict medical criteria involving testing for genetic diseases and a psychological evaluation. For the selection of the egg donor, the physical characteristics (phenotype) of the patients are also considered.
2. Treatment of the egg donor
The egg donor undergoes ovarian stimulation treatment (administration of subcutaneous hormonal injections) for one to two weeks. Stimulation is controlled by ultrasound scans and blood tests, and the oocyte pickup is done under sedation.
3. Treatment of the receiver
The treatment of the donee is subject to various therapeutic protocols depending upon whether she has mentrual cycles. It is always necessary however to administer medication (tablets and in some cases a single injection at the beginning of the cycle) in addition to having monitoring and evaluation scans.
At this stage of preparation which might include the synchronization of cycles at the same time as donor stimulation (lasting for around 15 days) there is always a close communication between the patient(s) and Ferticentro.
4. IVF / ICSI and embryo transfer
As in IVF / ICSI using a couple’s own sperm and eggs, the oocytes are transferred to culture media in the laboratory after pickup, and then treated and microinjected with one sperm each (i.e., one sperm per egg). The oocytes pass to other culture media, leading to the formation of embryos.
Between two and three days after fertilization, the embryos (usually only two) are transferred to the donee’s’s uterus, so that they implant and lead to pregnancy. The Portuguese law defines that a maximum of two embryos can be transferred, but this is always a clinical decision and each case will have to be individually evaluated. In cases where there are several good embryos, transfer can be done on the fifth day, with no additional cost from the prolonged culture.
The embryos are transferred to the uterus, and no anaesthesia is required. It is recommended that after embryo transfer the receiver should avoid intense physical exercise and, if possible, rest at home for at least 3 days.
If two embryos are transferred it is usual that only one will implant; patients’ must be aware however that ocassionally a multiple pregnancy might occur with two embryos. With this in mind the number of embryos which are transferred will always be based on a clinical decision and will be reviewed against the specific needs of each patient.
5. Embryo cryopreservation
Surplus embryos - those which have not been used in the treatment and are viable - can be frozen and used in a later cycle (in cases where the couple intends to have a second child or if the first attempt fails); may be donated for scientific research; can be donated to another patient(s); or can be destroyed. The couple is responsible for the embryo destination - provided that the conditions laid down by law are respected.