Oocyte donation explained in four simple steps By Inge Kormelink, IVF Spain.
10 day wait would be a breeze. Alas, after a few days the nerves set in and ‘knicker watch’ started. With every stomach twinge I analysed whether it could be a good or a bad sign; as ever, I used Dr Google to somehow get an answer! So my words of advice to prospective donor recipients is expect to go as nuts as you would on your own fresh cycle during the two-week wait! However you do this, it won’t be easy. Unfortunately for us this time, despite the twinges and positivity about the 80 per cent chance of a positive test, our luck was not in and the urine and blood tests came back negative. It should never be underestimated how devastating a negative result is after so much hope, combined with a double whammy of fake hormones going through your body. A good way to describe the feeling after a failed test is of being ‘broken’. It’s tough to find the strength to carry on. After now five failed attempts and the loss of a total of eight beautiful embryos, one could be forgiven for calling it a day. However, we are so lucky to have this amazing opportunity with IVF Spain and Fertility Road so, as they say, what doesn’t kill you makes you stronger - we will brush ourselves off, take a breather for a couple of months and try again in the late summer/early autumn. We have three blastocysts waiting for us and hopefully at least one may be our longed for precious baby. Our thanks go to Emma and Craig for putting this into words, and we’ll be sending positive thoughts their way over the coming weeks and months.
While Emma and Craig continue their journey with us, it’s interesting to look at what goes into egg donor processes. Many women who decide to create their family with the assistance of an egg (oocyte) donor wonder who the donor is as a person, and what physical and psychological characteristics she will transmit to the child. Patients who need an egg donor are unable to use their own eggs and so pass on their own genetic characteristics to the child. It is often difficult for them to imagine carrying or parenting a child with unknown genes. Because of that, infertility patients will go to great lengths to ensure knowledge of their donor’s history by using a donor who is a relative, close friend or a person they trust and view as a family member. However, in many countries the law requires that the egg donor is anonymous. For instance, here in Spain, donation is anonymous and knowing your donor is not an option. Therefore, it is important to find a wellrespected, trustworthy fertility centre that has a proven egg donation programme. It is essential to work with a clinic that provides appropriate screening and genetic testing for all donors, and here is what we believe you should bear in mind: An effective and successful egg donation programme depends on several factors: The availability of donors in the population • The donor’s health (tested for infectious diseases and screened for genetic disorders). The clinic should eliminate applicants who have a family history of ill health or if they have any infectious diseases. • The quality of oocytes – this factor can sometimes be attributed to the egg donor, other times the clinic and sometimes the sperm once fertilisation has occurred. • A donor selection and management programme that will provide the infertility patient with answers to all their questions while maintaining the anonymity of the donor. A strong egg donation programme in Spain, such as at IVF Spain consists of four simple steps: Legal requirements: According to Spanish law, the donor must not only possess similar characteristics to the mother but also the father, ensuring that their future children will have similarities to their parents. Both psychological and medical experts advise parents to tell the child. There are several reasons for this opinion. Firstly, every child has
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the right to know his/her genetic background, particularly since there have been many medical advances in identifying and curing genetically transmitted diseases. Secondly, keeping secrets represents a denial of reality and is likely to cause problems in family relationships. In addition, children’s trust in their parents may be shaken, as they wonder if other secrets have also been kept from them. We believe that children will not love their parents any less; to the contrary, they know that they have been born out of love and the desire to build a family. Their parents have gone through a long fertility journey to create this new life; their child. Phenotype matching This step is known as ‘phenotypic selection’ and is completed by the medical team. The matching is based on blood group and physical characteristics, also known as phenotype, and must be similar to that of the patient’s hair colour, eye colour, skin tone, shape of the face or body mass ratio. Although intelligence is not strictly genetic, many patients feel more secure if the donor can demonstrate a certain level of education or a favourable social and cultural environment. At IVF Spain, these steps will reduce the donor poll from 500 to just two or four. The matching process is done by doctors and the oocyte donation specialist team; in IVF Spain, we have improved this work thanks to a selection of donor algorithms. Genetic matching IVF Spain also offers a revolutionary possibility for parents using egg donors wishing to screen for or at least identify genetic diseases that can be passed on to their child, plus help match donors who share genetic similarities with the mother. This process is known as Recombine Preconception Genetic Testing. This test is used to identify more than 180 monogenic diseases in patients and donors. Matching process We select one donor who fits most closely to the patients and start the oocyte stimulation, synchronised to the recipient’s cycle. This takes place in the same timeframe in which the pregnancy treatment takes place, so that when the patient is ready, there are oocytes available for fertilisation. This phase is very important because the quality of the donor’s treatment will determine the quality of their oocytes and so the quality of the medical team and technician’s work is key at this stage to the success of the treatment.
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