The Clinic of Reproductive Medicine in Russia

Egg donation and ivf

Egg donation and
IVF/ICSI

The largest cryobank and catalogue
of egg donors

fresh and cryo donors
>350


eggs in the cryobank
>1000

What is egg donation

The development of different assisted reproductive technology programs has helped many women to have a long-awaited child. One of them is the IVF program with donor eggs, which is widely used in certain types of infertility and averaging 10% of all the other assisted reproductive technologies.

Principles of the method

The meaning of IVF with donor oocytes lies in the fact that the embryo is cultured in the uterus of the recipient. The Embryo was obtained as a result of the preliminary insemination of a donor egg cell and not recipient's own. This can be done using the sperm of a husband, partner or donor.

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frozen egg donors




The preparation plan for the extraction of the egg cells consists of three stages

Stage I
Includes an interview with the candidate and his examination. During the conversation, emerges information on the processes of pregnancy and childbirth, the acquaintance with the psychiatrist's conclusion about the health of the woman, as well as of the pediatrician from the children's polyclinic about the health of the woman’s children.Also clarified is the information on the infectious diseases and surgical interventions, the profession, the place of work and the presence of occupational hazards, the stance on smoking and the use of alcoholic beverages, sleeping pills and narcotic drugs. After that, general and gynecological examinations are performed, as well as an ultrasound examination of the pelvic organs.
Stage II
Is a general clinical and gynecological laboratory study and fluorography of the chest, medical genetic counseling based on the study of karyotype, as well as an examination for the presence of frequent mutations that cause cystic fibrosis, phenylketonuria, spinal muscular atrophy and adrenogenital syndrome.
Stage III
Examination and conclusions of a therapist about the absence of contraindications to donation and the genetics about the absence of hereditary pathologies.

The IVF protocol with donor eggs exists in two forms:

1. With the use of fresh eggs, obtained immediately as a result of puncture of the donor ovary.

2. With the fertilization of frozen eggs stored in the donor cryobank.

egg donation

In the first case, the standard protocol scheme includes:

  • Conducting preliminary surveys of the recipient and the donor;
  • The equalization of the menstrual cycle of the recipient and the donor, that is, their synchronization, through the use of hormonal means;
  • Obtaining egg cells (oocytes) and their fertilization;
  • Transferring of the resulting embryo into the uterine cavity of the recipient.

The disadvantage of this protocol is the length of the preparatory period, inconvenience for both participants of the protocol, the possibility of its disruption and a higher conducting cost.

The new method of vitrification, or rapid freezing of the eggs, whose survival rate during thawing is 98%, simplified and facilitated the procedure greatly. This protocol includes the following steps:

  • Survey and selection of the donors;
  • Carrying out hormonal stimulation of the donor;
  • Extraction and freezing of the material;
  • Selection of the donor by the recipient through a catalog of donors in the cryobank;
  • Defrosting of the egg cells and fertilization by spermatozoa;
  • Preparation of the future mother and transfer of the embryo into the cavity of her womb.

Both the recipient woman and her partner go through appropriate examinations and checkups.

Preparation for IVF with donor eggs

In cases of the use of fresh oocytes, the donor and recipient are treated at the same time. Preparation scheme:

In order to synchronize the menstrual cycles of the donor and the recipient, they are appointed Oral contraceptive drugs Or GnRH agonists (gonadotropin-releasing hormone),they oppress the menstrual cycle (Buserelin, Decapeptyl, Diphereline);

By means of gonadotropic hormones, menopur, puregon, or gonal-F, ovulation is stimulated in the donor and is followed by an ovulatory dose of hCG (human chorionic gonadotropin) and transvaginal ovarian puncture to obtain the eggs (after their maturity has been diagnostically confirmed;

After the fertilization of the oocytes, laboratory cultivation of the embryos takes place in a test tube, which takes about 5 days;

At the same time the preparation of the mucous membrane of the uterus (endometrium) with progesterone and estradiol preparations (Progesterone, Utrogestan and Progynova)to achieve its thickness of 0.7-1.4 cm, which happens 3 days before transfer of the embryos to the recipient woman;

The implantation of two embryos with the best parameters is performed on the 17th day of the menstrual cycle; Two weeks after the implantation, a pregnancy check is performed;

Continuation of taking progesterone funds before the 14th week of pregnancy.

When frozen oocytes are used, the same stages of preparation are carried out, with the exception of those relating to the donor.

Statistics

IVF using a donor egg for many women and couples may be a difficult decision in the psychological sense. In addition, sometimes it is hard to select a donor which would correspond to the necessary physiological, physical and other parameters.

At the same time, the program with donor oocytes as with the use of own gametal cells, can not provide a 100% guarantee of pregnancy and a successful delivery. For example, the chances of pregnancy using IVF with a donor egg in young women (25-35 years) are significantly higher than at 40 years of age. Therefore, in the first case after the first attempt of IVF, the percentage of successful pregnancy and childbirth is about 40%, whereas in the second case - on average 15%.

Why can I not get pregnant? The success of the first attempt to conduct the procedure in accordance with the statistics is generally 30-40%. There are various reasons for an unsuccessful IVF with a donor cell, which can not always be foreseen and eliminated.

The main ones are:

1
If the age of a woman exceeds 40 years, when there is a gradual decline in the genital functions of the body, and if the partner is 39 years old. In men of this age, a high frequency of significant spermatic fragmentation is observed, which affects the quality of the embryo.
2
Excess weight, which can be not only of nutritional nature (associated with overeating), but also with endocrine pathology - diabetes, hyperprolactinemia, hyperandrogenia, syndrome, or Itsenko-Cushing's disease.
3
Undiagnosed or insufficiently treated chronic Endometritis, from which Adhesions are formed and its structure suffers.
4
The thickness of the endometrium during implantation deviates from the optimal, by 7 to 14 mm. In these cases spontaneous abortions occur very often.
5
The presence of tubal pathology, in particular, Hydrosalpine: The liquid contained in the fallopian tubes can have a toxic effect on the fetus and lead to the fading of pregnancy.
6
Genetic changes of the 9th chromosome, in which one of its parts changes its position to 180 degrees, which is the reason for the disruption of pregnancy or the genetic transformation of an embryo, leading to miscarriage.
7
Pathological changes in the body's immune system, which include:
  • Antigenic tissue compatibility of women and partners, which provokes an attack by the immune bodies against the placenta;
  • Presence in the body of a recipient of antibodies to phospholipids phosphatidylethanolamine and phosphatidylserine which are involved in fixing (implanting) a fertilized egg to the endometrium;
  • The presence of antispermal, as well as antinuclear and anti histone antibodies to the cellular components of the nucleus that provoke the inflammation in the placenta; Antinuclear and anti histone antibodies are the cause of an unsuccessful IVF in half the cases of causes of unknown origin;
  • Excess of the natural embryonic killer recipient (CD56) by 12-18% in the blood or the endometrial content, which contributes to the synthesis of inflammatory cytokines. as well as the high content (more than 10%) and the activation of special cells (CD19 + 5 + cells), which worsen the processes of uterine circulation in the moment of embryo implantation.

In addition, the reasons for the failure of in vitro fertilization may be the non-compliance of a woman and her partner with the doctor's recommendations: sexual intercourse after embryo administration until a positive pregnancy test result is obtained, smoking and drinking alcohol, using various diets to reduce body weight, taking hot baths or visiting a sauna, taking certain medications without consulting a doctor, etc. The use of quality material, careful execution of all the survey points, compliance with all the rules and stages of preparation for performing in vitro fertilization with the donor's egg cell, as well as performing of the procedure by experienced physicians in most cases allows to achieve the desired results.

Physicians:

Lobzeva Diana

Fertility specialist

Fedorenko Ilona

Fertility specialist

Nazarova Alexandra

Obstetrician, Fertility specialist

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