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Donor Egg IVF with genomic screening



Oregon Reproductive Medicine

Fertility Road is accepting applications until 15 June 2017 for the amazing Fertility Journey – a donor egg IVF cycle with genomic screening – sponsored by Oregon Reproductive Medicine. Learn more about this incredible opportunity and submit your application today.


ORM is including genomic screening as part of its donor egg IVF Fertility Journey. Intended parents may be interested to learn more about the benefits of genomic screening for a donor egg IVF cycle. This screening will encompass three elements that are available to all ORM patients and which combine the clinical expertise of our genetic counsellors with the latest genomic technologies.

Prior to donor selection, we utilise two different but complementary genetic screening strategies: Genetic Family History Evaluation and Genetic Disorder Carrier Screening. Each provides essential information about genetic risks that cannot be uncovered by the other. After embryos are created, Comprehensive Chromosome Screening (CCS) using Next Generation Sequencing (NGS) technology can give us valuable information about the health and viability of the embryos.

Genetic Family History Evaluation All ORM donor applicants complete an extensive family history questionnaire. A stringent set of exclusion criteria are applied to exclude applicants with a significant personal or family history of a number of severe health conditions, birth defects, and mental illness.

While everyone has an increased risk for certain health problems based on their family history, ORM strives to reduce the risk for genetic diseases and serious health problems in donor-conceived offspring. Donors who pass the initial exclusion criteria have a consultation with an ORM in-house certified genetic counsellor to review their family history in detail. Our genetic counsellor obtains a complete three-generation family history and asks follow-up questions to clarify diagnoses, ages of onset, environmental contributors, and potential patterns within the family.

Genetic counsellors are expertly trained to assess family histories for the presence of major genetic diseases, which may go unnoticed in a questionnaire because they may have different features and levels of severity within a family. The genetic counsellor also assesses the presence of common health problems with a familial/ genetic component, such as heart disease, cancer, diabetes, and mental illness. ORM has developed our own donor exclusion criteria by following and expanding upon the American Society of Reproductive Medicine recommendations.

Once a donor applicant has been formally accepted to our program, our genetic counsellor completes a comprehensive Genetic Information and Family Tree (GIFT) summary. This assessment helps intended parents interpret the genetic risks present in a donor’s family history, which may be helpful during their donor selection process. This also provides a record of the donor’s family medical history that can be relied-upon in the future if needed.

A review of over 400 donor applicants to ORM found that consultation with one of our genetic counsellors uncovered new family history information for over 50%of applicants. In many cases the additional information was associated with an increased health risk for the donor’s genetic offspring, and these donors were then excluded from the program. It is important to remember that the vast majority of concerns uncovered by a thorough family history are NOT detected by genetic disorder carrier screening. The comprehensive family history review for donors is a unique part of ORM’s program.

Evaluating a donor’s family history is, however, only half of the equation. Since 50% of a child’s genes come from the paternal line, our genetic counsellors also evaluate the family history of the sperm provider just as thoroughly as the donor This process is improved by sperm providers asking family members about their health, ages of onset of any medical conditions, and causes/ages of any deaths.

Genetic Disorder Carrier Screening Our thousands of genes act as instructions to make proteins, which are the building blocks of how the body functions and how certain traits form. We have two copies of every gene, one from each of the egg and sperm.

“Carriers” of a genetic disorder have one copy that is not working correctly. Because the other is working fine, though, carriers are usually healthy and have no signs of the disorder. However, if the egg and sperm provider are each a carrier for the same mutations, there will be a 25%chance that a baby born of that combination will have that disorder. All ORM donor applicants have expanded genetic carrier screening for > 150 recessive conditions using the Counsyl Family Prep Screen. This occurs before they join the program and this screening is significantly more extensive than the standard practice of many clinics and agencies. It also includes a number of X-linked conditions. It is common to be a carrier of recessive genetic diseases – about 60%of individuals who have the Counsyl Family Prep Screen will be found to be a carrier of at least one condition. Most carriers have no family history of a genetic disease and would only have learned that they are a carrier if a child with the disease was born.

In most instances, women who are carriers of recessive conditions are still eligible to be donors. But having the donor’s results available to intended parents from the start allows them to avoid matching with a donor who is later discovered to be a carrier of the same condition as the sperm provider who is also tested causing the match to be cancelled. Advance carrier screening also reduces the chance of matching with a donor who is later determined to be ineligible due to her carrier screening results. Donor applicants who are carriers of recessive conditions associated with personal health risks to carriers, or of X-linked conditions, are excluded from being ORM donors due to the increased health risks to genetic offspring.

Comprehensive Chromosome Screening
In every IVF cycle embryos are first examined under the microscope in order to select the bestlooking ones. In addition to this visual inspection of the embryos, it is possible to count the number of chromosomes in each embryo. Chromosomes are packages of genes present in every cell of a person. Normally, there are 46 chromosomes (23 pairs) in each cell. Embryos with the correct number of chromosomes have the best potential for implanting and resulting in a successful pregnancy. Abnormalities in chromosome number (extra or missing chromosomes) are the most common cause of failed implantation in IVF cycles and miscarriages.

While chromosome problems are most common in embryos created using the eggs of older women, at ORM we have found that 1 in 3 embryos created from donor eggs (age 21-29) have chromosome abnormalities discovered through CCS. These embryos would not have been able to make a healthy baby. Using CCS to select the best embryos for transfer will in some cases improve the pregnancy rate, decrease the chance of a miscarriage occurring, and reduce the chance that the baby has a chromosomal condition such as Down syndrome. At ORM over 90%of our donor egg IVF patients now choose to do CCS with a frozen embryo transfer. CCS at ORM is performed in our in-house NGS laboratory which is a partnership with CooperGenomics, the global leader in reproductive genetic testing. We look forward to welcoming you to ORM in Portland and to helping you build your family! More information can be found on the ORM Genomics website


Every member of the ORM team is truly honoured to work with our patients to help them grow their families. As part of our Fertility Journey, ORM will help a couple or individual in need of assistance to fulfil their dream of building a family by offering a free donor egg IVF cycle with genomic screening at our world-renown clinic.

The selected recipient couple or individual will match with a fully-screened ORM Donor.

ORM’s Fertility Journey will cover the cost of the donor’s screening, treatment, egg retrieval and medications; the selected couple’s or individual’s pre-cycle testing performed at ORM; IVF process; CCS procedure on the embryos; transfer procedures and related medications. The selected recipient(s) will also benefit from consulting with ORM’s genetic counsellors when matching with an ORM egg donor. Certain costs will be the responsibility of the selected recipient(s). These include egg donor compensation; any legal fees for an egg donor agreement; any donor travel reimbursements; recipient(s)’ travel and accommodation; any precycle testing required on the selected couple not performed at ORM; and local monitoring in the recipient couple or individual’s home location.

ORM’s Fertility Journey is open to couples and individuals of all sexual orientations as well as to those that may need to work with a gestational surrogate. If you wish to apply to work with ORM, please visit CLICK TO APPLY detailing why you would like to be chosen and outlining where you are on your fertility journey at present, to receive an application and full terms and conditions. We welcome applicants of all ages, from all backgrounds, and at any point along their fertility journey – names and supporting information will be passed to ORM for selection. Applications will be accepted until 15 June 2017 and may require certain preselection medical testing.


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IVF Spain Update Us on Claire & David and Laura & Ian Progress



Claire & David IVF Spain

During the first week of August, Claire (42) and David (35), the winners of this year’s Fertility Journey, visited our clinic for their first embryo transfer.

They were pleased to share with us the emotion and joy created by their short stay in Spain;   

“We have spent some time in Alicante ahead of the transfer, relaxing in the area and preparing for our next visit to IVF Spain. Our experience with previous treatments with UK clinics has been very stressful but in Alicante, we have spent most of our time preparing for treatment by relaxing on the beach!”

Claire and David arrives at IVF Spain after having been trying to get pregnant for 7 long years and experienced 3 failed ICSI treatments with their own eggs. IVF Spain discovered that the quality of the embryos was poor and that they had always been transferred on day 3 of their development with a bad morphology. In order to increase their chances of getting pregnant the clinic recommended an egg donation treatment – a fertility treatment which that greatly depends on matching the perfect donor to the patient.

To protect both patients and donors Spanish law requires that the donation process must be completely anonymous.  In addition, donors must be in good condition and younger than 35. Moreover, both donor and patient must share a phenotypical resemblance: hair colour, BMI, eye colour, and so on.

Dr Herea

Claire and David were grateful that so many women in Spain were willing to donate their own eggs, enabling others less fortunate, the chance of forming a family.

“We are really grateful that there are people willing to donate eggs. If we are being honest, it has taken a while for us to understand the Spanish anonymity rules for egg donors, but we have taken the time to consider this. It’s hard not having control or letting another person being in charge for something related to your baby. However, we even think now it is better that way, because the more you know, the more you want to know and we do prefer knowing nothing and leaving it in the clinic’s hands.”

There are other factors, however, that are crucial to achieving a successful pregnancy: the quality of the embryo and the microenvironment of the endometrial lining. This means that a successful pregnancy also depends on the successful communication between the embryo and the endometrial lining.

When we discovered that Claire didn’t have a single positive pregnancy test, we suggested to perform an endometrial biopsy to analyse the retrieved sample by means of the ER Map® test (Endometrial Receptivity Map) and accurately determine the receptivity of Claire’s endometrium during the window of implantation (the moment when the endometrial lining is receptive).

”The test results showed that Claire’s endometrium was post-receptive, meaning that a transfer performed on day 5.5 of progesterone (like in 70% of cases) would not end up in a successful pregnancy” explains Dr Natalia Szlarb.

“Before coming to IVF Spain, we had never heard of an endometrial study or ER Map. The fact that the endometrial study analyses the best time to transfer the embryo could make a big difference to our treatment. We were really impressed with the accuracy of the test. Our ER Map test result was post-receptive and although this was initially a concern, we later came around to the view that knowing the best time to transfer the embryo would increase the chances of success, and this might have been the reason our other treatments in the UK had failed” – Claire and David.

There are other key factors, however, to achieve a pregnancy such as the male factor. David suffers from teratospermia which implies that 96% of the ejaculate sperm cells have an abnormal morphology. Luckily, we were able to improve David’s sperm quality and fertilize the retrieved eggs.

We now wish them the best of luck!

Although it will not be until mid-September when Laura (41) and Ian (44), the 2018 runners-up visit us in Alicante for their embryo transfer, they already talked about the differences between IVF Spain and former clinics. They were impressed at how extensively their case had been studied by our fertility specialists.

Laura and Ian IVF Spain

“I think the longer you have treatment the more difficult it becomes. When you begin there’s a naivety along the lines of, ‘we’ll have one, maybe two goes at IVF and have a baby in our arms’. After 7 treatments (and lots of add-ons) the feelings completely change. You feel terrified that it won’t work, and you’ll never become parents. You’re scared it will work and you’ll lose the baby again (Laura and Ian have experienced 5 losses). You’re scared of physically going through the treatment as you’ve had so much. Each test and treatment creates fear – fear that it will hurt, be traumatizing, that it will give you more bad news. Then there’s the impact on your own mental health and emotional well-being. Can I handle this? What if the results say something’s wrong with me? Will I blame myself? It starts to really damage your mental health and well-being. Financially you start to feel that you’re risking everything, and it may not pay off.

For us we have renewed hope with IVF Spain. We have undergone tests that we’ve never had before (ERA, NK biopsy and KIR). We have paid for lots of very expensive blood tests and drugs but never received this kind of analysis. So, we feel as though the treatment is now specifically for us.

This creates more positivity, a feeling of being cared for and that maybe, just maybe, we’ll get to be parents.

Plus, we’re now using donor eggs. The hope starts to soar and with that comes excitement. Hope is the only thing that keeps you going and overcoming the fears I mentioned. This opportunity with IVF Spain has given us hope that we thought we’d lost.”

Laura is 41 years old and has already been through traumatic losses including an ectopic pregnancy. Due to this and to the fact that Laura suffers from trisomy 22 syndrome, our medical team at IVF Spain recommended an egg donation treatment to increase their chances.

The couple is thankful for the egg donation process being anonymous, as otherwise it would be really difficult to find a donor:

“For us, it’s taken some of the pressure away. I can’t imagine how difficult it would be to choose a donor ourselves. But putting your complete trust into someone else’s hands is hard.

We’ve explored whether it would be better for our future child to know the donor. I think that’s something we’ll never know. But we hope that he/she will understand our decision to choose an anonymous donor. It would be good to know a little more about the heritage of the donor but then we also know that we often don’t even know our own heritage. We’ll make sure Spain is a key part of their story.

It’s also really odd to not know who this person is. What they look like and personality. What’s motivating them to help us. One of the things I’ve been really consumed with is the gratitude you have for this person. I’d like to thank them but can’t.

Anonymity means we have a chance to become parents. Without it there’d be a shortage of donors like there is in the UK. For us, this makes it a wonderful gift – a chance to hopefully find a donor that is perfectly matched to us genetically (due to the KIR tests) as well as in physical looks.

I can’t stop thinking about what our future child will look like – but I think that’s quite normal” says Laura.

Immunologically speaking, finding a matching donor for Laura is certainly a challenging task, which is why IVF Spain suggested that we find out her KIR via a blood test. Ian was also tested for his HLA-C in order to determine whether the maternal – foetal interaction will be optimal or not.

Thanks to the KIR-HLA-C genotyping test it is possible to determine if the uterine KIR and the embryonic HLA-C will both be compatible. If so, the pregnancy will carry on successfully; if not, then the most probable outcome will be an unviable pregnancy and subsequent miscarriage.

“We carried out the KIR-HLA-C genotyping and concluded that the patient had a KIR AA. It is known that KIR expressed by the natural killer cells present in the maternal part and the HLA presented by the trophoblastic cells together will influence the outcome of the pregnancy. With Laura’s KIR AA variant, the sperm would have to be HLA C1 C1 and the HLA of the donor should be as well HLA C1 C1; as her husband has a HLA C1 C2 variant, we will treat her with a medication that reduces her immune-genetic reaction. We believe that not paying attention to this issue in the past is what may have caused the implantation to fail” suspects fertility specialist Dr Isabel Herrera.

We tend to recommend a single embryo transfer, as it has been proven that on patients with an immunological profile such as Laura’s, a double embryo transfers would increase the immunogenetic reaction, hindering the achievement of a pregnancy” says Dr. Herrera.

It is also known that these cases tend to have a higher risk of pre-eclampsia, late spontaneous abortion or miscarriage.

Until their transfer day the couple will try to enjoy summer just as any other couple would;

“I’ve tried to just carry on as normal. Remain healthy, take pre-conception vitamins. Reach out and get support through the Donor Conception Network in the UK and connect with other people going down the DE route via online forums. It’s quite isolating and scary so it’s important to reach out and not feel so alone.

I’m trying to relax a little – not so easy with work but it’s a work in progress. I need to get that bit sorted now treatment is on the horizon.”

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Laura & Ian Fertility Journey Couple 2018



Laura and Ian IVF Spain

Laura and Ian are this year’s Fertility Road Magazine Runner-ups with IVF Spain. During their initial consultation with our specialist Dr. Herrera they were able to clarify all their doubts and were provided with a level of patient care, they had never experienced before throughout their 7-year-long journey. It was a completely different experience for Ian as well; this time he felt like a human being rather than a number.

You can find out more about their fertility journey here.

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Interview with Dimitrius Kavakas from Redia IVF Travel



Redia IVF Travel

While the doctors are busy assessing the couples that have applied for this truly wonderful offer of free treatment at their clinic in Crete we sat down with Dimitrius founder of Redia IVF Travel for a bit of Q&A.

Q: Redia Ltd has been a business consultancy for Fertility Clinics. What made you develop the IVF Travel Portal?

A: It was during my years of experience of trying to communicate with patients on behalf of fertility clinics that I realized what patients really look for. This is not just a treatment but the drive to make their dream come true. So the three main elements that concern patients, particularly in the UK, became our concerns in order to try to bring out solutions for them.

Q: Which are those elements you are talking about?

A: The main element is success. They get into a process that is not easy nor pleasant with the goal of becoming parents. The second element is affordability since they do not know how much they will keep on spending until they reach their goal. This unknown cost is really scary for many fertility patients. Finally, the third element is time. Fertility has a clock and is ticking fast. Being in an NHS waiting time may be detrimental to the patient’s fertility levels.

Q: So what does IVF Travel offer in response to these three elements?

A: What we do is offer multi-cycle refund guarantee IVF programmes so that we can either offer success, in which case the main goal of the patient is achieved at a set price that they know from the beginning, or we refund the cost of the programme up to 100% so as to take away the financial uncertainty from patients. In addition, we do that by offering affordable prices by having our patients travel to other countries where they can have low cost treatment without any waiting time.

Dimitris Kavakas

Q: By offering lower cost than UK clinics do you not discount on quality also?

A: No, in actual fact, our partner clinics offer an equal and sometimes much better quality than UK clinics. What you find in countries such as Spain, Greece and Czech Republic, for example, is that clinics focus more on the individual and each patient feels that they are really taken care of. In addition, most of our partner clinics have lab infrastructures that can only be found in the most expensive UK private clinics.

Q: Do you have a way to screen clinics and ensure quality?

A: It is in our vested interest to do so. You see, we are risking paying refunds back to patients since our business model is like an insurance. We earn more when our patients have quick success. So that is why we make sure that we only work with clinics that deliver high quality of services and results.

Q: You talk about affordability; can you give us an idea of the cost?

A: The cost of the programmes would depend on many factors. One is the individual clinic and country of choice since prices of treatment fluctuate between clinics and between countries. In addition, the success rates of each clinic determine their prices. There is also a risk element that affects prices, so female patient’s age group is also one of the factors. Overall, I would say that on average, the cost of a 3 cycle IVF programme with all medication included as well as methods such as blastocyst culture, ICSI, IMSI, Macs, assisted hatching and embryoscope time lapse, including embryo freezing costs, would be similar or slightly more expensive than a single cycle of IVF at a UK private clinic.

Q: Are there conditions of eligibility to enter the programme?

A: Yes, there are conditions, however, in practice we accept almost 90% of interested patients. There are age conditions regarding the type of treatment and the refund percentage. Women up to 37 years of age can have a 100% refund guarantee. Women between 38 to 39 years old can become eligible but only with 50% refund. From 40 years and over, patients can only get into a 100% refund programme if they enroll in one of our Egg Donation or Embryo Donation programme, which have no age limit. In addition to the age criteria, there are a few basic medical conditions that patients should meet to enter into the programme. We ask for specific screening test which are assessed by our medical experts to evaluate eligibility. If everything is OK, they sign a contract and start treatment.

Q: What if there is a discomfort of patients at a particularly clinic they did the first cycle? Do they have to stick with that clinic for all the cycles of the programme?

A: No, patients have every right to change the clinic they have treatment at between cycles. If the cost of the programme at a clinic they wish to transfer is higher, they would just pay the difference.

Q: Do you offer any payment schedule to help patients with their payments for the treatment?

A: At the moment what we can do is spread the cost of the 50% of the payment over 6 equal monthly installments without any interest. We do ask however for a 50% deposit.

Q: Do you only work with UK patients and where are the most popular country destinations?

A: We work with patients globally, so no, we are not limiting our services to UK patients. Currently we work with clinics in Spain, Greece, Czech Republic, Cyprus, Turkey, India, Malaysia and Mexico. The popularity of a destination depends on the patient origin. UK patients prefer Spain, Greece and Czech Republic mainly, Australian patients prefer Malaysia and North American patients prefer Mexico.

More information on Redia IVF Travel can be found on their website

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