As we await the news on IVF Spain’s second couple we asked their team to tell us how they find the perfect egg donors.
Women’s role change and their personal and professional development are important achievements in our current society, but it is common that they lead to a delay in motherhood and all the disadvantages it entails. The prevalence of infertility due to late motherhood is gradually increasing and the need to resort to egg donation treatments is becoming ever more commonplace.
Thanks to events like the Fertility Show, in which we participate every year, we have had the chance to meet many couples interested in egg donation as the solution to their fertility issues.
Egg donation is the most requested treatment by international patients in Spain, and especially in our clinic. In IVF Spain we consider the patient the centre of our work and motivation, so we strive every day to offer a useful, evidence-based and high-quality information to them.
We believe that any person or couple that decides to undergo a fertility treatment must have access to clear and accurate information that helps them choose according to their own needs. Therefore, we have decided to dedicate this article to explaining one of the most relevant and doubt-generating aspects of egg donation: the donor selection.
Due to numerous causes (a woman’s age, early menopause, genetic disease, ovarian resection, cancer treatment), the ovaries can lose their ability to produce good quality eggs or any eggs at all. In these cases, egg donation can help achieve pregnancy successfully and safely.
In fact, this treatment consists of a perfected in vitro treatment with the additional difference of using eggs from a donor; the sperm sample can be that of the male partner’s or also a donor’s. Among the treatment’s resulting embryos, and by means of advanced embryo selection techniques, the best embryo will be chosen to be transferred to the patient’s womb. If it implants successfully, a normal pregnancy will follow.
The main appeal of Spain as a destination for a fertility treatment is that it is a global leader in medicine in general, and in assisted reproduction in particular.
Another reason for foreign couples to show interest in Spain is that the donor system here, and our awareness-raising campaigns for the recruitment of donors means very short or no waiting lists, as opposed to the long waiting lists in other countries, especially in the UK.
Another key aspect of egg donation in Spain is that it is totally anonymous. In Spain the patient is not allowed to know the name of the donor, or see her picture and choose according to it, or have access to any information that would make it possible to identify her. The anonymity protection system is made so that the donor is not traceable by anyone except for the donor selection team. Still, the donor’s medical history will always remain in possession of the fertility clinic in question for the biological child to be able to access it in case of ever needing medical attention.
Since the responsibility of choosing the donor lies in the fertility clinics, the Spanish law strongly regulates the donor selection to guarantee the maximum possible phenotypical similarity between the donor and the patients and, of course, excellent health standards.
In IVF Spain we have an excellent egg donation program that relies on a pool of over 500 donors, in which all phenotypes are represented (Caucasian, Nordic, Mediterranean, West Asian, East Asian, etc).
This way we make sure that the donor and the patient share the maximum similarity in their physical traits during the donor selection process.
To be considered as a potential egg donor in Spain women must be within a range of 18-35 years of age. In IVF Spain we accept donors of 18 to 30 years of age.
In accordance with the Spanish law, we perform numerous medical tests to the aspiring donors, the results of which must be excellent in order to accept them as donors. IVF Spain takes the medical study one step further including a psychological evaluation and a genetic study.
The genetic study consists of an in-depth study of the patient’s medical history to evaluate the risk of suffering and/or transmitting hereditary diseases, a chromosome analysis to detect any possible alterations (which would be transmitted to the embryos), and a carrier map able to detect more than 300 monogenic diseases.
In our clinic the donor selection process for a concrete couple starts with a form that the patients complete, which consists of two parts.
On the first part, both patients fill out a questionnaire about the most important aspects of their own physical appearance. On the second part they give a priority number to each trait of a list of 5, which represent important aspects that the donor could share with the patients, including the blood group. For some couples, coinciding blood groups are not important because they plan to tell their future child that he or she was conceived through an egg donation treatment. For other couples the said coincidence is crucial, since they prefer not to share any information about the treatment with the child and maybe even with their families.
The form also has a section for the patients to add any possible personal preferences about the donor. Also, we request the patients to provide us a representative picture of them in which they like themselves and they are reflecting a personal trait that they like about themselves.
We take these pictures into account when choosing the final donor.
As mentioned, the law states that the chosen donor must be as physically similar to the patients as possible. Apart from that, IVF Spain guarantees a match for at least 3 of the 5 traits of the form’s list, although normally a complete match of the 5 traits plus the extras is achieved, thanks to the size and diversity of our donor pool.
IVF Spain works with a custom-made highly-specialised donor selection software that, after we introduce the patients’ data, generates a list of compatible donors in descending order of similarity. The human donor selection team then chooses the best donor among the list’s top 3, considering more subtle characteristics.
The selection is also done according to the donors’ biological availability, that is to say that each donor is ‘rested’ over a number of cycles. This means the collection of high quality and perfectly matured eggs is guaranteed, and we can avoid “overstimulation”, or an excessive pre-stimulation that would lead to the collection of a higher number of lower quality eggs.
In our clinic we advocate for “fresh” fertilisations and embryo transfers, since experimental data have shown a 10% decrease in the pregnancy rate when performing fertilisations with previously cryopreserved eggs or sperm, in comparison with using fresh samples. So, once the donor has been chosen and her availability has been confirmed, the donor’s ovarian stimulation and the patient’s endometrial preparation are synchronised.
This way, patients come to our clinic in Spain twice: the first time for a few hours for the consultation, physical exploration, performing of tests and design of the treatment strategy; and the second time, for around 10 days for the donor’s egg collection and immediate fertilisation with the male patient’s fresh sperm sample, in order to transfer a fresh embryo in blastocyst stage (around 5 days later) to the female patient’s womb.
The donors’ stimulations are performed in the same way and with the same medication as those of our own patients undergoing IVF with their own eggs. They are planned and cared for down to detail, personalised according to each donor’s hormonal response, and conducted so that the eggs’ maturation in each case is optimal.
All the treatment’s steps are taken optimally in accordance with the scientific community’s most advanced and recent knowledge. Thanks to this our success rates are well above the European average and among the highest in the world.
In IVF Spain we are aware of the strong emotional stress caused by going through a fertility treatment that may end up failing. For this reason, in our clinic we develop strategies for each concrete case, offering an individualised attention and personalising each step of the treatment in order to offer the maximum success chance in each cycle.