Fresh and Frozen Embryo Transfer

It is a common perception that fresh embryo transfers are more successful than frozen embryo transfers. The thinking behind this attitude could be that highest quality embryos are transferred during the fresh cycles, while the rest, less viable ones are saved for the future attempts. Another possible issue is  that people do not fully understand what freezing actually means and think that it may affect the embryo quality. As the matter of fact, this way of thinking is not correct.

The belief that fresh embryo transfer has definitely higher success chances than the frozen, is far from accurate.

 

Fresh embryo transfer

Before the cycle, female body should be prepared for the egg retrieval. Ovaries get stimulated in order to produce extra eggs. The medications used for the procedure are not light for the body as they are interfering with the hormones. If the first cycle is not successful or intended parents want more children,  with no frozen embryos in storage, it will be necessary to go through the stimulation and egg retrieval processes once again. Definitely not the best practice.

While the hormone levels are being manipulated with every new retrieval procedure, it is important to also consider that each fresh cycle can cost even up to 10 000 USD, depending on the location and clinic.

 

Frozen embryo transfer

Frozen egg transfer requires preparation too –  the uterine lining has to thicken in order to be ready for receiving the embryo. The medications used for the process are less expensive than the ones used while the retrieval and fresh cycle. Additionally, they are much less demanding of the body.

When the embryo transfer occurs a while after the stimulation and retrieval, female body gets the chance to normalize hormone levels and get back to natural state, which is more suitable for the conception. A lot of researchers argue that this can have a positive effect on baby and reduce the chances of low birth weight and preterm labour.

A lot of intended parents find it very comfortable, not having to worry about the egg production and the repetition of the retrieval procedure. With the frozen eggs in storage, intended parents have the ability to plan the date of their cycle months in advance and prepare for it appropriately.

 

Egg freezing

As medical technologies have advanced a lot, freezing techniques have altered and advanced too. Ultra rapid freezing method results in higher success rates than the slow freezing method that was used back in the days.

Important notice for the intended parents is that freezing does not change or affect an embryo. In fact, embryos are kept from aging and are conserved the way they were before freezing. This is also the hint that the chances of success can not be lower in comparison to fresh embryo transfer.

In terms of success, there are no clear evidences in advantage of fresh or frozen egg cycles, however, the same applies to the disadvantages too.

 

The best practice

In order for the embryo transfer to be most practical, both medically and financially, it would be reasonable to stick to the following route : after the egg retrieval, perform fresh embryo transfer and in case of further cycles, use the frozen ones. Repeated cycles should be planned with the storage of frozen embryos.

Before planning the retrieval and transfer procedures, intended parents should  discuss the action plan with the surrogacy agencies and the donation clinics. It is important to know how they plan the cycles, whether or not they give the opportunity to freeze embryos, which methods they use and how they come in accordance to the best practices of the embryo transfer .

 

Meeting With the Anonymous Egg Donor

Egg donation regulations vary across the countries. According to law, egg donation can be known or anonymous. It may happen during a fertility journey that parents request meeting with the anonymous egg donor. Further, we will discuss whether is it possible and what other alternatives do intended parents have.

It is not hard to understand why intended parents want to meet their egg donor in person. However it is important to take several factors into consideration :

When intended parents request meeting with the anonymous egg donor, the personality of a donor has to be revealed. This step completely opposes the regulation and the idea of an anonymous egg donation, during which the anonymity and privacy of a donor are absolutely untouched. While parents might promise and claim that they respect their donor’s privacy and will not disclose any details from the meeting, it will still come in conflict with the initial agreement and country’s regulation.  

More importantly, in some countries egg donation is possible and allowed only when it is anonymous. The best of surrogacy and egg donation agencies operate accordingly, within the framework of country’s regulation. They do not allow revealing donor’s personal information.  At the same time, agencies will have a database of egg donors which contains all of the essential information for the donation procedure – such as donor’s medical history, medical records, proof of her mental health, information about her appearance – eye color, hair color and etc.

 

When can intended parents meet with the egg donor?

Meeting with an egg donor in person may be of high-priority for some intended parents.  If this is the case, it is essential to consider it before planning the program and choosing the destination. Intended parents will have to choose the country where surrogacy is regulated by the law, is legal and egg donation does not have to be anonymous. When anonymity is not a requirement in the country and donor can be known, intended parents can then get acquainted with her through the personal meeting.

One more factor to remember is that the possibility of known egg donation does not necessarily guarantee it. Egg donor herself might have privacy issues and  have no  desire to expose her identity. Surrogacy and egg donation agencies will first have to clarify this issue and choose the donors from the database,  who do not mind being introduced  to the patients. Intended parents should always consider contacting surrogacy and egg donation agencies first and discussing their priorities and inquiries before actually planning the program.

 

Travelling Egg Donor

When parents need to choose an egg donor, they are first of all, concentrated on her satisfactory health condition. Usually professional agencies guarantee and are responsible for having mentally and physically healthy donors. Additionally, parents pay a lot of attention to appearance and ethnicity – it is natural to be concerned about physical genetic inheritance of your child.

 

It may happen that the desired egg donor is not in the database of the same country, where parents are participating in a program. That’s when they use a travelling egg donor.  Based on experience and in sake of positive outcome, we have decided to share our knowledge with our readers  – what should you take into account before choosing a travelling egg donor?

We have listed several hints for you :

 

  • Donor should not arrive at the destination earlier than 5 or 6 days before the egg collection. Here is why : yes, donor seems good, stimulation has started and everything is in order. However, on the 7-8th day of stimulation it may appear that follicles have not grown sufficiently and the program has to be cancelled. In this case, intended parents have to pay donor a partial fee for the service and cover the costs of medications that were needed during this 7-8 days. If the simulation problem is spotted after donor’s arrival and she has to go back, parents have to pay for the whole package. Of course, nobody needs such a risk. When donor arrives 5 days before the collection procedure, it is already clear by then, that everything is in order and donor is ready for the egg pick up.
  • Make sure that doctors from both countries (program country and donor country) are in touch with each other throughout the whole preparation process. First of all, they will need to exchange all of the important data about the donor. Secondly, in case something goes wrong, both sides will be equally responsible for the consequences and there will be no chaos while figuring out whose fault it was.
  • Don’t feel uncomfortable and require the stamped passport paper of the donor. Parents should be sure that the donor who arrived is the one they have chosen. For analogical reason intended parents can require their egg donor’s hair . Anytime in the future it will be possible to compare it with the DNA of a child. Yes, we know that this sounds weird but the history of egg donation remembers a lot of cases, when donors were changed behind parents’ back (common reason was that the desired donors did not have enough eggs). Parents should insure themselves from such cases, so why not double check? Additionally, this kind of approach will reveal the professionalism of the egg donation agency. Be sure that honest and successful agency will never refuse to fulfill your desire to feel protected from fraud.
  • Make sure that your travelling donor will have a companion, someone who will be able to provide assistance if needed. After the collection procedure as well as during the stimulation, egg donor should not travel alone. Check that your donor is in a well accommodated hotel with a good nutrition included – agencies charge you enough money for this arrangements.

 

Top 3 Egg Donor Agencies

Choosing the right agency is always of the greatest importance.Today we will reveal top 3 egg donor agencies in the world, but first of all, we have to define our “rules”. When we are talking about professional agencies, it’s pretty obvious that most of them have pretty big donor databases and are doing their job successfully. Choosing the best of best of course includes agency’s individual and careful approach towards each of the patients.

 

However, apart from reliability and availability, we decided to add more criterias while choosing the best ones:

 

  • Agency provides not only anonymous, but known donors as well.
  • Agency has travelling egg donors.
  • Agency’s database includes donors from different ethnic groups.

 

Egg donors from the top agencies travel all around the world upon patients’ requests and needs. These agencies have years of experience in handling tasks even abroad and until today maintain a very good reputation among colleagues and intended parents. Moreover, they treat their egg donors with great care and attention, which is also a huge step forward to success.

 

New Life Egg Donor Agency

http://www.newlifeeggdonors.com/

We have granted the honourable top position to this agency, because since 2008 their egg donors have travelled literally all around the world. Their database includes :

  • Ukrainian egg donors
  • Polish egg donors
  • South African egg donors
  • Black African egg donors
  • Chinese egg donors  
  • Thai egg donors
  • Indian egg donors
  • Caucasian egg donors

 

Global Egg Donor Agency

http://www.globaleggdonors.com/

Global Egg Donors may not have such a various choice in Asian donors, but their steadily good reputation and the years of experience with travelling donors indeed deserve our top ranking and appreciation.

 

Nurture

http://www.nurture.co.za/

Nurture egg donor program is doing amazingly well, with great service and responsibility they are always at patient’s disposal. However, their databases only include donors from South Africa and United Kingdom.

 

Reasons of Using an Egg Donor

How should parents know if it is time to start thinking about finding an egg donor? What if it is too early or what if donation is not needed at all? We will try to figure it out.

 

First of all, we have to mention that egg donation has become really successful. Procedures that use fresh embryo (! not frozen) have the likelihood of 43% to result in pregnancy.  A number of couples that want to expend their families have now the possibility to do so.

 

Situations vary. Females may experience fertility issues of several kinds. It is advisable to use an egg donor, when :

 

  • Follicle-stimulating hormone (FSH) level is high

In females, FSH helps to regulate menstrual cycle and produce eggs by ovaries.  Doctors measure the amount of the hormone in a blood sample. High level of FSH may mean the loss of ovarian function, menopause, polycystic ovary syndrome, chromosomal abnormality or the inability of the body to produce good quality eggs for fertilization.

 

  • Luteinizing hormone (LH) level is high

Similar to FSH, LH hormone regulates menstrual cycle and egg production. Doctors measure its amount in a blood or urine sample. Normally, levels of LH and FSH are rising and lowering simultaneously.  High levels of luteinizing hormone may also mean ovarian failure.

 

  • Anti-mullerian hormone (AMH) level is low

AMH is a substance produced by egg sacs, containing immature eggs. Blood test will reflect the remaining egg supply of a female. If the hormone level is low, the ovarian reserve is low accordingly.

 

  • Polycystic ovary syndrome (PCOS)

PCOS is a condition when female hormones are out of balance. We have already discussed this issue and you can read more about polycystic ovary syndrome on our blog.

 

  • Females are over 40

As we have already mentioned several times, age plays one of the major roles in infertility. Females in their 40s usually have high FSH and LH hormone levels, as well as low AMH level. With age, body’s reproductive system is becoming less functional. Females over 43 years tend to use egg donors for better outcomes. Ageing of Europe is also a demographic phenomenon and is characterised by a decrease in fertility. Many couples avoid creating/expanding families until they are 40. Consequently, their chances of reproduction without assistance are decreasing significantly. Same applies for the USA.

 

  • Females have menopause

Menopause is a normal, biological process for females in their 40s or 50s. However, it stops menstrual period permanently and so does it end fertility.

 

  • Mother may transmit a genetic disease

Many couples prefer to use an egg donor in order to prevent transmitting genetic disease to a child.

 

  • Several IVF attempts have failed

As we already said, in vitro fertilization is a process of fertilizing egg with sperm outside the body, in a laboratory dish. After couples have experienced 4 unsuccessful IVF attempts and doctors think the egg quality is poor, then it’s better to consider finding a donor.

 

Egg donation is used widely by LGBT couples. Same sex male couples from all around the world as using the donation  procedure to expend their families and become parents.

 

If couples experience above mentioned issues and doctors have already advised to think about donation, then they got a reasonable motive to do so. However, with the right agency and professionals, there is nothing to worry about 🙂

 

ABC of Egg Donation

In the field of fertility, egg donation is the process when a female donates her eggs to help other women conceive and provide help in reproduction. Not to confuse our readers, we will explain the procedure in the simplest way. The collection of eggs from the donor takes place in clinics and is done through the short surgical procedure. The collected “product” then can be fertilized in the laboratory, using the “in vitro fertilization”(IVF) technique or can be frozen and stored until the later use.

 

Egg donor ⇒ Eggs X Father’s sperm ⇒ Surrogate mother

Egg donor ⇒ Eggs X Father’s sperm ⇒ Mother

Egg donor ⇒ Eggs ⇒ Freezing and keeping until one of processes above needs to occur

 

Parents may consider finding an egg donor for a number of reasons including :

 

  • Eggs of the female partner can not lead to pregnancy (This can happen due to number of fertility issues)
  • Parent is a single male
  • Both parents are males

 

In case of traditional couples, as you have seen in the second scheme, the absence of ability to become a genetic mother does not necessarily mean that a female can not carry a child.  There are a lot of cases when a couple uses egg donation for fertilization but embryo is developed in mother’s uterus.

 

As you may have already noticed, children born with the donation procedure have genetic inheritance from egg donors and for that reason, it is of greatest importance that parents don’t choose the candidates independently. A lot of details need to be taken into consideration and donors are usually found with the help of agencies that own all of the essential data to help parents with the suitable choice. Data we are talking about, apart from appearance, includes proof of mental and physical health. We will discuss the process of choosing egg donors as well as suitable agencies step by step in our later posts.

 

Parents should not be doubted about the motivation of egg donors. Researches have shown that there are two reasons females choose to participate in the reproduction process – Altruism, monetary interest and of course the combination of both. Egg donors have no right to request any kind of information about parents or children and are out of the process once their contribution is compensated. However, it’s parents who may choose to get in touch with donors out of interest, reassuring in their choice or the intention to inform their child about genetics later.

 

However, the process is not as simple as it may seem as laws regulating egg donation vary from country to country. It may be completely restricted in one place, partially regulated in another and somewhat simplified in the third one.  As you have been shortly introduced to egg donation, we now are ready to discuss above described procedures in details.