How Does IVF with Egg Donation Work?

• Advanced age where the patient no longer has a viable oocyte reserve. This would include women who are menopausal or perimenopausal.
• Premature ovarian failure where the patient loses her fertility potential prematurely before the age of 40 (You can read more about premature ovarian failure and the possibility of receiving ovarian PRP treatment on the following link: Ovarian PRP Treatment for Premature Ovarian Failure).
• Loss of ovaries or ovarian function as a result of chemotherapy/surgery/accident or not having ovaries for other congenital reasons.
• Several IVF failures with own oocytes which may point to a genetic problem with the oocytes (In such cases, pre-implantation genetic testing can prove useful in determining possible genetic causes such as chromosomal aneuploidies, translocations, etc. that may be that cause of IVF failures or even recurrent miscarriages).
• Cases where the patient may not be happy with her own genetic background or physical appearance and may opt for using donor eggs with a different background.
• Male gay couples who would like to have a biological child of their own via gestational surrogacy will also require donor eggs for creating their embryos (This current post will only contain information on organizing an IVF cycle using donor eggs. However, you can use the following link to read more about our same-sex surrogacy program).

A number of steps are involved in organizing an egg donation IVF program. There are three people involved in such IVF cycles:

1- An egg donor: This is the egg donor whose eggs will be used during the IVF cycle.

2- The sperm provider: This is the person who provides his sperm sample in order to create the embryos for conception.

3- The carrier: This is the person who will carry the pregnancy and deliver the baby resulting from the IVF program.

In a traditional couple with a male and a female partner; the female partner would be the carrier, the male partner would be the sperm provider and they would use an egg donor in order to conceive. Before a treatment is organized, a number of pre-treatment stages are to be observed:

Stage 1: Assessment

An effective assessment of the female patient is required in her fitness to carry a pregnancy. Even though young and healthy donor eggs are being used during the IVF cycle, we need to ensure there are no uterine pathologies or hormonal imbalances which may interfere with a successful pregnancy. These would include:

– A trans-vaginal ultrasound scan of the uterus to screen for possible pathologies such as polyps, fibroids or any other issues. If the female patient still has menstrual cycles, the scan needs to be performed on day 2 or day 3 of the menstrual period. This is because early days of the menstrual cycle will give us information about the baseline conditions. If there are no menstrual cycles, then the timing of the ultrasound scan will not make any difference.

– If the female patient still has menstrual cycles, on the same day as the ultrasound scan, we also ask for the following hormonal assessment:

FSH
LH
Estradiol
Prolactin
TSH
AMH

These tests are performed in order to identify the most appropriate protocol to be used during the IVF treatment. If the patient no longer has menstrual cycles, then Prolactin, Estradiol and TSH tests are the only ones that will be required.

At this point, a semen analysis report from the male patient is also asked in order to make an assessment of the semen parameters.

Stage 2: Donor Matching

At this point, we will have agreed that donor egg IVF treatment is a suitable treatment option and that there are no identifiable pathologies that are likely to interfere with the process. We will be able to provide you with a donor form where you can specify certain features that you would like to see in your egg donor.

Given that egg donation in Northern Cyprus needs to be anonymous, we cannot share an egg donor’s personal contact information or her pictures with the recipients. However, we can share certain information such as physical features, occupation, hobbies etc. If you would like to use a known egg donor, you can work with an egg donor agency where you can organize your own egg donor independent from our hospital.

Once a suitable egg donor is identified, then we can proceed with the preparation period.

Stage 3: Preparation

Preparation for your egg donor would mean controlled ovarian hyperstimulation so that she produces multiple good quality eggs for the cycle. She will receive medication to stimulate her ovaries during this period.

For the female patient, preparation would mean preparing her endometrium for a successful embryo transfer. This would entail using estrogen and progesterone supplementations in order to mimic a natural endometrial cycle in preparation for pregnancy.

If the female patient has menstrual cycles, we will attempt to synchronize the cycles of the two women so that we can use fresh oocytes once they are retrieved. If the female patient no longer has menstrual cycles, we will use the egg donor’s menstrual period dates as a reference point.

If cycle synchronization is not possible and the patients do not wish to delay their treatment until a synchronization is achieved, the egg donor is cycled first and the male partner is asked to be present on the day of egg collection to provide his sperm sample. That way, fresh oocytes are fertilized with the male partner’s sperm sample and once the embryos reach a certain developmental milestone, they are frozen until the female partner is ready to receive them.

Stage 4: Arrival in Cyprus

We can organize so that the initial medication usage can take place locally in your hometown and you can be monitored remotely via satellite scan/test centers. Ideally, around day 13/14 of your medication use, you will be expected to arrive in Cyprus for your first consultation and the subsequent procedures of donor’s egg collection, providing a sperm sample and eventually the embryo transfer.

If the female patient is over the age of 45, then additional testing will be required. This is a requirement set forth by the ministry of health in Northern Cyprus:

An ECG test
Kidney and Liver function testing
An Echocardiogram
An internist examination

These tests are usually organized by your patient coordinator while you are in Cyprus and can be completed within a couple of hours in a single appointment at our hospital.

The following schedule is an example of how your treatment will be organized:

Day 21 of menstrual cycle– Down-regulation begins (Only for patients with regular menstrual cycles)

Day 2 of the following cycle– A scan and hormonal assessment, followed by estrogen supplementation. Estrogen supplementation is to be continued until the 12th week of pregnancy. If the female patient no longer has menstrual cycles, her egg donor’s menstrual cycle dates are used for reference.

Day 12 of the cycle– Possibility of adding prophylactic medication depending on previous assessment (antibiotics/ immunosuppression, etc.)

Day 13/14 of the cycle – Arrival in Cyprus and first consultation at our hospital. You will undergo an ultrasound scan and infectious disease screening.

Day 15 of the cycle– The day of egg collection and embryo creation. This is when the male partner provides his sperm sample. The female patient starts using progesterone supplementation.

Day 20 of the cycle– This is when the embryo transfer will take place.

In about 12 days, you will be asked to perform a beta hCG test to test for pregnancy in blood. Don’t forget to share your results with us!

You can also visit our “IVF with Egg Donation in Cyprus” page for more information on our donor egg IVF program.