Often and for different reasons (e.g. age, hereditary diseases, past surgical operations, and so forth), ovaries lose their ability to produce healthy egg cells. Egg cells are vital for conception. This makes anonymous egg donation necessary, as part of In Vitro Fertilisation treatments.
Egg donation in Spain is anonymous and altruistic, according to current Spanish legislation. Before a female donor is assigned to a recipient couple, she undergoes a strict battery of tests administered by our multidisciplinary team.
These tests include:
The donor then undergoes ovary stimulation to obtain an adequate number of oocytes. The retrieved oocytes are then fertilised and days later, when the resulting embryos reach their optimum state of development, they are transferred to the recipient mother’s uterus.
At Instituto Bernabeu, we perform rigorous and comprehensive screenings of donor candidates, including psychological, clinical and genetic evaluations, in order to maximize the suitability and safety of the procedure:
Tests for Cytomegalovirus (CMV).
Thanks to the Donor DNA Cryopreservation Repository that has been operating at Instituto Bernabéu since 2010, patients who require use of donated reproductive cells for their fertility treatment may have access to their donor’s DNA at any time in cases where diagnosis and analysis of a specific genetic illness is required for the future newborn.
Instituto Bernabeu is a leading egg donation centre in Europe. Because of our experience of more than 20 years, the large number of egg cell donations in our repository and the social and cultural status of our donors, we can guarantee that:
Steps in egg donation
Starting a treatment that uses donated egg cells is a very important decision that must be made with all the necessary information. For this reason, the doctor in charge of your case will provide you with detailed information about possible alternatives and the most relevant aspects of the treatment.
It is crucial that you are provided with detailed information about those aspects having to do with the donor, both as regards legislation and the selection procedures that are required to accept candidates as donors. Fortunately, legislation in Spain is clear, and it offers a legal security framework that allows treatments to be carried out in a simple way.
You will also receive information on the procedures followed to select the best donor for you based on your physical and clinical traits.
On this visit, and once you have agreed to take the treatment and selected a time frame to complete it, you will receive information on the necessary steps to get started. The arrangements to receive the embryos are much simpler than the ones for in vitro fertilization (IVF): they do not include daily injections and the number of visits for ultrasound control is limited. You could receive an approximate start date for the treatment at this moment.
At the end of your appointment with the gynecologist you should meet with your Comprehensive Care Provider to complete all the medical and legal requirements (i.e. to sign consents) and receive prescriptions for the necessary drugs as well as accurate and detailed instructions to use them.
At the moment when you are informed about the treatment that uses donated egg cells and you make the decision to start it there begins a process where all the different departments in Instituto Bernabeu are coordinated to offer you the greatest chances for success and the best personal care.
The endometrium is the “layer” in the uterus where the embryo becomes attached and is subsequently implanted so that pregnancy can happen.
This “layer” should be prepared and synchronized with the embryo. For this reason, drugs need to be administered to send the right signs to the uterus so that its “receptivity” is optimal.
Fortunately, preparation is extremely simple: injections, tests and frequent appointments are not necessary at this stage. In most cases only one injection is needed for the whole treatment and one or two ultrasounds are normally enough to confirm that preparation is going well.
The drugs needed for the treatment are administered orally or transcutaneously (i.e. patches) and have a high tolerance level, as the hormone levels that are sought are very similar to those in women during their natural cycle.
After egg cells have been retrieved from the donor, administration of progesterone begins, normally performed vaginally (eggs). The beginning of the administration of progesterone is extremely important, since it is when the sign for the endometrium to be receptive at the moment of transference is “sent”. In other words, it is what creates the correct synchronization between the embryo and the uterus.
You will receive accurate and detailed written instructions about each and every step for preparation. Even so, the whole of our team is at your disposal, so please do not hesitate to let us know if you have any questions or concerns.
Aware of the great responsibility that the trust placed on our team entails, we begin a thorough selection of egg donors to guarantee the highest quality and the best results to our patients. Having successfully passed a thorough analysis
(e.g. a psychological evaluation and medical, gynecological and genetic tests) and tested negative for the main illnesses that could be transmitted, the candidate is accepted as an egg donor.
Previously, the recipient couple has informed us about their blood type and their main physical characteristics (weight, height, skin colour, eyes, hair, and so on) and provided a photograph to facilitate the search for physical likeness. The law in Spain stipulates that under no circumstances will the identity of the parents or the donor be disclosed. Yet, the results of the medical and gynecological tests and the donor’s age may be disclosed in case they are needed in the future. In addition, the donor’s genetic matter (DNA) is stored for a period of 20 years in case it becomes necessary to carry out an advanced comparative genetic study of the future newborn.
Stimulation of the donor’s ovaries begins at the same time as the therapy to develop the recipient mother’s endometrium. Stimulation is key to future success. It is important to produce the highest possible amount of oocytes, but it is even more important to ensure their quality.
For this reason, we follow their development closely by means of ultrasound scans that allow us to determine the most optimal dose to enhance their quality without compromising the donor’s quality of life during stimulation –just like we do with all of our patients
When the right time has come, the donor is put under sedation in the operating room and her eggs are retrieved. At Bernabéu Institute we guarantee a minimum amount of 8 high-quality oocytes to our patients.
Simultaneously, the male provides a sperm sample. The sample is capacitated in the laboratory to increase its power to fertilize.
Fertilization is initiated in the Human Embryology Laboratory by joining an oocyte with the male’s sperm, either through the usual IVF procedure (more natural) or the ICSI procedure, whereby a single suitable sperm is injected into the oocyte through a thin needle. This procedure facilitates fertilization in cases of male pathology.
The result of fertilization (day 1 of the embryos’ life) can be seen within approximately 18 hours. At this point the amount of naturally fertilized oocytes, which is the same as the number of embryos, can be determined.
Just like it happens in a woman’s natural cycle, progesterone must be included in the recipient mother’s medication at the time of fertilization. This drug is extremely important, as the fetus will need it during the first months of pregnancy, until s/he produces enough placenta.
After fertilization, embryos start to develop in incubators in a culturing environment that provides them with everything they need in order to grow. They are watched daily, and both embryo cleavage (the number of cells) and important data about their morphology are recorded. The quality of each embryo is determined both by division and morphology.
Embryo quality is determined by a combination of cleavage and morphology. Every embryo faces a different fate. Some have good quality, others become blocked and others make it to the end despite their bad quality. From the way they evolve we propose either short cultures (2-3 days) or long cultures (4-5 days: blastocyst). 90% of our egg donation cycles reach the blastocyst stage.
Embryo transfer is normally scheduled between two and five days after fertilization (i.e. at the peak of the treatment). The goal is to move the embryo from the laboratory to its final destination for development: the future mother’s uterus. It is carried out with the help of an abdominal ultrasound in order to find the perfect spot for implantation.
A thin catheter is introduced through the neck of the uterus, and a drop taken from the culturing environment where the embryo is floating is poured into the uterus. Sedation is not necessary, it is not painful and, as a matter of fact, it is very similar to a regular gynecological checkup. The procedure is performed at a temperature of 36ºC in a dimly lit, sterilized room located next to the laboratory to make it as unintrusive as possible.
A pregnancy test is scheduled 13 to 14 days after starting to take progesterone to confirm pregnancy or not: it is determined by the blood levels of a hormone named beta-hCG. This hormone produces the embryo and is transferred to the mother through placenta. It is the first sign of the embryo and can be measured as proof of development.
In case of failed pregnancy, every member of the human team that participated begins to examine the whole treatment so as to evaluate the causes. Afterwards, a meeting with the couple is arranged to provide a medical report.
When pregnancy is confirmed and after 15 days, an ultrasound scan is performed to make sure that pregnancy is proceeding normally. To perform it earlier might create confusion and uncertainty, as the results are not conclusive in most cases.
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