The egg donation full guide in Azoury IVF Clinic.

The Egg donation process

If a woman suffers from severe ovarian insufficiency and is unable to conceive using her own eggs, the most appropriate solution is IVF with donor eggs. This is an excellent solution, as it has the highest success rate of any assisted reproductive technology.

Egg donation technology also allows a woman with severe ovarian insufficiency to carry a child and experience the full experience of motherhood. She is also legally the mother and enjoys full rights and responsibilities towards the child.

Therefore, IVF with egg donation is highly effective and allows many women who have lost the ability to conceive using their own eggs to realize their dream of pregnancy, childbirth, motherhood, and starting a family.

The success rate of egg donation reaches 70% on the first attempt, especially if the donor is young (under 30 years old). The cumulative success rate reaches 99% with repeated attempts and refusal to give up. The cause of failure is usually unknown, but bodies are different, and each woman's body requires a specific treatment. By changing the treatment after each failed attempt, we sooner or later find the treatment that best suits the woman's body and ensures success.

What is IVF with egg donation?

Egg donation occurs when eggs are taken from a young donor and given to a woman who is no longer able to conceive from her own eggs. These eggs are injected with the husband's sperm in the IVF laboratory, and the resulting embryos are then transferred into the woman's uterus. If pregnancy occurs, the pregnancy is normal, like any other natural pregnancy.

IVF with egg donation requires the signing of consent papers from the husband, wife, and donor. These papers specify that the donor wife, who receives the eggs, is the legal mother and has full rights and responsibilities towards the children born through the donation process. They also specify that the donor waives all responsibility for the donated eggs and is not even entitled to accountability regarding them. The legal father is, of course, the husband who provided the sperm. In some cases, and within certain religious sects, legal marriage papers are signed between the husband and the donor before the egg and sperm retrieval process is performed. The husband and the donor are divorced at a later date.

So, egg donation is a process by which a young woman (the donor) donates her eggs to another woman (the recipient). This process does not harm the donor or affect her egg reserve, allowing the recipient to realize their dream of motherhood. The donor's eggs are fertilized with the recipient's husband's sperm, resulting in several embryos. Two embryos are implanted in the recipient's uterus after being prepared with hormones. The excess embryos are frozen to increase the chance of pregnancy in the unlikely event that the first embryo transfer fails. They also provide a chance of having siblings for the child if the first embryo transfer is successful. However, it is important to emphasize that the excess embryos remain the property of the recipient's husband and wife.

Egg donation is an effective treatment for infertility caused by ovarian dysfunction, which is diagnosed through an ovarian ultrasound or ovarian reserve test. A woman of any age can suffer from ovarian dysfunction, but the older a woman gets, the more severe the dysfunction becomes. Ovarian reserve typically disappears after the age of 45. Women with severely reduced ovarian reserve can resort to IVF with egg donation, even after menopause.

The uterus, unlike the ovarian reserve, is not affected by aging. Even after complete menopause, hormonal therapy can be administered to prepare the uterine lining to receive embryos produced through IVF with egg donation. Unlike the uterus, the ovaries weaken significantly with age, not only in terms of egg number and reserve. Even if the number remains acceptable, the quality of the eggs declines, along with the quality of their content, which plays a significant role in embryo division, development, and quality. To use a comparison, eggs expire as a woman ages, decreasing in number and quality.

When should a woman resort to IVF with egg donation?

As mentioned above, egg donation (taking eggs from a donor) is typically used for women with low egg quantity and quality (poor ovarian reserve), manifested by elevated FSH and low AMH levels. There is no treatment to restore the reserve. Also, elevated FSH is a result of ovarian failure, not its cause. Treatment to lower FSH does not restore normal ovarian function and is ineffective. Ovarian failure usually occurs with advancing age, when a woman exceeds 42-43 years. However, it can occur in younger women with premature ovarian failure resulting from a genetic problem, chemotherapy, or endometriosis. Therefore, we advise women to freeze their eggs before undergoing any chemotherapy.

In addition to women suffering from ovarian insufficiency, women may resort to egg donation in the following cases:

• After repeated IVF failures, especially if the quality of the embryos is poor.
• When the woman has a good reserve but suffers from poor egg quality.
• If the woman suffers from a serious genetic disease.
• If the couple are related and their children suffer from genetic problems that cannot be avoided through pre-implantation genetic diagnosis (PGD).
• If the woman does not respond to ovarian stimulation treatments and does not obtain a sufficient number of follicles and eggs.

Who are the donors for IVF with egg donation?

A woman in need of an egg donation can bring a donor she knows personally, such as a sister or friend, provided the woman is young, free of any medical conditions, has a healthy ovarian reserve, and, most importantly, performs the donation of her own free will and without any family pressure.

If a suitable donor is not available, the Azoury IVF Center can secure a donor, as it is in constant contact with a large number of donors and has a full bank of eggs ready for donation.

The donors provided by Azoury IVF Clinic should fulfill all the following conditions:

• Her identity must remain anonymous to the couple requesting egg donation as their identity should remain anonymous to her.
• The egg donor must be under 30 years of age.
• The egg donor must be in good health.
• The egg donor must be free of congenital problems.
• The egg donor must be free of sexually transmitted diseases.
• The egg donor must give written consent to the procedure and fully waive her right to have any info regarding the fate of the eggs that she donated.

How does the process of IVF with egg donation or egg retrieval from a donor take place at Azoury IVF Clinic in Lebanon?

At Azoury IVF Clinic, the egg donation process is confidential, meaning the donor is anonymous to the couple and completely unaware of the fate of the eggs she donates, unless the donor is someone the couple knows. If the donor comes from our center, couples undergoing IVF with egg retrieval from a donor are not allowed to see or meet the donor. We select the most suitable donor who matches the physical characteristics of the wife, such as her skin tone, hair color and texture, and the couple's blood type and ethnicity. We can also provide the couple with the donor's physical characteristics, including her weight, height, and age.

For recipients residing in Lebanon

If a woman seeking egg donation is a resident of Lebanon, she can come to our center on the second day of her period, or any day if her menstrual cycle is irregular. During the first visit, we examine the uterus to determine its suitability for pregnancy. We also take details about her characteristics and blood type to select the most suitable donor. We begin uterine preparation treatments on the same day. There is never a waiting period for a donor, as we have contact with a large number of donors awaiting the donation procedure.

For recipients residing in Lebanon

If a woman residing abroad needs an egg donation procedure, she contacts us via written WhatsApp to the clinic number before her period. We ask her to send us photos of herself, blood tests, and her and her husband's blood type. We also ask her to send us an ultrasound or hysterosalpingogram to ensure her uterus is healthy and capable of receiving a pregnancy. Then, on the second day of her period, or any day if her period is interrupted, we prescribe the appropriate treatment and explain it to her so she can begin preparing her uterus abroad. Ten to 11 days after taking the uterine preparation medication, the woman comes to Lebanon with her husband for IVF with egg donation.

The steps of egg donation in Azoury IVF Clinic Lebanon:

After checking the quality of the recipient's uterus and its suitability for receiving embryos, and after selecting a suitable donor for the couple according to the specifications detailed above, the IVF process can begin with donor eggs.
On the same day the wife begins hormone therapy to prepare her uterus, we begin administering ovarian stimulation injections to the donor. It is not necessary for the donor to be on the second day of her cycle, as no embryos will be transferred to her. This method facilitates coordination and synchronization between the donor and the recipient, allowing us to use fresh, non-frozen eggs.
The donor's ovarian response to stimulation treatments is monitored through ultrasound. When the follicles reach the required size on the ultrasound, we administer the trigger injection to the donor and determine the timing of the egg retrieval.

On the day of the egg retrieval procedure, the wife begins taking progesterone, the hormone that ensures the interaction between the embryo and the uterus. On the same day, the husband must also provide us with his semen so that we can fertilize the donor eggs obtained through the egg retrieval procedure. If the husband is unable to come on this day, he will have previously provided a semen sample for freezing. On the day of the pick-up, the semen is thawed, and used to fertilize the donor eggs. If the husband is unable to come to Lebanon at all, his wife can bring the sample from abroad, and it will be frozen in our laboratory immediately upon her arrival to Lebanon.

After the donor's eggs are retrieved, they are evaluated, and we know the exact number of mature eggs retrieved. This number cannot be determined in advance, as the follicles seen on ultrasound may be empty. Each mature donor's egg is fertilized with the husband's sperm using in vitro fertilization (ICSI). This means that a mature sperm is selected and inserted into each mature donor's egg using a needle. The fertilized eggs are placed in a special culture medium that provides the necessary nutrients for the embryo. The embryos are then placed in an incubator, which provides them with the gases and temperature necessary for their division and development. At Azoury IVF Clinic, we have an incubator equipped with artificial intelligence, which provides the best and most stable conditions for embryo development at all times: The Embryoscope. The Embryoscope allows us to monitor the embryos without removing them from the incubator. Artificial intelligence provides us with an assessment of each embryo. The use of this smart incubator is very important during the IVF process with egg donation, as it ensures complete transparency of what happens in the IVF laboratory, allowing couples to be certain of the number and quality of the donor eggs they have received.

After two to five days, we know the number of good embryos obtained through IVF and egg donation. We transfer two embryos into the wife's uterus, and the excess embryos are frozen in the laboratory for use in subsequent attempts, whether the first transfer is successful or unsuccessful. The duration of embryo freezing does not affect their quality. After the embryo transfer, the wife who underwent IVF with egg donation can return to her normal life immediately. There is no need for a day of rest, sleep, or lying down, and she can even travel and take a flight home the same day.

What makes egg donation unique at Azoury IVF Clinic in Lebanon?

We always have donors available, so there's no waiting period for months to secure eggs. We offer egg donation even to women in their fifties if they're in good health and pregnancy does not present a risk on them. We have fresh eggs and a frozen egg bank, and the pregnancy success rate is the same in both cases, reaching 70%. However, we always prefer using fresh eggs when available, as they are cheaper on us (there are no freezing and thawing costs).

At the Azoury IVF Clinic, we guarantee that couples will receive at least four TOP embryos after undergoing IVF with donor eggs. If this number isn't achieved, which is extremely rare, we repeat the entire procedure at the cost of embryo freezing and frozen embryo transfer. In this way, Azoury IVF Clinic guarantees that couples will receive the largest possible number of eggs from the start of the IVF process with egg donation. If the number of eggs is not sufficient, the center will bear the cost of repeating the procedure.

Always remember that your success is our success. What distinguishes our center is our success rate and the trust of our patients. Whether you have undergone IVF using your own eggs or donor eggs, we sincerely wish you success and look forward to have great news from your side in God’s will.