Embryo Donation

Embryo implantation is a very complex process involving many factors related to the embryo itself, to the uterus and to the uterine conditions. In contrast to what patients think, embryo glue is not really a GLUE, it is a substance that is added to the transfer media that is suggested to protect the embryo during the transfer process and to increase its chances of implantation. The efficiency of this substance is still debated and it does not guarantee implantation.

All recent studies show that a woman can get back to her normal life directly after transfer. She can climb stairs, kneel to catch things from the floor, drive for a long distance, take a shower, sleep in any position, catch a flight…

Definitely not! And this is a general misconception! Each day a different group of follicles starts growing in a woman’s ovaries. The recruitment of these follicles and their first phase of growth are independent from hormones. When these follicles reach a certain size, their growth becomes dependent on hormones. The biggest and strongest of these follicles starts “taking all the hormones” produced by the woman’s body and continues to grow alone while the other follicles do not have “enough hormones” and die. The injection of hormones used during ovarian stimulation saves these follicles from dying but does not lead to recruiting more oocytes from the ovaries.

Using ultrasound, the doctor can see the follicles and follow up on their growth. The follicles are not the eggs, they are the “bags” that contain the eggs and help them become competent. It is impossible to see the eggs by ultrasound. Some follicles are empty and that’s why there is very often a difference between the number of follicles seen by ultrasound and the number of oocytes retrieved during oocyte pick-up for IVF.

This is the question that no IVF specialist can answer. If we knew the cause that will lead to failure, we would have solved it before transferring the embryos. We can only make assumptions about the causes. Embryo implantation in the uterus is a very complex process and multiple factors are involved. We can monitor and control all the factors we know about, like endometrial thickness, the timing of transfer and the absence of uterine problems. Other factors like immunity are known to play a role but cannot be controlled. The majority of factors remain unknown. Whether we like it or not, we always do our best but the final outcome is in God’s hands.

The urine pregnancy test cannot detect pregnancy very early. The pregnancy hormone, bhcg, appears in the blood before it appears in the urine. Blood test needs at least 12 days post-transfer to detect pregnancy. So there is no point in doing a home pregnancy test before that.

Teratozoospermia or the presence of a high percentage of abnormal sperm forms in the semen does not lead to a high risk of chromosomal abnormalities in the embryos. Teratozoospermia, decreases the chances of natural pregnancy as it reduces the capacity of the sperm cells to get to the egg and penetrate it. ICSI allows to completely surpass this problem and the embryos obtained have the same risk of chromosomal abnormalities as in natural pregnancy.

It is very rare that a couple donates his embryos. So Donated embryos are obtained from the eggs of a consenting egg donor that are fertilized with the sperm of a consenting sperm donor.

When a woman suffers from severe ovarian failure and her AMH level is very low, lower than 0.1, the only solution possible is IVF with egg donor. Vitamins, DHEA, stem cells and PRP were all proposed to be solutions in the past but none of them has proven to be efficient. In case the woman suffering from ovarian failure is very young we can attempt to do oocyte banking and IVF before resorting to egg donation. In case the ovarian failure is a result of advanced maternal age, egg donation is the most efficient and quickest solution possible.

The duration of freezing does not affect embryo or egg quality. One day of freezing is equivalent to a hundred years. In the past a lot of embryos or eggs used to degenerate during the freezing or the thawing process. However, with the emergence of vitrification, egg and embryo survival rates have become higher than 90%. Few months ago, a baby was born from an embryo that was frozen 30 years ago.

Most Sunnis agree that egg donation is not permissible, while the majority of Shiite authorities consider it permissible.