When it comes to both donor-egg IVF treatments and embryo adoption cycles, the endometrial lining of the recipient must be prepared in order to make it receptive, thereby increasing the likelihood of embryo implantation after the transfer of embryo. In order to optimally prepare the endometrium or the lining of the uterus, your doctor will institute a hormone drug protocol that is tailored to your situation.
During the process of donor-egg in vitro fertilization (IVF), your doctor will make use of eggs from the donor instead of the patient's eggs to create embryos after they have been fertilized with sperm donated by partners or donors. Immediately after this, new embryos will be transferred to the recipient's uterus for the purpose of getting her pregnant.
Donor-egg IVF is a major indication for women who have premature ovarian failure otherwise known as (POF), a condition that is explained as reaching menopause before the age of 40. POF is an indication of interruption of ovarian function, and consequently the lessening of a woman’s ovarian reserve.
That is why the process should begin with the estimation of fertility. A high amount of FSH (follicle-stimulating hormone) and/or estradiol levels can be discovered by taking blood samples on cycle days 2 or 3. It helps to detect POF signs even in women under the age of 40 years.
Medical assessments must include a complete history and physical examination to ensure that pregnancy will not affect the general health of women. It is important to look for factors that can negatively affect fertilization, embryo implantation and/or pregnancy.
Receiving individuals that have premature menopause require the preparation of the uterus by using estrogen and progesterone because they lack ovarian function. When fresh donor eggs are used, patients with the intact ovarian function may be prescribed these treatments or birth control drugs to synchronize their menstrual cycle with those of the donors.
The drug protocol for recipients
Generally, during egg donation and embryo adoption cycles, hormonal drugs which have estrogen and progesterone in them are frequently used with the aim of getting the endometrium thickened appropriately. In contrast, in cycles of IVF with own eggs, women only receive progesterone, provided that ET is conducted in the same cycle as the ovum pick-up (OPU).
In cases where the recipient's ovaries are still working perfectly, it may be necessary to stop the natural release of hormones by making use of oral contraceptives or GnRH analogues, such as Decapeptyl. If necessary, they are applied during the previous cycle to control the start of the cycle during which the IVF will be performed.
During the initial phase of the cycle up to day 14, the prescription drugs are based on estrogen. The administration can be carried out either by means of a patch route, for example, Evopad, or estradiol oral tablets such as Meriestra.
From day 15 forward, it is going to be changed to drugs containing progesterone, such as Utrogestan. Usually, they are applied through the vaginal, in the form of a soft capsule. They can be taken orally.
In new cycles of donor eggs, women begin with progesterone the same day that egg recovery is planned. On the other hand, with frozen donor eggs, progesterone should begin on the day of dehydration of the egg cells.
Some studies suggest that it can begin the next day without changing the chances for success. Performing this a day earlier, however, can have a negative impact on the end result.
If an expert believes that the endometrial lining develops well, the date of embryo transfer to the mother's uterus will be fixed.
It should be noted that patients still need to use progesterone-based drugs prior to embryo transfer, especially until the time appointed by the physician monitoring the case and can be extended up to 12 to 20 weeks after the pregnancy.
In a few types of medication protocols, progesterone treatment is also accompanied with estrogen in the course of the luteal phase (from day 15 of the cycle) to improve endometrial receptivity. If the pregnancy is not successful, medicines are negated until the next cycle.
However, needs and requirements may change by chance. While some women may need a lower dose, others may need more because of a number of factors. Therefore, a properly trained physician should decide which medicine to use and what the correct dose is for each patient.Although IVF has a high success rate, there may still be risks of birth injury due to the complex nature of the procedure. That's why it is good to keep a qualified birth injury lawyer on hand
In general, the price of IVF with donor eggs is considerably higher than the usual IVF programs using their own eggs. However, this has to do with the country in which the egg is donated, the type of egg donor (anonymous or known) and the need for added techniques such as:
Additionally, the use of fresh or frozen donor eggs should be considered when calculating IVF costs in donor ovarian cells. With fresh donor eggs, it is necessary to synchronize the donor and recipient menstrual cycles, thus increasing the cost and number of visits to the clinic. If frozen donor eggs are used, the treatment becomes cheaper because the process becomes shorter and simpler.
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