Donation Program gametes and embryos

Introduction

In Gris Reproducción-CIRH we have developed a program for the donation of gametes (eggs and sperm) to be able to treat those couples or single women who require it.

We have a semen bankin our facilities, which allows us to be more agile in the selection of the donor, without need of external services from another supplier Centre.

According to the Spanish Law 14/2006 of May 26, on assisted human reproduction techniques: "Every woman over 18 and with full capacity to act may be receiver or user of the techniques covered in this Law, she must provide the written consent to their use in a free, conscious and explicit manner. The woman may be a user or a host of techniques covered in this law regardless of their marital status or sexual orientation”.

Oocyte donation program:

The oocyte donation program is specially designed for women with the following problems:

1 .- Sterility caused by premature ovarian failure.
2 .- After having undergone the removal of their ovaries because of diseases like cancer or other diseases such as benign cysts or endometriosis (surgical menopause).
3 .- Patients with the risk of transmitting genetic diseases to their offspring.
4 .- When women are in their forties, egg donation is the technique with a better rate of success in assisted reproduction. Many women find themselves in the situation, looking for the right time to procreate, initiates the path to motherhood at an age at which their own eggs have aged. It is also where the risk of chromosomal abnormalities is higher.
5 .- Other causes:
* Low response: do not respond to ovarian stimulation.
* Recurrent failure of fertilization with ICSI.
* Lack of recurrent implantation of embryos after IVF cycles.
* Poor quality of oocytes.
* Repeated Abortions due to poor quality of oocytes, abnormal chromosome in women or embryos.
* Ovaries inaccessible to obtain oocytes: frozen pelvis, multiple adhesions ...

In all these cases, the receipt of donated oocytes is the only way to become pregnant. And it's possible, thanks to the fact that there are young women who take part in a program of egg donation that is strictly controlled, to help other women who want to have a child.

In our centre the donated eggs come from young women who meet the requirements by law, and undergo a cycle of ovarian stimulation. They receive a low financial compensation, for the inconvenience in travel, lost time and health risks. All of them have a normal study to prove there is no hereditary mental illness in them or in the family and have a normal blood test, which shows no existence of infectious or contagious diseases such as hepatitis B or C, the AIDS virus, syphilis, toxoplasmosis or rubella. Moreover, they undergo a complete blood test to confirm her state of health and a medical examination to detect any alteration. At the end of this process, and prior to its acceptance as a donor, she has an interview with the psychologist team to rule out mental abnormalities or possible distortion of the data given in the compilation of medical records.

The donation in Spain by law is anonymous, meaning that the recipient cannot meet the donor or the donor to the recipient. By definition the newborn child is legally of the woman or the couple receiving.

As for the results of the technique, the pregnancy rate per embryo transfer is 55%. The cumulative pregnancy rate per patient for 4 cycles reached 95%. The rate of miscarriage is 13% and the rate of ectopic pregnancy is 1.28%.

Oocyte donation technique

All couples who want to undergo this treatment must provide or obtain:

* The previous gynecological history.
* A report with the treatments done in other centers
* Update the serologic tests for hepatitis B and C, syphilis and AIDS for both spouses
* Rh and blood groups of both spouses
* Complete and sign the application form and formal consent for in vitro fertilization with donated oocytes.

The preparation of the endometrium or intrauterine mucosal lining of the uterus of the recipient is of vital importance to the technique's success. To achieve this goal requires the administration of exogenous hormones. These simulate the effects of ovarian hormones in the endometrial tissue.

In patients with normal ovarian function, embryo transfer could take place in a natural cycle, although given the difficulty of synchronization with the donor, this option is rarely used.

In patients with preserved ovarian function, we use GnRH agonists, in order to neutralize the action of endogenous hormones that may interfere with the cycle of transfer. With the arrival of menstruation, after the start of the GnRH analogues, we perform a vaginal ultrasound and a blood test of estradiol, to verify that the ovary is resting. If this is proven, hormone replacement therapy (hormone replacement therapy) will begin to stimulate the growth of the endometrial lining.

In patients without ovarian function, treatment replacement will begin immediately after provoking an artificial menstruation.

Hormone replacement treatment consists in administering estradiol valerate (ovarian hormone) oral or transdermal (through patches on the skin), with different increased doses depending on ecographic controls.
Several vaginal ultrasound scans are performed after starting the treatment of endometrial stimulation to measure the thickness and pattern of endometrial line.
The treatment can be maintained for a maximum of 100 days, as long as there is no vaginal bleeding. If this occurs, the recipient must inform us immediately to receive instructions.

The exact time of the donation (the donor extraction of oocytes) will be notified 36-48 hours in advance.
However, we have a previously sample of frozen semen in the Andrology Laboratory, so that the oocytes can be fertilized immediately in the event that we don’t have a fresh sample at the right time.
On the day of the donation there, a progesterone vaginal dose of 600 mg / day (divided into three times throughout the day) is added, continuing throughout the treatment until 3 months of ongoing pregnancy.

Fertilization is verified 24 hours after the donation of oocytes, and at this time we will report the number of fertilized oocytes (zygotes), which have been obtained. This is only indicative of the number of embryos available for transfer, as it is possible that not all zygotes reach the stage of pre-embryo.

Embryo transfer will take place two, three or five days after fertilization of the oocytes. The number of embryos to be transferred will be determined for each specific case, according to medical criteria agreed with the receptive couple. The pre-embryo viable not transferred will be cryo-preserved.

The donor performs a conventional IVF treatment. see oocyte donors area

Semen Donation Program:

Samples of semen donors:

Our centre has a large number of donors of semen, mostly university students, who are subjected to various tests and analysis of blood sample to ensure their health status and quality of semen.

This program is developed for the following medical indications:

1. Couples where the male presents a complete absence of sperm (azoospermia) in the ejaculation. If the testicular biopsy was discouraging, or the result of the biopsy doesn’t permit a cycle of IVF with testicular sperm microinjection-TESE, we then perform a specified artificial insemination with donor semen-IAD.
2. Women without a partner
3. Homosexual female
4. Genetic abnormalities in the male that are not available or do not want to make a Pre-implantation Genetic Diagnosis in an IVF cycle to avoid transmission of the disease.
5. Ejaculating dysfunctions in which sperm is not achieved recovering.
6. Certain infectious diseases can be transmitted by semen and "laundering" sperm is not satisfactory.

Embryo Donation Program:

Our clinic has a bank of frozen embryos which are kept from cycles of IVF / ICSI for later use. The couples here that have deposited their embryos can use them in case of failure to obtain pregnancy in a fresh cycle or to achieve a second pregnancy.
Our bank also has frozen embryos for donation, for those couples where neither woman nor man can obtain oocytes and sperm. These embryos come from couples that have undergone in vitro fertilization and have voluntarily donated their surplus embryos.
They can also come from the fertilization of eggs from an oocyte donor with donor sperm.
The technique of endometrial preparation for the transfer of donated embryos is similar to the oocyte donation technique.

Gris Reproducción CIRH-Lab has developed a special program of assistance to people residing outside of the Spanish state.