In vitro fertilization (IVF) consists of performing the fusion of the sperm and the egg in the IVF laboratory, that is, outside the female reproductive system. For an IVF process to be carried out, firstly we have to collect both the eggs and the sperm in order to put them together later, aiming at achieving the creation of an embryo.
When the embryo is obtained in the laboratory, it will be transferred to the mother’s uterus, waiting for embryo implantation into the endometrium to occur, which would mean the treatment has lead to pregnancy.
The eggs and the sperm used to carry out this process can become either from the intended parents and/or gamete donors.
Greek laws on medically assisted reproduction allow using donor eggs as long as the donor’s identity remains anonymous throughout the whole process and the recipient is not older than 50 years of age.
Women unable to use their own eggs to undergo in vitro fertilization can resort to egg donation as an alternative. Most common problems leading women to have no choice but to use donor eggs are:
- Premature ovarian failure (POF)
- Early menopause or premature menopause
- Recurrent miscarriage
- Implantation failure
- Advanced maternal age
- Genetic abnormalities likely to be inherited by offspring
- Previous IVF failure using the woman’s own eggs
Any woman presenting any of the above mentioned conditions may need donor eggs to become pregnant. Thus, they will become what is called donor egg recipients. The treatment they have to take is considered to be simple, since it is just about preparing her womb for the embryo transfer (ET) and the subsequent embryo implantation.
The endometrium is the uterine layer in which embryo implantation takes place. For embryo implantation to be successful, it has to reach a trilaminar appearance and an approximate thickness of 8 mm, so that the embryos become strong enough to attach to the uterus lining. To that end, recipients are administered hormone medications either through vaginal, oral or patch route.
Endometrial preparation is monitored via ultrasound scan until the specialist considers it has reached an optimal state to perform the embryo transfer. Usually, the woman has to start taking hormone medications—based on estrogens and progesterone—the first day of menstruation and will continue to due so until 10 day approximately.
Greek Law 3305/2005 governing medically assisted reproduction limits the number of embryos to be transferred to two in cases of egg donation.
As for egg donors, they have to undergo follicular puncture for ovum pick-up (egg retrieval). To increase the number of eggs obtained, donors are prescribed ovulation enhancing drugs during controlled ovarian stimulation (COS) within an average period of time of 10-12 days, after which follicular puncture will be performed.
How long does the treatment take
Bearing in mind that it is only necessary to prepare the endometrium and later carry out the embryo transfer, this treatment usually does not take longer than 10-15 days. Besides, in case you travel to Greece to undergo IVF with donor eggs, you should take into consideration the fact that some fertility clinics allow recipients to begin with the treatment in their country of origin, which translates into a shorter journey time.
- Fresh egg donation: In case you choose fresh egg donation, synchronization between the menstrual cycles of both donor and recipient is required, something that could prolong the duration of the treatment. Recipients must be in Greece in the very moment when follicular puncture is to be performed or even a day or two before to improve the synchronization and avoid unexpected issues.
- Frozen egg donation: If donor eggs were frozen (egg vitrification) after follicular puncture, then recipients only need to visit the fertility clinic for fertilization and embryo transfer. How long they have to remain there will depend on sperm, that is, whether it is fresh or frozen, as well as on which day of embryo development is the ET done.