In Ukraine, the use of assisted reproductive technology (ART) is allowed only upon medical indications. In order for women to undergo a fertility treatment, they have to provide a statement of a duly qualified physician, sign a written free consent, and a prescription by the Ministry of Health Care of Ukraine.
When a woman is unable to have children using her own eggs, turning to egg donation may be an excellent solution.
This fertility treatment is indicated in the following cases:
- Premature ovarian failure
- Early menopause
- Poor-responder to ovulation induction
- Repeated IVF failure in previous cycles using own eggs
- Recurrent pregnancy loss (RPL)
- Poor embryo quality
The Family Code, the Provisions of the Civil Code, and the Law entitled “Fundamentals of Health Legislation of Ukraine” are the regulations governing egg donation in Ukraine. They establish that egg donors must remain anonymous, or else be a relative or close friend of the intended parents. Oocyte sharing, i.e. a woman donates her excess eggs remaining after her own IVF program, is also allowed.
Process step by step
The first step involves the selection of the most suitable donor and later ovum pick-up through follicular puncture. Egg harvesting is always done once the patient has undergo ovulation induction through subcutaneous injections.
Next step is all about collecting a semen sample from the partner either through masturbation, sperm aspiration procedure from the epididymis (PESA), or testicular biopsy. In general, the latter types of semen collection are previously cryopreserved, and thawed on the day of the egg retrieval.
After being processed in the laboratory, the sperms are put in contact with the sperm in order for fertilization to take place, which can be done through standard IVF or ICSI. By means of standard IVF, the sperms will be the ones trying to reach the egg by themselves. As for the latter technique, a previously selected sperm is directly inserted into the egg.
Once the egg-sperm binding has taken place, the fertilized oocytes are placed in a culture medium for later embryo culture in an incubator. Observation of embryo development to decide which embryos present the best quality to be transferred is required.
In accordance with the Order of the Ministry of Health of Ukraine, embryo transfer can be performed either at an early stage of embryo cleavage (after 3 days in the laboratory) or up until blastocyst stage (after embryo culture for 5-6 days). Thus, one or three embryos will be transferred to the maternal womb, a boundary established by the Ukrainian Law.
Donor egg recipient protocol
Before the embryo transfer, preparation of the endometrium is required, as it is necessary for the embryos to be able to attach to the uterus. Preparation involves reaching an adequate endometrial thickness and composition.
For this to be done, it is necessary for the woman to take hormone medications, particularly estrogen combined with progesterone, as indicated by a physician. Generally, hormone administration starts on the first day of menstruation, and extends up to 10 more days approximately.
Endometrial growth will be monitored through ultrasound scan, and once it reaches a triple line pattern of around 7-10 mm, the embryo transfer will be scheduled.
If it is a fresh donor egg cycle, synchronization between the menstrual cycles of both the donor and the recipient is necessary. However, this is unnecessary if it is a frozen donor cycle.