How Does Donor-Egg IVF Work in Ukraine?

In Ukraine, egg donation is allowed and regulated by the Civil Procedural Code, the Family Code, and the Law of Ukraine “Basis of Legislation of Ukraine about Health Care”.

Indications

The main causes why a couple may need donor eggs to become parents are:

• Repeated fertility treatment failure with own eggs
• Possibility of transmitting a genetic disorder to offspring
• Early menopause or premature ovarian failure (POF)
• Poor egg quality

Donor eggs are used for an in vitro fertilization cycle (IVF), where they will be fertilized using the prospective father's or donor sperm.

Oocyte donation in Ukraine

Once this step is completed, the embryos will be cultured in the laboratory, and only those presenting the best quality will be transferred to the mother's uterus, since those are the ones with the highest implantation potential, and more likely to give rise to a pregnancy therefore.

For the transfer of these embryos to be carried out, Ukrainian regulations governing assisted reproduction establish that she must have previously signed an informed consent. This is an obligatory step, regardless of whether the gametes come from the receiving couple or have been donated.

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.

ICSI with donor eggs in Ukraine

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.

Should viable spare embryos be available, they will be vitrified for later use in a second assisted reproduction treatment.

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.

How much does it cost?

In Ukraine, egg donation must be an altruistic act. For this reason, the purchase and sale of eggs is forbidden within this country. This, however, does not prevent donors from getting an economic compensation for any inconveniences caused and the potential expenses derived from the egg donation process.

The total cost of the egg donation program includes the compensation given to the donor plus the medical screening, follicular puncture, embryo culture, and embryo transfer to the uterus of the recipient.

It all adds up to between €4,000 and €9,000 with an average cost of €5,511. Anyway, given that the total cost of the treatment may vary from clinic to clinic, these are just approximate prices.

Rise in the cost of egg donation

Broadly speaking, whenever the treatment is more expensive than usual, clinics usually have special offers or refund plans in case pregnancy is not achieved in the end.

Fluctuations in the cost of IVF

Before getting started with the IVF cycle, knowing what is and what is not included in the price is crucial, since there may be a cost increase depending on:

• Whether you use a single donor, that is to say, the receiving couple does not split their egg donor with other couples.
• Whether it is an ICSI or a conventional IVF cycle.
• Whether PGD (preimplantation genetic diagnosis) ir required.
• The stimulation of ovarian function medications the donor may need.
• The medications for preparing the endometrium of the receiving woman.
• Whether sperm cryopreservation is needed.
• Whether embryo vitrification and storage of the unused embryos is required.

Treatment costs may also be higher depending on the location of the clinic, so, if it is done in a big city such as Kiev, the price may increase. Besides, medical appointments are usually not included in the total cost of the procedure.

Nevertheless, no remarkable differences between cycles with frozen donor eggs and with fresh donor eggs can be found, although the success rates of the latter are generally higher.

Patients are advised to ask for an estimate at several clinics, always paying attention to the special features of each particular case, especially when it comes to dealing with foreign patients. Some Ukrainian clinics offer special services aimed at international patients, such as airport pick up or hotel reservation assistance.