Michelle Emblenton, biochemist at inviTRA, tells us the step-by-step process of IVF with double gamete donation:
A double donor IVF treatment is basically the same as a conventional IVF treatment. However, it involves two more people, being the sperm donor and the egg donor. The first step is the selection of the donor. If you are using an anonymous donor the clinic themselves will select the donors for you. Male donors have to undergo a physical examination, a kariotype to check that their chromosomes do not have any alterations, a seaman analysis to make sure their sperm is of good quality and a psychological assessment. Female donors will have to undergo similar testing with an ultrasound, kariotype testing, psychological testing.
For both, male and female donors, they will undergo tests to make sure they do not have any infectious diseases or genetic diseases, to make sure that the process is safe. The clinics themselves will do a phenotypical matching and this will look at things such as skin tone, eye color, hair color, height... to make sure that the babies have a good phenotypical match, that they will look like their parents.
Genetic matching is also something that can be carried out, but is not standard practice in all clinics. In genetic matching the DNA itself will be tested to make sure there is no possibility of genetically inherited diseases. Once the egg donor has been selected, she will need to undergo ovarian stimulation for approximately two weeks. This hormonal medication encourages the eggs within the ovaries to develop. When enough development has occurred of the eggs, which will be monitored during ultrasound, an oven pickup (also called a follicular puncture or an egg retrieval) will be programmed. This is an outpatient surgical procedure and is usually performed under a mild anesthetic or perhaps sedation. The liquid will be aspirated from the ovaries and the eggs within this liquid will then be selected in the laboratory for the fertilization procedure. After the egg donor has undergone the egg retrieval process, the process is finished for her. She may receive financial compensation for her inconveniences and possibly require a checkup or two afterwards, just to ensure that she is fully recovered from the process. The recipient woman does need to have her endometrium prepared in order to plant for the embryo transfer.
The endometrium is the lining of the uterus and it needs to become the correct thickness in order for an embryo to implant and grow within the uterus. So, the recipient moment will undergo hormonal preparation with estrogens and progesterone to develop and prepare her endometrial lining. When we have the donor eggs ready in the laboratory, we need to undergo the fertilization procedure. Donor sperm will be used for the fertilization procedure and, in this case, the donor sperm will come from previously frozen sperm samples. The first step for the sperm sample is to be thored and then it will undergo a seamen analysis to make sure that the sperm are healthy, have survived the thoring and that everything is okay for them to use. They will be prepared and capacitated and then the fertilization step can be performed.
This could be by classical IVF, whereby a drop of the sperm (prepared sperm) is added to the eggs and fertilization allows occur naturally. Alternatively, if the ICSI (Intracytoplasmic Sperm Injection Technique) is to be used, the specialist themselves will select one of the sperm into a microinjection needle and inject it directly into the egg cell in order to perform fertilization. Any fertilized embryos will then be cultured, allowed to develop for a few days in the laboratory and closely monitored. When the embryos are ready to be transferred, the embryo transfer will be programmed and the embryos transferred into the previously prepared receptive uterus of the recipient woman. If any pre-implantation genetic diagnosis is to be performed, a biopsy will be taken before the embryo transfer and the embryos will be vitrified to be transferred into the uterus at a later date.
The best quality embryos will be selected for the embryo transfer and, usually, one or two embryos transferred into the recipient woman's uterus. Any remaining embryos can be frozen for future use. After the embryo transfer, the final step is the two week wait or the beta weight, which must be respected before you can take the pregnancy test to find out if the treatment has been successful.
