The infertility therapy through the oocyte donation method is demanding for each couple undergoing the treatment. It is a very emotional and affective burden. On the other hand, it offers a real chance to have children also for those couples who had otherwise no chance.
The women suitable for infertility therapy by means of the oocyte donation method can be devided into two groups:
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non-cycling women (women in menopause, women suffering from premature menopause under 40 years of age, women after ovarian surgery because of a cyst or a tumour, women after radiation or chemotherapy)
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cycling women (regularly or irregularly), but not capable of producing high-quality oocytes (inborn or lower oocyte quality depending on age, repeated unsuccessful IVF cycles with own oocytes), a possibility of genetic disorder transfer.
The Recipient
Patients suitable for the oocyte donation therapy:
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women who have never menstruated spontaneously and have a uterus
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women who ceased to menstruate in young age. The cause can be genetic disorders (Turner's syndrome), auto-immune ovarian disease, radiation or chemotherapy by malignant diseases, ovarian surgery or unknown reason
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women who are carriers of hereditary diseases (cystic fibrosis, Morbus Recklinghausen) or who have chromosomal defects (deletion, translocation, inversion, mosaicism)
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women who underwent the therapy by means of IVF method and only few or no own oocytes were retrieved
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women who underwent the therapy by means of IVF method repeatedly and without reaching pregnancy with low-guality of their own oocytes
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women whose oocytes were not fertilized by the husband's or donor's sperm by means of the ICSI method (intracytoplasmatic sperm injection)
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women suffering from a serious form of endometriosis affecting ovaries
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women about 40 whose cycle starts to be irregular and who do not respond to ovarian stimulation
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the application of donated oocytes is by women about 40 the method of their choice because of their low chance to become pregnant from their own oocytes and because of the increased risk of morbus Down and other trisomies.
Benefits of the oocyte donation therapy
The success rate of the therapy reaches 55-60% for a cycle and exceeds the success rate of the IVF method by which the own patient's oocytes are used.
The oocyte donation in comparison with adoption also brings besides the father's clear genetic contribution (50%) the possibility for mother to influence the nutrition and contentment of her foetus already before birth.
As well as the experience with the pregnancy since its very beginning, delivery and immediate possibility of breast-feeding means an unambiguous benefit for thechild, mother and the whole family.
Risks
Similarly, as in pregnancies arisen from sexual intercourse or on the basis of the application of IVF method, 12-15 % of pregnancies in the oocyte donation therapy end by miscarriages. About 20-30% of pregnancies are multiple pregnancies depending on the number of embryos transferred.
Therapy Procedure
Should you be interested in the oocyte donation therapy, do not hesitate to make an appointment according to your wish for the introductory interview. We will try to decide if this method is suitable for you, we will inform you about the procedure of the donor gaining and testing, about the preparation and procedure of the therapeutical cycle itself, success rates and price of therapy.
Donor Choice
Oocyte donation in the Czech Republic is anonymus, voluntary and free of charge. Our donors are young women up to 35 years of age who fulfill the strict criteria for oocyte donor search (Guidelines for oocyte donation of The American Society of Reproductive Medicine, published in Fertility and Sterility, Vol. 77, No. 6, Suppl. 5, June 2002).
All these women are examined gynaecologically, endocrionologically and genetically and they are repeatedly tested for the presence of sexually transmitted diseases (HIV, syphilis, hepatitis, chlamydias, cytomegalovirus)
Recipient Preparation
As soon as you decide to undergo the oocyte donation therapy, it is necessary to test your uterus if it is able to create endometrium appropriate for the acceptance and nidation of the embryos transferred.
You will be prescribed synthetic oestrogen in the form of tablets, injections or adhesive plaster (Estrogen, Estraderm Agofollin) which you will take in the increasing dosage for 14 days. Then the sonography with endometrium examination will follow and possibly the dosage of estrogen can be changed. The testing cycle takes 2 to 3 weeks, in case of favourable results it is possible to plan a therapeutical cycle immediately.
The Therapeutical Cycle
The scheme of the therapeutical cycle with donated oocytes depends on the condition of the patient's menstruation.
Patients who menstruate
Before the onset of cycle the patient receives an injection of depot GnRH analogue
(Diphereline, Decapeptyl) which has the task to neutralize the patient's own hormonal background as it could have an adverse influence on the therapy. The influence of the injection lasts about 3 weeks and then the estrogen administration begins - as in the preparatory cycle. After 2 weeks a sonography examination follows because of the endometrium test and in favourable result the patient is prepared for an embryo transfer. This is possible during an 8-week-period while the patient is under estrogen.
Patients who do not menstruate
After menses induction by means of hormonal injections the estrogen therapy can start immeaditely.
During the recipient's endometrium preparation the donor's synchronization and stimulation begins. After oocyte maturation in the donor's ovaries their retrieval is performed and the gained oocytes are fertilized by the recipient's husband sperm (it is possible to use either fresh or frozen sperm). On the day of the oocyte retrieval from the donor the patient starts to take pregnancy hormon - gestagen (Utrogestan, Chinone) which prepares the endometrium for nidation. The second day after the oocyte retrieval and their fertilization the recipient is informed by phone about the number and quality of arisen embryos. After 3-5 days of cultivation the transfer of one or two embryos into the recipient's (future mother) uterus is performed. The remaining good-quality embryo can be frozen in the programme of cryopreservation.
After the embryo transfer the recipient continues to take estrogen and gestagen for 14 days and then she herself takes a pregnancy test in her morning urine (HCG). In the positive case she continues this hormonal administration for 2 next months. In the negative case the blood HCG assessment is done and its result determines the decision whether the pregnancy was reached or the therapy was not successful.