Egg Donation IVF Treatment

Patients who receive egg donation are those who, for a particular reason, do not have or cannot use their eggs. The conditions for a patient to receive an egg donation are listed in detail:

• If the egg reserve of the female patient is depleted ahead of expected time or the quality of the eggs deteriorates (early menopause)
• If the egg reserve of the female patient is too low or depleted in line with her age
• If the patient has a genetic disorder that can result in congenital diseases in her children
• If the female patient has a genetic disorder such as Turner Syndrome that damages her egg reserve
• If the patient has received radiotherapy to her genital area or chemotherapy that affected the ovaries
• If the female patient had her ovaries removed, has not had them since birth, or has damaged ovaries

There is an age limit for being an egg donor. However, for receiving egg donation, there is no age limit, but there is an age control, which aims to check the suitability of the patients for the treatment and pregnancy and to help the patients have a healthy process. In the law that controls the IVF treatments and specifies the rules, it is stated that if the female patient is over the age of 45 before receiving an egg donation, she needs to be checked to see if her general health is suitable for pregnancy. A confirmation is required from the Health Coordination Council. With the management of our specialised doctor, the patient gathers all the needed medical information. Our doctor then applies for the patient, and all legal documentation is completed without additional fees. Patients who receive the confirmation can receive the treatment legally. For patients over 50, especially those with a significant health problem, the Ministry of Health might want to see the patient face to face in addition to the required documentation. This is infrequent; our doctor collects the patient’s medical information and completes the application only after taking the correct medical precautions, significantly shortening the process. Consequently, it is a success-increasing factor that the doctor who will perform the treatment takes care of these operations.

How is egg donation treatment done ? This question should be answered before the treatment because patient compliance is increased when the patient is informed about the treatment procedure, increasing the chance of success. The treatment procedure and processes should be decided upon before the treatment, as the patient and the egg donor start their treatment simultaneously. To achieve this, the menstrual cycles of the patient and donor should be synchronised. Therefore, treatments with good donor-patient synchronisation have the highest success rate. Since there will be no return when treatment is initiated, patients must complete all the tests required for infertility research before treatment. These tests aim to determine whether the patient is suitable for treatment and pregnancy and to provide a solution if a problem is observed before treatment. Since the egg donation process requires the donor to mature eggs for the patient and use medication, all stages of egg donation should be discussed and clarified with the patient beforehand. You can find the stages of IVF treatment with egg donation in detail below:

The maturation of the inner wall of the uterus: For menstruating patients, egg donation treatment begins with menstruation. For non-menstrual patients, treatment may start at any time. Since the donor will also be used for the treatment, if the patient has menstruation cycles, the menstruation of the patient and the donor must also be compatible, so the donor develops the egg in one hand. The patient develops the inner wall of the uterus synchronously. In non-menstrual patients, donor donation is started according to the donor’s menstruation. In recent years, the method of developing eggs with the donor and making embryos with the sperm of the patient’s spouse, and then storing the embryos, and transferring these embryos only when the female patient is ready is frequently used for the patient groups from distant countries or who have difficulty in finding suitable donors, and this increases the chance of success in these specific patient groups.

The uterine wall thickening protocol is usually made with hormone drugs in the form of a pill. The aim is to prepare the body for pregnancy by imitating the maturation of the inner wall of the uterus as in a regular menstrual cycle. Drug doses are adjusted depending on the patient’s age, uterine condition and clinical history. After the beginning of the treatment, the uterine wall is measured at regular intervals, and the drug doses are adjusted if required. The hormones given not only thicken the inner wall of the uterus but also increase the feeding of the tissue and, therefore, the chances of embryo adhesion. The situation is the same for non-menstruating patients, which means that even when the patient is not having menstruation cycles anymore, as the uterus is the latest ageing organ in the body, it immediately returns to a young uterine structure and responds thoroughly generally with the appropriate supportive treatment. As most of the patients come from outside of Cyprus, the ultrasounds during this part of the treatment can be done where the patient lives. Our doctor will arrange the treatment according to the ultrasound results of the patient’s treatment. In this way, the time the patient should spend in Cyprus is reduced.

Dose increases without follow-up examinations and ultrasounds can adversely affect the internal wall of the uterus, thus reducing success. For this reason, a unique treatment program should be prepared for each patient, and dose changes should be made only during examinations. It is, therefore, essential for patients to have their internal wall measurements of the uterus in the recommended days. Vaginal ultrasound is preferred in examinations. The reason for this is that a more precise image is obtained on vaginal ultrasounds than on abdominal ultrasounds. In this way, examination results will be guaranteed.

Medications started in our female patients are not only hormone drugs, but antibiotics, vitamins, blood thinners, and immunosuppressive drugs will be added according to the patient’s condition. As each drug will not be helpful to each patient, administering the necessary medicines should be specially designed by evaluating the patient’s medical condition.

While the inner wall of the uterus of the female patient is thickened, the donor of our patient starts the egg development treatment with the drugs used in the treatment of a normal IVF baby. The success of the donor in developing eggs depends on the age, ovarian reserve, donation history and the treatment protocol used. Our doctor takes the criterion of 21-29 age as a priority in donor selection, accepts donors after the inspection of egg reserves, does not prefer donors who frequently donate, follows the treatment protocol personally and uses first-class recombinant drugs in the quality used for the patient. Unfortunately, the use of cheap drugs to reduce costs in the development of donors is widespread, and patients are not aware of this situation. In our centre, the drugs used in IVF patients are also used in donors, and the highest egg success is targeted with recombinant drugs.

When the donor’s eggs mature, the donor receives the trigger injection, and the eggs are collected 34-36 hours after this injection. In the period when donor eggs are collected, the male and female patients should have come to Cyprus. Our centre wants our patients to be ready for egg donation in Cyprus at least one day before the collection day so we do not take risks. Generally, we prefer to organise the interview of our patients with our doctor the day before the collection of eggs. Still, we can also arrange this meeting with our doctor on the morning of the procedure for the patients coming to the island at an inconvenient hour. In this way, our patients can find answers to all questions in their minds by discussing with our doctor before the procedure begins. The examination of the inner wall of the uterus is evaluated with this interview and subsequent examination. In addition, during this examination, our doctor will perform a test to select the catheter for embryo transfer and select the most suitable catheter to pass through the cervix and increase the transfer success. If there is stenosis in the cervix or a problem with the transition, the measures are planned for those that can be resolved. In this way, the chances of becoming pregnant after embryo transfer are increased.

Collecting the eggs of the donor: Egg collection is performed under the sedoanalgesia given to the donor (under a mild anaesthetic), and the matured eggs’ follicles are collected carefully one by one. It is treated with care so that the patient and the donor never meet, and the hours of operation for each are calculated accordingly. With proper treatments, egg collection is not a process that destroys the donor’s ovarian reserve and does not cause permanent damage to the donor. The collected eggs are delivered to the embryology laboratory with a specific code for that donor. Egg donation is a type of treatment that does not require surgery, and no incision is applied during both the collection and embryo transfer processes.

Fertilisation of the eggs: One of the most critical questions stuck in the patients’ heads is how the eggs are fertilised. After the eggs are collected, they are kept in suitable conditions for a while, and at the time to obtain the best quality eggs, the cells around the eggs are cleaned. In this way, the quality of the eggs is now observable and ready for fertilisation. Only the so-called M2 eggs are used at this stage because these oocytes (i.e., the eggs) have the genetic structure prepared for fertilisation. GV eggs, postmature eggs, or eggs with anomalies are removed from the total number of eggs and discarded from the donor treatment. M1 eggs can be kept for a while, and those that transform into the M2-type egg can be used, but those remaining at the level of M1 are discarded. For patients, the best quality donor eggs should always be selected and used. In this way, the number of embryos and chances of pregnancy increase.

In egg donation, sperm is taken from the male partner of a female patient. The male patient gives a sperm sample in the same approximate period that the eggs are collected from the donor. The timing for the safety of both the patient and the donor is adjusted so that an encounter is impossible. The sperm sample given by the male patient is used in the treatment, and if there is no particular freezing demand for the excess sperm, this material is destroyed. For all IVF treatments, if a sperm sample is to be given, the sexual abstinence interval of 2 to 4 days is the best, so sexual abstinence should be planned accordingly.

The sperm sample taken is first washed and concentrated in the laboratory. To increase the success of egg donation and IVF treatments, ICSI treatment is standardised, and fertilisation is performed by ICSI instead of the traditional method, which has lower fertilisation success. In ICSI treatment (intracytoplasmic sperm injection), sperms with the best mobility and structure are chosen, and these sperm are injected into the egg so that each egg has one sperm. In this way, the sperm does not need to spend energy to enter the donor egg, and the best sperm is used in fertilisation. This increases the success of fertilisation.

Development of embryos (embryo culture): One day after fertilisation, fertilisation control is performed in the laboratory, and the number and quality of fertilisation are determined. While 2 PN indicates healthy fertilisation, 3 PN or 1 PN indicates unhealthy fertilisation. For some oocytes (i.e. eggs), fertilisation may not be observed. The number of healthy fertilisations depends on the preparation of the donor, the quality of the egg, the sperm quality of the male patient, and the laboratory conditions. For this reason, donors in our centre are thoroughly followed up by the doctor and are treated with the highest quality medications in the same way as all patients. This enables the fertilisation success of the eggs, which are already obtained by correct treatment by a donor who has already been selected in the best conditions.

The embryos formed, the infants at the cellular level, are regularly monitored and followed in particular places in the laboratory, such as special nutrition and living environments. The development of good-quality embryos goes well, while the growth of unsuitable embryos usually needs to catch up. The embryologist follows this development and shares the acquired information with the doctors and patients daily. Since the donor has donated, as in all donations, there is no right to know any process after the donation. For this reason, the donor is not given any information about the patient’s or embryo’s development after the donation.

In embryo development, additional hormone supplementation is started to prepare the internal wall of the uterus for pregnancy. These supplements may be in the form of a vaginal gel, suppository, pill or needle. The patient’s clinical condition determines the choice of the drugs to be used and the dosage.

Embryo transfer: When embryos reach the appropriate maturity for transfer, embryo transfer is performed. This is a painless and straightforward procedure if there is no serious problem with the cervix or the uterus, and it does not require anaesthesia. The fact that our female patient is awake in the embryo transfer process also increases her motivation to witness this particular moment. It is beneficial for the success of the pregnancy. Therefore, in our centre, anaesthesia is applied only when necessary.

In the embryo transfer process, the infertility specialist can access the uterus from the cervix via a special catheter suitable for the patient, and the embryos planned to be transferred are transferred to the most appropriate area for pregnancy in the uterus. The third and fifth days are the most common embryo development days for transfer. As the embryos stay outdoors, the stronger ones survive, and those who are weak are eliminated. Although this may be a condition that increases the chances of pregnancy, sometimes it can cause the loss of embryos, can lead to a pregnancy and decrease the number of embryos. Therefore, when deciding on the day of embryo transfer, the doctor, the embryologist, and the patient, according to the status of the embryos and the patient’s clinical condition, will increase the chance of obtaining the best result.

The number of embryos to be transferred is another element that needs to be decided, and transferring more than three embryos in terms of health is not recommended because they will increase the risks associated with multiple pregnancies. In many countries, the number of embryos to be transferred is limited to 1 or 2, but in some countries, such as Cyprus, the maximum number of embryos to be transferred is 3. As the number of embryos to be transferred increases, the probability of pregnancy also increases. For this reason, patients may prefer to be treated in countries where their options can be evaluated correctly and where the transfer of up to 3 embryos is possible. Of course, patients should be well-guided about the number of embryos to be transferred and the treatment to be performed, and all possibilities should be discussed with the patients during the transfer pre-treatment. The general practice in our centre for deciding on the number of embryos to transfer is that the physician and patients decide together, considering the patient’s condition, type of treatment, and priorities.

On the day of embryo transfer, the embryos planned to be transferred are placed in the embryo glue at the laboratory in our centre without any additional fee. In this way, the chance of adhesion of the embryos is increased. Immediately before the embryo transfer, the hatching process to the appropriate embryos to increase the chances of pregnancy is carried out as a standard process without requiring an additional fee. In this process, the membrane surrounding the embryo is thinned from a specific point by a special laser, and the success of adhesion is increased.

Since we offer a good quality egg guarantee to our patients, if there is no severe problem with the sperm of our male patient, additional first-quality embryos of our patients can be present in our centre, and these embryos can be stored on behalf of our patients with the approval of our patients. Storage of good surplus embryos will provide a second opportunity to our patients if the pregnancy cannot be achieved. If the pregnancy is achieved, they will have the chance to have their siblings under the same genetic fraternity conditions.

The duration of egg donation treatment is based on the treatment of the female patient and the donor. On the one hand, the endometrium of the female patient (i.e., the inner wall of the uterus) is prepared for pregnancy. Still, on the other hand, the donor simultaneously develops eggs for our patient. For this reason, if the menstrual cycles of the patient are present, the menstrual cycles of the donor and the patient must be compatible. The treatment plan must be prepared according to the synchronised menstruation of both individuals. If the patient does not have any menstruation, the treatment plan is prepared according to the donor’s menstruation plan. The treatment process lasts 17-21 days, according to the protocol. In patients who need to receive suppression by the extended protocol, treatment starts before menstruation and the total duration of treatment is approximately 24-28 days. Since most of our patients are from outside of Cyprus, the part that includes medication and ultrasound checks are completed in our patients’ countries to shorten the duration of their stay in Cyprus. During this process, the treatment protocol and drug use are determined by our doctor, and according to the results of the examinations performed by our patient’s doctors, a treatment plan is made by our doctor and the required drug dosing is done remotely. What our patients should request from their doctors is written to them. Our infertility doctor, who follows the donor and regulates the treatment, brings our patients to Cyprus when the eggs reach the expected maturity and completes all the IVF procedures in Cyprus. In this way, the length of time that our patients need to stay in Cyprus is between 6 and 8 days, depending on the day of transfer, and therefore, the duration of stay is much more convenient.

For the person who will donate eggs, applications are accepted within the TRNC Ministry of Health criteria framework. To be a donor, the requirement of being between 20-35 years of age is legally sought, and to ensure the success and quality of the egg obtained, our doctor prioritises the applications between the ages of 20-29.

Another issue investigated in donors is genetic characteristics and hereditary diseases. This study performs a detailed family history of blood donor karyotype analysis (chromosome number anomaly screening) and genetic diseases in the region (for example, diseases more common in the Mediterranean region, such as Thalassemia and sickle cell anaemia). If a suspected case is encountered, additional searches are made for suspected diseases, and only people with routine scans can be donors.

Another issue that must be investigated in donors is infectious diseases. Although most of our donors are university students, all donor candidates are screened before all donations in terms of infectious diseases such as Hepatitis B, Hepatitis C, HIV and Syphilis. Treatments are initiated only with the donors whose infection tests are negative.

Before becoming a donor, the attending physician interviews all candidates, some general characteristics such as blood group are screened, detailed background and medical history are taken, and a thorough psychological evaluation of the donor is carried out; in addition, the infertility specialist carries out the gynaecological examination, and only the candidates who have passed all the evaluations are accepted as donors.

All these assessments are very important for the protection of the patients who will receive the donation and for the protection of the health of the donor candidate. For this reason, all medical evaluations our doctors make are stored in written patient files, and archived information is carried out in coordination with the Ministry of Health.

In all our donor treatments, we show the same attention and care to our donors and patients, which will suit this serious volunteering they are doing. Similarly, we use the same quality medication and treatment methods for our patients and donors, thus ensuring maximum success in donor egg donations; additionally, we secure the health of our donors.

Egg donation is a process that should always be carried out with the same care in IVF centres. Due to the subject’s sensitivity, collecting all the information about the donor, donor matching and treatment of the patient and donor are carried out by the same infertility specialist. This factor maximises the chances of success and the reliability of treatment.

One of the most essential parts of egg donation treatment is the determination of the donor and synchronisation with the patient who will receive treatment. Even though the donor has undergone all tests and evaluations, several other factors should be considered in determining the appropriate donor for the patient. One of these is that the donor’s physical characteristics should be compatible with the recipient’s patient or compatible with the characteristics they want. Of course, not all the features of the child are inherited from the egg, but the semi-properties are passed from the father. However, if the donor’s genetic characteristics match the female patient’s genetic characteristics, the child will be similar to our female patient. Generally, the features scanned for compatibility are skin colour and tone, hair colour and type, eye colour, race, height, body structure, and face shape. Since the Cyprus law cannot share any characteristics that disclose the identity of the donor and the donor must be anonymous, the donor’s photographs cannot be shared with the patients to protect the security of both the patient and the donor. Among appropriate donors, the doctor decides on the most suitable donor who will suit the patient’s physical characteristics, which is shared written and orally with the patients.

Another feature that can be screened for compatibility is the blood group. The fact that the child’s blood group is compatible with his / her mother or father ensures that the child is safer in terms of blood donation in the future and also prevents the parents from having a hard time if they do not want to share with their children the fact that they received egg donation. Nevertheless, blood group compliance is not a factor that increases the success of treatments, and even if the blood group is incompatible, the patient can be treated with a donor from a different blood group if the patient approves.

Among the evaluated features of the donors are social characteristics such as personality traits, occupation and educational status. The compatibility of these characteristics is evaluated as much as possible while making the selections.

For patients with menstrual periods, another feature that is very important in the selection of donors is the date of their menstrual period because, in selected treatments with fresh eggs, the donor should be treated at the same time as the patient and should receive treatment at the same time. For patients who do not have menstruation, only the days of treatment according to the donor’s menstrual period are determined. To increase the success of treatment, our doctor takes care not to shift the menstrual cycle of the donors to a large extent. This enables the obtaining of maximum quality eggs from the donor who does not break the laying pattern, and this method is preferred for success. For this reason, the synchronisation of patients whose menstruation is incompatible should be done over a long time, or another donor matching should be recommended to the patient.

Following the egg development treatment applied to the donors, obtaining a certain number of eggs is expected. Several elements are decisive in obtaining the desired number and quality of eggs. These are the donor’s age, the donor’s ovary, the donor’s donor’s ovarian reserve, the quality of the treatment and follow-up applied to the donor, the quality and correct use of the egg development drugs, and the donor’s compliance. The proper combination of all these parameters will maximise the success rate of egg donation.

Our centre’s parameters are meticulously evaluated, and our specialist physicians arrange the most optimal treatments. These guaranteed egg donation treatments ensure that more eggs are provided to the patient than the patients will need in a treatment process. This means nasty surprises, such as a few eggs, are prevented at the last minute. Furthermore, in our centre, the patient is offered much more than the eggs required for only one treatment. If there is no severe problem observed with the sperm, good-quality embryos can be provided for the majority of our patients after treatment and for a second treatment. In this way, our patients can receive a second treatment with only frozen embryo transfer treatment, get a second chance, or receive a second treatment service more appropriately for the siblings.

Egg donation is a process that affects patients psychologically, and very detailed information contributes to the relief of patients and makes the treatment more compatible. In egg donation, some of the hereditary characteristics of the donor will be passed on to the child with the egg transferred due to DNA transfer. For this reason, the more similarity between the donor and our female patient at the donor’s selection stage, the greater the likelihood that the child will be similar to the mother. When a donor with characteristics identical to our female patient’s is selected, the child will bear the donor’s characteristics. These will be compatible with the mother so that the child will resemble their mother. On the other hand, since half of the child’s genetic characteristics will be transferred from the father’s sperm, the child will also resemble their father.

The duration after egg donation is as important as the treatment itself, as some essential things can be taken to increase the chances of the treatment’s success and contribute to a smooth pregnancy process. Therefore, we continue providing professional support during the treatment process and before and after.

In the treatment of egg donation, the factors affecting the success of the pregnancy are the donor’s ovarian reserve and quality, the age of the donor, the quality of the treatment applied to the donor and the quality of the egg obtained, the number and quality of the sperm of the male patient, the status of the female patient’s uterus, the compliance of the female patient to the drug use, the stress situation in the couple, the quality and number of embryos being transferred and the quality of the doctor and the laboratory. Following the embryo transfer, patients’ compliance and sustainability of the process will be factors that will increase the success rate.

One frequently asked question is what should be done after embryo transfer. After the transfer, a 1-2 hour rest and a quiet day is recommended. Lying down for a day after transfer will not increase the success of pregnancy and may increase the likelihood of stress-induced issues. For this reason, we recommend that our patients be as mobile as pregnant women after a transfer.

As with all assisted reproductive therapies, after these treatments, we recommend that teas such as sage tea and green tea and caffeine-containing beverages such as coffee and cola should not be consumed, which may cause uterine contraction. In addition, it is recommended that the patient refrain from eating foods that cause gas and swelling, as these decrease patient comfort.

B-Hcg test, which is a pregnancy test, is performed 12 days after the transfer and determines if our patient is pregnant or not. Tests performed before the recommended date may lead to misleading results because both the value may be lower, and, in some cases, the test may be positive even if the patient is pregnant. It may increase the chance of miscarriage by causing unnecessary sadness. Patients should have the test on the recommended day and deliver the result to the doctor. Our doctor will provide detailed information about the status of the pregnancy by making the necessary evaluation. If the test result is positive, the patient’s pregnancy is determined, and two days after the test, repetition is recommended. The rate of increase in the value provides information about the course of pregnancy and determines the ultrasound day. These patients should continue their medication exactly as planned after the test result and should not reduce or stop any medicines unless that is what our doctor recommends. Regulations of medicines are still our doctor’s responsibility, and drug regulations and modifications are made routinely when needed.

As with all IVF treatments, the result of the treatment with egg donation may be harmful as well as positive. Test repetition may be requested in suspicious cases where negative results are obtained. The patients whose definite negative results are confirmed discontinue the medications, and a detailed file review on why the pregnancy could not be obtained is made. Additionally, the investigations that can be made over the current situation and the additional measures that can be taken (if there are any) to prevent another failure are determined. These aim to increase the chances of pregnancy in a second trial.

Egg donation is legal in Cyprus, and applicable laws and regulations protect patients. All egg donation treatments are carried out under the control and supervision of the TRNC Ministry of Health. In our treatments, the condition of marriage is not required. We record all our patients who have indicated themselves as a couple. Similarly, the embryos made with the donor egg and the sperm of the male patient are also recorded completely legally in their name.

In addition, it should be noted that all egg donors should receive infection scanning, genetic screening, psychological evaluation and blood screening as designated by the Ministry of Health. All the egg donors admitted to our centre undergo these tests before the egg donation, and only those with completely healthy results are accepted to make donations to our centre.

Complete patient confidentiality is maintained in egg donation IVF treatment, and no identity information or treatment details of patients or donors are shared. This rigorous control ensures that the donor and the family do not detect each other so that both are entirely safe. In addition, the information is not shared with third parties because most of our patients choose to keep these treatments confidential; we respect their wishes and pay attention to keeping patients’ information completely legal.

By law, we cannot share information on egg donation IVF prices on our website. You can contact us for detailed information.