IVF Treatment with Embryo Donation

This question may be more explanatory when asked, “What is egg and sperm donation?” because the structures that make up the embryo are egg and sperm cells, and embryo donation is the treatment of in vitro fertilisation of eggs and sperm that are both received from donors. So, this treatment involves transferring the embryos, in the cell phase, into the patient’s uterus, where the egg cell is taken from a donor and fertilised with a sperm sample selected by our patients. In this process, the womb of the female patient is made ready for pregnancy before transfer, and this allows for a very high success rate of pregnancy. Sperm donation is the only option for male patients who do not have sperm production or cannot use a sperm sample for some reason and for female patients who do not have a male partner. Similarly, egg donation is the only opportunity for female patients if the egg production is exhausted or the eggs cannot be used for specific medical reasons. As with all other treatments, our aim in embryo donation treatment is to provide our patients with the highest success by offering the proper treatment to the right patient group. In this process, considering the issue’s sensitivity, we aim to protect the confidentiality of our patients.

Treatment with egg and sperm donation (i.e. embryo donation treatment) can be done in licensed in vitro infant centres in countries where egg and sperm cell donations can be legally made. The treatment of donations in legal countries is an issue that should be considered for patients because it protects the patient, the correct and regular follow-up of the donors and the transparency. We perform all our treatments in Cyprus with the approval of the Ministry of Health and offer our patients a legal guarantee. In other words, it is entirely reliable to make egg and sperm donations in Cyprus. Although egg and sperm donation treatments can be performed in some other countries, Cyprus is preferred because it is much more economical than both its European and Asian counterparts, and it has higher success rates than its counterparts due to its legal framework. In Northern Cyprus, the official language is Turkish, and English is also known and spoken widely on the island. Thus, patients from Turkey, Europe, and the Middle East are chosen. All over the world, Cyprus is a preferred country for the treatment of embryo donation.

In all the centres where these treatments are performed, there should be a tank system in which certified sperms can be stored and controlled, and the safety of this system should be ensured. In addition, the treatments must be performed by specialists who have completed their field education and have the necessary certificates or certificates. Our doctor in our centre, Asst. Prof. Burcu Özbakır is a specialist in gynaecology and obstetrics and is the only doctor with a diploma in IVF treatments from her studies in the United Kingdom.

Egg and sperm donation treatment is only applied to patients who are obliged to take egg and sperm donation together. In summary, eggs and sperm cells are offered to our patients only when needed. When receiving egg donation, it is a necessity for a female patient. When the male patient should have a sperm donation, or when a male partner is absent, both the egg and the sperm donation are the only solution for our patients to be able to have their children. Therefore, the requirements for egg donation and sperm donation are set out below:

Conditions where sperm donation is a must:

• The male patient does not have sperm with fertilisation capacity
• The male patient has a disease that can be genetically transmitted to his children
• The male patient has a severe disease such as HIV and HCV, which can transfer to his children or his partner
• Repeated insemination failure due to sperm from male patients in previous treatment stories
• There is no male partner

Conditions where egg donation is a must:

• Reduced ovarian quality or premature depletion of ovarian reserve (early menopause)
• The female patient’s ovarian reserve is low or depleted due to her age
• The female patient has a disease that can be genetically transmitted to her children.
• The female patient has a genetic disease that depletes the ovarian reserve (e.g. Turner Syndrome)
• The egg structure or reserve of the ovary of the female patient is impaired due to chemotherapy or radiotherapy to the genital area
• The female patient’s ovaries have not been present since birth or have been removed or damaged

Although there is no age limit for getting egg and sperm donation, there are some legal regulations in the female patient applications so that the female patient can carry the pregnancy and healthily have her child. While for patients under 45 years of age, the treatment can be performed directly, for patients that are 45 years of age and above, some scans need to be made, and it should be demonstrated to the Ministry of Health that there is no additional harm to the patient to be pregnant and that the general health of the female patient is sufficient to be pregnant. Regardless of the form of treatment, it is obligatory to make some analyses which are specified in the related law and which are required to be completed in patients aged 45 years and above, and with the results of these analyses, it is obligatory to obtain approval from the Ministry of Health. This approval should be received before the start of the IVF treatment; it ensures that both patients are treated safely and that the treatment is done legally. In the case of 50-year-old or older women, if the patient has serious health problems, the Ministry of Health may wish to meet with the patient in addition to the application dossier. This situation is rarely seen; with some health measures taken based on preliminary examinations performed by our physician, the approval process goes very smoothly. For this reason, our patients’ medical processes in our centre are progressed by our specialist physician, so the chance of success can be increased to a much higher level.

In vitro fertilisation with embryo donation is a sensitive treatment in which both the egg and the sperm cell are donated, and the patient’s knowledge of the treatment process before treatment allows the treatment to go much more harmoniously and synchronously and, therefore, increases the chances of pregnancy. In addition, it is only possible for the patients to obtain sufficient information before treatment if the specialist physician can understand the patient’s clinical situation and present the patient with a unique treatment plan; therefore, the success rate of the patients is much higher in the doctor-managed therapies. In our centre, our specialist physician examines all the information and tests of our patients in detail and offers special pre-treatment and treatment plans for the patient. Since both the egg and the sperm will be taken from donations, pre-organising both donated cells and performing controlled treatments are other factors that bring success. In these treatments, egg donation and sperm fertilisation can either be performed concurrently with the development of the inner wall of the uterus, or the embryos can be prepared and stored under the patient’s name before the endometrium is ready. There are risks in both administrations and which method is safer and better for our patients is determined according to their clinical status.

Our patients should have completed all the research that needs to be done before starting a treatment. These investigations may be tests or examinations. Since the sole purpose of these studies is to ensure that our patients have the best possible health for a healthy pregnancy, the tests should be completed, and our doctor should take the necessary precautions before the treatment starts.

The treatment of patients should be precise before the start of the treatment of donors, as the process of embryo donation requires processes such as the development and storage of eggs and the export and storage of certified sperm.

The stages of IVF treatment with egg and sperm donation are described in detail below:

Maturation of the inner wall of the uterus: For menstruating patients, in vitro fertilisation with embryo donation begins with the menstruation of patients. For patients who are not menstruated, treatment can be initiated at any time. If the patient is to be synchronised with the egg donor, the donor’s menstruation must also be compatible with the patient’s menstruation. In patients who have no menstruation, treatment can be started with the donor’s menstruation. Especially for patients who have an unpredictable internal wall development and require a guarantee for a good number of embryos, in cases where it is difficult to find donors, or for the patient groups coming from distant countries, it is possible to pre-fertilise the donor with the sperm and to store it on behalf of the patient and to transfer the embryo to the female patient when the inner wall of the uterus matures. This method can increase pregnancy success in selected patient groups.

The inner wall of the uterus is the place to hold the transferred embryo and is where the pregnancy will take place. Therefore, it is essential to thicken and mature the inner wall of the uterus. The first treatment is usually started as a pill treatment, and the type and dosage of the drugs to be used are decided according to the status of the patient’s uterus, age and medical history. When the treatment begins, the patient has her endometrium measured at the requested intervals, and if necessary, the drug doses are adjusted. Vaginal ultrasound examination provides a much clearer image, making more accurate treatment is possible. For this reason, we recommend that the examinations should be performed with vaginal ultrasound rather than abdominal ultrasound. The hormone drugs used by the patient both thicken the inner wall of the uterus, increase the blood supply and nutrition of the tissue and increase the chance of pregnancy. Even in patients who do not have menstruation, the uterus responds very well to this hormone treatment and returns to a young uterine structure with appropriate treatment. Since the vast majority of patients come from outside of Cyprus, these pre-examinations can be done in the place where the patient is located, and the results can be sent to our doctor, who will make the dose adjustments remotely and therefore significantly shorten the amount of time that the patient needs to stay in Cyprus.

Treatments without examination follow-ups and inaccurate drug-dose increases can only result in an average success rate as the treatments are not given according to the development of the uterus. Therefore, the patient is given an average treatment. For this reason, we keep our pregnancy success at the maximum by providing periodic intervals of examination and dose changes with the recommendations of our doctor.

In addition to hormone therapy, the treatment is organised according to the patient’s needs by adding antibiotics, blood thinners, vitamins and immune system regulators.

While preparing the inner wall of the uterus of the female patient, the donor starts receiving medications that are used to develop eggs. The quality and number of eggs the donor will develop depends on the donor’s age, the history of donations, the ovarian reserve, the type of treatment used and the medication. In our centre, donors between the ages of 21 and 29 are given priority, and many analyses, including an egg reserve scan, are done before the donor is accepted. Donors who make frequent donations are not accepted, and our doctor treats the donor using first-class recombinant medication that is also used for our patients. The use of cheap and low-quality drugs to reduce costs in the treatment of donors is a common situation which inevitably affects pregnancy success. In our centre, donors are administered the best quality recombinant drugs, thus achieving the highest success.

After the donor’s treatment, a trigger injection is made when the eggs reach the desired maturity, and the eggs are collected after 34-36 hours. Male and female patients should be present in Cyprus when eggs are collected. For this reason, for the safety of our treatment, we ask our patients to be present in Cyprus one day before the collection of eggs. One day before the egg collection, our doctor discusses with our patients and examines our female patient to see if everything is OK. This can be done on the morning of the collection of eggs at the latest. This allows for the last control and evaluation of the endometrium thickness before the procedure and the selection of the catheter to be used in the transfer by our doctor. In this way, our patients’ preparation for embryo transfer can be done in advance to perform in the most appropriate conditions. In this doctor’s meeting, our patients can also find answers to all the questions in their minds before the procedures start.

Collecting the donor’s eggs: Eggs are collected under sedoanalgesia and mild anaesthesia, and the matured eggs’ follicles are collected carefully. The egg collection for correctly treated donors does not adversely affect the ovarian reserve and does not cause any permanent damage to the ovary. This is a non-invasive process where a special needle collects the eggs, enabling the donor to go home on the same day. To ensure that patients and donors do not encounter, the hours of operation are planned very carefully, and this issue is approached with high sensitivity in our centre. The collected eggs are taken into the embryology laboratory and recorded individually with the donor code number.

Fertilisation procedure of the eggs: After the eggs are collected, they are rested for a particular time in the appropriate environment and cleaned from the cells around them during that time to obtain the best quality eggs. After cleaning, the eggs are fertilised, and their quality is determined. A total of 4 types of eggs are available, but only M2-quality eggs can be fertilised. Eggs in the development stage M1 have not yet reached sufficient maturity but can reach the M2 level if waited for a while. The fertilisation process can be applied to those who have completed their development from M1 quality to M2 quality in this waiting period. Eggs called GV are eggs that have no fertilisation capacity and are not used for treatment. Eggs, termed as postmature or anomalies, do not have typical structures or are too old, and they are not used in the fertilisation process as they are unhealthy. In our centre, only the best quality eggs are selected and used in our therapies, so the number of embryos and the probability of pregnancy increase to very high levels.

While the good-quality eggs are selected, the sperm sample, which our patients have already determined, is removed from the tank, and the best sperm is chosen based on structure and movement. These selected sperm are injected into the egg with a particular system so that there is one sperm per egg. This specific treatment is called ICSI (intracytoplasmic sperm injection) and is routinely added to the treatment of all embryo donation and IVF treatments in our centre; in this way, the fertilisation success of the eggs is increased. This success is because the sperm does not require additional energy to enter the egg; only the best sperm is selected and used.

Development of embryos (Embryo culture): After fertilisation, embryos are monitored periodically and scored with a particular system. The number of fertilisations is determined on the first day. The embryos, called 2 PN, are the markers of good fertilisation, while the embryos 3 PN and 1 PN indicate unhealthy fertilisation. For some eggs, no fertilisation is observed. As both the egg and sperm will be taken from donations, the success of fertilisation is expected to be high. This is because only healthy and young donors are used to obtain eggs and sperm, who go under a wide variety of tests and are expected to provide a high-quality cells. The rate of healthy fertilisation depends on the preparation of the donor, the medications used by the donor, the quality of the eggs, the quality of the sperm and the laboratory conditions. This success is further increased by using only certified sperm in our centre. The egg donors admitted to our centre receive treatment under our physician’s supervision, and the highest quality medicines are also administered to our patients. This makes it possible for a donor to produce the highest quality eggs whose preparations and scans are already correctly made.

The developed embryos, in other words, the cellular infants, are fed by the embryologist in special conditions in the laboratory and with special liquids. The embryologist regularly monitors the environment, makes necessary adjustments, and shares the development of embryos with patients and physicians daily. The sperm and egg donor do not have the right to know the process after the donation, as in all other contributions. Therefore, no information is reported to the donor, including the patient or embryo development process.

During the process of developing embryos, our female patient starts additional hormone medication to prepare the inner wall of the uterus for pregnancy. This medication may be in the form of vaginal suppositories, gels, tablets or needles. The choice and dosage of the drugs are based on the patient’s current medical condition.

Embryo transfer: This is the procedure of transferring embryos ready to be transferred. Embryo transfer is a painless procedure if the cervix or uterus does not have a severe problem and does not require anaesthesia. In addition, since meeting the embryo(s) is an extraordinary moment, we prefer that the patient witness this process, which increases our patients’ motivation and success. For this reason, anaesthesia is applied in our centre only if medically necessary.

In the embryo transfer process, the infertility specialist passes through the cervix and reaches the uterus through a pre-determined catheter that is suitable for the patient. Immediately after that, the embryos selected for transfer are transferred to the most appropriate point in the uterus. The optimal embryo development stages for transfer are the embryos’ third and fifth development days. As the number of days in which the embryos remain in the laboratory environment increases, unhealthy or weak embryos can be eliminated, and the success of embryos can be increased. However, as the number of days in the external environment increases, the ability of the embryos to survive decreases, and some embryos can be lost while they are healthy. Therefore, To give the best answer to the question “On which day should the embryo transfer be performed?” the doctor, the patient, and the embryologist must act together.

Another issue that needs to be decided is the number of embryos to be transferred. It is legally possible to transfer 1 to 3 embryos in our centre. The number of embryos to be transferred to the patient depends on the development and number of embryos, the medical condition of the female patient, the condition of the uterus and the patient’s thoughts; as the number of embryos transferred increases, the success of the pregnancy increases. Hence, patients prefer to be treated in countries where they can receive the proper treatment and where up to 3 embryos can be transferred if necessary. The only negative aspect of more than one embryo transfer is the increased risk of multiple pregnancies (especially twins). For this reason, as in every stage, the infertility physician should inform the patient correctly at the stage of embryo transfer, and the most accurate choices should be made by evaluating the current clinical findings. In our centre, the treatment method, the patient’s medical condition and priorities are evaluated individually, and the doctor and the patient make the decisions together.

Before embryo transfer, some treatments that increase pregnancy success are offered to our patients free of charge in our centre. The embryos planned to be transferred are stored in the embryo glue fluid. This liquid is also known as embryo adhesive. Immediately before the transfer, a unique laser-assisted hatching process is applied to these embryos, free of charge. This increases the chance of the embryo holding on to the uterus.

In our centre, because our patients are presented with perfect-quality eggs and sperm, the number of good-quality embryos is usually more than what is transferred. In this case, we advise our patients to freeze these good-quality extra embryos and store them under their name. One reason for this is that if our patient achieves a pregnancy on the first try, she will have the chance to be treated another time for a full biological sibling. If the pregnancy is not achieved in the first attempt, a second trial can be made at a much more affordable price.

The duration of embryo donation treatment is based on the treatment of the female patient and the egg donor. Since sperm is supplied from the bank and various options are already available at our centre, no waiting period is required for sperm. In this process, while the inner wall of the uterus is prepared for pregnancy with medications, the donor receives egg development treatment simultaneously. The treatment begins with synchronising the donor’s menstrual cycle and the patient’s menstrual cycle, if there is any. If our female patient does not have menstrual periods, treatment can be planned according to the donor’s menstrual cycle. The treatment lasts from about 17 to 21 days, depending on the type of treatment program selected. For patients who require hormone suppression with a long-cure protocol, the treatment is started before the menstrual period, and the total duration of medication use is between 24 and 28 days until embryo transfer. Since most of the patients come from outside of Cyprus, to shorten the duration of their stay, they can spend this time in their local country after the treatment program and prescriptions are prepared. Before the procedure, our patient only uses medication and has ultrasound follow-ups at specified intervals. Our doctor shapes the whole process, and the determined treatment program is regulated remotely by the doctor according to the ultrasound results of our patient. As the requests are given to the local doctors in writing and the required examinations are very basic, they can efficiently perform what is needed in these ultrasounds. On the one hand, our physician follows the donor. On the other hand, she organises the patient’s treatment remotely, and when the eggs reach the expected maturity, the eggs are collected. Fertilisation is carried out with the sperm selected by our couple. During this process, the medications of our female patient are rearranged. Although the patients do not need to be present until our laboratory is ready to transfer our embryos, we recommend that our patients are in Cyprus on the day of the egg collection from the donor as both the selection of sperm can be made more efficiently, the examination of the female patient can be done before the medications are regulated, and the transition to the uterus before the procedure can be evaluated. These increase the chances of pregnancy. This results in around 6 to 8 days that our patients must stay in Cyprus, depending on the transfer day. If our patients do not want to be here for the last check after completing all the preliminary preparations, the duration is only 3 days. However, we do not recommend uncontrolled treatment unless there is a very urgent situation. In addition, even if no sperm sample is taken from the male patient, the male partner needs to be together with the female patient, both in terms of legal approval and increasing the morale of our female patient and increasing the success of pregnancy. For this reason, we recommend that male partners be with their partners during treatment.

Since embryo donation consists of egg and sperm donation, the egg donor and the certified sperm are needed. The following describes the selection criteria for both groups, respectively:

First, we will talk about egg donation. For egg donation, applications are accepted according to the TRNC Ministry of Health criteria. To be able to donate eggs, the donor should be between 20-35 years of age, but for high success, donors in the 20-29 age range are selected as the priority.

Genetic features and hereditary diseases should also be investigated in egg donors. After obtaining a family history of genetic diseases, a karyotype examination for chromosome analysis is performed, and screening for more common genetic diseases (diseases more common in the Mediterranean region, such as sickle cell anaemia and thalassemia) is performed. Additional screening is performed if there is a suspected disease in the medical history. All females with expected screening results may be donors.

Another analysis that is necessary for egg donation is infectious diseases. All donor candidates are screened for infectious diseases such as Hepatitis B, Hepatitis C, HIV and Syphilis before donation, and only patients with negative infection scan results are taken as donors.

Some general scans, such as blood groups, are made to the donor candidates who pass all stages, and a specialist evaluates them. In this evaluation, all medical history and background are assessed, a detailed psychological analysis is performed, and the infertility specialist investigates compliance with treatment through a gynaecological examination. They are successfully passing all these evaluations as a donor, which is intended to protect both the donor and the health of our patients. All information is carefully collected and archived and, if necessary, only shared with the Ministry of Health.

Like our patients, we show our utmost care during the donor treatment period in a way that suits this serious volunteerism. For this reason, donors use the same quality medication and treatment methods as the ones used for the patients so that the best medication is used for the donor’s health, which makes it possible to achieve maximum success.

In sperm donation, a different method is followed under the laws in Cyprus. Since the centres are not allowed to take direct donations from individual sperm donors, only imported certified sperm is used. This is a healthier process and the legal method for the patient’s assurance. There are sperm banks in different countries; some of them use more advanced technology than others and accept the sperm of the donors passing through more stringent controls. Trusted sperm banks should also keep their donor information very strictly; all data should be kept for at least 50 years, and selected sperm samples should reach the centre in a fully secured liquid nitrogen tank. Cryos is the most prestigious sperm bank in Europe. It was established in Denmark, so we work with Cryos.

Sperm donors who apply to the Centre of Cryos undergo a general screening, followed by infection screening, blood group analysis and genetic screening, and they are also screened for common genetic diseases. Family history and psychological analysis are completed, and sperm samples are taken from the appropriate donors, marked with a particular coding system and frozen. Six months after the sample is given, the donor is re-tested for infections, and only the samples of donors who have negative results in both analyses can be used. The certification of the sperm sample is a long and laborious process due to all these studies.

All general characteristics of the sperm donor taken and recorded as sperm samples are recorded. It is forbidden to share any information that may reveal the identity information of the donor following the legal legislation in Cyprus. However, all anonymous information can be shared with the patients. In our country, information such as weight, height, eye colour, hair colour, skin colour and tone, blood type, profession, education status, age, race and country of sperm donor can be shared with patients.

Again, under the legal regulations in Cyprus, no information is given to the donor about the receiving family, and the donors do not have any right to receive information about the recipients.

Selecting both donors is essential since it contains both egg and sperm donations. Receiving information about donors, donor-patient matching, and the egg donor treatment by the doctor who also treats the patient will increase the success.

The interview can do sperm selection with the embryologist. During this selection, the physical characteristics, blood group, occupation and educational status, and age and racial characteristics of the sperm donor, which are anonymous information, are shared, and the appropriate sample is selected together.

The egg donor selection is somewhat more specific because the recipient patient and the donor need to be physically compatible with the physical properties, such as the blood group, and synchronise the recipient patient with the donor. For this reason, the egg donor with the desired size, body structure, hair colour, skin colour, eye colour, blood type, and race characteristics is found first.

For both sperm and egg donor selection, blood group similarity is a desired factor. If the child’s blood group is from the same blood group as a parent, it will be a good safety measure for blood donation and for parents who do not want to tell their child that they have received egg and sperm donation. Nonetheless, a blood group does not affect the success of treatment, and even if the blood group is incompatible, if the patient especially wants a particular donor, treatment with that donor from a different blood group can be done with the patient’s consent.

Another factor used during the evaluation of the egg and sperm donors is the character information such as personality traits, educational status, occupation, and the choice of suitable donor combinations is made when making choices.

Another feature in the selection of egg donors is the menstrual cycle. Because when the treatment is done by using fresh eggs, the female patient and the donor should be menstruating at the same time and receive treatment at the same time. To maintain treatment success, donor menstrual cycles must not be too shifted; in this way, it is possible to obtain the highest quality eggs from the egg donor. Therefore, synchronising patients and donors whose cycles are incompatible should be extended over a long period, or other donors should be recommended for treatment. If our female patient does not have menstrual periods, treatment can be started quickly with the cycle of the donor the patient has chosen.

Another treatment plan is to prepare and store embryos in advance using the cells of the selected egg and sperm donor. This way, it is possible to start embryo transfer by choosing from pre-prepared embryos when the patient’s endometrium is ready. In this method, since the embryos have already been prepared, the need has already been completed, and the possibility of treatment cancellation is zero.

For the selection of both sperm and egg donors in Cyprus, information such as photos, telephone, and addresses to reveal the identity of the donor cannot be shared by law; thus, both sperm and egg donors should be anonymous. Donors have no right to know any information about the recipient’s patients under the same law. Thanks to these laws, both the identity of the donor and the identity of the family and the child are protected.

When egg development treatment is applied to donors, it is planned to obtain a certain number and quality of eggs. The determinants for the desired quality and number of eggs obtained are the donor’s age, ovarian reserve, frequency of donations, the quality of the treatment and follow-ups, the quality and correct use of the medications and the donor’s compliance. The presence of these factors together increases the success. Our centre pays significant attention to these markers; only specialist doctors prepare the donor. Thus, our donors can develop more eggs than the patient needs for the treatment, obtain more embryos than expected, and avoid the possibility of not achieving an embryo. Another advantage of developing many good embryos is that it allows our patients to store them for a second trial. In this way, if pregnancy cannot be achieved in the first treatment, the patient can go for a second try with the frozen embryo transfer treatment, or if she can achieve pregnancy, she will have the chance for a more suitable treatment if she wants to have a sibling for her baby.

It is a frequently asked question to whom the baby resembles in embryonic donation. As both sperm and eggs are received from donors, the baby will be similar to a mixture of both donors. The reason for this is that the DNA of the baby, i.e. the genetic structure, comes from both donors. Therefore, choosing donors with similar characteristics will enable the child to resemble the patients and the mother and father.

The process after treatment is critical because some measures will increase the chances of pregnancy and also help to have a more comfortable pregnancy. For this reason, we provide professional support to our patients not only before and during the treatment but also after the treatment.

Factors affecting success in embryo donation include age of egg donor, ovarian reserve and quality, quality of treatment applied to both egg donor and female patient, number and quality of eggs obtained from egg donor, status of female patient’s uterus and response of the endometrium (inner wall of the uterus) to medicine use, the compliance of the female patient with the medicine use, the number and quality of the embryo transferred, the stress status of the patients and the technical skill of the doctor and the laboratory. It is observed that the success rate is higher in patients with higher compliance.

It is sufficient for the patient to rest for 1-2 hours after embryo transfer, and in the following days, she should avoid heavy work similar to what a pregnant woman would do. Long-term bed rest is not recommended since the level of stress increases and the success rate of pregnancy decreases.

Another issue that needs to be considered after embryo transfer is food/drink consumption. We recommend that our patients avoid consuming caffeine-containing beverages such as coffee and cola and refrain from drinking teas such as green tea or clary sage tea that can cause contractions in the womb. In addition, it is essential not to consume any food that might cause gas in the intestines, as this prevents discomfort in the abdomen.

Twelve days after embryo transfer, a B-Hcg pregnancy test in the blood determines whether the pregnancy occurred. Suppose the test is performed before the recommended date, even if a pregnancy occurs. In that case, the test might not be positive yet or might give results that are lower than expected and might, therefore, create stress in the patients and increase the risk of miscarriage. The patient must take the test on the recommended day and share the result with the doctor. Our doctor evaluates the results personally, indicates if there is a pregnancy and its status and gives suggestions about the condition. If the results are positive, we ask our patient to repeat the test 48 hours later. The rate of increase between the two test results will give more information about the course of pregnancy. Values and increase rates are calculated, and the date is determined for the patient to have an ultrasound. Patients with a positive test result should continue all the recommended medications after the treatment and should not stop any medicines without notice. Our physician controls the medications, which are reorganised according to the appropriate gestational week.

As with all IVF treatments, IVF treatment by embryo donation may lead to negative results as well as positive results. If the test result is negative, the test may sometimes be required to be repeated. In patients with definite negative test results, medication use is discontinued. The patient’s file can be examined again. Additional investigations can be done to determine why pregnancy could not be obtained, and further measures that can be taken, if any, can be determined. This detailed study aims to increase the chances of pregnancy in a possible second trial of the patient.

In Cyprus, both sperm and egg donation are legal treatment methods, and embryo donation, in which these two treatments are combined, is entirely legal and protected by relevant laws and regulations. All IVF treatments in our centre are performed under the control of the TRNC Ministry of Health. In addition, as stated in the relevant law, the condition of marriage is not required for in vitro fertilisation. In the presence of a male partner, we record all the embryos created on behalf of our patients, who are referred to (or registered) as pairs. In cases with no male partner, the file is opened only for female patients, and embryos are recorded only for female patients.

Some basic scans, such as all infection scans, genetic and psychological analyses and blood group determinations, are done as standard for donors of sperm and eggs used in the treatment of embryo donation by the Ministry of Health. Following the legal regulations, our centre uses only certified sperm imported from abroad, and selected sperm samples are taken to the centre after being checked and approved by the Ministry of Health. All the necessary analyses for the egg donors accepted to the centre are done before the donation, and only the donors who have typical screening results are accepted for treatment.

In vitro fertilisation with embryo donation is a treatment where patient confidentiality is vital and no identity, communication information and treatment details of patients are shared with third parties. This is why we protect our data in a strictly controlled manner, ensuring both the donor, our patients and the child are legally protected and ensuring the protection of families who will not want to inform their children in the future about the IVF treatment. Under the law, the donor is kept anonymous; the family and the child cannot contact the donor, and the donor cannot contact the family and the child.

As per the law, we cannot share embryo donation IVF price information on our website. You can contact us for detailed information.