Dr.
Anita presented a paper on Donor- recipient synchronization for the success of donor egg
IVF at the 2015 International congress of the “Academy of
Clinical Embryology” held at Kochi. The success of donor egg program
depends greatly on the synchronization of both the donor and the recipient, to
get simultaneous periods and to start the luteal support on time.
Successful Synchronization :-
- S - Simultaneous Periods
- U - Ultrasound Scan
- C - Coordination
- C - Communication
- E - Email Synchronisation
- S - Screening donor
- S - Success
- F - Freezing semen sample
- U - Unforeseen Risks
- L - Luteal support
Simultaneous periods is a must, so change the
period date of the recipient by giving combined pills or progesterone, as
needed. It is better not to change the period of the donor as it may be
associated with longer stimulation and higher gonadotropin consumption and
lesser pregnancy rate.
Ultrasound scan is the magic tool to
success. Keep checking the follicular growth and endometrial thickness. In case
thickness is not sufficient you can increase the dose or consider adding
Sildenafil.
Coordination between the team members
team comprising infertility specialist, IVF coordinators, international
client manager and embryologist is very important and they should meet
regularly to keep update of the list of patients, donors and their
timing. Train efficient staff to be the coordinators who can communicate well
and arrange for the timely screening. If patients are abroad, let them
collect the medicines in advance, as it may not be available in some
countries.
Communication with the patient and donor
before starting the ART cycle should be constant, so that the program goes
well. Provide guidance for recipients in the form of leaflets and
online information, to get proper understanding about the timing and
procedure.Counsellor should meet both the donor and the recipient , to make
them understand the implications fully and properly.
Email Synchronisation will be helpful for the NRI
patients, this will help to reduce their frequency and number of visits. The
female partner can be given priming tablets to start on the second day, so that
she can cut short her visit for embryo transfer. The scans can be done locally
and results mailed to the doctor, so that date of luteal support can be
advised.
Screen the donor at least 1 month
before, or earlier to pickup potential problems like ovarian cysts, pelvic
infections and other medical problems.screening should include AFC and AMH as
needed , so that the recipient does not end up with poor responder, after
all the synchronization.Deficient endometrial lining can be avoided by
screening in advance. Difficult embryo transfer is not an issue, if there is
MET
Success of the treatment
depends on synchronisation, health of the donor, condition of endometrium of
the recepient, ART lab facilities and the expertise of the medical team.
Freezing of semen sample can
be done, when the male partner visits the clinic for the first time, so that a
repeat visit can be avoided, when his wife comes for the donor egg program.
Unforeseen risks like Illness of the
donor or her family member, can cause chaos, so the recipient should be
counseled about the possibility. Some clinics have standby donors, who are on
pill.
Luteal support should be started
for the recipient either the night before egg pick up or at least on the day of
retrieval , as the window of implantation is small
Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com
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Dr. Anita Mani is a
renowned infertility specialist in south India with 15 years experience in
ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART
hospitals in Cochin and Bangalore, along with her spouse Dr. S
Mani. She completed MRCOG, from Royal College of
Obstetrician and Gynaecologist London, DFFP from ART Warwick
university and worked in UK for 5 years. Dr. Anitha believes in
scientific and ethical practice and is currently the director of Gift Gyno
IVF centre Cochin and Bangalore. Apart from advanced
laparoscopic surgeries, she is also an expert in various ART techniques
including IVF, IUI, ICSI , donor egg / sperm. Her
proficiency is in genetic abnormalities and high risk pregnancies.
