Donor- recipient synchronization for the success of donor egg IVF

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

anitadane@gmail.com

www.giftivf.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.