Embryo Donation
Embryo Donation
Embryo donation is the donation of surplus embryos created through IVF for another couple to use when they cannot conceive naturally.
This method can be an option for couples undergoing infertility treatment and increases hope for having a child by preventing embryos from being discarded. The donor couple can donate embryos that were created during IVF but were not used. These donated embryos may be transferred into the uterus of a couple undergoing IVF treatment to help them achieve a chance of pregnancy.
Embryo Donation and the Meaning of “Embryo”
Embryo donation refers to the donation of a human embryo—also known in Turkish through the Arabic-derived term “cenin”—which forms when an egg is fertilized by sperm.
The concept of embryo donation is carried out by fertilizing an egg obtained from a donor with sperm obtained from a donor, and transferring the resulting embryo to the woman who will carry the pregnancy.
Who Is Embryo Donation For?
Embryo donation is performed for couples or individuals who need both an egg and sperm. Single women who have no eggs or who are of advanced age can become pregnant through the transfer of embryos created with both egg and sperm donation.
It is also used for couples who have genetic abnormalities in their eggs and sperm due to various genetic reasons.
Women with decreased ovarian reserve
Couples where the male partner has sperm production problems
Couples with repeated IVF failures
Couples with genetic problems
Couples who failed other fertility methods such as IUI or IVF
Couples with a history of recurrent miscarriage
LGBT+ couples (female–female and male–male couples)
Couples who are in the adoption process
Embryo Donation and Donation of Frozen Embryos
According to the laws prepared in the TRNC, it is prohibited to use embryos that individuals did not use and then donated. At DrHIT Cyprus IVF Center, we do not use such embryos under any circumstances. However, we do use embryos that we create in our clinic using gametes obtained from donors chosen by the recipient individuals.
Embryo Donation Process
Application: The first step is for couples or individuals interested in embryo donation to apply to a clinic or fertility center.
Evaluation: The clinic evaluates applicants through a series of medical tests and examinations. Factors such as medical history, age, general health status, and other criteria are considered to determine suitability.
Embryo Selection: Applicants select from embryos created through donor gametes. In this process, embryo characteristics, health background, quality, and other factors are considered.
Preparation: A series of medical tests is performed for both the embryo donor process and the recipient, and hormonal medications may be used to prepare the recipient’s uterine lining.
Transfer: After preparation is completed, the embryo is transferred to the recipient’s uterus. The transfer is a medical procedure and does not require anesthesia.
Monitoring: After embryo transfer, the recipient is followed periodically and pregnancy tests are performed. If pregnancy is achieved, regular medical monitoring continues throughout pregnancy.
HSG (Uterine X-Ray)
This procedure clarifies two issues. First, uterine shape abnormalities and space-occupying structures such as fibroids or polyps are identified. In such cases, corrective surgery with hysteroscopy usually resolves the problem. Congenital anomalies known as Müllerian anomalies may result in preterm birth, and therefore single embryo transfer may be required.
Second, uterine adhesions that occur after previous curettage, surgery, or scraping procedures are detected. Starting treatment without resolving these issues is incorrect.
Blood Tests in Embryo Donation
Standard tests are first performed for the woman who will carry the baby. Infectious disease tests, thyroid tests, and various hematology and biochemistry tests are performed.
Physical Examination
First, the medical and family history of patients is taken. In suspicious cases, cardiology and internal medicine consultations are requested from other specialist physicians. Additional tests and examinations may also be requested depending on the situation. These evaluations aim to ensure that the woman can go through pregnancy without problems.
Ultrasonography
The aim of this examination is to detect cysts and masses that may be present in the abdomen.
Endometrium
This structure is the tissue lining the inside of the uterus. Proper evaluation by ultrasound is extremely important. Previous intrauterine procedures may permanently impair the endometrium. In menstruating women, the endometrium should be checked between days 14 and 27 of the cycle.
In menopausal women, evaluation should be done after administering estrogen hormone for 14 days.
Preparing the Egg Donor
The process begins with selecting the egg donor. It is important to select egg and sperm donors in accordance with the recipient family’s blood groups. If the baby’s blood group does not match the mother and father’s blood groups, various psychological and sociological problems may arise.
Tests to Be Performed for the Egg Donor in Embryo Donation
These tests can be listed as follows:
Serological Tests
VDRL, HBsAg, Anti-HCV, HIV duo
Hematological Tests
Complete blood count is performed to determine whether there is any risk during egg retrieval. Anemia, thrombocytopenia that may cause clotting disorders, and infections are evaluated.
Coagulation tests are performed: aPTT and PT/INR.
Genetic Tests
Karyotype: Even donors who have given birth should undergo a chromosomal analysis called a karyotype. Sometimes abnormalities in sex chromosomes do not appear in the first child.
Cystic Fibrosis: A hereditary disorder frequently seen especially in Europeans and must be screened in donors.
Mediterranean Anemia (Thalassemia): Common in countries associated with the Mediterranean. Tested with hemoglobin electrophoresis.
Recombine Test for Embryo Donation
With this test, screening can be performed for nearly 500 of the most common hereditary diseases. The cost of this test is approximately €1,000.
CentoScreen®️ Carrier Screening test content:
Comprehensive screening panel sequencing 331 autosomal and X-linked recessive disorders.
≥ 20x coverage
CNV reporting for 34 genes
Additional assays for SMN1, FMR1 & CYP21A2 included
The turnaround time for both tests is 3–4 weeks. The cost of this test is also €1,000.
Recombine and CentoScreen tests are performed upon request, and patients pay this fee separately.
The tests performed for the egg donor may vary depending on the patient’s preferences. The blood tests listed above are standard tests.
Verbal and Psychological Tests for the Egg Donor
With the help of psychologists in our clinic, the egg donor undergoes:
Psychological Tests
These tests screen for various psychiatric conditions believed to have a hereditary component. Disorders such as schizophrenia, paranoia, personality disorders, oligophrenia, and cyclothymic disorders are assessed.
If requested, an IQ test can also be performed. At DrHIT Cyprus IVF Center, we use donors who have at least a high school diploma.
Donor Selection in Embryo Donation
Egg donors face a serious loss of work time due to the difficulty and time-consuming nature of the procedure. Therefore, in countries where egg donation is allowed, the donor’s work loss is compensated. In England, donors are paid up to approximately 4,400₺, while in Israel the minimum amount set by the state is at least 27,000₺.
The minimum cost of well-known South African agencies cooperating with our clinic is 70,000₺. Since the amount in England is very low, no English donor donates in their own country. For this reason, about 90% of English patients travel abroad for donation.
Today, the most preferred donors in Europe and Asia are from former USSR countries such as Ukraine and Russia. The most important factor in this preference is physical and athletic characteristics. Donors with the most economical and superior features are preferred from these countries.
Since the age of marriage is early in these countries, many donors become mothers at a young age. Receiving eggs from young mothers is advantageous. A donor who has delivered a healthy baby is considered more reliable than a donor who has not.
Preferred Characteristics in Egg Donors
Donor Age
The most important characteristic is donor age. We do not use donors over the age of 30. A younger donor egg increases the chance of success. In addition, using young donor eggs reduces the risk of hereditary diseases that may occur in the baby (such as Down syndrome and Edwards syndrome).
Having Healthy Children
Having healthy children reduces the likelihood of hereditary diseases.
Having both female and male children greatly reduces the risk of sex chromosome disorders transmitted through X and Y chromosomes.
Height
At our clinic, we do not use donors shorter than 165 cm. Our patients do not prefer short donors.
Eye Color
Egg donation and sperm donation should be planned according to the eye color of the intended parents. Using a dark-eyed donor egg or sperm for parents with light-colored eyes may lead to the baby having dark eyes. Since this may conflict with inheritance expectations, it can cause psychological and sociological challenges for the child and family in the future.
Skin Tone
As is known, the donor’s skin tone plays a role in determining the baby’s skin color. Dark tone can be dominant. Reviewing the intended parents’ skin tone and following the advice of an experienced physician is the best choice. Our 30 years of experience helps us make donor matching easier for our patients.
Education Level of the Donor in Embryo Donation
Education systems differ between countries. In many former Eastern Bloc countries, university diplomas can be obtained more easily. While there is a certain standard in countries such as the USA, Canada, and Türkiye, the education level in certain fields can be lower in countries such as Turkmenistan, Azerbaijan, and Ukraine.
Education level is not a direct parameter reflecting a donor’s intelligence. However, graduating from selective and difficult schools may partially reflect the donor’s ability. Children of families who graduated from good schools may find it easier to succeed academically, but many children of individuals with limited education can also be very successful.
IQ is more closely inherited from the father and EQ from the mother. A child’s success is also closely related to the environment in which they are raised. Many psychological disorders are associated with childhood environment. For example, children exposed to violence may develop psychopathic personality traits. A healthy and loving environment is essential for the child.