Interview with the head of the reproductive medicine centre “Embrions” Dr. Gints Treijs.
In about 5% of all IVF cases, it is necessary to use donor eggs.
In Latvia, the number of infertile couples is much larger than the number of women who choose to become an egg donor.
People’s dreams, goals, and priorities in life are very different. It can be a dream of a good career, traveling the world, having a big house in the suburbs, a reliable and loving spouse… However, human dreams in any period for as long as mankind remembers itself is the desire to become parents. The dream to hold a new-born, watch their first steps, teach to read and learn the most important values of life is so human, that all the other dreams sooner or later are sub-ordered to this dream. Unfortunately, not all couples can fulfil this dream naturally without medical assistance.
Nowadays at least 11-13% of couples face infertility problems. “Causes of infertility are varied, with timely diagnosis and treatment most couples can have their own babies,” says Dr. Treijs. However, there are situations when even the most advanced infertility treatment technologies cannot fertilize the female egg because there simply aren’t any… Most frequently it is in the cases when the woman has received radiotherapy or chemotherapy due to malignant tumours, both ovaries are surgically removed or premature ovarian exhaustion or menopause has occurred. Sometimes the eggs are present in the body, but they do not mature and fertilize due to ovarian genetic or functional disorders.
“In the future with the help of biotechnology we will be able to ensure that, where appropriate, stem cells will form eggs. Now we must accept the number of eggs that each woman has,” says Dr. Treijs.
Dr. Treijs reassured that there is no reason to despair because anonymous and unselfish egg donors can help women who, due to various problems, cannot have children.
To understand the essence of this story we must talk about egg reserves. Egg reserves are already formed when the woman herself is a foetus and develops in her mother’s body. The number of eggs is enormous – several million. Although the number of primal eggs is very large, nature is structured so that immediately after birth eggs begin to die. When the girl reaches puberty, in both ovaries “only” 400,000 to 500,000 eggs remain. During the fertile period (from the first to the last menstruation) cyclically develops and 400-500 fully mature eggs capable of fertilization are released. Unfortunately, the rest gradually die and are not used. As for the female body, the ovary is the organ that is used the least rationally – only 1%, the remaining 99% are not utilized.
By participating in an egg donation program, a woman additionally spends only a mere of 15 to 30 eggs, which by their nature do not cause significant damage to her natural cycle – they are tailored for destruction anyway. Egg donation is more a psychological act.
Any woman who feels the desire to help fulfil another family’s dream of a baby can become an egg donor. From the doctor’s point of view, the donors must be physically, mentally and reproductively healthy, aged from 18 to 35, without bad habits, and preferably with at least one own child.
A woman who has decided to become an egg donor should contact and make an appointment with a doctor in one of the reproductive medicine centres such as the clinic “Embrions”. During the visit, the doctor will present the procedural steps and respond to questions. Then the necessary examinations will follow, and the donor data will be included in the register – physical parameters, health history, family history, personality traits and information on hobbies, if the donor wants to reveal it.
The time from the examinations to the actual egg donation is variable – from a few weeks to several months, even a year. It depends on when the future parents who need artificial fertilization choose the relevant donor. Also, the menstrual cycle introduces its corrections because the cycle of the donor must be aligned with the cycle of the woman in whose uterus the fertilized egg must be placed.
Donor medical stimulation usually begins on the second or third day of the menstrual cycle and lasts an average of 10-14 days. During this period the woman receives injections and on average every third day must arrive at the clinic for an ultrasound to watch the growing follicles. When the doctor thinks that the follicles have grown sufficiently and eggs are ready for extraction, under an intravenous anaesthesia follicular puncture and egg extraction is performed. All collected eggs are fertilized in the laboratory with the recipient partner’s sperm and placed in special thermocabinets that provide an ideal environment for cell growth – identical to the female body. After puncture, the donor receives recommendations on lifestyle and medications, if required. After the egg donation, another follow-up visit is needed on day 5-7 of the next menstrual cycle.
The most important possible procedure-related side effect is the ovarian hyperstimulation syndrome, which can affect 1% of cases. The signs include discomfort or pain in the lower abdomen, and bloating. Complaints usually disappear with the onset of menstruation, and the feeling returns to normal.
If a woman wants to repeatedly become a donor Dr. Treijs recommends to do it not more often than 2-3 times a year, because the ovaries, after stimulation, must return to the normal rhythm. Allegations that medications for the ovarian stimulation in the long-term increase the risk of cancer or infertility and speed up ovarian aging, are contradictory and could theoretically apply to women who have made the procedure more than 12 times. In Latvia, this procedure is not recommended more than 5-6 times.
“We, the doctors, would very much like for women to change the attitude towards this special form of donation and to increase the number of women who would like to donate their eggs, to receive enough for all couples who are waiting,” hopes Dr. Treijs. According to our national legislation, each donor can help to give life to no more than three babies. This may be the same or a different family.
“Egg donation is the demonstration of the highest generosity and human empathy,” says Dr. Treijs.