Double Donation

The process of double donation can vary significantly depending on the clinic and country where the treatment is conducted. Therefore, it is challenging to establish a universal standard process. Nonetheless, the double donation process usually involves four crucial steps, which can take anywhere from one to six months to complete. Factors such as donor availability, the clinic's location, and the country where the treatment is conducted can impact the timeline. The success rate of a double donation cycle primarily depends on the donors´age and ovarian reserve. However, male factors can also play a vital role. On average, double donation cycles have a success rate ranging from 60-80%. It is best to ask your doctor directly about how they calculate the success rate. The most common reasons to proceed to this treatment are failed previous treatment with own eggs and sperm , extremely low ovarian reserve AMH < 5.0 pmol/L, maternal age, and single female aiming to maximise the success rate. The following is a breakdown of the five steps involved in the double donation process:

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1. Assessment to determine suitability for treatment.

• For the female recipient partner, blood tests such as FBC, TSH, and PRL are typically conducted alongside a transvaginal scan to assess the ovaries and uterus. This scan helps determine whether the uterus is fit for treatment, meaning that no structural issues such as polyps or fibroids are found, and if possible, the thickness and pattern of the uterus lining also should be checked. Both gametes will come from donors and for that reason there are not relevant investigations to conduct on male partner (if applicable).

 

2. Matching the donors (Sperm donor & Egg donor)

• Legislation regarding gamete donation varies across different European countries. In some countries, gamete donation is anonymous, while in others, it is identifiable. However, the next step after determining the suitability of the donors is to match them with the patient or couple. Once the donors are selected, they will undergo an IVF cycle to generate embryos for a third-party patient, known as recipient.

 

3. Preparation of the uterus & Embryo transfer procedure (ET)

• In double donation treatment, the embryo transfer procedure is often performed under a medicated cycle. This is also known as Medicated FET. The recipient begins with estrogen (E2) medication on the first day of their menstrual period to prepare the lining of the uterus. Around two weeks after starting the preparation, a transvaginal scan is conducted to assess the thickness and pattern of the lining. If both parameters are good, then the patient is given progesterone administration (P4) to open the implantation window. The patient is then scheduled for an ET after five full days of progesterone. The procedure is conducted in a theatre that is close to the lab. Most of the time, sedation is not required, and the entire process takes only 10-15 minutes. During ET, a vaginal procedure is performed where doctors insert a gynae speculum and an embryo transfer catheter. The embryos are then carefully placed inside the cavity of the uterus. To ensure accurate placement, the majority of clinics perform the procedure under abdominal ultrasound guidance. Most clinics limit embryo transfers to one at a time.

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4. Pregnancy test 

• The pregnancy test should be conducted normally after 10-14 days following the embryo transfer on the blastocyst stage (day 5). It is recommended to have a determination of B-HCG level in the blood rather than a urine test, as it is more precise. If the result is positive, instructions will be given to return after 4-6 weeks to perform a transvaginal scan to check the viability of the embryo. If the result is negative, the medication intake will stop and a conversation with your doctor will occur in most cases.

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