FERTILITY ROAD ARTICLE 32
Donor Egg IVF…with Oregon Reproductive Medicine
Oregon Reproductive Medicine have now selected a couple to go forward and be a part of our unique Fertility Journeys project. We are delighted to introduce Chris and Anne, who after repeated attempts to become pregnant, and a failed shared egg donor IVF cycle in the UK, have been selected to work with ORM, in the form of a donor egg IVF cycle with an ORM donor.
I was nearly 40 when we met and, by the time we were married three years later, my biological clock had been ticking for some time. Until then I hadn’t considered having a child, being more a career and ‘travelling the world’-type girl, and of course not meeting the right person hadn’t helped! It also hadn’t occurred to me that I would have difficulty getting pregnant, despite all the statistics. However, in spite of my optimism, nothing happened.
So we decided to seek help and went through initial fertility tests with the NHS. The NHS fertility test results were a bit devastating, telling me that I had very low ovarian reserve and was not even a candidate for IVF. The only way I would have a child would be through donor egg IVF. Initially, I didn’t want to do that, thinking somehow I would defy the odds and conceive naturally if we just kept trying.
Eventually, we had to admit defeat and went back to the private clinic to start the process of egg donation IVF. The main obstacle for us was finding a suitable donor. I am half Chinese and half English and we wanted a donor to be very similar. Obviously, these are very few and far between in the UK. However, the clinic called one day to say that they had a donor who was perfect! Unfortunately, she already had one couple arranged, but they wanted to share the costs and we could be the second recipient of her eggs if she delivered sufficiently. Of course, we said yes.
We went through the process, more testing, injections, pills and eventually transfer of our solitary little Day 3 embryo that had made it. The pregnancy test came back positive three weeks later! I went through morning sickness and then had my nine-week scan. Devastation again, my pregnancy sac was empty, I had had a missed miscarriage.
Six months later, we decided to have one last push at it. There were no donors in the UK, at all, anywhere. And the UK clinics told us they were unable to use the donor banks overseas, who did have suitable donors for us, so we considered using an overseas clinic. A friend had had a successful egg donation pregnancy after attending an overseas clinic so we researched this option. At the last minute, we arranged to go to the Fertility Show in London.
It was at this show that we first met Oregon Reproductive Medicine. One of the ORM physicians Dr. Bankowski, his coordinator Lauren, Craig their London based International Programme Director, and other team members were all present. We went back a couple of times during the day to consult with Dr. Bankowski and talk with some of their team, and we had a good feeling about them. They seemed very interested in us personally. Craig shared his recent experience of becoming a parent through egg donor and gestational surrogacy IVF as an ORM patient. They talked us through the Comprehensive Chromosome Screening (CCS) testing that they do, the success rates and the potential benefits to the child.
They took on board our requirements for an egg donor and told us about their in-house egg donors. One of the features we really liked about ORM was their screening of donors. ORM’s egg donor profiles are great with photos and plenty of information about family, personality, education, medical and genetic background etc. We learned that they would also genetically test Chris’ blood to help ensure that neither he nor a selected egg donor would be carriers of the same recessive genetic disease.
We were told we would need to visit twice, once for testing and once for the transfer. We were a bit unsure how it would all work, using a clinic in the US and needing support in the UK during the process. Dr. Bankowski’s coordinator explained that all the medications I would require for the IVF cycle would be sent to me from the US and Lauren would work with me to coordinate my monitoring in the UK.
Having turned the page on the first stages of our path to parenthood, we’re excited to be working with ORM and to share the next steps in our Fertility Journey as they unfold!
Dr. Bankowski’s Comments on Chris and Anne’s Journey
Chris and Anne are a lovely couple and we at ORM feel privileged to be able to help them on their path to parenthood. We are delighted to have them be a part of the ORM Fertility Journey. Many of our patients from around the world come to ORM with fertility backgrounds similar to Chris and Anne.
As every woman ages two critical factors that make it more difficult to conceive are a diminished ovarian reserve (the capacity of a woman’s ovaries to provide eggs capable of fertilization), and the rate of abnormal embryo formation (embryos with the incorrect number of chromosomes). From 35 years of age, these two factors increase significantly and for a woman over the age of 40 the rate of abnormal embryo formation can be in excess of 70%. These factors, however, do not themselves prevent a woman from carrying a pregnancy, and many women over the age of 40 are able to have healthy egg donor pregnancies.
Chris and Anne’s initial egg donor IVF cycle in the UK – a shared egg donor IVF cycle that only resulted in one embryo which was transferred on Day 3 – unfortunately did not progress beyond nine weeks. While we cannot know for certain, it is highly possible that the single transferred embryo did not have the correct number of chromosomes. This is one of the most common causes of failed IVF implantation and miscarriage or can result in a baby with one or more conditions linked to chromosomal abnormality – most of which are life-threatening but which also include Down’s Syndrome. Abnormal embryo formation is a natural occurrence with even around one in four embryos formed with a young woman’s egg being abnormal. Moreover, embryos that begin to arrest development in the embryology laboratory and are transferred at Day 3, rather than at the blastocyst stage – Day 5-6 – have a significantly lower chance of success. At ORM we only transfer Day 5-6 embryos.
Understandably Chris and Anne were disappointed and exhausted from their multiple attempts at pregnancy and this failed IVF cycle. We are proud to be able to offer Chris and Anne renewed hope and an increased chance of becoming parents through ORM’s egg donor IVF programme. At ORM we have experienced success rates of over approximately a 70%chance of a live birth when transferring one embryo and over a 90% chance when transferring two embryos.
In addition to ORM’s customized protocols and world-class embryology laboratory, two elements of Chris and Anne’s fertility treatment will differ from their prior egg donor IVF cycle in the UK: working with an ORM egg donor to optimize their chance of multiple healthy embryos; and testing the embryos with Comprehensive Chromosome Screening (CCS) using Next-Generation Sequencing (NGS) technology to ensure that only an embryo that has screened as normal is transferred.
ORM’s exclusive egg donor programme consists of remarkable, accomplished young women. ORM donors have been screened by ORM’s physicians, in-house genetic counselors, as well as a psychologist to ensure medical and psychological suitability for egg donation. ORM’s egg donors are in their twenties to maximize the quality of eggs produced. Chris and Anne will have the opportunity to work with our egg donor matching coordinator and genetics counselors in selecting an egg donor from ORM’s programme of more than 130 amazing egg donors.
CCS at ORM involves the laser removal of about five cells from each embryo at the blastocyst stage – Day 5-6. These cells are then tested using the most advanced genetics technology available, NGS, to determine the number of chromosomes per embryo. ORM is proud to have an in-house genetic testing laboratory in partnership with Reprogenetics, an internationally renowned expert in genetic testing. Embryos are frozen while the cells are tested. CCS testing will help ensure Chris and Anne have the best chance of a successful pregnancy and a healthy baby by only transferring an embryo that has screened as normal.
The entire team at ORM is honored to be working with Chris and Anne and we look forward to guiding them through the next stage of their Fertility Journey!