Specifics, Safety And Protocols Of Italian Ovodonation

Ovodonation (or donation of oocytes) is a process in which a female individual spontaneously gives birth to one’s own ovum so that they can be used with heterologous fertilization by a couple with fertility problems.

Ovodonation

Oocyte donation This procedure is more complicated than the donation of male seminal fluid (semedonation), as it requires a small surgical procedure (called follicular puncture) to extract the oocytes. The female gametes thus extracted are then fertilized in the laboratory with the seed of the partner or a donor alien to the couple, through the most appropriate medical-assisted procreation techniques.

The donor who decides to donate oocytes to other women at an assisted reproduction clinic must be subjected to specific examinations such as, for example, health history and analyzes for infectious and genetic diseases.

A brief premise: requirements for heterologous fertilization

Heterologic Fertilization is a medication-assisted procreation technique (PMA) that helps couple couples who want a child but can not spontaneously engage in a pregnancy.

In heterologous fertilization, one of the two gametes used for procreative purposes (female oocytes or male sperm) does not belong to one of the parents who undergo treatment, but comes from a subject other than the requesting couple (donor).

In Italy, the use of this technique is legitimate (as indicated in the ruling 162/2014 of the Constitutional Court) in a course of treatment where the infertility or infertility of at least one of the two parents is established And there are no other effective therapeutic methods to solve this condition. However, heterologous fertilization is only allowed for sexually-identical couples, married or cohabiting steadily. They will therefore not be able to use the donation either single persons or couples of the same sex.

Ovodonation: what is it?

Ovodonation is a process that involves the inoculation of the ovule coming from a specifically stimulated donor, and the transfer of the embryo thus obtained in the recipient’s uterus.

Ovodonation is a process

To whom it is addressed

In proven infertility conditions, women may resort to seizures if they have:

  • Old age;
  • Insufficiency or poor premature or congenital ovarian reserve;
  • Pathologies that have compromised reproductive capacity;
  • Chromosomal or genetic abnormalities;
  • multiple abortions;
  • Repeated failures of other medically assisted procreation techniques.

Ovodonation in Italy

In Italy, the creation of heterologous fertilization has found some obstacles, including the lack of donors that makes it impossible to meet all the demands. In our country, donations are voluntary and free (there are no forms of economic compensation).

This aspect is set to prevent the trade of oocytes and seed which, in addition to being excluded from the ruling 162/2014 of the Constitutional Court, is also forbidden throughout Europe. For a pipeline, it is therefore necessary to find who, under such conditions, can accept to undergo hormonal treatment and enter the operating room to help another woman have a child. For this reason, finding gametes, especially women, is very difficult.

To overcome the obstacle represented by the few donations, hospitals and Italian centers specializing in heterologous fertilization can find oocytes through two options:

Sharing eggs (egg sharing): a patient undergoing homologous fertilization (where the eggs are his and the sperm of the partner) may decide to donate the ovules to another woman.

Obtaining ovules from foreign banks: PMA centers conclude agreements with foreign banks to find seminal fluid or cryoconvived oocytes (note well: it is possible to acquire gametes from suppliers, but not to buy or market them, since their market is Prohibited by law).

In any case, however, strict controls are required to ensure that donors do not have infectious diseases or chromosomal abnormalities. Suppliers’ foreign banks must also guarantee the traceability of biological samples and the safe transport conditions.

Donor Requirements

To access heterologous fertilization, it is possible to use frozen oocytes in the centers themselves, or donated by women in turn to subjected to assisted fecundation.

Oocyte donation can be made in the presence of the following requirements: The woman who gives her oocytes must be between the ages of 20 and 35; The donor must be in perfect state of health, physical and mental; The donor’s ovulatory function must be normal; Each donor has a maximum of ten births with his own gametes;

Those who donate oocytes must not have malformations, genetic or congenital or hereditary diseases (not even the closest family members may have it, so the donor may not have been adopted because it is essential to know the medical history);

In addition to the previous requirements, potential donors of ovules will have to pass two indispensable tests: on the one hand blood tests and, on the other hand, a gynecological examination to evaluate fertility.

Donor selection

Ovarian donors are healthy women, young (20-35 years) and proven fertility. These criteria are needed to ensure optimum recovery of oocytes in terms of number and quality.

The donation of oocytes must take place in an anonymous and voluntary form.

In the selection process, the donor’s family and personal clinical history, gynecological health status, psychological, aptitude and professional conditions, as well as specific tests to exclude infectious or hereditary diseases are evaluated.

For matching, guidelines for heterologous fertilization recommend that the donor’s immunologic (physiological) and phenotypic characteristics – such as skin color – be compatible with those of future parents, so the clinic must ensure some criteria, Such as respect for the eternity and the blood group. This promotes the natural process of family integration.

How’s it going?

Stimulation of the donor’s ovarian activity

Once the most suitable donor is selected, it is subjected to controlled ovarian stimulation by administering hormones. The purpose is to induce the maturation of several follicles to extract, if possible, more oocytes, before natural ovulation occurs (in order to collect egg cells it is necessary to locate them first).

administering hormonesThe donor is then subjected to periodic ultrasound and hormone doses to control the evolution of the process and determine the time to collect the ovules by follicular puncture (surgical intervention to extract the ovum of the woman from within mature anthrax follicles).

Recovery of oocytes

When the follicles reach a diameter of approximately 16-18 mm, oocyte withdrawal (follicular puncture or pick-up) is programmed, then the hCG hormone is administered to induce ovulation within the next 36 to 48 hours.

Recovery of the oocytes is carried out by transubstantial transjaginal puncture (hence from the donor’s vagina). This procedure is performed after administration of a mild anesthesia, generally local, and sedation. The surgery is performed by a gynecologist, embryologist and anesthesiologist, and lasts about 20 minutes.

The gynecologist opens the cervical canal with the help of the speculum and introduces the ultrasound along with the suction needle. With the support of transvaginal ultrasonography, the physician then locates the follicles, and the sting of these is accomplished one by one, collecting the fluid they contain, inside which the oocyte is present.

Always maintaining a temperature of 37 ° C, the transferred material is transferred to the lab, where embryologist specialists recuperate and select the mature eggs, and prepare them for use.

Endometrial preparation of the receiver

The oocytes thus obtained will be inseminated fresh or cryopreserved and used in the appropriate times. Before artificial insemination, the endometrium of the recipient woman must have an optimal receptivity for embryo implantation.

Recommendations:

Prior to oocyte withdrawal, it is crucial that donor respects absolute fasting during the 6 hours prior to surgery. This precaution is necessary for the pick-up to take place normally and does not imply any side effects or unforeseen complications.

The patient is admitted to the clinic on the same day of induced ovulation, one hour before the surgery.

The patient is admitted to the clinic on the same day of induced ovulation, one hour before the surgery.

Risks and possible complications

Ovodonation is a painless process, carried out under sedation. The woman may leave the center shortly after the follicular puncture; It is however recommended that you wait about an hour to fully recover from local anesthesia and to go to the clinic.

After withdrawal, menstrual abdominal pain or mild vaginal bleeding may occur. To recover from the pipeline, it would be best to stay at least one day and not undergo great efforts.

The response to ovulation inducing drugs should be monitored (with ovaries and / or hormone doses) in order to suspend treatment in the event of ovarian hyperstimulation syndrome, ie the development of an excessive number of follicles . This condition may involve various symptoms such as increased ovarian volume, abdominal pain, weight gain, lack of breath and nausea; In the most severe cases, an abdominal distension and blood clots can be formed that may require hospitalization.

Donating eggs does not compromise the donor’s future fertility. Usually, a period of 2 months is indicated between the intervention.

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