Nine questions to ask at your first consultation for egg donation at a fertility clinic
Many patients come to us shortly after having received what is for them a life-changing diagnosis: they will need to use donor eggs if they want to conceive. Some have assimilated this news, but others are still so confused that they have no idea how to prepare for their first consultation. As specialists at ProcreaTec we try our best to explain the logistics, but many times we have difficulty communicating some general ideas due to the seemingly confused state of the patients. Here are nine questions you should ask your fertility doctor the first time you have a consultation on egg donation:
1- How does your clinic differ from other clinics?
Ask the doctor what distinguishes them from other fertility clinics. At ProcreaTec, we always say that our goals are to give the patient individualized attention and provide the option of the latest cutting-edge technology.
2- What are the success rates?
It is important that the clinic be audited on their results by a national institution. In Spain, the Spanish Society of Fertility reviews the statistics and audits different clinics every year. For egg donation the pregnancy rates should be over 60%. At ProcreaTec we reported to the Spanish Society of Fertility 65.87% in 2013, and our results were audited. It is important for the patient to know that the clinic has been made accountable for their statistics. We reported these statistics in an earlier post “HOW OLD IS TOO OLD TO DO IVF?”
3- Who will I be in contact with throughout treatment?
It is extremely important that you are able to communicate with the clinic easily. At ProcreaTec we think it is essential for the patient to be able to speak in their native language if possible. That is why we have English, French, German, Italian, and Spanish-speaking coordinators to accompany you from the very beginning to the end. Fertility treatment is already quite stressful so it’s important for you to not have to worry about language barriers. The clinic should also give you the name of your contact(s) so that you know who you will be in touch with and who to go to when you have questions. A personal, efficient, and more individualized service is key to feeling comfortable and confident with the clinic you choose. This is especially true when going abroad, where most of the communication will be via phone or email.
4- Where does the clinic get their donors?
In Spain, the laws on performing marketing campaigns is pretty restrictive but if the clinic wants to advertise, they must send their ideas and advertising material to the Organización Nacional de Trasplantes- the National Organization of Transplants. This is generally not done in the smaller clinics like ProcreaTec. Our donors at ProcreaTec come to donate having learned about us by word of mouth from a friend or family member.
5- Are donors exclusive?
Before you begin, it is interesting to find out how many recipients receive eggs from one donor. When a donor is stimulated, some clinics use high dosages of injected hormones in order to obtain as many eggs as possible to be able to split between two or three donors. At ProcreaTec we prefer to use low dosages of hormones to stimulate our donors. We get fewer eggs but they are usually better quality eggs. We match one recipient to one donor.
6- How are the patient and the donor matched?
They are matched by height, weight, hair color, eye color, skin tone, and blood type. Donation is anonymous in Spain so the aforementioned characteristics are the only ones we are allowed to give by law. Many times we get a wish list from the recipient of all types of characteristics they are looking for in a donor. We cannot tell them specifics. If I see a recipient cannot accept the anonymity required by Spanish law, I strongly urge them to go to another country where donors are not anonymous.
7- Does the clinic prefer a transfer on day+3 or day+5?
The longer embryos are in the lab, the better the lab has to be. If you are looking at a clinic that does not believe in or does not go to Day+5, that could be a sign that their lab is not tiptop. I am not suggesting that everyone in every circumstance should go to Day+5, but if no one at the clinic believes in Day+ 5 culture, it usually means that their Day+5 results are not adequate.
8- How many embryos are transferred?
The tendency in 2015 is moving towards a Single Embryo Transfer (SET). At ProcreaTec, for women under 40 one or two embryos are transferred, and at over 40 we suggest a SET. If the patient transfers just one embryo, we suggest that they go to blastocyst (Day+5 culture) in order to select the very best embryo.
9- What happens if we don’t get eggs from the donor or if there are no embryos to transfer?
If the reason for having no embryos to transfer is thought to be due to the donor eggs, the clinic should repeat the cycle free of cost or at least provide a discount for the next cycle. It is always important to remember that the sperm makes up half of the embryo, so bad embryos are not always due to the eggs. Many times the problem lies in the sperm.