IVF with egg donation Lebanon

SUMMARY: An egg donation is an extra option that involves using the egg donor’s oocytes for fertilization for extreme cases when it is impossible to use the Patient’s oocytes. The egg donation can be chosen also if the Patient’s oocytes have poor fertilization potency (the previous IVF cycles failed) or the Patient has a low ovarian reserve (based on the ovarian reserve screening tests’ results).

More details about oocyte donation (egg donation) package and IVF cycle in Dr. Bernard Kassab’s Clinic.

Dr. Bernard Kassab’s Clinic has both standard IVF cycles and IVF cycles with sperm or egg donation option. Every IVF cycle is a “roadmap” created by Dr. Bernard Kassab from its “draft configuration” to its perfect version. Every IVF cycle is flexible in its core as the management strategies can be different on every stage of IVF cycle, some screening tests can be done several times to choose the most effective medications with the minimal side effects for every case, the ovarian stimulation protocol can be changed from the one to another, and the additional techniques or options can be synchronized with the drafted treatment protocol if necessary.

Multi–flexibility of IVF protocols makes all kinds of new things, such as the implementation of the additional options in the current IVF protocol possible. If it is impossible to use the Patient’s oocytes for fertilization, or if the Patient would like to try tandem ovarian stimulation when the Patient and the egg donor both undergo ovarian stimulation, Dr. Bernard Kassab “tunes up” the whole treatment protocol in the best possible way.

Any IVF cycle can be designed involving egg donation, sperm donation or embryo donation. This is done to boost the chances of culturing the healthy embryos or to transfer the already cultured embryos into the Patient’s uterus.

STEP 1 | INITIAL CONSULTATION. Selection of the egg donor.

IVF cycle with egg donation involves an egg donor, the Patient, and the Patient’s husband. The great plus is that it is possible to use a known or unknown oocyte donor. An egg donor is accurately selected according to the set criteria: with the same physical characteristics (height and weight), with the similar appearance (having the resemblance with the mother), with the same blood group (as the Patient), with the similar genetic content (the genetic abnormalities, chromosomal abnormalities, and abnormalities that affect the genomes are excluded).

STEP 2 | Egg donor pre–treatment screening and controlled ovarian stimulation.

Before the egg donation cycle is started, the egg donor undergoes the screening tests to exclude the diseases and genetic abnormalities. When the pre–treatment screening results are obtained, Dr. Bernard Kassab schedules the consultation to discuss further steps of IVF cycle.

The egg donor undergoes controlled ovarian stimulation (mild or intensive one) with oral pills and injectable hormones. This stage of the IVF cycle is managed by Dr. Bernard Kassab as it is vital to have the clear results of ovarian response to stimulation and to control follicle development and oocytes’ maturation. Moreover, ultrasound–guided monitoring of the follicle development helps Dr. Bernard Kassab to create the visual “map” of the oocytes that can be collected during oocyte pick–up and to count an approximate number of them.

After the controlled ovarian stimulation, the egg donor undergoes an oocyte retrieval procedure. Egg retrieval is performed under ultrasound guidance. All oocytes are collected together with the fluid and taken to the IVF laboratory immediately.

STEP 2 | The patient’s pre–treatment screening and controlled endometrium preparation.

The Patient undergoes pre–treatment screening tests (including the Pelvic exam and blood tests) as it is essential to exclude the diseases and uterine abnormalities and to confirm that the Patient can carry the baby. If the results of the screening tests are normal, the Patient starts an endometrium preparation cycle.

The Patient is prescribed the oral estrogen to prepare her uterus for the embryo transfer procedure. Endometrium preparation is usually started at the same time as the oocyte donor starts her ovarian stimulation cycle.

STEP 3 | Sperm collection and sperm preparation. 

The partner’s sperm is collected and prepared for further fertilization the same day as the oocyte donor has her oocyte retrieval procedure. If the partner’s sperm cannot be used for the oocyte fertilization (because of genome abnormalities, damaged DNA, transmitted genetic diseases, diseases of the partner that makes it impossible to collect the sperm sample or the sperm sample contains mostly abnormal sperm cells, etc.) the donor’s sperm is used to fertilize the eggs.

STEP 4 | Fertilization and embryo culturing. 

Collected oocytes are comprehensively investigated before fertilization. Every mature oocyte is fertilized with the partner’s sperm or with the donor’s sperm conventionally, using ICSI technique (one sperm cell is “caught by its tail” and injected in one mature oocyte) or using IMSI technique (the sperm cells that would be injected in the oocyte is comprehensively investigated and only the boutique–quality sperm is chosen for fertilization).

After fertilization, the newly generated zygotes are placed into the incubator for 2–5 days, where their development is continuously monitored by the embryologist. The zygotes with the high potency develop into embryos. Those zygotes that stopped their development are excluded from the zygotic cohort. Some embryos can also stop their development, and they are also excluded from the embryonic cohort suitable for the further embryo transfer.

STEP 5 | “Validation” of the endometrium preparation for the actual embryo transfer.

The patient’s endometrium preparation is monitored via transvaginal ultrasound scans for visualization of the intrauterine endometrium growth and blood tests for measuring the hormonal levels. This dual management shows what is going on inside, and indicates the right time frame for performing the embryo transfer based on the stage of the endometrium receptivity, thus boosting the embryonic chances to implant successfully.

STEP 6 | Embryo selection, embryo transfer and vitrification of the embryonic cohort that is left after the embryo transfer for the future.

Before the embryo transfer procedure, the embryologist investigates every embryo, excluding those that have poor implantation potential based on their development activity and choosing for the transfer only those embryos (one or two) that can be labeled as boutique–quality ones. The remaining viable embryos are vitrified on the same day as embryo transfer for future FET cycles.

STEP 7 | Embryo transfer day and pregnancy test day pre–scheduling.

Ultimately, the embryo transfer day is there. Before the actual embryo transfer, the mock embryo transfer can be performed to make the “Roadmap” of the Patient’s uterus for the smoothest transfer ever. The mock embryo transfer is a painless procedure that can be done manually or manually under the ultrasound guidance to visualize the way for a flexible catheter to the womb.

The embryo transfer is also short time and painless procedure, so there is no necessity for sedation. After the embryo transfer, the blood pregnancy test is scheduled in two weeks after it. If the blood pregnancy test is positive (the hCG levels are high), Dr. Bernard Kassab will schedule the early ultrasound scan to check the embryo’s gestational sack “launching” and the embryo’s heart activity as early as week 6 or week 8.