Egg Donation Process
When coming to Russia for egg donation treatment, you need to know that everything will be made as easy and stress-free as possible. This is particularly important for patients who have already been through many difficulties before choosing egg donation in Russia. If you have a very supportive local doctor, your Initial Consultation as well as preliminary tests may be done in your home country. This method (our Shared Care programme) makes it possible to complete your egg donation treatment within one single visit to St. Petersburg. If you have no local consultant willing to support you during your donor egg treatment, please visit us for the Initial Consultation and then for the Embryo Transfer itself.
In recent years, we have maintained a 60% clinical pregnancy rate and 49% live birth rate by international egg donation patients.
How do we proceed?
In order to offer you the best personal treatment, we need to be aware of your relevant medical and reproductive history, the current status of your reproductive organs (ovaries and uterus) and hormonal levels. After years of effective egg donation practice it has become apparent for me that a thorough examination of each patient or couple, including the reasons why they have not managed to have a child, enables us to offer a higher probability of success. It also allows us to treat our patients very individually. Some patients need just a couple of months to get prepared for the embryo transfer, while some might need half a year to prepare before their uterus may accept the embryo (for example, women who have been in menopause for several years without hormone replacement therapy).
There are two ways for us to obtain your detailed medical information: either by inviting you to an Initial Consultation and examination to St. Petersburg or by asking your local consultant to provide the necessary examination and by offering you the Initial Consultation per phone (Shared Care Programme). Before Initial Consultation we ask you to fill in our medical form.
Within our Shared Care programme your local doctor carries out the ultrasound and laboratory tests and discusses the results with us. I then agree your treatment plan with your consultant and later on your consultant prescribes the required medication and performs your ultrasound examinations before you come for the Embryo Transfer.
How long will you need to stay in Russia for?
This mainly depends on two factors. The first is whether you come twice (for an Initial Consultation and then the Embryo Transfer) or once (only for the Embryo Transfer, assuming your local consultant can perform the necessary tests in your home country). The second factor is whether you will be using fresh or frozen donor eggs, fresh or frozen sperm from your partner, or donor sperm.
If you decide to visit us first for an Initial Consultation, you only need to spend a day and a night in St. Petersburg for this first meeting. I would advise you against flying in and out of the city on the same day as this would put you under too much time pressure, especially if your flight is delayed. Also, this would not allow you to make the most of your visit. I find that most of our patients prefer to spend the night before, and sometimes also the night after the Initial Consultation, in a nearby hotel. This means they can be sure that they won’t have to rush around or risk getting stressed by travel delays or other issues. Having a slightly longer and more relaxed visit will also enable you to become comfortable with the journey, the city itself, the clinic and the staff, all of which can serve to reduce the emotional strain of the whole future procedure.
The length of your second visit depends on whether you prefer to use fresh or frozen eggs and fresh or frozen sperm from your partner or donor sperm:
- If you use fresh donor eggs and fresh sperm from your partner, the overall duration of your stay is 10 nights.
- If you use fresh donor eggs and frozen sperm from your partner or donor sperm (which is also frozen) your stay is 5 nights.
- If you use frozen donor eggs each partner will need to come only for 1 day: sperm collection and embryo transfer. These one day visits are also possible on weekends.
If your partner has already provided sperm on the day of the Initial Consultation, this can be frozen and then defrosted to fertilise the donor’s eggs on the day of Egg Collection. In this case, you will need to arrive 2 days before the planned Embryo Transfer date and will only need to spend 5 days in St. Petersburg. It is good if your partner accompanies you on your Embryo Transfer visit, but you may also choose to come alone. Our team will do their best to make you feel comfortable and taken care of.
In certain cases I do recommend using fresh sperm. In some patients, sperm quality is not good enough for successful freezing and defrosting. In others, the sperm quality is very good and may be used for the simple IVF procedure (without ICSI). However, once even good-quality sperm has been frozen and thawed, it is usually necessary to carry out IVF with ICSI to ensure good results.
In simple IVF, the sperm and the eggs are placed together in a nutritious liquid culture where the sperm cells fertilise the eggs on their own, by their own efforts. For IVF to work well, there should be a sufficient number of sperm cells and most of these must be motile (they must move well). In IVF + ICSI, every single egg is injected with a single live sperm cell selected by an embryologist. The ICSI method tries to ensure that the majority of eggs are not wasted due to sperm cells being too slow or available in a very low number. ICSI is therefore performed if the risk of fertilisation failure by simple IVF is significant.
I believe that in cases when your fresh sperm is good enough for normal IVF, it is a pity to freeze it to do ICSI afterwards. IVF is a more natural procedure due to the fact that it allows sperm selection to be carried out by nature. It is also less invasive and several per cent more effective than ICSI.
In other words, those patients who have indication for ICSI anyway, benefit from sperm freezing, because sperm freezing does not introduce new artificial elements (such as ICSI) in the treatment. In other cases the decision for sperm freezing should be discussed individually after evaluating all the medical, social and organization issues.
The donor eggs should be fertilized or frozen within 4 hours after the egg collection, otherwise they become too old and incapable of further development. This is why we need to make absolutely sure that we either have frozen sperm available in the clinic, or that your partner is available to provide fresh sperm.
Procedure when using fresh donor eggs and fresh sperm
If you plan to use fresh sperm from your partner, your partner must arrive in St. Petersburg two days before the planned Egg Collection date of your personal individual donor, who was matched to you or chosen by you in advance and accepted by you. (This is different from the procedures in some other clinics around the world, where you are expected to use whatever eggs are available on a certain date.) Your individually matched or chosen egg donor undergoes stimulation especially for you. That is why although Egg Collection happens on the planned date in the majority of cases, sometimes it can vary by up to one or two days before or after the planned date. The reason for this variation is in the individual response to stimulation by every woman. Some women need 10 days to grow mature eggs, others 14 days, and this is true of each woman, including egg donors. The duration of ovary stimulation may also vary by the same person from cycle to cycle.
Our aim is to provide our clients with the best possible chances. To do so, we need the highest-quality eggs. To receive them, we stimulate egg donors very thoroughly and attentively, choosing an individual protocol and dosage. We do not stress the egg follicles by stimulating them with the highest dosages, if they are growing slower than planned, to get eggs “on time”. Nor do we do the opposite, i.e. we do not reduce the medication dosage dramatically at the end of the stimulation phase if the follicles grow faster than planned. Both the above methods of stimulation reduce the egg quality and your chances. We just follow the natural response of the follicle to the minimal possible dosage. This is also healthier for the donors.
This is why instead of just collecting eggs precisely on the planned date to make the timing more convenient for you, even if the eggs are too young yet or too old already, I prefer to ask your partner to arrive two days in advance or freeze sperm earlier than two days before the planned egg collection. This allows us to collect eggs on the best possible date, receive the highest quality eggs and provide you with the maximum chance of pregnancy. My many successful patients agree with me that staying a couple of days extra is worth it for the wonderful result!
There is currently a new logistic option available to freeze sperm in your local clinic and send it to us. We are happy to arrange this option for you on request.
We usually provide our clients with no less than 10 donor eggs. But much more important than the actual number is their high quality, which is achieved by very thorough egg donor screening and selection as well as the individual attention paid to follicle stimulation in the donors.
The eggs are fertilised with the fresh sperm on the same day that they are collected, after which the fertilised eggs are grown in the embryology laboratory for five days. Once the fertilised eggs start splitting into first two and later many cells, they are called embryos. After usually 5 days of being cultured in the laboratory, one or two embryos are replaced in the egg recipient. If the egg collection is Day-1, then the embryo transfer will be Day-6. And we would like to have two days on either side due to the variations in the Egg Collection date. That is why you will need to spend a total of ten days in St. Petersburg, if you use fresh donor eggs and fresh sperm from the partner. Fortunately, St. Petersburg is a delightful city to visit!
Procedure when using fresh donor eggs and frozen sperm (husband/donor)
If you plan to use frozen sperm from your partner to fertilise the donor’s eggs, he may provide his sperm for freezing at the time of the Initial Consultation or at a separate 1 day visit to AVA-Peter. Or your partner can collect and freeze sperm at your local clinic and it can be sent to us. Because of this, we will already have sperm ready for use on whichever day the egg collection takes place. You will therefore only need to book a 5-day trip to St. Petersburg for the ‘Embryo Transfer’ visit and to come alone or accompanied by your partner.
Procedure when using frozen donor eggs and frozen sperm (husband/donor)
We are happy to propose our egg donation programme with frozen (vitrified) donor eggs to those patients who would like to shorten the duration of their stay in St. Petersburg, for example by only coming for a weekend. This programme does not require synchronisation with an egg donor, as the menstrual cycle of the recipient is the only important timing factor. The eggs can be thawed on the planned day so that the embryo transfer is performed on the day required by the patients. The male partner needs to travel for one day to freeze his sperm and the female partner needs to travel for 1 day for the embryo transfer 1 or more weeks later. The clinical pregnancy rates after transfer of fresh embryos created from frozen donor egg are the same as with fresh eggs. The disadvantage of using frozen eggs is in the wastage of 20-25% of eggs during freezing-thawing process, which results in a significantly lower amount of eggs available for fertilization in comparison to the procedure with fresh donor eggs.
The Initial Consultation in AVA-Peter
St. Petersburg
In order to assess my patients properly, we recommend that both partners come to St. Petersburg for an Initial Consultation. This naturally involves a certain amount of travelling time, effort and expense, but it allows us to give you the best chance of success and the maximum feeling of safety and comfort. During the Initial Consultation, we discuss your medical history. It is very important to receive information about your previous attempts of fertility treatment to understand what can be optimised, i.e. what can we do better to achieve a healthy pregnancy. We perform an ultrasound (which is painless) to assess the condition of the uterus and the ovaries. We also take samples of blood and semen for laboratory tests. We discuss the procedure thoroughly, and take photographs of both partners in order to ensure a good physical match with the egg donor unless you prefer to choose your egg donor yourself from the detailed Data Base from IDEAS [dr-zaytseff.com How you can choose your donor yourself]. I also recommend that you supply several photos of you and your partner in your twenties or thirties in case you would like us to match a donor to you [dr-zaytseff.com How we can match a donor to you] or if you would ask us to double-check if the donor or donors, chosen by yourself from the Data base of IDEAS [dr-zaytseff.com How you can choose your donor yourself], resemble you well.
Before you leave the clinic after your Initial Consultation we make you an individual egg donor proposal to your consideration. You will also know exactly what steps you have to take and when to travel to St. Petersburg again. We write all this information in your personal Treatment Plan that you receive at the end of the Initial Consultation. Your Treatment Plan will include all the individual steps of your preparation for your Embryo Transfer, which will take place in the time frame that is convenient for you, as agreed with you at the Initial Consultation. I will also provide you with a prescription for the medications you need. Depending on which ones you can obtain in your own country, you may decide only to buy a certain number of these in Russia. You can purchase them all in a nearby pharmacy. None of the medications have to be kept chilled, so you can simply pack them carefully in your luggage. Please ensure that you keep your Treatment Plan in your hand luggage with you when passing Customs so that you can answer any questions about your medication easily, just by showing your Treatment Plan.
As soon as you have obtained all your medication, you will be ready to start treatment once you have chosen your egg donor from the Data base of IDEAS or confirm that you are happy with the donor we have matched to you [dr-zaytseff.com How we can match a donor to you]. Depending on your schedule and menstrual cycle (if still present), you may be able to start treatment within a few weeks of the Initial Consultation.
Sometimes, before starting your Embryo Transfer cycle we first need to treat hormonal problems or problems within the uterus. In other cases it may take up to half a year to prepare the uterus of the recipient for pregnancy, if you have already been in the menopause for several years and have not used any hormones. Our recommendations for treatment are always personalised according to your medical situation.
Very occasionally, after the Initial Consultation, it is clear that a patient will not be able to have a child even with egg donation treatment, or that her chances of pregnancy are very low. This is a very sad situation, but I prefer to tell patients this bad rnd_news honestly at an early stage, rather than allowing them to start their treatment if it has no chance of success.
But having seen very many patients over the last ten years, I have come to the conclusion that there are almost no “bad” or “unpromising” egg donation recipients. I believe that only if there are serious general health problems that make pregnancy inadvisable, or (very rarely) severe, untreatable conditions within the uterus or if there is no uterus at all we have to say no to egg donation. In all other cases, I use effective methods to enable me to prepare all my egg donation recipients properly.
Details of our Initial Consultation and Treatment Schedule.
If you are interested in egg donation in St. Petersburg, please fill in our Questionnaire
Shared Care programme
If you only want to come to St. Petersburg for the actual Embryo Transfer, (i.e. you do not come for the Initial Consultation first), you can use our Shared Care programme. For this, you need a very supportive Consultant in your home country, who will perform the same steps as we do in St. Petersburg, and who is able and willing to help you at different stages of your egg donation treatment. This will include carrying out an ultrasound examination of the ovaries and the uterus, doing blood, smear and semen tests and checking the laboratory results, providing prescriptions for medication, and giving you ultrasound monitoring. It is also very important that your local Consultant is ready to communicate with us via e-mail/phone about your medical history, Treatment Plan, ultrasound and laboratory results. We need to establish a good contact with your Consultant as his or her medical advice is essential for your egg donation treatment to be successful, as your local consultant is the specialist who knows you best. After all, without having examined you personally, we cannot receive as much information about you distantly as your Consultant will receive from your personal communication with him or her and from your medical examinations.
If your local consultant is willing and able to support you in these ways, you only need to travel to St. Petersburg once, for the Embryo Transfer itself.
Details of our Shared Care schedule
If you are interested in egg donation in St. Petersburg, please fill in our Questionnaire