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| Oocyte
donation:
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This
proceeding is done to get
a woman undergoing treatment pregnant
using oocytes donated by another
woman. With this technique, elderly
women who have not succeeded in
getting pregnant have a good chance
of success now..
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The Oocyte Donation
Program offered by Plenitas is anonymous
and voluntary, meaning that, unless otherwise
agreed, recipients will not receive identifying
information about the donor. In turn,
the donor will not be given information
about the identity of the recipient/s,
neither will she know about the outcome
of the oocyte fertilization, or if a pregnancy
was achieved, or if a birth finally occurred.
It is a voluntary act. The donor expresses
her wish to donate, and gives her consent
by signing a document containing the information
received from different professionals
in various consultations. The professionals
provide donors with a detailed explanation
of the steps to be taken to participate
in the program, and the risks associated
with donation. These steps include the
preliminary examinations (medical, psychological,
genetic and infectological tests) the
donor must undergo to participate in the
program. These proceedings are carried
out in compliance with the guidelines
set forth by the American Society of Reproductive
Medicine (ASRM).
In what
cases is Oocyte Donation applied?
Women who have
already entered menopause due to age-related
causes or other reasons. Women with deficient
production of oocytes. Women with prior
unsuccessful in vitro fertilization attempts.
Women who are potential transmitters of
hereditary diseases who wish to avoid
transmitting them to their children.
Oocyte
Donors: Requirements and Methodology
Volunteers willing
to participate as donors should be aged
21 to 29. Donors are evaluated by a group
of physicians and psychologists belonging
to the institution in charge of the Oocyte
Donation Program. The evaluation covers:
a detailed questionnaire about history
of genetically transmitted diseases of
the patient and of her first and second
degree relatives, blood karyotype, detection
of the most frequent mutation of the cystic
fibrosis disease, infectological tests
to rule out HIV (AIDS), syphilis, hepatitis
B, hepatitis C, and routine tests for
a clinical evaluation, blood group, gynecological
exam (with pap smear) and transvaginal
ultrasound. If the prospective donor meets
the requirements to join the program,
she must express her willingness to do
so by signing a document giving her consent.
With this, the information process concludes,
and she is recorded in an institutional
registry where her clinical history, identity
information, picture, physical traits,
and psychological evaluation are filed.
To be able to donate oocytes, the donor
receives a medication (similar to that
received by patients under assisted reproduction
treatments) that stimulates ovulation
and makes ovaries produce a larger number
of eggs during that cycle. Then, when
the donor's follicles have the appropriate
size for ultrasound scan, the transvaginal
ultrasound-guided aspiration is performed.
How is
oocyte donation carried out and who can
receive it?
This program offers
the possibility to achieve pregnancy through
the transfer of embryos obtained from
the union of the donor's oocytes with
sperm obtained from the husband, partner,
or semen bank as the case may be. The
technique used in Plenitas program to
achieve egg fertilization is called ICSI,
and it involves the microinjection of
a single sperm into an egg. This technique
seeks to evaluate the maturity of the
eggs to offer eggs which are apt for normal
fertilization. In addition, the injection
of sperms makes the first step of the
fertilization process easier. Once formed,
the embryos are transferred to the recipient's
uterus the second or third day following
the microinjection.
Requirements to
join the program as a recipient:
To be admitted into the program, recipients
should not be older than 50.
Preparing the endometrial
lining:
Once admitted into the Oocyte
Donation Program, the recipient
may start taking the medication necessary
for the embryo transfer when her doctor
deems it appropriate. The medication involves
the administration of estrogens to make
the endometrial lining highly receptive
to the embryos.
The medication
used for preparing the uterus depends
on the presence or absence of ovarian
activity in the recipient. If the patient
is not menopausal, her cycle may interfere
with the preparation of the uterus, and
a medication (Lupron) is administered
to suppress ovarian activity while the
proceeding lasts. If the patient is menopausal
(she has not menstruated for more than
a year) there is no ovarian activity and,
thus, the only proceeding is the preparation
of the endometrial lining (uterus lining
where the embryos are implanted). After
the donor's follicle aspiration, at least
four mature oocytes are set aside (Metaphase
II). Afterwards, on that same day the
oocytes are injected, and on the following
day the fertilization is observed. The
embryos are transferred within 48 or 72
hrs. after the aspiration. The program
has a strict policy limiting to two the
number of embryos to be transferred to
the recipient in each attempt. This decision
seeks to diminish the incidence of multiple
pregnancy - which is an undesired outcome
in an assisted fertilization proceeding.Applying
this policy, the program's rate of global
clinical pregnancy is close to 50%, based
on statistics of 2004 and 2005, with a
triple pregnancy incidence of 0%. Embryo
transfer is a simple proceeding involving
no risks, the resulting discomfort is
similar to that of a pap smear, and it
lasts 15 minutes approx. Once the transfer
has been completed, the patient must rest
for 48hrs. Two days prior to the transfer,
Micronized Progesterone is administered
to the patient, and its administration
continues up to the third month of pregnancy.
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