Donor egg in vitro fertilization (IVF) is an option for women who cannot use their own eggs in an IVF cycle. Thousands of successful donor egg cycles have been conducted throughout the world, and there is no increase in birth defects or other fetal abnormalities with this pregnancy method. Egg donors can be either known or unknown to the patient and are usually aged in their twenties or early thirties. A known donor can be a friend or relative, while unknown donors are those anonymously chosen from the UAB donor egg pool. Patients undergoing donor egg IVF are administered medications to synchronize their cycle with that of the donor’s. The donor undergoes ovulation induction with injectable gonadotropins until her eggs mature and are ready for retrieval. Then the donor eggs are combined with the patient’s partner’s sperm and placed in incubators for three days. Once mature, the embryos are transferred to the patient’s uterus. The number of embryos transferred depends upon many variables. Additional embryos can be frozen for use in future cycles. Prior to embryo implantation, the patient will have received hormones, such as progesterone and estrogen, to mimic the normal pregnancy process.
Preimplantation Genetic Diagnosis
Some couples are at increased risk for transmitting genetic diseases to their children. The disorders include hemophilia, Tay-Sach’s disease, Sickle Cell Anemia, Cystic Fibrosis, Down’s syndrome, and others.
Women over the age of 38 or those with recurrent miscarriage may be at risk for chromosomal abnormalities called aneuploidies. Preimplantation Genetic Diagnosis (PGD) allows the embryologist to screen embryos for these and many other genetic abnormalities.
PGD patients undergo in vitro fertilization to create embryos that will be transferred to the uterus. Once the embryos mature, the embryologist makes a small hole in the embryo’s outer membrane using a laser. A single cell is withdrawn for the PGD procedure(s) without damage to the embryo. Each cell contains the complete genetic makeup of the embryo.
The cell is examined for an abnormal number of chromosomes, using fluorescent in situ hybridization (FISH). FISH, enables the embryologist to count chromosomes and often identify other abnormalities.
The polymerase chain reaction (PCR) is used when damage, or disease, is suspected on a particular chromosome segment. The PCR duplicates and amplifies certain chromosome sections so that disorders can be seen.
Some diseases, such as hemophilia, are sex-linked meaning they are transmitted on the X chromosome. Because males have only 1 X chromosome but females have 2, these sex-linked diseases are more apparent in males. Hemophilia is an example of a sex-linked disease, meaning that males are the ones usually affected. FISH can be used to separate male and female embryos, and in this case, only female embryos would be transferred to the mother. The same applies if a chromosomal abnormality is seen using PCR in that only normal embryos would be transferred.
While no procedure is guaranteed to eliminate birth defects, there are many genetic diseases that can be identified using PGD and research continues to expand the list. Using PGD lowers the chances of genetic birth defects.
UAB Medicine’s nationally recognized physicians have years of experience in diagnosing and treating both male and female infertility. We treat infertility with a team approach that includes a urologist, a reproductive endocrinologist, specialized nurses, and laboratory scientists. A variety of conventional treatments are available, including corrective microsurgery. For those who do not have a condition that can be treated, procedures such as intrauterine insemination or in vitro fertilization (IVF) may be used to help a couple get pregnant. Our fertility experts will determine a treatment plan that is best suited for each individual man and his partner. As a major center for research, UAB Medicine continues to investigate new advances in fertility treatment aimed at increasing the chances of conceiving healthy babies.
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